TMJ Is Such A Pain!!!

There are few educational courses you can sink your teeth into… Puns aside, last Tuesday I took a one-day course on an area of massage I am immensely interested in: the TMJ.

The TMJ, also known as the temporomandibular joint, is, at its simplest, the jaw. Made up of the mandibular fossa of the temporal bone and the condylar process of the mandiblei, the TMJ is a very important joint but like all joints, is susceptible to both normal wear and tear and repetitive strain. Either of these can lead to dysfunctionii and this also can mean pain to surrounding bones and muscles.

Profile image of TMJ bone structuresiii

When we think of jaw pain, one group that often springs to mind are those who have had or are going in for dental work. When we get braces put on or taken off, fix that root canal, book in for implants or extraction surgery, or even just go for a cleaning, we ask a lot from our jaws – keep the mouth wide, keep the head and neck as still as possible, keep that tongue out of the way, and of course, remember to keep breathing.

Other groups whose jaws are similarly at risk from overuse, misuse, or even abuseiv might include actors, singers, mouth-instrument players, athletes who wear mouth guards, nightly-teeth grinders, and people involved in motor vehicle accidents. This is because, like their dental counterparts, these people continually put emphasis on specific jaw movement and/or are dealing with jaw recovery.

Now back to pain. Pain is a very subjective concept so I will not try to define it here but what I can review is how pain might present itself in someone experiencing TMJD:

  • Limitation in opening the jaw
  • Limitation in closing the jaw
  • Headaches (frontal, temporal, occipital)
  • Tenderness on the muscles surrounding or on the joint itself
  • Ear ache
  • Teeth sensitivity
  • Postural issues (how a person ‘carries’ themselves when sitting and standing)
  • Trigger pointsv
  • Clicking, popping or other noises when opening/closing the jaw
  • (to a lesser extent) Ringing in ears

So if this is sounding somewhat familiar, what should you do?

Book in for an assessment and treatment, of course!

What can you expect at your first visit?

  1. The first time we meet, I will review your online health history intake form (whether you are a returning or new client).
  2. Then I will take 10-15 minutes to do a specific TMJ assessment. I have many tools to use such as asking you questions, taking measurements of your jaw, palpating (specific, external touch) around the muscles and bones affected, performing a test for jaw function, etc.
  3. If I believe there is a possible dysfunction in the TMJ, a 45-minute treatment will follow.
    • Although the components of the treatment can vary, it usually starts with the massaging of external areas like the pecs, shoulders, neck, cheeks and jaw. This is because these areas, often postural in nature, can have a huge influence on our jaw’s position. Like a typical massage, this “pre-work” is used to warm up but also assess the tissues and structures involved.
    • After the external components have been massaged, I will use a gloved hand (latex free!) to work inside the mouth. Please note that before any work is done inside the mouth, we will discuss hand gestures so that you may stop treatment at any time, ask questions, give feedback, etc. Once inside the mouth, I will work on the main muscles that affect jaw dysfunction: the masseter, temporalis, and pterygoids. I don’t expect you to know what each of these do but I will explain why I am working on each one when in treatment.
    • Again, as with any type of massage you receive from Inglewood Massage, our aim is always to keep you comfortable, confident and informed.
  4. After the treatment, you can expect some homecare. If you have any questions, please do not hesitate to ask at the treatment or email/call later.

Follow-up appointments will depend on the severity of the issue(s) found but you should expect that jaw work, like most treatments, relies partly on the therapist and partly on the client. I will do everything to make/keep you educated and empowered in your health journey.

And, as I learn more about assessing and treating TMJD and take further classes to become fully certifiedvi (please note, I can still work on you without this!), I am excited to add this new modality to our roster of services!

Yours in Health,

Carly Turner, RMT

i 2019 Mara Boaru for Seminars for Health

ii When someone says TMJD, they are referring to temporomandibular joint dysfunction

iii Creator: PJS – Information extracted from IPTC Photo Metadata. Viewed Google image on March 4, 2019. https://www.health.harvard.edu/oral-health/temporomandibular-joint-dysfunction

iv It isn’t to say that misuse is always conscious. Instead, I am suggesting that when we are in pain doing an action or using our body in a certain way/position, we often create new habits that decrease the pain/discomfort and that becomes our new “normal”. However, misuse can also lead to abuse and by ‘abuse’ I mean when we are conscious of our actions when we know better.

v “a localized usually tender or painful area of the body and especially of a muscle that when stimulated gives rise to pain elsewhere in the body” – as defined by Merriam-Webster.com.

vi Carly completed the Seminars for Health one-day course called TMJ Level 1 – Intraoral. She plans to take Level 2 in November 2019 and become fully certified.

Let’s Talk…

Today is the day that Bell does their #LetsTalk campaign, encouraging talking about, and reducing the stigma of mental health issues. This is a fantastic goal, and one that we have needed for a very long time, to break the silence surrounding mental health issues, but, I feel that we need to take this to the next level, and do more than just talk.

