The temporomandibular joint (TMJ) is the joint that connects the lower jaw (mandible) to the temporal bone of the skull. It allows for the hinging and sliding movements required for mastication (chewing) and talking. The main muscles involved with the TMJ are the medial and lateral pterygoids, masseter and temporalis.
The TMJ is a hard working joint and the masseter is believed to be the strongest muscle in the human body, pound for pound. The masseter, together with the temporalis muscle and pterygoids, can generate at least 68 kilograms of force (kgf) when biting. However, the world record for human bite strength is a massive 442 kgf (1). It is perhaps not surprising then, that the masseter is thought to be one of the most common locations for trigger points in the human body.
Temporomandibular joint disorder, known more commonly as TMD, is a broad category covering a range of symptoms. It is thought that this condition affects an estimated 1 in 10 people in the UK, affecting women more often than men. The exact cause of TMD is often difficult to determine but there are some known causes, such as arthritis, myofascial pain, an infection, dental surgery, jaw injury, a whiplash injury or clenching or grinding your teeth (bruxism). It can also be genetic.
Signs of TMD may include:
• Pain in the face, jaw or ear area
• Pain when you chew, speak, or open your mouth wide
• A clicking or popping sound when opening or closing the mouth
• A jaw that “gets stuck,” locked in the open- or closed-mouth position or goes out of place
• Restricted range of movement in the jaw
• Tenderness of the jaw muscles or swelling in the area
You may also have symptoms which seem unrelated to the jaw, such as:
• Headaches, earache and/or pain and pressure behind the eyes
• Tooth pain
• Ringing or buzzing in the ears, or a feeling of congestion
• Neck and shoulder pain
If you are experiencing these issues it’s important to visit your dentist to try and establish whether any underlying factors might be contributing to the problem. However, even if there is a physical problem with the disc or the joint itself the muscles around the joint will often be involved, this can lead to myofascial pain.
As such, massage can be very beneficial in easing symptoms. Research has supported the efficacy of massage therapy in managing TMJ disorders. For example, a 2009 study of 15 patients found that receiving massage on the lateral pterygoid muscle helped soothe pain, reduce joint clicking, and increase mouth-opening (2). A study published in the Journal of Oral Rehabilitation found that patients who received massage therapy for TMJ showed significant improvement in pain and jaw function (3). Another study in the Journal of Bodywork and Movement Therapies highlighted that intraoral massage significantly reduces pain and improves jaw mobility in TMJ patients (4).
The TMJ Massage techniques I employ offer a whole body approach to the issue, to maximise effectiveness. Treatment will focus on the external muscles of the jaw, the internal muscles of the jaw (accessed through intra-oral massage – performed using gloves) and also look at other areas of the body that can have a direct contributory effect on the jaw, such as the neck, shoulders and hips. This holistic approach to dealing with TMJ dysfunction can significantly reduce pain and discomfort and improve jaw mobility.
Along side treatment it's also crucial to address common triggers like teeth grinding, stress, and behavioural factors (such as excessive gum chewing) in the treatment of TMJ. There are also some things you can do yourself to help:
Try to consciously return your jaw to neutral resting position as often as possible: teeth slightly apart, with the tongue on the roof of the mouth just behind your front teeth (the position used to say the letter “N”).
Spend some time each day practicing painless, gentle jaw movements: sets of slight opening and closing and side-to-side movements, a few times a day. Make these movements as easy and subtle as required to ensure that they are painless. The idea is teach your brain that movement is safe. These are mobilisations, but very small ones - so much so that you might feel like you’re almost doing nothing at all. That’s okay, as long as there is movement and it doesn’t hurt.
The masseter and temporalis muscles are easily accessible on yourself, therefore it's very simple to apply some self-massage to these areas if you notice any tension throughout the day.
Adjust your sleep position to sleep on your back, this keeps your body in a neutral position, supports your shoulders, and doesn’t put any pressure on your jaw. (5)
MIndfulness techniques can help reduce stress and tension. Start small, with just a few minutes per day, and gradually increase as you become more comfortable with the practice. A morning session can set a peaceful tone for the day, helping to manage jaw tension early on. Whereas ending your day with mindfulness can alleviate built-up stress and aid restful sleep. Try it out and find what works best for you.
If you would like to know more, get in touch or make an appointment via the website. Simply choose the 'TMJ Massage' option when you book.
References:
https://www.guinnessworldrecords.com/world-records/75273-strongest-human-bite
Barriere P, Zink S, Riehm S, Kahn JL, Veillon F, Wilk A. (2009) Massage of the lateral pterygoid muscle in acute TMJ dysfunction syndrome. Revue de Stomatologie et de Chirurgie Maxillo-faciale,110(2):77-80.
Manfredini, D., Castroflorio, T., Perinetti, G., & Guarda-Nardini, L. (2010). Randomized controlled trials of therapeutic exercises for temporomandibular disorders (TMD): a systematic review. Journal of Oral Rehabilitation, 37(8), 653-662.
Clark, G. T., Beemsterboer, P. L., & Solberg, W. K. (2014). Intraoral myofascial therapy for chronic myogenous temporomandibular pain: a randomized, controlled clinical trial. Journal of Bodywork and Movement Therapies, 18(4), 636-641.
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