What to know when seeking manual therapy for jaw tension and pain

So far, since I began doing intraoral work for jaw issues in 2013, I’ve had several clients come in for TMJ relief sessions who had previously seen multiple practitioners who worked inside their mouths to try to relieve their TMJ symptoms.

They had seen chiropractors, chiropractic neurologists, Rolfers, dentists trained by the Las Vegas Institute (LVI), and/or other massage therapists.

These clients told me, “No one has ever touched me there,” after I worked on their lateral pterygoids.

These are small, hard to access muscles, and they are often key muscles to address to release jaw tension. It takes patience to get close to them and gently influence them to soften and lengthen.

You can see in the image below that there are two heads to the lateral pterygoid muscle. The upper head attaches to the disc (not labeled) between the temporal bone and mandible. Tension in this upper head pulling the disc anteriorly may create clicking or popping sounds on opening and/or closing the jaw.

It is important to address this early on to prevent irreparable damage. Even when there is damage to the disc or the ligament behind the joint (also not labeled), manual intraoral therapy can relieve tension.

The medial pterygoids are also major culprits.

anatomy of the jaw muscles

It’s not that the other jaw muscles don’t contribute. The external jaw muscles — the masseters and temporalises — also play a role in jaw tension and pain (they can have trigger points and taut bands within the muscle).

I’ve learned through trial and error that one 75-minute session provides relief (sometimes tremendous relief, as in pain-free and a spacious feeling around the TMJs), but it will probably not last. That’s often the issue with bodywork: the soft tissues tend to revert toward their previous tension until we change that strain pattern through timely repetition.

For longer-lasting relief, 5 sessions in 4-6 weeks with support for habit change and self-care homework can retrain the jaw muscles to lengthen and relax.

I don’t work with insurance, but even people living on a budget who are determined to get gentle, lasting TMJ relief have found a way to pay my reasonable rates. To that end, I offer various ways to pay for it (all up front, pay for a single session before deciding to do the 5-series then pay the balance at the second session, or pay session by session). I offer a $50 discount for 5 sessions within 4-6 weeks to encourage people to get the 5 series.

If jaw tension or pain resulting from jaw tension is your major complaint, and you’d like a sense of spaciousness in your TMJs (if you can even imagine how great that would feel), please seek a practitioner that works intraoral on the pterygoid muscles.

Click here to book a free 30-minute consultation. (My practice is in Austin, Texas.)

Things that distinguish my work:

  • I work as gently as possible. Sometimes people feel therapeutic pain, as in “this hurts a little but it’s exactly what I need to relieve this tension”.
  • I never make any sudden moves, and you can signal me to get my hand out of your mouth (and I watch you for signs of discomfort).
  • My sessions start with full body alignment and progress toward the intra-oral work, ending with deeply relaxing craniosacral therapy to help your system integrate the changes.
  • My referral partners include dentists, chiropractors, doctors, a Rolfer, acupuncturists, craniosacral therapists, an Ayurveda practitioner, a Somatic Experience practitioner, and many massage therapists.

I started a Facebook group, Word of Mouth: Resources for Jaw Pain/Dysfunction, for people who want to work on their jaw issues. You can ask questions and learn more there.

I hope this information helps you ask informed questions when choosing a practitioner to relieve your jaw tension and pain. 

Suggestions to relieve insomnia and get to sleep

A couple of months ago, I blogged about some exciting new research about insomnia. It seems that when we lie awake at night, unable to fall asleep, it’s because our brains are overheating. They tend to generate more warmth during the day and cool down at night.

So something happens that moves us out of this biorhythm and into the minor hell of insomnia (or major, if it goes on long enough). When you would like to be sleeping, the monkey mind grabs onto thoughts and won’t let go — generating heat in the brain and preventing sleep.

The researcher experimented with a cooling cap. It seemed to me that there were alternatives that were much simpler and more accessible.

Disidentify with your thoughts

First of all, disidentifying with your thoughts is a useful skill anyone can learn with a little practice. Thinking is what the mind does. It serves a purpose. It is not inherently bad.

