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TMD/TMJ – Let’s Jaw about Jaws

You might not give much thought to your jaw until you have a problem with it.

But let’s think for a moment about what a remarkable structure it is.

 

When talking about the jaw we mean the bones, joints and soft tissues that form it. The main bone is the mandible which is also known as your jaw bone. It moves thanks to your two jaw joints which are on either side. They are called the temporomandibular joints or TMJ for short. They are sliding hinge joints, which means they can move in several directions to help you chew many different types of food. The main muscles of chewing are the masseters, which you can find on either side of your face. Try placing your hands flat on your cheeks and clench your jaw. You’ll feel your masseters immediately tighten up – in fact, for their size, they are the strongest muscles in the body.

The strength of your masseters is very helpful when chewing on tough foods, but not so great when things go wrong. As anyone who has experienced jaw problems knows, there are lots of strange and seemingly unrelated symptoms that can be traced back to tension in your jaw. These are categorised as Temporomandibular Joint Disorders (TMD) or just TMJ for short.

Symptoms of TMD/TMJ

Symptoms can include pain, discomfort and tenderness in the jaw joints and the face; clicking, grinding or popping noises in the jaw when opening or closing the mouth; jaw locking when open, or inability to open the mouth fully; headaches and neckache; vertigo – dizziness; tinnitus – ringing, buzzing or fullness in the ears; ear pain; poor sleep. 

Sometimes the causes of TMD/TMJ are clear. Damage to the jaw joints due to injury or a degenerative condition such as osteo-arthritis can cause the joints to become misaligned and worn.

Bruxism is long-term tooth grinding or clenching and this can be another major cause of jaw problems as well as damaging teeth. Many people suffer from bruxism at night when they are asleep and therefore have no control over what their jaw is doing. People with bruxism are often given a night splint or tooth guard to help protect their teeth from further damage. In many cases they grind their way through a succession of splints over time. But although bruxism is a well-known cause of TMD/TMJ, the cause of the bruxism is not as clear.

 

A myofascial perspective on TMD/TMJ

When considered from a myofascial perspective, TMD/TMJ is not just a mechanical problem with the position of the jaw joints. The muscles of the jaw, face and neck all attach into points on the skull which are close together. Fascia surrounds and connects all of these structures on many levels – the muscles are encased in and defined by fascia, the ligaments that form the structure of the jaw joints are also formed from fascia, and even the bones of the jaw and skull have fascial connections that are continuous with the soft tissues connected to them.

Fascia can therefore often be a main culprit in otherwise unexplained TMD/TMJ. In its natural state, fascia is a free moving and fluid tissue. However sustained pressure, repetitive movements and, in particular, stress can cause fascia to change consistency as it tightens and the fluid is squeezed out. This creates fascial restrictions or trigger points which lead to the development of all of the common symptoms of TMD/TMJ.

Consider for example what happens when you go to the dentist for any major dental work – an extraction, filling, or crown. You are required to keep your mouth open for prolonged periods of time while various pressures are applied to your teeth and jaw. This in itself can cause tightening in the fascia and muscles supporting the jaw, and many people can trace the start of their TMD/TMJ back to dental work.

Similarly, consider a stressful period of work, probably at a computer, where you are working to deadlines. Stress is a major cause of TMD/TMJ as your mind and body often can’t just switch off when you stop working and go to sleep. Bruxism is often due to tight fascia which in turn keeps your masseter muscles tight. At night they try to release themselves but are stuck in a tight corset of fascia. it is their attempts to get free that cause the tooth grinding and clenching that leads to TMD/TMJ.

The causes of TMD/TMJ may be directly in your jaw, but they can also come from associated fascial structures in your face, neck and shoulders, which accounts for some of the less obvious symptoms such as headaches and tinnitus.

How to help relieve TMD/TMJ symptoms

Working with a trained myofascial therapist and/or self-help myofascial exercises can help to release the restrictions that are causing your symptoms and return your jaw to more normal pain-free balance. There are many simple self-help exercises that can release your jaw, neck and shoulders and, if used regularly, can help to counteract stressful periods in your life and prevent restrictions and symptoms from building up.

Find out about some simple self-help myofascial exercises to try in our video:

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