Treating TMJ issues: asymmetries in the rest of the body affect the jaw joints

Jaw pain is rarely entirely in the jaw!

If you were building a tower, and one of the floors wasn’t level, it would affect the floors above it — unless you somehow compensated.

The Leaning Tower of Pisa is kind of like that, only it’s because it settled unevenly on the ground beneath it. As they built it over the years, it would sink, stabilize, sink more…

The structure of the body is like that too — even when standing on level solid ground.

Because the jaw is near the top of the skeleton, imbalances below can affect the alignment and functionality of the temporomandibular joints (TMJs).

The primary cause of most jaw pain is asymmetrical hypertonicity. Thanks, TMJ Mastery teacher John Corry! That means that some of the muscles that affect the jaw are tighter than others.

I include a basic structural evaluation in my free TMJ consultations. It’s pretty cursory. I’m just looking for asymmetries. Here’s how I do it.

The patient stands with their shoes off.

I feel the space under theIr arches and check whether their feet (or one foot) are pronating or supinating.

Checking the points on the tops of the hip bones to see if they’re level comes next.

I ask about scoliosis and pelvic floor issues.

I check their shoulders to see if they’re level.

I look at the patient from each side to see if they have a pelvic tilt toward the front or the back and view their spinal curves.

When they are lying on my massage table, I can check for a leg length discrepancy with their legs flat, and then with knees bent. I can also see whether their feet point up symmetrically, which usually indicates asymmetry in the hip joints.

I also feel the space beneath the ears between the bones to see if it’s symmetrical.

When the skull and spine are out of alignment, it can contribute to multiple dysfunctions, with TMJ issues being one of them. (Ask me — I experienced intermittent right jaw clicking and my face drifting slightly to the left in meditation until my chiropractor realigned my AO joint, which also resolved issues that were all on my left side.)

1 shows the line between the mastoid processes. 2 shows the C1 vertebrae. From the sides, feel the convex bony area beneath your ears and come down up to 1/2″ to feel the ends of the C1 vertebrae. Notice if the space is symmetrical.



For more on this, including exercises you can do starting at 5:25, watch this video.

The last part of my evaluation for symmetry is to place the pads of my fingers over the TMJs right in front of the ears and ask my client to open and close repeatedly.

Often one side moves first.

Often one side feels closer to the ear than the other.

Sometimes one side sticks out more than the other.

Try it on yourself. What do you notice?

None of this is super precise. I’m just getting a basic read on asymmetries in the structure of the patient that may affect the jaw.

Have you noticed that you have a dominant side? A side that feels stronger than the other? Most of your issues occurring on one side only?

Have you ever had a foot, ankle, leg, or hip injury? Can you still tell a difference between the injured side and the uninjured one? Can you balance easily on each foot?

How’s your posture? How about your sleep posture?

Also, do you primarily chew on one side of your mouth?

Becoming more symmetrical can be a good long-term project that can pay off with more ease of movement, less discomfort, better balance, injury prevention.

Symmetry is an ideal, like perfection. Most of us are doing the best we can. There’s always going to be some asymmetry in the body (our abdominal organs are asymmetric), but we can definitely address our most dysfunctional areas.

The functional movement screen is a set of 7 movements you do with a trainer, who scores you and can prescribe workouts that strengthen your weaknesses. FMS was developed to identify athletes who were prone to injury before they got injured. It can work for ordinary people too.

Here’s a link to view the screening movements. You can find a trainer near you online.

Practices of non-linear movement can help if done regularly over a long period. These movements work both sides of the body. They increase flexibility and balance and fluidity. And they are fun! Examples:

  • yoga, especially alignment-oriented types like Iyengar and Anusara
  • qi gong
  • tai chi
  • Gyrokinesis
  • martial arts
  • dance

The type of bodywork that directly addresses asymmetries is called structural bodywork. There are two main schools of training: Rolfing Structural Integration and Anatomy Trains Structural Integration. Neuromuscular therapy also assesses posture and gait pattern and can address imbalances.

Coming soon! A class for dental offices

I have been taking a fantastic class called NLP+Presentations. The first part was this past weekend, and the second part will be in mid-February.

I’m working on a presentation for dental offices. It will be an hour max, so it could be a lunch-and-learn or a training offered to staff early or late in the workday.