The question is whether thinking is appropriate when you want to be sleeping. There’s thinking, and then there’s mind-running-amok.

To disidentify with those thoughts, you simply choose to focus your attention on your breath, or on sounds, sensations, rhythms, your weight against the sheets and pillow, a chakra, your whole body, a state of wonder, an image — find something that works for you. (All this stuff is happening all the time. “Life is what happens to you when you’re busy making other plans,” right?)

Notice that your thoughts are often about something that’s neither here nor now — they’re in the past or future. Bring your attention into the present moment. What are you actually experiencing?

Your mind may interrupt, but as you continue to focus on your present experience, it will interrupt less and less often, and you will fall asleep.

Also, notice whether that thing your monkey mind won’t let go of is something you have any control over. If you can’t influence it, give it up. Trickster is having fun with you. Just plain let go and hand it over to God, the Universe, Spirit (GUS will take care of it). Now go to sleep.

If you can influence it, unless it’s truly life-or-death, sleep on it and see what option comes to mind when you wake in the morning. In other words, pose the question “How can I influence this for the good of all involved?” Let your unconscious mind work and play with the situation while your conscious mind takes the restful break of sleep. When you wake, notice what comes to mind.

You may want to do some journaling.

Drink some cool, clear water

Drink a glass, or half a glass if your bladder wakes you up early, of water that is between room temperature and cool. Ice isn’t necessary — some people believe that ice is too cooling and not good for the human digestive system’s operations. After all, the human race has done pretty well without iced drinks for millenia upon millenia.

Take a mouthful of cool water, close your mouth, hold it for a bit, and then swallow.

You can also put a cool compress of a wrung-out washcloth on your forehead. Do both!

And, while you’re doing these things, think about the cowboy song Cool, Clear Water while you do this! Let water represent the sleep you want to experience.

Here’s a video of the original by the Sons of the Pioneers. Maybe you have a favorite version.

Yawn and open your mouth when you lie down to sleep

Since it’s currently believed that the purpose of yawning is to cool the overheated brain, yawn several times when you are ready to go to sleep.

Also, you can open your mouth just wide enough to let air (cooler than your body, of course) circulate in your oral cavity and cool the adjacent brain. Try parting your teeth half a finger-width.

Continue to breathe through your nose, not your mouth, unless you have nasal congestion.

Use acupressure to reduce heat

I shared this with my bodyworker/acupuncturist Patrice Sullivan, who got excited and shared with me some of the pressure points that reduce heat, because in Chinese medicine’s understanding of health, the body can get out of balance and have too much heat — and of course this can affect the brain.

Press into pressure points with a fingertip or pencil eraser to stimulate them, unblock meridians, and release heat. Press briefly and see what happens. Then try pressing steadily for 30 second to 2 minutes.

The list below includes the poetic names of the points for fun. You may want to google each point to view a graphic with more precision about the location.

  • Gallbladder 42 and 43, Earth Fivefold Convergence and Clamped Stream, are on the foot between the fourth and fifth metatarsals.
  • Liver 2, Moving Between, is on the top of the foot between the first and second toes before the webbing starts.
  • Gallbladder 34, Yang Hill Spring, is outside the knee, in a depression just below the head of the fibula (smaller lower leg bone) toward the front.
  • Heart 7, Spirit Gate, is on the hand on the crease of the wrist closest to the hand, in line with the ring finger.
  • Large Intestine 11, Crooked Pond, is located at the end of the outer elbow crease.
  • Governing Vessel 20, Hundred Convergences, is at the crown of the head.

Report back so others may benefit

I’d love to be wrong about this, but in my opinion, Big Science is probably not going to fund research on simple, effective ways to relieve insomnia unless they can make money off it by selling you something they’ve patented. So it’s up to us to figure out what works and let others know.

Please feel free to try any or all of these methods to relieve insomnia and please report back on what worked and didn’t work for you in the comments for this post.

Thank you.