Tag: pelvis

My Practice

Treating TMJ issues: what various professions do to help

What do various healing professions do to treat TMJ issues?

I’m going to try to answer that, to help you be better health-care consumers and know what to expect in terms of results.

By the way, I am a massage therapist who specializes in TMJ work, including intra-oral (inside the mouth) work, in which I’ve had advanced training from three teachers and experience since 2013. I admit, I am biased!

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 do have the skills to release tension in the external jaw and neck muscles. Maybe that’s all you need, if your jaw pain is mild and intermittent. You will feel better after such sessions.

But if you are really suffering from long-term jaw pain and dysfunction, you definitely need more than that to get relief. You could 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.

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

Here’s a look at results you might expect from working with practitioners in different professions:

  • 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 (massage therapist)
  • doing myofascial release on your external jaw muscles (massage therapist)
  • releasing neck tension (massage therapist, physical therapist, chiropractor)
  • getting your pelvis aligned and balanced (massage therapist, physical therapist, craniosacral therapist, chiropractor)
  • getting your head aligned on top of your spine (craniosacral therapist, chiropractor)
  • preventing your teeth from cracking due to grinding (dentist or over-the-counter night guard)
  • checking whether grinding in your sleep is related to airway obstruction (sleep specialist)
  • reducing tension in your internal jaw muscles (massage therapist with special training, physical therapist with special training, Rolfer as part of 10-series)
  • restoring alignment in the cranial bones (craniosacral therapist)
  • repairing or replacing a dysfunctional articular disk (oral surgeon)
  • getting whole-body therapy to help with alignment issues and release strain patterns (craniosacral therapist, Rolfer, Zero Balancer, yoga teacher, yoga therapist)

There is one major caveat here: these are generalities based on my own knowledge and experience. Each profession has its specialties. Not all physical therapists work on the jaw or pelvis — in fact, not many do.

Do not hesitate to ask questions and do your own research.

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

What to do if you have jaw issues? I offer a 30-minute in-person TMJ consultation to gather information and evaluate your issues. I teach clenchers an alternative to clenching as well as the above information to stop grinding.

These habits are major contributors to TMJ issues, and you can change them.

If you’re not in Austin, I can do the above as well as help you learn what to ask about when seeking TMJ relief near you. Just let me know if you need a phone or Zoom consultation.

I offer a combination TMJ Consultation plus TMJ Relief session in person in Austin, Texas. The consultation serves as an intake, so I have a better idea of what your issues are and how we’ll measure progress. Your consultation is free when combined with your first TMJ Relief session. This is a two-hour session.

To be fair, when you’ve had TMJ issues for a long time, or they are acute, you may need multiple sessions to retrain your system to retain the ease and alignment, along with doing your homework to stop clenching or grinding your teeth.

I offer a package of four TMJ Relief sessions for 10 percent off single sessions, best done a week or two apart. These sessions are 90 minutes and integrate various bodywork modalities — including work in your mouth — so that you feel great when you get off the table. They are best done over 4 to 6 weeks.

If you’re really adventurous, you can schedule a 75-minute Self-Treatment for TMJ Issues session on Zoom where we’ll do an intake and I will teach you how to work on releasing the tension patterns that cause problems, including working in your own mouth. You’ll need clean hands and short nails. It’s really not that hard! Learn more about it here.

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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 back of your pelvis includes the base of your spine, the triangle-shaped sacrum. Your jaw — mandible — is near the upper end of your spine, and it has a special relationship with the uppermost two vertebrae at the top of your neck, C1 and C2.

Because the opening/closing motion of the jaw is both hinging and gliding (open your mouth slowly and you can feel it hinge, then glide forward as you open wider), the axis of rotation is not in the actual jaw joints but is located between these two vertebrae, according to Guzay’s theorem (Guzay was an engineer interested in neurology).

The images below show the TMJ and the axis of rotation when with jaw closed (left) and open (right). The upper cross-hairs show the TMJ, and the lower cross-hairs show the actual axis of rotation for jaw opening and closing. 

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

When your pelvis is misaligned, it affects these vertebrae, impacting neck and head posture and neurological well-being. (This is why nearly everyone I treat for TMJ issues also has neck issues, which I treat too.) 

How can the pelvis affect the jaw? There is a tough, inelastic membrane surrounding your spinal cord that connects your sacrum with your cranium. The dura mater lines the inside of your neurocranium, includes membranes between the two hemispheres and between the cerebrum and cerebellum of your brain, and forms the dural tube containing cerebrospinal fluid that surrounds the spinal cord, all the way down to your sacrum. 

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

When the sacrum is not aligned with the other pelvic bones — in other words, when you have sacroiliac joint problems, it torques the inelastic dura mater all the way up to the upper neck vertebrae that affect the movement of the 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 central nervous system.

Here’s a little exercise: put your fingertips in front of your ears and open and close your jaw slowly a few times. Notice if your left and right TMJs move differently. You may notice one side opens first and/or protrudes further out or forward than the other. 

This shows your TMJs are unbalanced. Because the mandible is one bone with two joints, even if one joint is out of balance, the other joint is affected, though you may not feel symptoms in both. 

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

The floor of the mouth, viewed from below.
The floor of the pelvis, viewed from above.

Other ways these two areas resonate:

  • The sacrum also crosses the midline and has two joints on either side, the sacroiliac joints. 
  • The pelvic floor and the floor of the mouth are similar in structure, as seen in the images above. Both are horizontal tissues in the more vertical body. The places where vertical and horizontal tissues meet are generally more subject to holding strain patterns.
  • Fascia in muscles and bones connects the pelvis and jaw. Restrictions in the fascia affect the alignment of bones.
  • 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 jaw issues? I offer a 30-minute in-person TMJ consultation to gather information and evaluate your issues. I teach clenchers an alternative to clenching as well as the above information to stop grinding.

These habits are major contributors to TMJ issues, and you can change them.

If you’re not in Austin, I can do the above as well as help you learn what to ask about when seeking TMJ relief near you. Just let me know if you need a phone or Zoom consultation.

I offer a combination TMJ Consultation plus TMJ Relief session in person in Austin, Texas. The consultation serves as an intake, so I have a better idea of what your issues are and how we’ll measure progress. Your consultation is free when combined with your first TMJ Relief session. This is a two-hour session.

To be fair, when you’ve had TMJ issues for a long time, or they are acute, you may need multiple sessions to retrain your system to retain the ease and alignment, along with doing your homework to stop clenching or grinding your teeth.

I offer a package of four TMJ Relief sessions for 10 percent off single sessions, best done a week or two apart. These sessions are 90 minutes and integrate various bodywork modalities — including work in your mouth — so that you feel great when you get off the table. They are best done over 4 to 6 weeks.

If you’re really adventurous, you can schedule a 75-minute Self-Treatment for TMJ Issues session on Zoom where we’ll do an intake and I will teach you how to work on releasing the tension patterns that cause problems, including working in your own mouth. You’ll need clean hands and short nails. It’s really not that hard! Learn more about it here.