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

So far, in five years of practice, I’ve had two 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 two clients both told me, “No one has ever touched me there,” after I worked on their lateral pterygoids.

These are small, hard to access muscles, and in my opinion, they are most often the key muscles to address to release jaw tension.

anatomy of the jaw muscles

It’s not that the other jaw muscles don’t contribute. They do, and in roughly 10% of the TMD cases I’ve worked on so far, one of the medial pterygoids is “the problem child” creating the most pain and dysfunction in the jaws.

The external jaw muscles — the masseters and temporalises — also play a role in jaw tension but are never (that I’ve seen so far) the biggest contributors.

In other words, about 90% of the time when people have jaw pain from muscle tension, the lateral pterygoids are the main source.

It’s not that these other intra-oral practitioners have nothing to offer. Chiropractors, Rolfers, and massage therapists have definitely helped me, and I’m not familiar with the others. Also, some LVI-trained dentists do receive specific training in treating TMJ issues — and I’m sure they can help with more complex or advanced problems.

The only complaint I’ve heard about going to a physical therapist for TMJ relief is that they work aggressively, with little concern for patient comfort. I’m pretty sure that is because they are restricted by insurance companies to the amount of time allowed to address a given problem. If you can handle it, they probably will work on your lateral pterygoids.

You can always talk to them first about what to expect.

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.

I’ve learned through trial and error that one 75-minute session provides relief, but it may not be lasting. For longer-lasting relief, 5 sessions in 4 weeks with support for habit change and self-care help retrain the jaw muscles to lengthen and relax.

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 on the lateral pterygoids.

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. 
  • I never make any sudden moves. 
  • My sessions start with full body alignment to get you relaxed and progress toward the intra-oral work near the end. 
  • My referral partners include dentists, chiropractors, doctors, and 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. 

Sunday morning: a little trauma release, a fine buzz, then some yoga jazz, and a tribute to a teacher

Long-time readers know I spent some time and energy on learning the trauma releasing exercises of David Berceli and practicing them. (If you’re a new reader, go to the tag cloud in the right panel and click TRE or trauma releasing exercises to see the many posts on the topic. If you want to learn them, I recommend Berceli’s book and video.)

I haven’t written much about them for a while. I still value them very much as a tool for releasing tension.

Sometimes at ecstatic dance, I allow my legs to shake for a little while, which releases leg tension, especially around my hip joint. (Nobody notices or comments, ever.)

Some mornings I wake up and just know I need to do them. I may tremble for 30 seconds to a minute or two. It doesn’t have to last long to be effective.

I imagine that the more you do them and really surrender to them, the less you need to do them. Also, the more you do them, the more aware you become of tensions accumulating in your body, and you adjust sooner — taking a deep, cleansing breath to let it all out, stretching and moving the tense area.

This morning I did them for longer, because my body wanted to keep going. First my legs surrendered to the shaking, then left my arm flapped, then right my arm flapped, then my lower spine hammered, then my upper spine waved, then more legs, and so on. It’s entertaining to witness where the surrendering moves!

Then afterward, the fine buzz inhabiting my body. Mmm.

Walk to my yoga mat. Tadasana, feeling feet, upward energy. Stretching arms up into hastasana circling to anjali mudra several times to warm up, each with my gaze a little higher, a little more backbend.

Then from hips, float down into uttanasana and just hang. Feel my tight hamstrings. Hold. Breathe. They become like rubber bands, surrendering to the stretch. Then extend spine and re-bow.

Left leg back into lunge. Feeling the tight gastrocnemius and soleus. Push heel back and breathe. Right leg back to join it. Breathe length into calves.

Plank, with spread fingers, sturdy column arms under shoulders. Feel strength. Pressing palm and fingers evenly into mat, slowly lowering into chataranga, feeling creaks and twinges in shoulders and elbows.

Once flat, press pelvis and tops of feet into floor and lift up into bhujangasana, cobra. Imagine the fronts of my vertebrae, deep in the middle of my torso, fanning wide open to give and receive and expand my energy. This spine, this flexible column of bone, fluids, muscle, nerve, this backbone. Yes.

Turn toes under. Strongly lift my body up, elevating my pelvis as high as it will go. Push palms and fingers evenly into floor. Push heels back to stretch my soles (I’m hearing my teacher Eleanor Harris now). Lift sit bones to ceiling. Feel strong shoulders. Downward-facing dog, adho mukha svanasana.

“Enjoy your breath,” as my teacher Brigitte Edery is fond of saying. And I do.

Then bring right leg forward into lunge. Then today’s standing sequence: warrior two, extended side angle, reverse extended side angle, triangle, reverse triangle, ardha chandrasana, warrior one, warrior three. Nice standing vinyasa (with room for improvement in the sequencing, I notice), and I am aware of all the different stretches each pose brings where spine meets pelvis meets thighs.

I am pleased with my balance in ardha chandrasana, but I need to put my extended arms on the top of a stool to hold warrior three. There’s always an edge. Today, and probably for a few weeks (or months, who knows?), that’s mine — balancing in warrior three.

Then back to lunge, uttanasana (notice how much deeper my fold is), extending spine, and reverse swan dive up, arms circling into anjali mudra.

Repeat on other side.

I follow with pigeon, a deep twist (thrilling as my shoulders reached the floor), happy baby, and rock to standing.

I am in my body, ready for today, for ecstatic dance, for community, for work, for learning prenatal massage.

Feeling very grateful for my friends, and for my teacher Gabrielle Roth, whose work I knew better than I knew her personally, who was so influential in opening my awareness up to new movements, rhythms, and energies in life, who is in her own life now moving into stillness. She dedicated her life to healing the mind-body split. Amen to that.

Here’s my favorite Gabrielle quote:

After you jump, before you land is God.

I’m going to light a candle and open myself up to God.

Science discovers how massage affects cells after exercise

I love it when science deepens our understanding of something people know from experience to be true. The latest such finding to catch my eye is in my own field, massage therapy. People love massage and not all that much is actually known about how it affects the body’s systems or its long-term benefits.

Canadian scientists studied what actually happens at the cellular level when someone who has vigorously exercised gets a massage. Here’s an article explaining the study, and here’s the abstract for the research findings.

In short, massage applied to muscles after vigorous exercise reduces inflammation and promotes growth of energy-producing units (mitochondria) in muscle cells.

“The potential benefits of massage could be useful to a broad spectrum of individuals including the elderly, those suffering from musculoskeletal injuries and patients with chronic inflammatory disease,” said Tarnopolsky. “This study provides evidence that manipulative therapies, such as massage, may be justifiable in medical practice.”

The researchers also busted the myth that massage reduces lactic acid, which builds up in cells during exercise and has been thought to contribute to muscle pain. Massage had no effect on lactic acid build-up.

Here’s something to look forward to:

One future research direction will be to examine the long-term effect of massage after a workout.