I probably don’t need to tell you that some people complain of jaw pain after receiving dental work.

Dental professionals need to accommodate them by offering frequent breaks from wide-open mouth position — some even use devices to keep the mouth cranked wide open.

Dental offices also experience cancellations when someone’s jaw pain has flared up and they can’t even imagine holding their mouth open for dental treatment.

In fact, dental professionals are often the first health care professionals to let someone know that their clenching and/or grinding habit is damaging their teeth.

Although they offer orthotic devices to protect teeth and/or try to realign the TMJs, and they can usually repair the tooth damage they encounter, they don’t work on the biggest cause of jaw pain — myofascial tension. In fact, most dentists receive little or no training in the jaw — their domain is teeth and gums.

As a massage therapist, my domain is the myofascial realm of muscles and soft tissues. I work on postural issues, shoulder and neck tension, decompression of cranial bones, and do intra-oral work on all four internal jaw muscles — as gently as possible.

I can help dental offices help their patients, and I believe we can work well together.

If you think your dentist might be interested in this free training, please connect us. I’ll be offering trainings starting in late February.

Treating TMJ issues: sleep posture

Are you aware that there is a pillow specially designed for people with TMJ and neck issues? I’ve had one for several years, and I love it. I take it with me when I travel and when I camp. Since I started using it, I’ve never woken up with neck or jaw pain.

It’s the Therapeutica Sleeping pillow, designed by a chiropractor and an ergonomic designer. It’s…different-looking.

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It’s designed for people who sleep on their sides or their back.

I don’t believe there are any pillows designed for stomach sleepers, which is hard on the neck and not great for your organs either.

This pillow comes in five sizes, and you order the size that fits your shoulder width. The proper-sized pillow keeps your head and neck aligned with your spine. Since we spend a third of our lives sleeping, this is important! Good sleep posture makes a difference over time, resulting in fewer neck and jaw issues.

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The indentations on the “wings” relieve pressure on your jaw when side-sleeping. Some users also find it helps with shoulder issues.

The pillow comes with a 5-year warranty not to lose its shape or resilience, and many users have used it long beyond 5 years. I put a king-size pillowcase on my average size pillow, which comes with a zippered case.

At $86.99 for an average size, the Therapeutica Sleeping Pillow is expensive for a pillow. If you average it out over 5 years, though, you pay less than $20 per year for child, petite, average, and large adult sizes, and about $22 for extra large. When you look at it that way, it seems totally reasonable to spend this much on a pillow.

Note the link above is for the average size. Be sure to measure and get the size that’s designed for your shoulder width.

Are you a back sleeper? It’s the recommended sleep position for people with TMD. The back-sleeping-only pillow is called the Travel Pillow, and it comes in three sizes.

On Amazon, read the reviews and the Q&A. Note that not everyone likes this pillow. I believe you should try it for a week before deciding, because it may be very different from what you’ve been sleeping on, and therefore it will take time for your body to adjust. You can and will adjust if you give yourself time.

Your flexible spending account may cover the cost, so check on that if you have one. With Amazon, you can use an app like Honey that watches for price changes and notifies you via email if the price drops within 60 days.

For more on TMD and sleep, check out these sites:

If you’ve found relief from TMJ pain using this or a different pillow, please share in the comments.

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 chronic or more severe 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.

Also, since COVID is still around, ask what their COVID safety protocols are.

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, chiropractor)
  • getting your head aligned on top of your spine (chiropractor)
  • preventing your teeth from cracking due to grinding (dentist or OTC night guard)
  • reducing tension in your internal jaw muscles (massage therapist with special training, physical therapist with special training, Rolfer)
  • 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.

Treating TMJ issues: who experiences it?

Did you know that about 12 percent of Americans are experiencing TMJ disorders at any one time? Also, women are 9 times more likely than men to experience severe pain and restricted jaw movement?

Some known causes are autoimmune diseases, injuries, infections, dental procedures/prolonged mouth opening, pre-surgery breathing tube insertion, and arthritis. (How about stress?)

The majority of women who have TMJ disorders are in their childbearing years — which indicates that hormones may play a role.

Genetic and environmental factors can increase the risk. A particular gene variant more prevalent among TMD sufferers increases sensitivity to pain. Gum chewing and sustained postures may also play a role. (Data from TMJ.org.)