We are now at a point in time where most people have at least heard the message about mental health. We are generally aware that it affects many, many people, in all walks of life, that it affects not only the person, but their families, work environment, and so on. Celebrities such as Selena Gomez and Lady Gaga are actively open about their battles with mental health issues. Larger companies are putting more money into providing mental health supports, such as Telus, who has recently provided $5,000 per employee per year towards mental health treatment as part of their benefits package. We are talking the talk. But, can we walk the walk?

I think we need to take a deeper look into why so many of us have issues with anxiety, depression, and addictions. What is it about our lives that have so many in such desperate need? I think a big part of that is, many of us are under enormous pressure to “succeed”, and yet, we have such a narrow view on what “success” is. North Americans work some of the longest hours, with the fewest days off, of most of the industrialized nations, yet, we not only feel guilty for actually taking our legitimate vacation and sick days, but we sometimes even brag about how long it’s been since we last had a day off! We compensate for our lack of time with our children by keeping them over-busy with sports, clubs, and other after-school activities, and organize elaborate, expensive birthday parties and gifts. We feel compelled to buy the latest gadget, phone, vehicle, and fashions – even if we can’t afford it, it’s the mark of “success”! In the meantime, we struggle with fitting all this busy-ness into our lives, with long hours at work (or sometimes 2 or even 3 different jobs!), often trying to do the workload of 2 or 3 people due to cut-backs, then struggling to keep the house clean, and, who has time to cook properly now?, so we get take-out or frozen food and feel guilty that we didn’t find time for that yoga class, or to prep food for the following week… And we wonder why anxiety and depression is affecting so many of us, and that’s not even taking into account the many people who don’t have neuro-typical brains, who have learning differences, or chronic health issues, or who just can’t handle sitting at a desk for 8 (or 9 or 10) hours a day.

It’s time for a change. Now, change is going to be more difficult for those who are barely struggling to get by. That’s why it’s up to ALL of us. We need to start by making those little changes, that we can. We need to start by being KIND and FORGIVING to one another. That includes, especially, online. It’s so easy to make snarky comments on Facebook and Twitter. To point out how “ridiculous” someone is being. To start name-calling and hate-bombing. If you don’t agree with someone, you are absolutely entitled to your opinion. State your opinion with grace, and provide back-up information. Be respectful, even if you disagree. But, don’t start bashing someone and calling them names just because they hold a different opinion from you! And, if you see online bullying, stand up for the receiver, even if you don’t agree with their position, NO-ONE deserves to be bullied! And, kindness does not mean that we allow people to walk all over us.

We need to start encouraging NORMAL, POSITIVE TOUCH (with consent!) to casual friends. Ranging from a hand on the shoulder, to a hug in greeting, to whatever it looks like for you, but NOT including aggressive, possessive, non-consensual, invasive touch! When in doubt, ask if it’s ok, and be totally fine if the person says no, even if they received a hug from you in the past. Human beings need human touch in order to survive and thrive. While we need to be aware of creepy, intrusive behaviour, we shouldn’t be afraid to reach out and touch someone, and, sometimes, all it takes is a hug to calm anxiety down or break through a depressive episode (not always, but sometimes). (On a side note: because it is a source of positive, safe human touch, massage therapy can be an effective treatment for depression and anxiety.)

We need to SUPPORT ONE ANOTHER! Let me say this, again. We need to SUPPORT ONE ANOTHER! Whether it’s organizing a daycare carpool or babysitting circle, or encouraging your friends to come with you for a hike in the mountains, or bringing over food when a friend has a new baby or has been sick. This used to be the norm, but it’s fallen apart. It takes a village to not only raise a child, but to live, and we have lost our village. It is EXHAUSTING trying to do everything by ourselves, having no-one to catch us when we fall! Even if we just don’t have the mental or physical energy to do something like that, ourselves, simply sending a text to a friend, letting them know that you are thinking about them, and want to make sure they are OK can make a difference.

We also need to open our minds to ALTERNATIVE DEFINITIONS OF “SUCCESS”. Ultimately, success should mean that the person is becoming the best version of themselves, and are happy. That may differ from what is traditionally thought of as “success”. For some, it’s the high-end corporate job, with the big house, fancy cars, etc. For others, it’s the quiet cabin in the middle of no-where, with a garden and a few animals. Yet others have few of the traditional trappings of success, and may struggle financially, but they have a big, happy, noisy family filled with love. Or, it may be an artist who can’t handle a traditional job, and may have mental health issues, but creates beauty on a canvas. Whatever it means to that person, we need to accept it, and see them as a human being. We also need to recognize that there is no timeline to being “successful”. Life is a journey, and there are many paths that we take, and many stops along the way.

Is this going to put a halt to mental health issues? No. Absolutely not. But, what it will do is grant space in this world to people who have those issues, and reduce some of the pressure we place on people in general. But, by being KIND and FORGIVING, NORMALIZING POSITIVE TOUCH, SUPPORTING ONE ANOTHER, and opening our minds to ALTERNATIVE DEFINITIONS OF “SUCCESS”, we learn compassion, and take some of the weight off of each other’s shoulders, including our own, making this a better, and easier, world to live in.

~ by Kim Umphrey, RMT