The Temporomandibular joint (TMJ) joint connects the lower jaw (mandible) to the skull (temporal bone) in front of the ear. People can experience pain around the joint and this can greatly impact activities like chewing and yawning, and the ability to open the mouth fully.
The joint has a large cartilage disc inside it, and a blow to the jaw such a punch or knock playing sport can lead to jaw pain that lingers long after the incident.
Some people will experience TMJ pain from grinding their teeth, and this may also lead to headaches. In this instance, treatment might be seeing the dentist to organise a night splint to decrease the effect of the grinding.
For those who experience a locking sensation, or difficulty opening their mouth, and get mechanical pain from opening their mouth wide as in chewing, the McKenzie Method (also known as Mechanical Diagnosis & Therapy or MDT) may be able to provide a simple solution.
Mechanical Diagnosis and Therapy (MDT) is widely used for spinal problems, and more recently the principles and mechanical syndromes have been applied to extremity musculoskeletal problems such as the wrist, knee, shoulder and even jaw.
One of the most common classifications is derangement syndrome, which describes a presentation in which repeated movements causes a decrease in symptoms and a restoration of restricted range of movement. So, in the case of a person with jaw pain, repeated movements of the TMJ would be able to rapidly resolve the jaw pain and allow the jaw to open fully without pain.
A case study by Krogg and May (2012) described the application of repeated movements using MDT to a patient with a 7-year history of non-specific temporomandibular pain and reduced function, who had had lots of previous failed treatment. Examination using repeated movements resulted in a classification of derangement, and the patient rapidly responded in 4 treatment sessions, with an abolition of pain and full restoration of function, and remained improved after many years.
A useful analogy to describe how MDT can be used to fix a TMJ problem is to think of the disc inside the TMJ, like a hinge in a doorway. If the hinge is slightly misaligned (from a trauma like a blow to the jaw playing sport), opening and closing the door will stress the surrounding structures and cause creaking and grinding and the door will not open freely.
If you can move the hinge the right way to line it up again, the door will open freely and all stress on the surrounding structures will be relieved. So, the key is to find the specific movement of the jaw that lines it up again and restores the joint back into its normal position.
An excellent short video of this and how MDT works can be seen on the link below, where a real patient with an 8-week history of jaw problems is shown how to rapidly relieve his problem with simple direction specific exercises.
(Treatment of a chronic jaw problem using the McKenzie Method)
If you suffer from jaw pain it is worth getting an assessment by a McKenzie trained physiotherapist. It is usually about finding the right specific exercise that will unblock the joint, and get things back to normal.
Come and see our McKenzie Method Specialist Physiotherapist Joel Laing at Absolute Health & Performance in Melbourne’s CBD for a practical, efficient solution to your TMJ problem.
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References:
Krog, C. and May, S. (2012). Derangement of the temporomandibular joint; a case study using Mechanical Diagnosis and Therapy. Manual Therapy, 17(5), pp.483-486.
YouTube. (2016). Rapid Change in Jaw Pain: McKenzie Method Evaluation of TMJ. [online] Available at: https://youtu.be/QbbGGdDhUXI [Accessed 15 Dec. 2016].
