Treating TMJ issues: the jaw-pelvis connection

The jaw-pelvis connection is real! When I ask my TMD (temporomandibular disorder) clients if they also have pelvic alignment issues, a lot of them say yes.

If your pelvis is out of alignment, quite often, so is your jaw.

Here’s how that relationship works: The pelvis includes the base of the spine, your sacrum. Your jaw — mandible — is near the upper end of your spine, and it has a special relationship with C1 and C2, the uppermost two vertebrae of your spine at the top of your neck.

Because the opening/closing motion of the jaw is both hinging and gliding, the axis of rotation is not in the actual jaw joints but is located between these two vertebrae (Guzay’s theorem — the images show the TMJ and the axis of rotation when with jaw closed — left — and open — right).

(Image source: The Heart of Listening Volume 2 by Hugh Milne)

When your jaw is misaligned, it affects these vertebrae, impacting spinal and head posture and neurological well-being.

When your pelvis is misaligned, especially the sacrum, it also impacts posture and neurological well-being.

How does that happen? The dura mater is a tough, inelastic membrane that lines the inside of your cranium and forms a tube containing cerebrospinal fluid that surrounds the spinal cord.

It’s the connection between the upper vertebrae and the sacrum. 

The dural tube is attached to the C1, C2, and C3 vertebrae and then descends unattached all the way down to the sacrum, where it attaches to bone again. The dura mater continues to the tip of the coccyx.

When the pelvis is not aligned, it torques the inelastic dura mater, and that torque continues all the way up to the upper neck vertebrae that affect the movement of the temporo-mandibular joints — TMJs. 

This torquing of the dura mater may be seen in abnormal spinal curves, pelvic rotation or tilt, head tilt, and cranial bone misalignment, which can affect your fluids, hormones, and nerves.

If your pelvis is giving you problems, put your fingertips in front of your ears and open and close your jaw. Notice if your left and right TMJs move differently. You may notice one side opens first or otherwise moves asymmetrically.

It seems likely to me that this contributes to nine times more women than men suffering from TMJ disorders, since women tend to have more pelvic floor issues than men.

The floor of the mouth, from underneath.
The floor of the pelvis, from above.

Other ways these two areas resonate:

  • The mandible crosses the midline and has two joints on either side, the TMJs. 
  • The sacrum also crosses the midline and has two joints on either side, the sacroiliac joints. 
  • The front of the pelvis, the pubis, also crosses the midline, and the hip joints (acetabula) lie on either side.
  • The pelvic floor and the floor of the mouth are similar in structure, as seen in the images above. The pelvic floor and the floor of the mouth are both horizontal tissues in the body, which consists primarily of vertical tissues. The places where vertical and horizontal tissues meet are more subject to holding tensions.
  • Fascia, which surrounds and permeates muscles, connects the pelvis and jaw. Restrictions in the fascia affect alignment.
  • Many people clench their jaws when stressed — and may also tighten their anal sphincters. 
  • At about day 15 in embryological development, two depressions form: one develops into the mouth and the other develops into the openings at the other end of the digestive canal.

What to do if you have a misaligned pelvis and jaw issues? An evaluation will help identify your specific issues. Any thorough evaluation for jaw pain will include an assessment of pelvic alignment.

A treatment plan will include manual therapy as well as homework in the form of recommendations to work on alignment, perhaps with a physical therapist or by taking alignment-oriented yoga or Pilates classes.

If you suffer from TMJ issues, I host a Facebook group called Word of Mouth for people looking for information and solutions for these issues.

I offer free 30-minute consultations to evaluate TMJ issues that can be done in person in my Austin, Texas, office, or from anywhere over Zoom. Schedule your free consultation session here.