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.

Massage therapy for jaw pain

The January/February 2019 issue of Massage & Bodywork (magazine for massage therapists) includes the article “Temporomandibular Joint Disorders: Biting Off More Than We Can Chew”. It’s full of information about the anatomy, pathology, demographics, contributing factors, symptoms, and treatment options for TMJD. The author is Ruth Werner, who wrote A Massage Therapist’s Guide to Pathology.

The article mentions that many dental professionals enthusiastically recommend massage therapy as an early intervention for TMJ disorders, which are often accompanied by dysfunction elsewhere in the body — the shoulder girdle, pelvis, and feet, for example.   Regular massage therapy sessions can also help relieve pain and tension in the external jaw muscles.

The author states, “The [internal] pterygoid muscles require more specialized skill… Work inside the mouth carries some serious responsibilities… It’s not for beginners, and it’s not for dabbling. When things go wrong in this joint, problems can reverberate through the whole body… [Massage therapists working inside the mouth should] get advanced training…

“Intraoral massage may trigger unintended responses… Emotional release in response to work in and around the mouth is also a strong possibility. It is critical that massage therapists be mindful of their scope of practice and respectful of their clients’ processes if this happens. Massage therapists must be prepared to be present, nonjudgmental, and appropriately supportive for this kind of event. Once again, it’s not for dabblers. If you want to do this work, get appropriate training.”

After reading this, I feel good about what I do. Massage therapists trained to work inside the mouth mostly follow three paths of advanced training: craniosacral therapy (like me), neuromuscular therapy, and structural integration (aka Rolfing).

Also, not all craniosacral therapists or neuromuscular therapists work with the internal pterygoid muscles, so be sure to ask beforehand if that’s what you expect. That was part of my training with Ryan Hallford, not (so far) with the Upledger Institute.

Also, I’m thanking the Upledger Institute for my training in SomatoEmotional Release as well as past experience and research in trauma recovery.

I’m grateful to see that treatment for TMJ disorders by licensed massage therapists is getting media attention, and that TMJD itself is getting more recognition. The TMJ Association recently announced that the National Institutes of Health have agreed to do more research. It’s very much needed — practitioners know what we don’t know, and it’s a lot.

Free consultation for TMJ issues

I’m please to announce I’ve added a new service. If you have jaw pain or dysfunction and are wondering if I can do anything for you, please schedule a free 30-minute consultation.

A lot of people, including dentists, are not aware that appropriately trained massage therapists can work on relieving your TMJ issues that are due to muscle tension or trauma. 

Screen Shot 2018-05-30 at 8.44.49 PMI’ll ask about your symptoms and your history. I’ll also evaluate your body, including your neck and jaw.

Then we can talk about treatment options. If you’ve never had manual therapy for jaw pain and dysfunction, or if you’ve received it previously from a different practitioner, I’ll be happy to tell you what a typical session is like and the typical progression if you are curious about buying a series of sessions.

Please note: What I find once I start working and how well your system responds are variable with bodywork.

I’ve been doing TMJ Relief sessions since 2014. My teacher was Ryan Hallford of the Craniosacral Resource Center in Southlake, TX. I’ve taken his cranial base/TMJ class twice and been a teaching assistant for it when Christian Current taught. In addition, I’ve studied craniosacral therapy with the Upledger Institute.

Please let me know if you have any questions, and don’t hesitate to read the testimonials on my What People Are Saying page.

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: the relaxing breath

Today I want to complete something I promised, sharing a quick way to relieve stress. This is important since so much TMJ misery is related to stress. Either the pain causes you to feel stressed, or your stress from other reasons creates muscle tension, which creates pain. It can be hard to break that cycle.

Some people have a hard time relaxing. The pressure to perform, to get things done, is on. Maybe they have a lot of energy but haven’t learned or had a chance yet to create time for themselves yet. (Yep, in my 30s.)

Or they’ve gone through a stressful period and it feels like their body forgot how to unwind. (Been there multiple times.)

Perhaps they’ve suffered a trauma that keeps them hypervigilant. (I know that one too well.)

Some psychotherapists specialize in helping trauma victims rebalance their autonomic nervous systems, so they can pendulate between fight-or-flight only when a true threat is present and rest-and-digest when they’re safe (and enjoy its benefits of better digestion, better healing, and inner peace). If this is the case with you, check out Somatic Experiencing therapy.

Others just need a little help to get started relaxing. Massage can help tremendously.

A meditation practice is a commitment to relax while sitting upright every day, with attention on your breath and sensations, observing the activity of your monkey mind with some detachment and humor (or horror!).

In fact, I have been curious for years about how relaxed I can become without falling asleep! It’s what drives me to meditate daily, do 10-day vipassana meditations, float in floatation tanks, and get esoteric acupuncture.

If you’d like to start rebalancing from stress into relaxation on your own, there’s an exercise I recommend called 4-7-8 breathing (the Relaxing Breath). Dr. Andrew Weil, who has been practicing and writing about holistic health and integrative medicine for 30 years, came up with it, although its roots are in yoga.

Screen Shot 2018-07-18 at 8.45.34 AM

The video is 3:18 long. Dr. Weil recommends doing 4 breath cycles at least twice a day for two months to get the benefits.

After a month, you can increase to 8 breath cycles, the maximum.

He recommends slowing the cycle down, with the limiting factor being how long you can comfortably hold your breath.

After practicing this for 4-6 weeks, you can begin to use it when something stressful happens. It’s a great resource for me when another driver does something alarming, but there’s no accident and I am left with the residue of stress in my body. A few of these breaths rebalance me. It can help with cravings and falling asleep.

After 2-3 months, it changes your physiology. It lowers heart rate and blood pressure, improves digestion, and is much more powerful than anti-anxiety drugs.

In essense, you are retraining your nervous system to be more relaxed. In my 7 years of doing bodywork, one day I realized this is what we bodyworkers are doing: retraining your body to be more relaxed and functional.

You may become less stressed from using this technique (yay!) and still benefit from receiving a TMJ Relief session to retrain your jaw muscles into relaxation.

If you’re ready to have that conversation with me, please connect. I’d love to hear from you.