TMJ Exercises

In this video, Michael Eric Everson from Everson CE Education will go over TMJ exercises you can use in your practice to help with the pain. Several key muscles are discussed, along with how to relax them via stretching and other methods. Please note that this video is for educational purposes and does not replace professional medical advice.

Transcript

All right, So you've done your massage, You've developed a treatment plan, Whatever that may be for them, Once a week for a couple of weeks, Once every two weeks, Twice a week for a couple of weeks. I'll let you guys decide that, That's based on your intuition. One thing that I feel like is really important in the interim between those treatments is going to be doing self-care. Now, We all know that people are hesitant, They don't do self-care, Whether they're busy with kids, Family, Life, Whatever it may be. So I like to keep it pretty simple. If it's someone who's really hesitant and they're self-aware enough to know they won't do them, Then you can give them a really simple plan with just some heat, Maybe one or two exercises. But I would just level with them. Sometimes you gotta put the coach hat on as a massage therapist or manual therapist and say, Look, Just try this out one week. It's all you need. Once in the morning, Once at night, Five to 10 minutes. Just try it, And I guarantee that when they come in for their next treatment, Not only are they gonna feel better, But they're also gonna have more self-awareness of what's going on, Which helps you. They're going to build confidence by just doing it. And as we know, In this world to get success at anything or to manage pain in this instance, Consistency is key. So just get them to try it for a week and if they're feeling better, Try to keep them on that train because doing self-care is what's really gonna help with the pain management of TMJ issues in the long run. For now, I'm gonna show you guys a couple of exercises that I think work really well, And this is gonna depend on what the people present with, But these, In general, I think work quite well. The first thing I'd suggest for self-care, The easiest thing to do is going to be either heat or cold. Now, If someone is acute and they've got swelling, Cold could be a really nice vasoconstricting and also helping to decrease some of that inflammation, Having an analgesic effect. It's going to make them feel better. If someone is acute and they have really tense, Tight muscles in the neck, In the jaw then heat will be a really nice thing they can do it's super simple this is the most basic thing and they can put it on for a couple minutes they can also do contrast therapy where they do hot and cold And for this, There's a lot of different opinions on it, But you can start cold, Go hot, And usually one to three. So 20 seconds of cold, A minute of hot. And they could do it however they want. But if they are more acute, I would start and end with cold. And if they're more chronic, Then I would start and end with heat. And they can use this also as the precursor to doing the other exercises in this video. The first stretch that's really nice, Especially if someone is presenting with neck tension that may be causing the jaw pain, Is going to be to stretch the upper traps. If they have a head forward posture, You can get them to bring their chin in slightly and then you can stretch at three different angles. So first to get the posterior fibers, You can get them to rotate their head. And bring their nose in towards their armpit. This gets the posterior fibers of the upper traps. They can do this on both sides. Sides. To get the middle fibers, You can get them to reach their hand over their head. And then just stretch out the middle. Fibers of the upper traps. And once again, Do this on both sides and you can hold it for about 30 seconds. To get the more interior fibers. Bring their head back slightly. And then. To the side and that will get more of the anterior fibers and some of the anterior neck muscles. That's a really nice one for the upper traps. There's also one called the occipital lift where you take the heels of your hands. And you place them just beneath the occiput on both sides, Kind of covering the whole area of the occiput. With them relaxed with the heels of the hands in place. You just go from side to side. Lifting on one side and so lifting and kind of twisting like this. This is a really nice one for headaches and I find clients really enjoy this one and it's kind of a dynamic stretch. Lifting the occiput so it's good for stretching the suboccipitals and the upper traps. Up and just try to remain relaxed. Mine are pretty tight as you guys can notice. And you just go back and forth. People really like this one. It's a little less boring to be dynamic than do those more static stretches. And they can be quite useful. And you're making sure when you're going from side to side that you're lifting the occiput just gently, But a little bit just to encourage a little bit of movement in the joints and a little bit of traction in the upper back. Cervical spine. Whew, That felt good. If you suspect with your client there's some sort of relationship between the ear and the jaw, Then doing an SCM, Sternocleidomastoid stretch, Is going to be really helpful and probably very useful. Now, If they also have an anterior head carriage, This muscle can get really compressed. So stretching it out feels amazing and it'll help to encourage the neck back a bit, Which will encourage C1 to C3 to just ease off a little bit, Which is going to help with jaw pain. So how do you do this stretch? You make sure they bring their head back. And then, So they are a little bit retrusion to the jaw, Especially if they have a head forward posture. And then they can rotate to the side. And then once you've rotated as much as you can 90 degrees looking over your shoulder, You can gently encourage the head back. Maybe you guys can see this on me. And this stretches out all these muscles which helps to bring that head forward carriage a little bit. Back and to ease off those neck muscles. Now you can do this on both sides. So once again, Rotate the head 90 degrees. You're looking over the shoulder and then encourage your head back. Slightly stretching out the sternocleidomastoid and anterior neck. Muscles. They could hold this for about 90 seconds. They can even do it with a muscle energy technique so you can get them to gently using 20% pressure. For about 10 seconds, Press into their hand. And relax. And then back. Into the stretch for 30 seconds. You could tell them to do that three times. That's more of a dynamic stretch and in all honesty will probably work a bit better than just the static stretch. If you suspect that they're using their suboccipital muscles a little bit too much especially during swallowing like we show during the assessment, A really nice thing to do is just some simple self-massage on the suboccipitals coupled with a little bit of active movement. Okay, So let's say head forward posture. You can