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 has 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 ask about structural anomalies in my TMJ consultations. I’m interested in whether one foot is flatter than the other, whether there’s a leg length discrepancy or a pelvic tilt or curvature of the spine.

I’ve been known to slide my hands under a client’s arches with them standing to see if their arches are symmetrical.

When a client is lying on my massage table, I can check for a leg length discrepancy.

I can also tune into their cranial rhythm and notice whether there’s asymmetry in the flexion and extension motions at the feet, which indicates asymmetry in the pelvis.

I also feel the space beneath the ears between the bones to see whether the skull is sitting symmetrically atop the spine.

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 a 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 (or have the client place their fingerpads) over the TMJs right in front of the ears and ask them 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.

One side may move with more ease 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 client’s structure that may affect their TMJs.

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 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 as easily on your left foot as your right, or is one side weaker?

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 self-care 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 asymmetrical), 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 and increase neuroplasticity in the brain. 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.


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.

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 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.

Treating TMJ issues: who experiences it?

Did you know that about 12 percent of Americans are experiencing TMJ disorders at any one time? This is from TMJ.org.

Also, did you know that women are 9 times more likely than men to experience severe pain and restricted jaw movement? The majority of women who have TMJ disorders are in their childbearing years — which indicates that hormones, pregnancy, labor, and delivery may play a role. 

Also, many women have full-time jobs and still do the majority of the housework and child care. If that’s not stressful, I don’t know what is! 

Some known causes, according to TMJ.org, are autoimmune diseases, injuries, infections, dental procedures/prolonged mouth opening, pre-surgery breathing tube insertion, and arthritis.

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.

How about stress, I ask? How about clenching and grinding habits and the resultant muscle tension from overuse of jaw muscles? 

The way I see it, after working on TMJ issues therapeutically as a massage therapist since 2013, in addition to the known factors listed above, these issues can also stem from:

Stress and the accompanying muscle tension

Habits like clenching and grinding the teeth and bracing the jaw 

Dopamine deficiency 

Structure, including skeletal asymmetries as well as poor waking and sleeping posture 

Medications that have jaw pain as a side effect

Family patterns that may be learned or genetic

There’s a sad lack of research and data on this topic, and I note that it’s one of many issues that affect more women than men (like migraines) that do not get much attention from the health care field. 

Imagine that migraines got as much attention from the medical field that erectile dysfunction has gotten. 


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.

Treating TMJ issues: reducing night grinding

A reader asked about grinding the teeth during sleep (night bruxism). Sleep labs have begun to investigate this.

They found that about 1 in 4 people with sleep apnea also grind their teeth while sleeping. When the apnea is treated, the bruxism goes away. So..if you grind, consider going to a sleep lab.

Most people do a little bit of clenching or grinding while asleep.

When is it a problem? When you wake up with jaw or facial pain, earache, headache, or experience difficulty chewing (TMJ disorder). Or perhaps your dentist sees wear and tear on your teeth. Severe bruxism can crack teeth and require expensive dental work.

Why do people grind their teeth at night more than just a little bit? Stress is the main cause and well worth examining. Reducing stress during the day is likely to result in less grinding at night — but no studies have been done on this that I know of.

However, one of the few people I know who stopped grinding their teeth in their sleep said that when they started a regular, daily meditation practice, their night bruxism gradually stopped. 

If you have personal experience, please share. We need these stories! 

Body mechanics can also play a role. Posture both while awake and asleep influences your nervous system and can produce or relieve stress and tension. Just as with athletic training, learning and practicing good posture may require special training. The Alexander Technique, the Feldenkrais Method, alignment-based hatha yoga (Iyengar and Anusara), and structural integration bodywork (i.e., Rolfing) may all be of help.

A special pillow that keeps your head and spine aligned can be helpful. The Therapeutica Sleeping Pillow comes in different sizes based on the distance from your neck to outer shoulder for side sleepers.

Probably the simplest thing you can try is changing your sleep position. If you have night grinding and sleep on your side, try sleeping on your back. It may take some getting used to but may bring you some relief.

Night bruxism may be an attempt to realign your cranial bones. Several sessions of craniosacral therapy may help.

If you have night bruxism, what has helped you?