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Osteopathy & the Jaw

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How much do you enjoy having a cheese platter? I am not sure it’s worth me even answering that question. What about, how much do you love singing in the shower? Imagine if these simple activities became difficult. Normal behaviours of your jaw involve talking, eating and yawning. So, when this joint is not functioning, it can have a significant impact on your daily life.  Dysfunction of the jaw occurs in 25% of the population, slightly more so in women and usually in people between the ages of 20-50 years old.

Anatomically your jaw is referred to as your TMJ or temporomandibular joint.

All pathologies of the TMJ are now termed Temporomandibular Dysfunction (TMD).

What are the symptoms of TMD?
Looks- like limited mouth opening
Sounds- are clicking, popping, catching or locking
Feel- pain when chewing, ache over head, neck and/or ear region

How can an Osteopath help?

The results of manual therapy trials for jaw pain suggest that manual therapy is a viable and useful approach in the management of Temporomandibular dysfunction/TMD. Manual therapy has also been shown to be more cost-effective, and less prone to side effects than dental treatment. (Kalamir, et al., 2007)

There is a link between your neck (cervical spine) and your TMJ. As you open your mouth, your neck extends backward. When you close your mouth, your neck bends forward into flexion. Your osteopath will assess your neck prior to treating your TMJ, as stiffness or restriction in this area can promote pain/TMD.

The treatment and management of TMD involve a multidisciplinary approach, and you will find your practitioner working closely with your dentist. If your pain wakes you at night or intensifies upon drinking hot or cold beverages than your osteopath is likely to refer you to your dental practitioner. In addition, if the pain is throbbing in nature the cause may be related to the tooth and will need further dental management.

Humans move the TMJ 1,500-2000 times daily, which means it is one of the most used joints in the body. Limits in range of motion can be caused by several factors including; muscle overuse, external injury, emotional stress and misalignment of the teeth. Osteopaths tend to work through all the muscles surrounding the jaw as well as others that could contribute to tightness in the area. When necessary we can also treat the joint and muscles from inside your mouth to help reduce compression of the jaw.

Complimentary to dental or osteopathic management relaxation and exercise strategies can play a huge role in managing your pain. I have listed a few useful approaches.

1.    Download the app Calm
This helps you to learn the skill of meditation and listen to sleep stories to help you fall asleep. Decreasing stress levels may help reduce any clenching or grinding that you may be doing

2.    ‘Clucking’
This sound is created by pressing the tongue against the roof of your mouth. This is used to help to breathe. You can try to then maintain this position during normal activity.

3.    ‘The surprised look’
Keeping the tongue on the roof of your mouth slowly open your mouth. You can place some slight overpressure with your hands on the sides of your jaw to create a small downward stretch. Ensure not to push into pain.
Hold for 10-15 seconds, repeat 3-5 times.

4.    Masseter massage
Place the fingers of your hands on your cheeks and gently clench. You should feel some muscles pop up into your fingers. Relax your jaw. Then using your finger pads gently massage these muscles in a circular motion. If you find any tender spots you can hold some extra pressure down to wait for a small release.
About 30seconds - 1minute in total.

You can discuss these and further techniques with your practitioner.

Remember that TMD is a common problem that can be treated and managed just like any other musculoskeletal complaint. There is not one method that suits all approach, which is why it is important to seek support from your local practitioner.

Written by Melissa Arnts who is a practicing Osteopath at Without Limits Health.

Bibliography
Management and Treatment of Temporomandibular Disorders: A Clinical Perspective [Journal] / auth. Wright Edward and North Sarah // Journal of Manual & Manipulative Therapy. - [s.l.] : Taylor and Francis, 2009. - 4 : Vol. 17. - pp. 247-254.
Manual therapy for Temporomandibular Disorders: A review of the literature [Journal] / auth. Kalamir Allan [et al.] // Journal of Bodywork and Movement Therapies. - [s.l.] : Elsevier, July 19, 2007. - 1 : Vol. 11. - pp. 84-90.
Temporomandibular disorders [Book Section] / auth. Okeson Jeffrey // Conn's Current Therapy 2018 / book auth. Kellerman Rick and Bope Edward. - [s.l.] : Elsevier, 2017. - Vol. 1.
Temporomandibular dysfunction [Online] / auth. Clinical Edge // clinicaledge.co. - September 21, 2016. - January 22, 2018. - https://www.clinicaledge.co/blog/webinar-temporomandibular-dysfunction-with-dr-stephen-shaffer.
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