get them to bring their chin in towards their chest. Just gently and slowly. And that encourages a stretch in the suboccipital muscles in the back. So if they're compressed forward like this. When we bring it back, They stretch and then once your chin is forward, They eat. Longate. What they can also do is take your thumbs and place them on the back on your ox butt, So. This. And then. So once your thumbs are on. . . Here's suboccipital muscles. Or your fingertips, Whatever feels comfortable for the client. You can get them to kind of shorten the muscle. And you could teach this to them. Shorten the muscle. And then bring chin in towards the chest and as they're doing that, Stretching down and self-massage. Down that muscle and they can go back and forth. Once they're in the elongated. Fully stretched position just to help elongate those muscles even more. And decrease the compression on the cervical spine, Especially C1, C2, And C3. Now they can shorten the muscle again. And then you can get them to bring their chin towards their chest. And as they do that, Just do a little bit of self massage. As they're moving through. The movement just all in the name of decompressing the suboccipital muscles. This is a really nice static stretch. Just bringing the chin in and stretching. Stretching those suboccipital muscles. But it's also nice to as a self-massage to just help elongate and decompress those muscles. We've talked about it, You guys know the importance of the master. If you found trigger points in their master or you suspect that it's part of their TMJ problem, Doing some self-massage there, It's gonna be really nice. It's a pretty easy one to find, Just tell them to clench their jaw. You can even show this to them before they leave your massage clinic or manual therapy clinic. Clench the jaw, They can feel the muscle. And then. You can just do this himself. Massage in that area. Now before they do this self-massage on this area, Some heat can be really nice to just help warm up the tissue before you go on and work on it. And you can tell them, Hey, If you find a trigger point, There's some referral pain into the joint or somewhere on your face or teeth. That after they've held it for about. 60 to 90 seconds or the pain dissipates. Then place a little bit of heat on for about a minute. Take the heat off and then they can do a dynamic stretching massage technique. And that's really going to help to decrease that jaw tension, Especially in the master, Which is, As we all know from taking this course, The master plays a big role in TMJ pain. The temporalis is another muscle they can target with self-massage. Now, There's the anterior, Middle, Posterior portions, So make sure to tell them about how it's a fan-shaped muscle. You can bring them to your phone or a computer and show them how the muscle is situated, Especially if you feel like the temporalis is one that is causing or is a part of the problem with their TMJ pain. Simple once again here. Just some nice self-massage. You can get them to clench their jaw. So they can feel where the muscle is and follow it as they're clenching. And then just some nice self-massage back and forth. Along this muscle and if they feel like there's a trigger point, Once again tell them to hold it there for however long it takes for the pain to dissipate. They don't have to put a crazy amount of pressure, But as long as it feels like it's getting better. And just like the master, They can place some heat on for a minute. Take it off and then the dynamic massage afterwards with the mouth opening and closing as they're working through the fibers of the temporalis. All the way along the fan from the interior to the back. Middle to the posterior. So all the exercises that I've shown you guys so far, The decreasing the forward head posture, The working on the upper traps, The SCM, Suboccipitals, Master, Temporalis, Those are ones that are really nice and they're usually not going to aggravate anything. These jaw exercises, Mouth opening, Mouth side to side exercises can sometimes aggravate the pain a bit, But if you really feel like they have a tracking issue or their joint is really stuck, Then these are some nice exercises that they can also do. Now let's assume they have pain on their left side. You can place your finger on the left side and do a mouth opening exercise where you Place two fingertips on your chin. Bring your chin back slightly, Especially if you have a head forward posture. Stand up straight. And then. . . You can do some mouth openings. As they have their fingertip on the jaw. Make sure your posture is good and then they can just encourage a little opening. If they have a lack of opening, This will be nice for stretching things out, Stretching out the joint capsule. So that's a nice one for mouth opening. Side to side, If you feel like they have a deviation to one side or the other. You can get them to move. Side to side And if they feel like moving one way is a little more tense, They can. . . Hold there for a little bit. And just do a little bit of a stretch. You can even work down the masseter on the side that feels a little more tense and hopefully that will help even out if they have any deviations. When it comes to working on the pterygoids, That's something that I like to do in clinic. It's usually going to be an intraoral thing, So. That's one that clients, You know, Teaching them to go inside their mouth and do it, They're a little more hesitant. So I tend to do that just in my treatments when they come in. We can't ignore the fact that what may be contributing to DMJ pain is just general stress. It may not be the sole thing that's causing the pain, But it could be a part of it. So simple breath exercises, Especially at the end of the day, That will help with sleep and decreasing that sympathetic nervous system are going to be very helpful. This can be really simple for any of you guys have done yoga, Deep breath in through the nose, And sigh it out through the mouth. Deep breath in through the nose, Slowly lifting the stomach, The chest, The throat. And saw it out. Once they've done a couple of those, Which are really stress relieving, Some deep breaths in through the nose. And out through the nose. Slow and steady, They can lie down, Put some nice calming music on. And just do some breath work. There's tons of tutorials on YouTube. That show you how to do this and it's something that is really nice for just decreasing the sympathetic nervous system decreasing some of that stress some people could just be there go go go go and they have a really hectic lifestyle with work and kids and family whatever it may be there could be some sort of stressor like. Some sort of family occurrence, Death in the family, Who knows what it may be, But just reconnecting with their breath. Is going to slow them down. And it's going to bring them back, Ground them a bit, And hopefully that will help decrease at least some of the psychological stress and some of the things that can play a role in increasing tension in the body.