Choose a practitioner for intra-oral TMJ therapy that works on the lateral pterygoids

So far I’ve had two clients come in for TMJ relief sessions who have previously seen multiple practitioners who worked inside their mouths.

They’ve seen chiropractors, chiropractic neurologists, Rolfers, dentists trained by the Las Vegas Institute (LVI), and/or other massage therapists.

These two clients both told me, “No one has ever touched me there,” after I worked on their lateral pterygoids.

These are small and hard to access muscles, and in my opinion (and my main TMJ teacher’s opinion), they are most often the key muscles to address to release jaw tension.

anatomy of the jaw muscles

It’s not that the other jaw muscles don’t contribute. They do, and in roughly 10% of the TMD cases I’ve worked on so far, one of the medial pterygoids is the problem child.

The external jaw muscles — the masseters and temporalises — also play a role in jaw tension but are never (that I’ve seen in 5 years) the biggest cause.

In other words, 90% of the time when people have jaw pain from muscle tension, the lateral pterygoids are the biggest culprit.

It’s not that these other intra-oral practitioners have nothing to offer. I’m not familiar with all of them, but chiropractors, Rolfers, and massage therapists have definitely helped me.

But if jaw tension and pain resulting from jaw tension is your major complaint, and you’d like a sense of spaciousness in your TMJs (if you can even imagine how great that would feel), go to a practitioner that works on the lateral pterygoids.

Click here to book a free 30-minute consultation.

Other things that distinguish my work:

  • I work as gently as possible.
  • I never make any sudden moves.
  • My sessions start with full body alignment to get you relaxed and progress toward the intra-oral work at the end.
  • I offer you legal hemp oil to relieve anxiety, pain, and inflammation before working in your mouth. It’s not required, but some clients really like it.
  • I offer single TMJ Relief sessions as well as a TMJ Relief Program consisting of 5 sessions in 4 weeks for lasting change, along with education and support for habit change and self-care.
  • I created a Facebook group, Word of Mouth: Resources for Jaw Pain/Dysfunction, for people who want to work on their jaw issues.

I hope this information helps you at least ask informed questions when choosing a practitioner to relieve your jaw tension and pain.

Treating TMJ issues: types, causes, and exercises

I just discovered an excellent new source of information about TMJ pain and dysfunction. It’s a really great website called Be My Healer offered by a doctor of physical therapy, Sophie Xie.

She’s got a couple of posts about TMJ issues. (If you have other issues, please look around. I am impressed with the quality of her posts in terms of credible information, writing to a lay audience, and her images. You go, Dr. Sophie Xie!)

First, this article helps distinguish between types and causes of TMJ dysfunction. In short:

  • Type 1 is arthrogenous TMJ, meaning the problem is related to the functioning of the bony temporomandibular joint. There are two causes: arthritis and disc displacement. She recommends the best treatments for each cause. (I can’t help with these, but exercises* can help. If you’re in Austin and have disc displacement, I can refer you to a couple of oral surgeons who are getting great results.)
  • Type 2 is myogenous, meaning muscle-related. Causes include bruxism (clenching and/or grinding), muscle imbalance (such as forward head posture, chewing on the same side, playing the violin), and systemic influence causing muscle tension (such as chronic stress, fibromyalgia, PMS).

Dr. Sophie Xie writes, “TMJ massage therapy can help by releasing the tense mastication muscle and provide pain and stress relief. However, you will need to call around to find a massage therapist who is specialized in intraoral release to receive the most targeted treatment.”

Here’s me raising my hand, signaling “Pick me!” I can help with all of the muscle-related types of TMD. I offer intra-oral work, help relieve forward-head posture, and help you relax from stress.

Again, exercises* can also help.

  • Type 3 is idiopathic, referring to a single cause: trauma impacting the joint  from accidents, injuries, dental treatments, even violent laughing or yawning.

Dr. Sophie Xie writes, “Post-traumatic TMJ pain is highly preventable. Early intervention such as physical therapy and massage therapy are excellent in preventing scar formation and muscle stiffness​. Gentle and progressive jaw stretching and exercises* will build a strong muscle function to keep chronic and repetitive TMJ pain away.”

Again, I can help.

*In her post Say goodbye to TMJ pain with these 5 convenient jaw exercises, Dr. Sophie Xie describes and shows (with delightful illustrations) exercises to strengthen and balance your jaw muscles.

She writes, “Most people experience significant TMJ pain reduction with daily exercises after 5-6 weeks. You should experience even faster results if you are also combining TMJ massage therapy with a nightly mouth guard.”

Her website has a contact page if you want to work with her. (I believe she’s practicing in Washington state.)

If you are in Austin, Texas, I’m happy to help.

Treating TMJ issues: releasing trigger points in your jaw muscles

You have four jaw muscles: the two large ones on the outside of your head (the masseter and temporalis) and the four small ones inside your mouth (two medial pterygoids and two lateral pterygoids).

Any of them can get trigger points.

