The temporomandibular joint (TMJ) is a synovial joint formed by the condyle of the mandible, the articular eminence of the temporal bone, and the articular disc that is interposed between the two for cushion and better fit of the joint.
When treating the TMJ, the plan of care should address the cause and all contributing factors to the problem. Treatment of other regions of the body such as the cervical and thoracic spine and its related musculature, shoulder girdle, and the lumbar spine and pelvis and its related musculature are also important as they may contribute to the postural component of a TMJ problem.
Physical therapy treatment can include:
- Modalities such as Class 4 laser and ultrasound
- Manual therapy techniques with hands-on treatment such as massage to the soft tissue, mobilization of the spine and TMJ, myofascial release techniques to decrease muscle and joint tension, craniosacral techniques to restore head, neck and pelvic balance and restore proper cerebral spinal fluid flow.
- Dry needling to reduce muscle trigger points (knots).
- Exercises such as the 6 listed below and others as needed to address any contributing issues.
These 6 specific exercises are designed to relieve TMJ discomfort by correcting the head, neck, and shoulder posture. Learning a new postural position requires replacing old muscle memory with new muscle length-tension relationships, restoring normal joint mobility of the TMJ, neck, thoracic and lumbar spine and restoring normal shoulder blade and pelvic stability by activating shoulder blade and core muscles for normal body balance.
Perform the exercises one after the other until your session is complete. It will take about one minute.
Perform 6 repetitions of these exercises 6 times a day (6 x 6). Practice and patience are needed to correct old habits.
The goal is be able to practice these exercises while in your best posture which includes: head over your neck, shoulder blades back and down & belly button pulled away for your shirt to activate the core muscles – Combination of exercises #1, 2 and 3.
- Stabilized Head Flexion = upper cervical flexion (Nodding): Most patients have a forward head posture with upper neck extension. To correct: Nod just your head about 15 degrees x 6 times.
- Lower Cervical Retraction: Slightly tuck your chin and move your chin straight back, making a double chin. Hold for 6 seconds x 6 times.
- Shoulder Girdle Retraction for Scapular Stabilization: Pull your shoulders back and down squeezing your shoulder blades. Add Core Activation by pulling your belly button away from your shirt. Hold for 6 seconds x 6 times.
- Rest Position of the Tongue:
- Place your tongue lightly to the roof of your mouth just behind your upper front teeth and make a clucking sound. Your tongue position after the cluck is the optimal rest position of the tongue without pressure up or forward x 6 times.
- Take 6 deep breaths from your diaphragm while in the rest position.
- Control TMJ Rotation on Opening: Keep your tongue to the roof of your mouth and open and close your mouth x 6 times.
- Mandibular Rhythmic Stabilization: While in the rest position, apply light pressure to opening, closing and lateral deviation. Hold for 6 seconds x 6 times.
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