Understanding TMJ Disorder and why is Myofascial Release therapy a very effective treatment method for this presentation
Temporomandibular Joint (TMJ) disorder is a common condition that affects millions of people worldwide. It is characterised by pain in the jaw joint (TMJ) and surrounding muscles (mastication muscles primarily). It might also lead to difficulty and pain when opening the mouth or eating, difficulty sleeping, increase anxiety, headaches/migraines, ear pain or blurred vision/dizziness.
We’ll further explain in this article why TMJ Disorder happens and also how it’s physiologically possible and how does it cause all the above symptoms.
When we’re faced with TMJD there isn’t many options available for us to try and solve the problem. Yes your dentists can identify it, but then what? Is there a path in place within the health system for people presenting with this condition for them to get hold of the problem?
The answer is “no”.
All the system usually offers is a mouth guard that barely ever works, with most people chewing through it within a few weeks.
Here is where Myofascial Release Therapy (MFR) comes into play as a solid tool that has shown to be an effective treatment method for TMJ disorder related symptoms. We’ll explain how MFR works a bit later on in the post.
Understanding TMJ Disorder
The temporomandibular joint (TMJ) is a hinge joint that connects the jawbone to the skull, or upper and lower mandible. It is therefore an essential joint for eating and speaking.
This joint might become inflamed or damaged resulting in TMJ disorder.
Although this does happen, a problem with the TMJ joint is not the main cause of TMJ Disorder and its related symptoms symptoms.
So what’s the most common cause for TMJ disorder if the problem is not in the joint?
The National Institute of Dental and Craniofacial research (NIDCR) classifies TMJD by the following:
“Myofascial Pain”
This is the most common form of TMJD and it consists of the following symptoms:
- Pain or tenderness in the fascia and muscles that control the jaw, neck and shoulder function.
- Pain in and around the ear
- Difficulty chewing or biting
- Clicking or popping sounds when opening or closing the mouth
- A locked or stiff jaw, pain when opening the mouth
- Headaches or migraines
What causes TMJD?
When we try to explain the cause of TMJD we enter grey territory, with different professionals having a different theory.
If we go by the NIDCR research though that classifies TMJD as “Myofascial Pain” we can’t go wrong.
Now we might have to change the question that gives title to this section to “what causes Myofascial Pain?” And within Myofascial Pain, what are the leading factors to TMJD in particular?
Myofascial Pain happens as a consequence of the Myofascial tissue being inflamed.
Inflamation of the Myofascial tissue can happen due to different stressors, here is a list of the most common:
- Inadequate postural patterns
- Emotional stress, anxiety
- Overuse, repetitive motions
- Injury, physical trauma
- Surgery
- Infection
- Diet, hydration
- Chronic medical conditions, such as fibromyalgia or rheumatoid arthritis
When it comes to TMJD caused by Myofascial inflamation the presentation can develop as a result of a combination of the previous causes but ultimately the most common are
- Stress/ anxiety
- Inadequate Postural patterns
We must mention here dental work and inflamation of the myofascial tissue around the hips and Psoas muscle as two factors that seem to be very often related with TMJD.
Once the myofascial tissue is inflamed around the jaw area it triggers itself even further, entering what in our clinic we call the jaw cycle.
How does Stress physiologically translates into TMJD?
This might be the hardest thing to understand when trying to figure out this whole Myofascial and TMJD thing.
We could get really really scientific and geeky with the answer but I’m going to oversimplify it so it’s easier to understand.
The Myofascial tissue has the ability to respond to chemical changes in the environment where it lives, we’re talking about chemical changes within our body.
When we are under prolonged stress or simply in a fast paced society that overstimulates our nervous system, our breathing is off, our body lives in fight or flight mode too much and our brain produces stress hormones rather than happy go lucky hormones most of the time.
The myofascial tissue reacts to these enzymes and gets inflamed as a result.
Usually when treating TMJD clients we find inflamation of the Myofascial tissue around the neck and shoulders area, as well as back, hips and psoas and of course jaw muscles.
We can release the Myofascial tissue and reduce inflamation effectively with Myofascial Release therapy.
What factors determine these previous structures to become inflamed and not others resulting in TMJD and not in another condition?,
that is uncertain although we might want to have a look here at the other causes of Myofascial inflamation to have a more complete picture of the presentation and why it happens.
