Top Five Fun Facts About The TMJ

That pesky jaw joint (better known as the temporomandibular joint or TMJ).

So many of us - 35%! - have issues with it yet only 5-10% of us actually seek treatment. Temporomandibular joint dysfunction (TMD for short) tends to hit in people ages 20-40, affecting women more than men.

Despite TMD being so common, not many people know what it is or what to do about it. Here are the top 5 things I want you to understand about the temporomandibular joint and dysfunction:

Top Five Fun Facts About TMJ/D

1. The TMJ moves out of its socket and has a disc

Closed jaw

Open jaw

The TMJ is not your average joint! When you open your mouth fully, the first half of that movement is the jaw rotating in the socket. In the second half, the jaw bone comes out of the joint and moves forward.

The disc is a little piece of tissue that sits on top of the condyle like a hat. It helps the jaw slide nicely out of the socket, holding the jaw in place when the mouth is fully open and returning it to its closed position. Thanks, little disc!

To feel the movement of your jaw, place your hands flat on your cheeks, just in front of your ears. Slowly open your jaw and feel the condyle pop forward into your hand about halfway through opening.

2. Discs can slip forward and that’s okay!

One of the most common causes of TMD is the disc can be displaced anteriorly - in other words, the disc can slip forward in the joint. This may result in clicking or locking of the jaw or it may not - in fact, 9-31% of people moving about their lives have an anteriorly displaced disc and absolutely no symptoms!

The biggest thing to remember with disc displacements is that discs remodel and heal. If you have a symptomatic disc issue, the name of the game is to lessen the irritation of the tissues for a little while to allow the disc to remodel and the TMJ to heal. We do that through manual therapy and specific exercises.

3. Sounds are totally fine, as long as they aren’t painful

Most jaw sounds are related to the discs and if it doesn’t hurt, don’t worry about it. Popping, clicking and snapping are all common sounds in people with no TMJ-related pain.

These sounds are also not predictive of more problems down the road, so ignore them as best you can. It’s hard - the jaw is right beside your ear and the noises can be LOUD! Be armed with the knowledge that these sounds typically decrease over time and everything will be just fine.

4. Your jaw has a resting position and you should be in it most of the time

Check in with your jaw right now - are your teeth together? Are your jaw muscles clenched, tensed or relaxed? Where is your tongue - is it flopped against your bottom teeth or resting on your palate?

Your jaw should be at rest most of the time. In fact, your teeth should only be in contact for 8-15 minutes per day!

Here’s what you need to look for in a resting jaw:

• Teeth slightly apart - your teeth shouldn’t be touching anywhere and be about 1mm apart

• Tongue against the roof of your mouth - your tongue should be resting comfortably against your palate. It should be a few millimetres away from your teeth at the front.

• Relaxed muscles - the chewing muscles in your cheek and on the sides of your skull should be nice and relaxed.

This resting posture is also heavily dependent on good posture throughout your whole body. For tips on this, visit our previous blog posts on posture Your Head Is A Bowling Ball & Ergonomics: The At Home Edition.

5. All those chewing habits can lead to TMD

We’re talking clenching, nail biting, cheek biting, lip pursing… all those mindless mouth habits so many of us are guilty of doing on a daily basis. All that added muscle activation can lead to overuse of the jaw muscles, causing anything from headaches, pain in and around the face and ear, tooth pain and tinnitus.

Since 45% of TMD is muscular in origin, it’s really important to identify and stop these habits. Changing these habits, like all habits, is really hard to do but it can mean the difference between pain and being pain-free.

If you are dealing with TMD, book with one of our therapists with advanced training in TMD. Book online, through email or call us at (778) 630-8800.

Questions I Get Asked the Most as an RMT (Registered Massage Therapist)

Our fabulous RMT Gabrielle De Winter joined us in January of this year. An instructor at the West Coast College of Massage Therapy, she has pursued further training in jaw pain, also known as temporomandibular joint dysfunction. In this short question and answer blog, Gabrielle answers the questions she most frequently gets as an RMT.

Gabrielle’s Most Frequently Asked Questions 

Do you get free massages? 

Only from my husband! Most RMTs are independent contractors that don’t have built in extended medical benefits through their union (in fact we don’t have a union) or through their workplace. Some RMTs will work out exchanges with other RMTs they know. Mostly, we will need to book in with a practitioner to get a massage, just like everyone else. 

Do your hands get sore? 

Sometimes! But if you’re in an appointment with me as your therapist, I’m more concerned about how your body is feeling and not thinking of my own. 

Can massage help migraines and headaches?

 Yes! Tension headaches are typically muscular in origin and respond well to massage. I have a particular interest in treating tension headaches with massage. I did a study in school where we found tension-like headaches can be reduced significantly with massage.

Migraine headaches are a little trickier - sometimes massage can help calm down the nervous system. Migraines are usually multi-faceted and if you haven’t tried massage, it may be worth a go.

If you come in for massage related to headaches, I’ll ask you a lot of questions around your activities, if you’ve seen your dentist or optometrist lately, if you have balance issues… From there, we will figure out the best course of action with massage therapy.

Is massage painful?

 It doesn’t have to be! I want to work within your comfort level and what’s safe and effective.

What if I fall asleep and snore?

If I notice that you’re falling asleep, I’ll ask if you’re okay with me working on you while you’re asleep. If that’s fine, great! If not, I’ll make sure you stay awake while I’m working on you.

But this happens all the time! We are engaging with the autonomic system and if the goal is relaxation, people definitely sometimes fall asleep.

Is it okay to ask for more or less pressure?

Absolutely! We will discuss this on our first visit - what kind of pressure you’re comfortable with. While we are in the treatment, if you decide the pressure level needs to change, we can adjust as we go.

Are my muscles tight? 

Muscles can be “tight” but we can use better words to help us better describe what is happening. What feels “tight” is often a muscle which has been shortened, lengthened, or aggravated. 

What most patients think of as “tight” is a shortened muscle. Muscles cross joint(s) that they act on which as a result can limit their range of motion if they are shorter than usual. In order for me to see if a muscle is short, I would perform a muscle length test, which involves bringing the insertions points of a muscle away from each other so I can see if a shortened muscle is decreasing a joint(s) range or movement. 

Muscles could also be felt as “tight” if they are in a lengthened position. Much like a rubber band stretched out. This happens often to desk workers who sit for long periods of times with their shoulders rotated forward. In order for their shoulders to be forward, the muscles that bring the shoulders back will lengthen to allow that opposite position of the shoulder blades to happen. Some of the muscles between the shoulder blades, namely the rhomboids and the middle fibres of trapezius in this desk worker scenario tend to become lengthened and weak overtime. 

Muscles can be aggravated or carry extra tone for a number of reasons. Common reasons are injury, overuse or poor posture. When a muscle gets aggravated, it may react by feeling tight, stiff, or sore. A few ways to avoid having constantly aggravated muscles include regular stretching, strength training, and of course a massage with your favourite RMT. 

Are you looking for a massage? You can book with Gabrielle online, by emailing us or giving us a call at (778) 630-8800.