What is a trigger point? Healthy muscle tissue is made of bundles of fibers that run in the same direction. This tissue is pliable. It stretches or contracts when you move.

Screen Shot 2018-07-12 at 8.36.04 AMA trigger point is a spot where the muscle tissue has lost its pliability. A massage therapist may feel that the fibers in a particular spot have become glued together and hard, creating a small nodule. The tissue feels denser and often rolls under the fingers, compared to healthy muscle tissue.

This causes that band of muscle fibers to become shorter and tighter, restricting full range of movement of the entire muscle.

If you can’t open your mouth wide, or move your jaw easily left and right, forward and back, you may very well have trigger points in your jaw muscles.

Trigger points usually feel tender when you apply pressure to them, and they may also refer pain elsewhere. They may also form “constellations.” This makes them the tricksters of the nervous system.

You can work on your own trigger points to release them. It helps if you’ve received trigger point work from an experienced massage therapist, but you can learn to do it yourself. Even then, you may prefer to have someone else work on them, especially if you have a lot of them in multiple jaw muscles.

Screen Shot 2018-07-12 at 8.08.14 AMMy favorite reference book for working with trigger points is The Trigger Point Therapy Workbook, third edition, by Clair Davies and Amber Davies.

It is written for laypeople to release their own trigger points, but I know many massage therapists who use it as a reference book in their offices.

When I am working on TMJ issues, I notice that many people have trigger points in their masseters, the big external jaw muscles on the sides of your face that run from your cheekbone to the bottom of your jawbone.

Here’s how to find trigger points in your own jaw: using a bit pressure, drag your fingers slowly down the masseter muscle on one side of your face. Do this several times, experimenting with adding pressure, and notice if there are tender spots or “roll-y” spots. Repeat on the other masseter.

If you don’t have masseter trigger points, this usually feels pretty good.

Screen Shot 2018-07-12 at 8.41.19 AM
Source: The Trigger Point Therapy Workbook

If you find trigger points in your masseters (and you can still have TMJ issues without them), there are several ways of treating them.

Some therapists apply a huge amount of pressure. I don’t recommend this because if you have TMJ issues, your jaw is probably already out of alignment, and this could make it worse.

A better way, in my opinion, is to use less pressure. Yes, you can gently release trigger points!

I learned to do this from a local (Austin) massage therapist who is very experienced with trigger point release. She’s worked on me and released many trigger points, teaching me how to do this in the process.

If you have a lot of trigger points, I highly recommend seeing her. She works intra-orally, as do I, but her experience is greater than mine, and she’s amazing at discovering patterns if you have “constellations” of trigger points. She’s going to be more efficient than I can possibly be. She is the queen!

If you are interested in having her work on you, her name is Rose of Sharon, and you can reach her by phone or text at 512-282-1672. Please leave a message with your name and number so she can contact you.

Treating TMJ issues: what various professions do to help

I’m going to write about what various healing professions do to treat TMJ issues to help you be good consumers and know what to expect in terms of results. I am a massage therapist who specializes in TMJ work, including intra-oral (inside the mouth) work, in which I’ve had special training.

I want to say up front that most massage therapists do not work inside the mouth, which is where the jaw muscles most likely to be causing TMJ pain are located. Most massage therapists have the skills to release tension in the external jaw and neck muscles. Maybe that’s all you need, if your jaw pain isn’t severe and it comes and goes. You will feel better after such sessions.

But if you are really suffering from chronic or severe jaw pain and dysfunction, you probably want a lot more than that. You will greatly benefit from intra-oral work, which takes special training and experience to do effectively.

Do not hesitate to ask whether a therapist you are considering working with is trained in releasing tension in the internal jaw muscles and uses gloves or finger cots.

Whole-body work can also help, when the TMJ pain is related to your posture (for instance, head forward posture).

These are the major results that help with TMJ symptoms, along with the professional training that can provide them:

  • reducing stress (massage therapist, acupuncturist, yoga teacher, meditation teacher)
  • reducing tension in your external jaw muscles (massage therapist)
  • releasing trigger points in your external jaw muscles (any kind of therapist with trigger point release training)
  • releasing your neck tension (massage therapist, physical therapist, chiropractor)
  • getting your pelvis aligned and balanced (massage therapist, physical therapist, chiropractor)
  • preventing your teeth from cracking due to bruxism (dentist)
  • reducing tension in your internal jaw muscles (massage therapist with special training, physical therapist with special training, Rolfer)
  • getting craniosacral therapy to restore alignment in the external cranial bones (craniosacral therapist)
  • getting craniosacral therapy to restore alignment in the internal cranial bones (craniosacral therapist)
  • repairing a torn or perforated articular disk (oral surgeon — get reviews first)
  • getting whole-body therapy to help with alignment and release strain patterns (craniosacral therapist, Rolfer, Zero Balancer, yoga teacher, yoga therapist)

This is a brief and imperfect overview to help you get the results you want, and there are many fine points not mentioned here.