Inadequate postural patterns
Inadequate postural patterns can also lead to TMJD.
Specific postural patterns can cause increased load to neck, shoulders, and back, which can in turn cause tension in the jaw muscles, leading to inflammation and pain in the myofascial tissue surrounding the jaw.
A very common postural patterns is a kyphotic mid back combined with an overextended neck (picture above).
You can see how being stuck in this posture is constantly loading the neck and shoulder area with the consequent symptoms.
Another postural pattern we see in clients experiencing TMJD is what we call “flat back”.
Increased load can cause the development of Trigger Points in the myofascial tissue, these Trigger Points, commonly known as knots, can cause pain and other symptoms either locally in the area where they’ve developed or referred to another part of the body.
This is common in TMJD, where, for example, Trigger Points in the shoulder muscles (Upper Trapezius) tend to refer pain and other symptoms upwards into the head, like dizziness, headaches or jaw pain.
This is why posture matters; there is a lot of controversy lately about the importance of posture and it’s clear here that it is definitely important when we look at the right reasons why this is true.
It is important to address postural patterns in order to prevent pain and symptoms like those present in TMJD.
We point our clients towards the right tools for addressing these postural patterns. We recommend a combination of Myofascial release therapy (to release the areas that are shortened) and exercise rehab (to strengthen the areas that are weak)
Other causes of TMJD
Stress and poor postural patterns are not the only cause for TMJD as we mentioned above.
Dental work can be a trigger of TMJD symptoms.
Another more shocking TMJD-related cause is hip tension and Psoas muscle tension.
The psoas muscle is located deep in the pelvis. This muscle is part of the deep front Myofascial line which means that it’s Myofascially connected to the diaphragm and to the neck muscles.
When this muscle is inflamed it can contribute to TMJD.
Myofascial Release is again a very effective tool to releasing the Psoas muscle.
What is Myofascial Release Therapy?
Myofascial Release Therapy (MRT) is a type of soft tissue therapy that focuses on releasing tension, inflammation and therefore pain in the fascia.
The fascia is one of the connective tissues in our body. It’s a spider web-like tissue that holds our organs, muscles and bones in place. It’s a highly sensitive tissue (it has more nerve endings than the skin itself) and it responds to both chemical changes and pressure changes in our body. Two examples are stress (for a chemical stressor) and postural patterns (for a pressure stressor).
To release the fascia we apply steady pressure over a period of time. There are thought different tools within Myofascial release therapy that can be used in different situations.
Direct Myofascial work, for example, where the tissue gets taken in the desired direction,
or Indirect Myofascial work where the therapist holds a specific part of the body and tunes into the myofascial tissue with the intention of releasing it.
Myofascial work is also a great door into the nervous system and it’s a great treatment method for stress and anxiety.
Myofascial release has been shown to be an effective treatment method for TMJD, through different routes and simultaneously it helps reduce inflammation and tension in the Myofascial tissue.
It’s effective in the release of Trigger Points that are causing the TMJD symptoms located in the neck and shoulder area as well as the jaw muscles and Psoas.
It’s also effective in increasing the activity of the parasympathetic nervous system (the happy go luck guy) and therefore tackling the TMJD problem through the stress alley as well.
When we really understand why we’re having TMJD symptoms, why we are clenching or why our jaw hurts, Myofascial release is a no brainer as the most effective treatment method available to deal with TMJD and all these symptoms.
On top of it, it’s non-invasive, it feels amazing, it improves sleep and by increasing the parasympathetic nervous system activity it increases our efficiency and widens our options in life.
What else can be asked!
About the author
Rocio Santiago
MA in Nursing, Dip. Soft Tissue Therapy
Ro initially began her career as a nurse. Following this and after a difficult time in her life that resulted in a career change, Ro went on to train at one of the leading soft tissue therapy schools in Europe, completing a 3 year degree level course and specialising in effective soft tissue manipulation for the treatment of musculoskeletal pain.
The treatment method Ro uses consists of a combined approach using different specialised techniques, myofascial release and trigger point work among others, with the intention and focus on providing effective results in the least possible amount of time.
Combining her training, science background and life experience, her treatment method is based in science and built using a whole body approach, where mind and body are addressed as one.
Ro has been seeing clients as a soft tissue therapist for 8 years, successfully treating a wide range of conditions.