Treating TMJ issues: releasing trigger points in your jaw muscles

You have eight jaw muscles: two pairs of large ones on the outside of your head (the masseters and temporalises) and four small ones inside your mouth (two medial pterygoids and two lateral pterygoids).

Any of them can get trigger points.

What is a trigger point? It’s unhealthy muscle tissue that causes pain.

Healthy muscle tissue is made of bundles of fibers that run in the same direction. This tissue is pliable. 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 the fibers in a particular spot feel hard, creating a small nodule. The tissue feels dense and often rolls under the fingers, 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 usually feel tender when you apply pressure to them, and they often refer pain elsewhere.

Where several of them occur in an area, they form “constellations.” If one of those trigger points in the constellation is primary and the rest are satellites, it usually 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 someone else 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.

When I am working on TMJ issues, I notice that many 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 pressure, drag your fingers slowly down the masseter muscle on one side 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 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 works intra-orally, as do I, but her experience is greater than mine, and she’s amazing at discovering patterns if you have “constellations” of trigger points. She’s going to be more efficient than I can possibly be. She’s the queen!

If you are interested in having her work on you, her name is Rose of Sharon, and 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.

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.