Definition of Tmj
Disorder with the muscles of mastication
Where is the mandible
The mandible hangs in a ligament and muscular sling that is influenced by the position of the head, neck and rest of body.
The position of your body directly effects this
Contributing factors
- what is the difference between intrinsic extrinsic
Intrinsic- Genetic development of muscles,lig, and bone
( what your born with )
Extrinsic- trauma (to head and neck)
Contributing factors
- tissue alteration
Tooth loss
Cranial bone misalignment
Hyper mobility of joints
Contributing factors
- stress
Increase tone in jaw
Clenching
Bruxism (grinding)
Gum chewers
Contraindications of TMJ
Don’t compress carotid artery
Unilateral work only (one side at a time)
Avoid deep work over styloid process
Do not compress the joint superiorly
History questions for TMJ
- Dental work, grinding, trauma, whiplash, location & type of pain
- where is the pain
- does the pain get worse, protraction/retraction, opens/closes, chewing, swallowing
- are their popping, clicking noises
- has the jaw ever locked
- headaches
- are they a mouth breather
- do they smoke
- what are activities of daily living
Observations and palpations
- full postural assessment
- palpate muscles of mastication
- active rom to the mandible
- depression/elevation
- lateral deviation
- protraction/retraction
Observations
-a C wobble indicates
A C wobble indicates a capsular source on the Side the jaw deviates towards
Observations
- an S wobble indicatesn
An S wobble indicates a muscular source such as trigger points
Treatment plan for TMJ
-decrease sympathetic nerve firing w/ rocking, shaking, effleurage
-work muscles of mastication and expression
-work on postural imbalances
-ischemic compressions (don’t push superiorly)
-attachment work on hyoids with scooping and striping (work whole muscle)
-muscle rolling on scm (picking up and rolling muscle)
-
