Who would’ve thought that you would have to stifle your yawn anywhere but a work meeting or any meeting where the stakes are high? Not me. That’s until I had temporomandibular joint disorder.
If you’re reading this, it is likely you are annoyed at being unable to do the most elementary activities such as yawn, sneeze, or speak due to jaw pain that you might even describe as ear pain.
Even as I type these lines, I have yawned a bazillion times, just by typing the word yawn! It’s the type of contagion we all prefer, instead of the one that caused the pandemic. Anyway, I digress.
If you have woken up to a stiff, tender, and painful jaw, you are probably wondering how it came about and what could’ve caused it.
A stiff jaw can be considered silly and simply irritating when your body needs to yawn. The same stiff jaw can be a real hindrance to your body and overall health if, for example, routine medications cannot be swallowed.
Irrespective of how or how much your symptoms are affecting your quality of life, temporomandibular joint (TMJ) disorders cannot be ignored.
Unlike most joints that are clearly visible, easy to locate and therefore understand, the TMJ is relatively harder. Let’s begin with the anatomy of this frequently used but mostly over-looked joint in the body.
Anatomical design of the temporomandibular joint (TMJ):
- As the name suggests, the joint consists of a temporal (the skull bone behind the ears) component and a mandibular (the bone felt on the chin) component. It is, essentially, the joint where the jawbone is attached to the rest of the skull.
- If you were to hold a hand puppet, the TMJ would be the hinge at which the puppet’s mouth opens and shuts.
However, unlike the puppet, which only allows for an opening and closing, the TMJ is designed such that it allows a forward and back motion too, called protrusion and retraction.
The open-close mechanism enables speech and eating. The forward-back enables chewing and grinding actions.
Joint stiffness or pain occurs because of restrictions in these movements, sometimes leading to clicking sounds and in extreme cases, a locked jaw.
Causes of TMJ disorders:
- Stress- Most often, stress is held in the facial and neck muscles, unconsciously. This can lead to tightness in the muscles around the jaw causing pain and tenderness.
- Trauma- a blow to the head or whiplash injury from a car crash can cause injuries to the muscles and tissue around the head and neck.
- Arthritis- the degeneration of the cartilage tissue between the bony structures can result in inflammation and pain.
- Dislocation- in rare cases when the bony structures are out of synchronicity they can cause clicking, grinding and pain.
- Dental troubles- an improper bite can lead to symptoms.
- Grinding/clenching of teeth- chronically can lead to TMJ disorders.
Symptoms of TMJ disorders:
- Pain in your face, jaw, neck, shoulders, or ears that is exacerbated when you try to open your mouth wide.
- Stiffness in the face, jaw, neck, shoulders, or ear when you try to open your mouth wide.
- Tenderness and swelling on that side of your face.
- Clicking or a grinding sensation
- Jaw getting locked in an open or closed position.
- Occasionally toothaches, dizziness, earaches etc.
Physicians and/or dentists are often the first point of contact for TMJ disorders. After investigating the causes, the treatment strategy usually involves painkillers and physical therapy. When these options don’t work then surgical management of symptoms is considered. However, most times, symptoms are relieved with regular physiotherapy
Physiotherapy for TMJ disorders:
Your physiotherapist will carry out the evidence-based physiotherapy protocol with a detailed history and thorough assessment.
Following the assessment, the most effective treatment techniques will be selected among the available options. This may include manual therapy methods to relieve stress and release the muscles around the joint. Techniques such as dry needling and mobilization are often used.
Exercises are an important adjunct to the manual therapy methods. Here are the common exercises that you will be prescribed to alleviate your symptoms.
- Goal: This exercise helps you align the jawbone while you chew.
- Instructions: Press your tongue to the roof of your mouth. Now place one index finger onto the left TMJ and another index finger on your chin. Drop your chin, applying light pressure with each finger and keeping the tongue to the roof of the mouth. Repeat this exercise for the right TMJ.
- Prescription: Do 3 sets, 10 reps, 2xday
Mandibular Stabilization Exercise:
- Goal: This exercise similarly tries to align the jawbone and improve its range of motion over time.
- Instructions: Start with the jaw in a neutral, relaxed position. Hold your thumb to the base of the jaw, just below the chin, and apply gentle pressure as you open your mouth. Repeat the motion, moving your thumb to the left and right sides of the jaw respectively.
- Prescription: Do 3 sets, 10 reps, 2xday
- Posture: Start by lying on your back.
- Instructions: Focus on doing a little chin tuck by gently bringing your chin to your mid throat by doing a gentle nod. You should feel the tightness in the front of your neck slightly. Do not overly tuck your chin in. It will flare up your bigger muscles (SCM) which you do not want to use. Progress by holding a chin tuck and taking a diaphragmatic breath.
- Prescription: Do 10 seconds, 10 times, 3-4xday
Side-to-Side Jaw Exercise:
- Material required: you will need a small object, like a flat wooden stick. It will work to target the jaw’s range of motion.
- Instruction: Place a clean wooden stick, like a craft stick, in your mouth, biting it softly between your top and bottom teeth. Now begin shifting your jaw from side to side without loosening your bite on the stick. Shift your bottom jaw forward and back, keeping your teeth clenched.
- *Progress by using a thicker object.
- Prescription: Do 3 sets, 10 reps, 1xday.
Tongue Up Exercise:
- Posture: Get into a seating or standing position.
- Instruction: gently touch your tongue to the roof of your mouth. Now, without letting your tongue drop, extend your jaw as far down as you can. Still without moving your tongue, close your jaw and then open it again.
- Prescription: Do 3 set, 10 reps, 2xday.
At Revere, we specialize in manual therapy and hands-on techniques. We respect and value your time and that’s we why offer the best hands-on, individualized therapy with no extra charges for dry needling.
If you are struggling with symptoms of TMJ disorder, reach out to us at email@example.com. We are offering a free 10-minute consultation call with our expert physiotherapists. Call us at (604) 566-5108.
If you feel ready, book an appointment with our expert physiotherapists. Share this article with friends and family who also have chronic jaw pain and could benefit from the best physiotherapy services at Revere Physiotherapy.