By Professional Physical Therapy with Michael DelloRusso, PT, Clinic Director
The temporomandibular joint (TMJ) enables jaw movement and the ability to open and close your mouth. Experiencing pain or discomfort in your jaw or near the ears could mean you have a TMJ disorder. If you do, knowing the symptoms of the condition and identifying the causes is the first step to finding relief and physical therapy can help.
Physical Therapists can help people suffering from facial or jaw pain, a condition that is called temporomandibular disorder or TMD. This is a broader term that refers to a variety of problems relating to the jaw. TMD is sometimes incorrectly referred to as simply “TMJ”, which represents the name of the joint itself. Although incorrect, many people use these terms interchangeably.
Professional PT’s Michael DelloRusso, PT, Clinic Director sees many patients with facial pain but says, “Most of our TMD patients come from the dentist, ENT or doctor that ruled out any dental or neurological problems. Once we rule out problems coming from the teeth, vascular or nervous system we can start a treatment plan focused on the musculoskeletal structures. Our first line of defense is finding out why our patient has pain. Once we find out the behavior or cause of the problem, then we try to change that.”
Common Causes of TMJ
- Muscular overuse: is the most common cause of TMJ. Overuse or jaw muscles that are in constant contraction including but not limited to clenching teeth, grinding teeth at night, or chewing gum.
- Poor posture: misaligned spine may cause the lower jaw to rest incorrectly and create a bad bite.
- Trauma: joint is damaged by a blow or other impact.
- Dental procedure/oral Surgery – dental procedure with an open mouth for an extended period of time can cause pain.
- Stress/Anxiety – stress can cause you to tighten facial and jaw muscles or clench the teeth
- Behavior patterns – repetitive behavior including chewing gum, biting lip, biting inside of cheek, biting nails, chewing on a pen, biting water bottle, playing musical instrument (trumpet, oboe, violin), clenching, leaning on chin, using laptop computer in bed and poor ergonomics has a big influence on how jaw functions.
Michael DelloRusso also shares that TMJ affects patients of all ages and different types of lifestyles. He says, “The problems are all different. I see young teenagers that experience stress from school with postural issues because they are on their phones all the time and in the classroom. I also see patients in their 70- 80s with arthritis in the joint. We customize a treatment plan for all conditions and see great results.”
Symptoms of TMJ Disorder
Signs and symptoms of TMJ may include:
- Jaw pain
- Neck or shoulder pain
- Pain when you chew, talk or yawn
- Popping or clicking sound when you open mouth or chew
- Grinding in the joint, also called crepitus
- Locking of the joint, making it difficult to open and close your mouth
- Pain in and around the ear or ringing in the ear
- Deviation or deflection of the jaw when the jaw goes to one side.
TMJ Treatment with a Physical Therapist
Physical Therapy is a very common treatment for TMJ and TMD. Physical therapists take a comprehensive approach to assess the problem and develop a treatment plan to decrease pain, assist in pain-free jaw opening, restore mobility in the joint and educate the patient on ways to maintain healthy function. Treatment includes:
- Manual Therapy: various techniques are used for muscles that are tight, stiff, or sensitive.
- Therapeutic Exercises: allows patient to practice proper jaw alignment and postural awareness while exercising, i.e., lat pull-downs, rows, shoulder extensions.
- Postural Instruction/Ergonomics: influences how the jaw rests, i.e., working at a computer, leaning forward can affect placement of jawbone.
- Oral Posture: referred to as the “TMJ resting mouth position” which positions the tongue, lips, and jaw in a particular way to manage teeth clenching and ensure optimal health.
- Application of heat: heat used on the jaw can relax muscles and decrease pain.
- Temporomandibular Joint Mobilizations: PT places thumb or finger in the mouth along your teeth to mobilize the jaw (with gloves, of course).
- Relaxation Exercises – tips to relax and heal painful jaw muscles.
Self-Care at Home for TMJ
Many people experiencing pain when they chew, or yawn can find some relief by trying a few simple things at home.
- Eat soft foods
- Eat smaller bites
- Heat on the face
- Visual and audio cues: put stickers on computer or set frequent reminders on your cell phone to practice the “TMJ resting mouth position”.
- Avoid resting your chin on your hand
- Practice relaxation techniques
- Improve posture
If you suspect you may be dealing with TMD or TMJ disorder, don’t wait. Find out how Professional Physical Therapy can play a role in your recovery. However, not all physical therapists have special training to screen and treat TMD and TMJ. Find a Professional Physical Therapy specialist in your area and schedule an appointment today.