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. 

My advanced integrative bodywork practice

Featured

I make my living doing advanced integrative bodywork in Austin, Texas. I use four main techniques: craniosacral therapy, biodynamics, Zero Balancing, and orthopedic massage. As standalone treatments or integrated as needed, depending on my clients’ needs and preferences, these techniques can accomplish the following:

  • reduce stress and deepen relaxation
  • improve the flow of fluids
  • harmonize your body’s systems
  • strengthen your body’s innate healing abilities
  • deepen your resilience
  • align your structure and ease your movement
  • free the flow of energy
  • facilitate healing from injuries
  • help you feel expanded and confident

Click here to view my business website.

TMJ Relief

Since 2014, I’ve been developing skill and expertise in offering relief from jaw tension, pain, and dysfunction. I offer four ways to be of service to people with jaw issues:

  • You can join my Facebook group, called Word of Mouth: Resources for Relieving Jaw Pain/Dysfunction, which offers educational units as well as connection with others working on their jaw issues.
  • Schedule a free 30-minute consultation so I can learn about your jaw issues, do an evaluation, and discover if we’re a good match for successful treatment.
  • Schedule a 75-minute TMJ Relief session (can be right after the consultation if that time slot is available on my online scheduling program).
  • Join my TMJ Relief Program, designed to create long-lasting relief by offering 5 sessions in 4 weeks along with an email after each session with education, exercises, supplement recommendations, and more.

You would need to be in Austin to receive a session, but the Facebook group is open to people anywhere who are seeking to address their jaw issues. The educational units available in the group include teaching a relaxed mouth position, jaw exercises, self-massage, relaxation techniques, terminology, sleep positioning, and more.

If you’re interested in joining the group, click this link, answer the three questions, and you’re in!

If you want to get better at healing others and/or self, read this blog post

My wonderful craniosacral therapy teacher of the past few years, Ryan Hallford, wrote a blog post entitled Soft Mantras for Hard Lesions. Although specific to biodynamic craniosacral work, in my opinion it applies to so much more – all types of healing work with others and all healing work on self.

ryanSubstitute “stuck places” for lesions and consider his statement that this post is about our mindset when encountering them, and you can understand how applicable this is to all realms of life.

Toward the end of the post, he lists three mantras (internal prayers) that a person intending to heal (self or other) might find helpful to ask.

I’ve read this blog post three times now and decided to write down the questions to carry with me at all times. This is a practice I use when I want to integrate something new into my being. The writing of it helps me commit it to memory as my pen moves across the paper letter by letter, word by word, and carrying the written paper with me signals my commitment to integrate it.  Continue reading

Massaging levator scapula

I’m a massage therapist making sense of what I discover working on clients — the most common issues I encounter, why people have these problems, and what to do about them (massage-wise and making minor but meaningful lifestyle changes that result in more well-being).

Recently I posted about massaging the upper trapezius muscles. In that same shoulder/neck area, another muscle, levator scapula, gives some people a lot of problems.

As I mentioned in my earlier post, the upper trap issues seem to be from working with the hands out in front of the body, such as using a keyboard, cutting hair, chopping vegetables, operating a cash register, and so on.

If the bulk of your time is spent with  your arms just hanging down, surrendered to gravity, you wouldn’t have issues with your upper traps.

I don’t think there are many jobs like that! Irish dancer, perhaps?

Levator scapula (sometimes called just levator) attaches to the upper inner corner of the shoulder blade and to the transverse processes of the top four neck vertebrae (the bony parts that stick out on the sides of your neck under your ears). Levator lies underneath the upper trap and other muscles.

250px-Muscle_élévateur_de_la_scapula

250px-Levator_scapulae

I notice that some folks just have upper trap issues, and some have both upper trap and levator scapula issues. Trap issues come from working with the hands out in front. Levator issues come from raising the shoulders up toward the ears. In fact, levator scapula means “elevating the shoulder blade”. This is often accompanied by the “head-forward” posture.

If you rub across the top of your shoulder between your neck and shoulder joint and feel your fingers crossing over a tight but tender lump of a muscle, it’s your levator.

People who have pain in levator are raising their shoulders toward their ears, and they are most likely unaware they are doing this. They just notice the pain.

