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.


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 also teach clenchers an alternative to clenching and provide known ways to stop grinding, from those who succeeded.

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, and in Taos, NM, in sumemrs. 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: foods and nutrients that can make a difference

There are so many things you can do to relieve the stress that usually accompanies TMJ pain and dysfunction. Today I want to write about nutrients that can make a difference.

You can get these nutrients in the form of supplements, and sometimes that’s easiest, but studies are finding that our bodies are not absorbing some of the expensive supplements we take to improve our health.

Fresh and organic foods grown in good soil make it more likely that your body will absorb and integrate these nutrients for your benefit.

You’ll want to first get your digestive system in good shape if it’s not, especially healing any leaky gut issues by consuming prebiotic and probiotic foods daily to build a healthy gut microbiome. (You may be surprised at the health benefits — it’s now proven that regular consumption of fermented foods reduces inflammation anywhere in the body.)

There’s a lot of information available online, and you can also work with a nutritionist.

On to the nutritional foods! The B-complex vitamins are 8 vitamins that often occur together in food sources. They give us energy, and stress depletes them, so when you’re stressed, you need even more B vitamins to avoid fatigue.

Clenching and grinding your teeth are signs of stress, and these habits also stress the muscles involved, creating tension and pain and other jaw issues.

Reducing stress is a key to changing the patterns that result in TMJ issues.

Note that 30-60% of people do not absorb folic acid (B9) and B12 unless they are in the methylated form, so if you’re buying a B vitamin supplement, read the labels. 

Best food sources: meat (especially liver), salmon, dairy, eggs, legumes, brewer’s yeast, spinach, and mushrooms.

Screen Shot 2018-07-02 at 11.03.29 AM

Vitamin C produces collagen (see below), which is present in the cartilage in your joints. The articular disk in your TMJ is made of cartilage, and you want to keep it healthy and undamaged. If your TMJs click or pop or crunch or otherwise make noise, this disk is at risk.

Vitamin C is also easily depleted by stress.

Best food sources: fruits like guava, oranges, kiwi, grapefruit, and strawberries, and veggies like bell peppers, kale, broccoli, and brussels sprouts.

Vitamin D3 helps with bone health and muscle function, decreases pain, and improves feelings of well-being. It’s an antidote to stress.

Most people (except those working outdoors with the sun shining directly on their skin without sunscreen) need to supplement to get enough, although you can get at least some of the D3 you need from sunshine. Outside peak UV hours is best, of course.

Cod liver oil is the highest food source. You can also place store-bought fresh or dried mushrooms in sunshine to absorb Vitamin D from the sun. 

Glucosamine helps preserve joint health, rebuilding cartilage (the disc between your upper and lower jaw bones is made of cartilage), lubricating joints, reducing pain, and improving range of motion. More effective than ibuprofen at reducing pain, it can also help with jaw clicking. It can take 4-8 weeks of supplementation to ease pain. 

This is a nutrient that isn’t easily found in food, except for bone broth made with chicken feet, ox tails, marrow, tendons, knuckle or cartilaginous joints, or shrimp shells. If you decide to supplement, plan on taking 1500 mg daily.

Type II collagen can also help preserve cartilage. Some collagen products also contain glucosamine, so read the label if you take collagen. 

Vitamin K2 helps with calcium absorption, which strengthens bones and nerve function.

Food sources: the Japanese fermented soybean dish natto, grass-fed butter, Gouda, Edam, and Brie cheeses, grass-fed meat, pasture-raised eggs, sauerkraut, and yogurt/kefir.

Magnesium and calcium are essential minerals that many of us are deficient in. Magnesium helps with muscle function (muscle tension causes jaw pain). Calcium helps with bones and nerve signaling.

Food sources for magnesium include leafy greens, dark chocolate, avocados, almonds, pumpkin seeds, and figs. If you supplement, try magnesium threonate or glycinate to bypass bowel distress. 

Food sources for calcium: sardines (with bones), yogurt or dairy kefir, raw milk, and cheese.

Omega 3s have been shown to ease pain and inflammation as effectively as ibuprofen.

Food sources: wild salmon and other fish/seafood like mackerel, herring, sardines, anchovies, and oysters, seaweed, walnuts, chia seeds, flax seeds, and hemp seeds.

New research indicates that grinding during sleep and restless leg syndrome may be related and that both are signs of a dopamine deficiency. Tyrosine is an amino acid that helps your body produce more dopamine.

Good sources are beef (specifically skirt steak, so bring on the fajitas if you eat meat), lean pork chops, salmon, lean chicken breast, and firm tofu.

Do you notice some foods appearing over and over? Wild salmon, pasture-raised eggs, yogurt/kefir, sardines with bones, leafy greens, and cruciferous veggies are particularly nutrient-dense foods that you can incorporate one or more of at every meal.

As always, get the best quality food you can find and afford: grass-fed/grass-finished meat, pasture-raised organic eggs, wild-caught low-mercury fish like salmon and sardines, organic fruits and vegetables, hormone-free organic dairy.

Why? Because the cells in your body are constantly turning over! They die and new ones are born.

What do you think the new cells are made of? The foods and fluids you consume! The better quality of food and drink that you consume, the healthier you become.


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 also teach clenchers an alternative to clenching and provide known ways to stop grinding, from those who succeeded.

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, and in Taos, NM, in sumemrs. 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.