TJM (Jaw) Pain and how we can help

Are you experiencing clenching, grinding, painful chewing, headaches or neck tension? TMJ Physio might be for you! Read below to learn about Sarah Graham’s journey to becoming a passionate, TMJ focused physiotherapist in Calgary and how she might be able to help you feel better QUICKLY!

As a second-year physio student on a 6-week clinical rotation, I was lucky enough to be placed with a physiotherapist who treated TMJ dysfunction. I distinctly remember putting my gloved hand along the patient’s lower molars and doing my first TMJ mobilization to help the joint move properly. I really hoped I was doing it properly since I had only ever done it on classmates during physio school. The improvement was immediate, and I was so relieved to have been able to help the client manage their incessant jaw pain and lack of mobility. I followed this with education for the patient about muscle release and at-home exercises with the guidance of my mentor, and thought to myself, “I think I like this TMJ physio stuff”.

Can I tell you what my favourite part of treating the TMJ as a physio is? The quick response to treatment and the improvement a lot of folks have within a single session. Often people only need one or two sessions to see huge improvements in pain, mouth opening, headache management, and/or neck tension. This doesn’t happen with all patients, but for those who feel almost immediate improvement, after years of discomfort, it feels like a miracle. Getting emails from clients saying they can eat a hot dog, or chew a steak without pain for the first time in years, or haven't had a headache since our last session, is so gratifying. Some clients are on a surgical waitlist and try physio in the interim to help manage symptoms and end up not needing the surgery. It’s amazing to me how much can be accomplished by the safe, conservative treatment that is physiotherapy for jaw issues. I just wish more people knew it was an option before considering more invasive procedures.

You might be wondering what sets me aside from every other physio when it comes to treating TMJ dysfunction. All physios are technically able to treat TMJ, which is why you see it on every physio website, and I would say many are not comfortable putting their hand in people’s mouths, which is very important to treat certain dysfunction of the jaw. Unless a physio has lots of experience treating TMJ or has further training in that area, you might not be getting the specialized care that you should be - this is what I wanted to avoid. Nobody wants their GP to do their heart surgery right? I knew there was so much more to learn about how to best treat the jaw, so I took it upon myself to learn more. I took a TMJ course taught by two reputable FCAMPT-certified physios (this is a very prestigious certification in the physio world) with extensive experience and post-graduate education, and it absolutely changed how I treat the jaw. Learning the tricks of the trade from truly knowledgeable and experienced professionals was exactly what I was looking for, and so I was certified by SMART PT in Upper Neck and TMJ Management. This is a great certification to look for when trying to find a TMJ-focused physio for yourself.

Did you know the neck is also closely related to TMJ issues? As a structure adjacent to the jaw, there are a lot of muscles and connective tissues that cross between the jaw, mouth, head and neck. One frequent offender is the upper fibres of the trapezius muscle (UFT), which runs from the shoulder blades and collarbone and attaches to the bone right behind the ear. Another very important muscle group are the suboccipitals, which sit right at the base of the skull and can refer directly to the TMJ area, which is commonly very tight, especially in those with a head-forward posture and can lead to headaches or even dizziness.

Did you know that your TMJ or neck tension issues might be a big contributor to recurring headaches? There is a phenomenon known as “referral patterns” for pain, where every muscle has its own pattern. Basically, muscle pain can be felt elsewhere in the body; for example, when people have a heart attack, they don’t feel pain in the heart but often can feel pain in the left arm - this is part of the referred pain pattern for the heart. There are many muscles involved in jaw and neck movements that can refer pain to the head. Sometimes, these muscles can also trigger migraines, which can also be improved with TMJ treatments. A sign this could be happening is that you tend to have worse headaches when you are more stressed than usual or with increased upper body muscle tension, as stress and clenching often go hand in hand.

Many people are clenchers, including yours truly. Some folks are nighttime clenchers only, and others clench their teeth unconsciously during the day, often both! If this is you, here is some information that can help slowly get you out of this habit - I’m going to teach you the proper resting posture for your mouth/jaw. Here it is: Teeth apart, lips together, tongue resting on the roof of your mouth. I once had a dental hygienist tell me that your teeth should not be touching unless you are eating. Clenching when stressed or focused is something I still catch myself doing, so don’t feel bad if you can’t change this habit; it’s a tough one to break, but just keep at it and if you need more guidance or treatment for your jaw, neck or headaches, I’d love to see you in the clinic.