Sometimes it’s one-sided pain. The cause is often cradling a telephone receiver between the ear and shoulder to have the hands free while talking on the phone. If you work in an office and talk on the phone for much of the day, you can avoid levator pain by using speakerphone or a device that sits on your shoulder and holds the phone receiver up to your ear….

When it’s two-sided pain, the cause is usually an unconscious, habitual tension, a response to stressors of raising the shoulders toward the ears (“turtling”).

As a stress response, this would protect the vulnerable neck area, but since our modern stressors are usually not predators out to have us for dinner, the solution is to start catching yourself doing it and consciously retrain yourself to lower your shoulders. Your body will eventually catch on, and lowered shoulders will become your new habitual posture! (Also practice moving your head slightly back, if you have the “forward head” posture.)

You can lengthen the levitator muscle by standing and letting your shoulders drop downward, surrendering to gravity. You can hold a light weight — 1 or 2 pounds, or a can of soup — to help pull your arms and shoulders down and let the levator lengthen.

It also feels good to make forward and backward circles with the shoulders. Spend more time where it does the most good.

You can also stand and lower your ear to your shoulder, alternating sides. I think slow is good.

Another good practice is letting the head float up, as if it were a helium balloon. You can release all kinds of neck tension this way.

For massaging the levator, it usually feels awesome to press on the end of the muscle that attaches to the top of the shoulder blade. This is a magical point on almost every body that feels terrific to have pressed!

If you have a hard time finding that corner of the shoulder blade, put the client’s hand behind their back to make the shoulder blade pop out. You will feel that upper corner more easily. Static pressure and rubbing the corner area both feel great.

Because levator is deep to the upper trap and neck muscles, it’s difficult to knead the way you can knead the upper trap. I like to work my fingers around the inner part and bottom corner of the shoulder blade. Then, standing at the head of the table, I pull on the edge of the triangle that’s opposite that upper inner corner, leaning back and pulling it toward me. (You can also push this edge toward the head when standing at the client’s side.)

This allows levator to go slack and shorten, taking the pressure off it. I usually hold this for about 15-30 seconds.

Then I do the opposite. Standing at the head, I place both thumbs on that upper inner corner of the shoulder blade and lean into it. This gives levator a nice stretch. I hold this for 15-30 seconds too. The entire shoulder blade will have more mobility.

And yes, I can shorten and lengthen levator scapula during Ashiatsu barefoot massage sessions, using my feet!

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.

How to create inner peace

This morning I woke early and sensed a shift in my energy.

Without thinking about it, I started happily organizing some accumulated clutter in my bedroom that I’d been procrastinating on. I even fixed a couple of broken things. I cleared some space, found good places for stuff, and created more visual order.

I found a business card I’d been looking for, someone who asked me to contact her once I got my massage license, which I did about a month ago. I’ll call her today. Yay.

I do care about having an orderly home, and yet managing stuff (even living in a trailer!) often gets the better of me.  I make it a low priority. It’s not that I’m a terrible slob, although I’m sure I am in someone’s eyes. I pile things up to deal with later. I start doing things and get distracted and don’t finish. I leave stuff out to remind me that it’s not “done”. Then I notice I have a lot of piles, and clearing them seems like drudgery of the worst kind.

Today I created order and completion without thinking about it, because something opened up. I felt more upbeat. I was observing myself, thinking, “Wow, I am behaving differently. I like this. I feel energized and productive. Something has shifted. What happened?”

This is what I attribute the shift to. (Or perhaps the stars had something to do with it.)

On Tuesday evening, I went to bed aware of how much I mentally obsess about problems. By obsess, I mean they occupy my attention during times when I am not actually communicating with the person I have issues with, or I am imagining how I will handle something in the future. I do this often, usually not making much progress.

This ruminating helps me get clearer about my feelings and what I want, but it also distracts me from being fully present. I’m “in my head”. I’m feeling tense and anxious. I’ve become a slave to my thoughts, especially my fears. I get stuck and then don’t know how to stop. And then I become aware of my state.

It’s a way that I create my own suffering. I’d like to get out of my own way.

I vowed to myself that night that since this habit doesn’t really serve me all that well (except when it does give me insight and direction), that I was going to do something different yesterday.

