Treating TMJ Issues: choose a practitioner who works on your lateral pterygoids

Recently I’ve had two clients come in for TMJ relief sessions who have previously seen multiple practitioners who worked inside their mouths. Between them, they have seen chiropractors, chiropractic neurologists, Rolfers, dentists trained by the Las Vegas Institute (LVI), and/or other massage therapists.

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

That surprised me.

These small muscles are hard to access, being nearly surrounded by bones (cut away in the image below so you can see the two-headed muscle), and in my opinion, they are often the keys for releasing jaw tension and also for relieving clicking and popping noises. (Notice that the upper head is attached to the articular disc that separates the temporal bone and the mandible —the two bones of the TMJs.)

anatomy of the jaw muscles

It’s not that the other jaw muscles don’t contribute. They do. I’ve found tension in the temporalises, trigger points in the masseters, and taut bands in the medial pterygoids.

I usually save the lateral pterygoids for last when working on someone’s internal jaw muscles, because they are harder to access. It helps to have tiny pinky fingers, and even then sometimes I need to ask a client to shift their jaw to the side so I can reach them.

Sometimes I can’t reach them on the first visit, but any release of tension in this area near the joint is therapeutic.

People are not aware that there are jaw muscles here! I’m touching in a place where people never get touched. This area can be sensitive.

When I get on or near a lateral pterygoid, it can be a revelation. “That’s the place!” they exclaim when I remove my finger.

Once I get there, I don’t need to stay long.

It’s not that these other intra-oral practitioners mentioned above (at least in these two clients’ experiences) have nothing to offer. I’m not familiar with all of them, but chiropractors, Rolfers, and massage therapists have all helped me.

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

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


I invite you to work with me!

MaryAnn Reynolds, MS, LMT, BCTMB
Austin, Texas
Biodynamic Craniosacral Therapy • TMJ Relief
online scheduler: maryannreynolds.as.me
text or voicemail: 512-507-4184

Treating TMJ issues: releasing trigger points in your jaw muscles

You have nine jaw muscles: two pairs of large ones on the outside of your head (the masseters and temporalises), four small ones inside your mouth (two medial pterygoids and two lateral pterygoids), and one in the floor of your mouth (digastric).

Any of them can get trigger points.

What is a trigger point? It’s unhealthy muscle tissue that causes pain that can occur locally to the trigger point or at some distance — referred pain.

Healthy muscle tissue is made of bundles of fibers that run in the same direction. This tissue is pliable. It contains fluid. 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 some tissue in a particular spot feels hard, creating a small nodule that’s hard and stiff. The tissue feels dense and often rolls under the fingers when compared to healthy muscle tissue.

Trigger points cause that band of muscle fibers within a muscle to shorten and tighten, restricting full range of movement of the entire muscle.

Trigger points feel tender when you apply pressure to them.

Where several of them occur in an area, they form “constellations.” If one of those trigger points in the constellation is the primary one and the rest are satellites, it takes trial and error to locate and treat the primary one — and until that happens, the satellites keep reoccurring.

This makes them the tricksters of the nervous system, and it’s why specialists in trigger point therapy are rare and sought after.

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 a massage therapist work on them, especially if you have a lot of them.

Even with an experienced therapist working on your trigger points, sometimes the body clearly says “no more today,” a signal to move on to another technique and schedule another session.

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 many massage therapists use it as a reference book in their offices. I got my copy spiral-bound for ease of use.

When I am working on TMJ issues, I sometimes notice that 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 of pressure, drag your fingers slowly down the masseter muscle on both sides of your face. Do this several times, experimenting with adding pressure, and notice if there are tender spots or small dense spots that roll under your fingers. 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
Left: trigger point locations in the left masseter. Right: areas of associated pain. Source: The Trigger Point Therapy Workbook. 

If you find trigger points in your masseters (and you can have other 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 applying lots of pressure 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, Rose of Sharon, 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’s amazing at discovering patterns if you have “constellations” of trigger points.

If you are interested in having her work on you, 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.


I invite you to work with me!

MaryAnn Reynolds, MS, LMT, BCTMB
Austin, Texas
Biodynamic Craniosacral Therapy • TMJ Relief
online scheduler: maryannreynolds.as.me
text or voicemail: 512-507-4184