I decided to dissolve my preoccupation. That is, when I realized that I was not feeling happy and present and content because my mind was rehashing some issue and I was feeling lack of joy in my body, I would take an impression, a snapshot, of my full experience—the images and words in my mind and the feelings in my body representing the person or the problem—and imagine that whatever power gave it substance (Higgs boson?) simply withdrew from it.

I saw, heard, and felt it fall apart. Images of faces and places, my own internal dialogue about it, and the worries, fears, and stuckness I felt in my body all lost coherence, dimensionality, reality. They fell apart into a pile of atoms that were swept away by the solar winds.

If it’s all illusion anyway, you might as well make it work for you. You can dissolve the illusions that don’t bring inner peace, joy, and freedom. It’s like dissolving whatever is within that keeps me from fully occupying and experiencing myself in this moment.

Mind you, I’ve just been doing this for one day, and I only did it a handful of times, but that was enough to create the energy shift I felt this morning.

If you’d like to try this, here you go:

  1. Think of something that’s been worrying, preoccupying, or troubling you, something you feel anxious or disturbed about.
  2. Take a snapshot of your whole internal state, and notice how you represent it. Is it a memory or something you imagine happening in the future? What does it look like? Are you telling yourself about it in an internal dialogue or monologue? What sensation are you feeling and where is it in your body?
  3. Just like a movie scene dissolves or fades so another scene can begin, allow the images to dissolve into pixels, dust, atoms. Turn down the volume of the sounds and words until you hear silence. Tune into your body and the sensations you are actually feeling. Let the feelings drain down into the ground. Note: It’s important to really take your time with this step. First you acknowledge your internal visions, words, and sensations. Then you allow each one to exit in a way that works for you.
  4. Notice the absence of the preoccupation. What are you experiencing? If there’s anything else related to the original state, allow it to fully exit.
  5. Bring back the images, words, and/or feelings. How is this experience different from the first time?
  6. Dissolve them again. How is this different from the first time?
  7. Imagine that any time in the future, when you notice you are not being present/feeling happy/being preoccupied, you have this powerful tool to create inner peace at your disposal.

The most abandoned TRE experience yet

Wow. I just got up off the floor after the most abandoned TRE experience yet.

I wasn’t paying that much attention as I did the exercises. I’ve learned them pretty well by now and was doing them by rote. I actually was watching, and then just listening to, a crazy Werner Herzog video called Even Dwarves Started Small, which is in German (with English subtitles), and the cast — as far as I can tell — is entirely composed of dwarves. Boisterous, noisy, German-speaking, laughing, cackling, yelling dwarves.

Whew.

So the theme tonight was chaos, and chaos I got.

The real releasing started with the last step of Exercise 7, when I placed my feet flat on the floor. It started out with my usual leg shaking. Then pelvic rocking.

Then my left hand started quivering, then my left arm was shaking, then it was wildly flapping like a crazy bird! My left shoulder got involved and at times was pounding into the floor.

It just went on and on and on. Two separate times I went through wildly chaotic lengthy releases of my left shoulder and arm.

My whole body released in a way it hadn’t before. I was not only rocking vertically, but I began to roll horizontally as well! I had some big neck releases.

Tonight as soon as I slowed and one movement ended, another one started up elsewhere in my body.

My legs got wild again, knees slamming into each other.

Now, as I type this, my whole left arm feels different, buzzing with a kind of energy I don’t ever remember feeling there.

Left shoulder. What is that? I had a rotator cuff injury several years ago that didn’t go away until months later when I finally got treatment for it. Maybe living with that pain was trauma I stored, and even though my injury healed, my energy didn’t. And now, through these exercises, my energy body is healing itself.

Then again, I’ve had many issues that these exercises could be helping me recover from: birth injury to a sacral nerve, scoliosis, PTSD.

Who knows? It’s a mystery. We’re a mystery.

I just know it’s good to release tension.

And…it’s very sexual without being sexual at all. It’s pure tension release, with that same element of abandonment and surrender to the body’s processes that really good passionate sex has.

I have a feeling that doing these exercises for a couple of months may add passion to my sex life when I have a lover again!

I wonder if distracting my conscious mind with the crazy video helped my unconscious mind let go even more.

Hmm.

My left hand just wanted to do some more releasing.

Okay. That’s better.