Metro Physiotherapy and Injury Clinic

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TMJ Specialozed Physiotherapy

JAW JOINT DYSFUNCTION & SPECIALISED PHYSIOTHERAPY TREATMENT

jawAt Metro Physiotherapy and Injury Clinic, we have a SPECIAL INTEREST in providing TMD treatment and complete case management of it.

Temporo-mandibular joint ‘TMJ’ dysfunction (TMD) or so-called jaw joint problem can be treated successfully with physiotherapy since it is seen as a joint, muscle, and ligament problem.

7 signs of Unhealthy TMJ;

  • Clicking
  • Jaw pain
  • History of injury
  • Tight cheek muscles
  • Eating changes/difficulties
  • Difficulty opening mouth widely
  • Nocturnal grinding/clenching and broken teeth

*** The TMD often comes with neck pain and headaches due to poor posturing at a desk, driving and looking at your phones and tablet devices to say the least!!

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Jaw joint is recognized as a unique joint in the human body for its construction. It is made of a pair of joints, one on each side and it is the only ginglymoarthrodial joint in the body (ginglymo = hinge or rotate & arthrodial = glide).  That means it moves in 3 dimensions, up and down, left to right and front to back.


Front-Back

MANDIBLE


Up-Down & Left-Right :

MANDIBLE


The jaw joints are formed between the glenoid (articular) fossa of temporal bone and the condyle of mandibular bone and located just in front of your ear canals. You can easily feel them by placing your index fingers in your ear canals and open and close your mouth. You can roughly feel the first 50% of the full range of mouth’s motion in your fingers. However, wider you open, less you feel as the mandible (bone of lower jaw) moves down and forward from your fingers in the second 50% of the mouth’s range of motion.

Temporomandibular joints are such unique joints. It is because one piece of bone called the mandible (lower jaw bone) is connected to the temporal bone (a part of the skull) on both sides not by bony connections but only by soft tissues such as ligaments, capsules, tendons and muscles. This is where a pair of temporomandibular joints is formed. This means the balance of movements and a synchronicity of left and right TMJ are very important for its healthy functioning.

At Metro Physiotherapy and Injury Clinic, we have a SPECIAL INTEREST in providing TMD treatment and complete case management of it. 

image004As mentioned above, jaw joints have a unique function and a complex combination of movements. Therefore, it requires a deep knowledge and integrated skills in assessing and treating this condition successfully. The therapist at Metro Physiotherapy and Injury Clinic has completed extensive training program in the assessment and management of temporomandibular disorders (TMD) and have treated many hundreds of patients successfully. The physiotherapist also presents at seminars and workshops to other physiotherapists.

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Reference: J. Okeson 2012: Normal TMJ mechanics and intra-articular disc movement

Is it your long term problem?

There are many patients suffering from TMD arrive at our clinic after a long journey. It is quite typical that patients present to the clinic after going through different dental professionals and specialists and they have spent a long time and a large sum of money. Often mouth/occlusal splint is prescribed or teeth filing may have been done to help with your occlusion (bite).

It is the jaw joints and surrounding tissues that are often the problem in TMD. So physiotherapists specially trained to treat this pair of joints can provide you with an ACCURATE diagnosis and an EFFECTIVE management of TMD. It is like any other joint issues that you go and seek help from Physiotherapists such as neck and back pain, shoulder pain and knee pain.

How does TMD occur?

During most of our lifetime, we do not open our mouth very wide, except biting into a big burger or yawing..  Usually ‘opening-mouth-wide’ lasts only for a few seconds.

You may have had an extensive dental work such as dental implants or orthodontic work that requires you to open and keep mouth wide. You may clench or grind your teeth when sleeping or you may have had an accident that caused a traumatic facial injury and required facial surgery. These procedures, injuries or habitual factors may cause the jaw joint capsules, ligaments and muscles to overstretch, overwork or injure. This leads to the imbalance in the mechanics within the temporomandibular joint. As a consequence, those 7 signs of unhealthy TMJ may arise.

It may also be a result of an accumulation and combination of certain negative habits such as clenching while working. It is particularly the case during high stress situations. A poor chin-poke posture using computer or types of work that involve looking down for a long period of time (chefs, craftsman, and clinicians) predispose people to TMD. Normally, human teeth are in contact for a total of 5-10 minutes in any given 24-hour period. So if you are clenching your teeth while facing the computer screen for hours per day, no wonder that your muscles around the jaws and neck/shoulders get tighter and sorer from overworking.

Injuring the jaw joint structure causes inflammation and scarring as it heals. This process may take a few weeks to a few months. By the time you have your next big bite it has already stiffened up and it is either too stiff or, if you force it open, it would cause some tearing of the scars. Again, this causes further inflammation and pain, so it goes on and on.

The result is an imbalance of movements between the pair of jaw joints and a disc sitting within each joint, which gets pushed around and when it gets squeezed out, it causes those dreaded clicky or popping sounds. It may have nothing to do with your teeth or your bite.


TMJ anatomy and Clicky/locked jaw joint

MANDIBLE


A detailed assessment is the first step of treatment

At the first session, your TMD will be assessed by measuring and finding out what structures (i.e. jaw joint capsule, ligaments, muscles and tendons) are the primary issues and treat accordingly by hands on therapy and prescription of home exercises.

TMJ Physiotherapist will provide you with thorough education and treatment. You will also be much more involved in your own care by performing prescribed home exercise program. So you will feel more in control of your own symptoms. You will certainly feel happier because you know you can make a difference to your TMD by doing your own home exercise program in between your Physiotherapy treatment sessions.

Treatment session (40 minutes) would typically consist of consultation, physical examination and treatment. You will be asked to do a specifically targeted home exercise program. Then you will typically attend weekly sessions over the next few weeks until clinically significant benchmarks are achieved such as how wide you can open your mouth. Once the symptoms are under control, the treatment sessions will be a few weeks apart and then you will be discharged with maintenance exercise program or you may regularly come in for a check up and maintenance to make sure you don’t relapse. Having said that, generally speaking, once the TMD has been completely treated, you would not need to perform home exercise program too often.

Ultimately, the goal is to restore the mechanics of the jaw joints. As mentioned, one piece of bone called mandible forms two jaw joints, one on each side. If one jaw joint is painful, stiff or clicky, then most probably the other side would have some issues, even though it may not feel there is any issues. This will also be treated once the symptomatic joint is treated.

Speak to us now

If you are suffering from any of “7 signs of Unhealthy TMJ”, come and have your jaw joint assessed by TMJ specialised Physiotherapist. Treatment for TMD is a fast developing field worldwide. There are few TMJ specialised clinicians in Australia, with a proper knowledge and skill to treat it successfully. In our clinic, we have treated many patients who have successfully recovered from TMD including people who had previously been advised that surgery was the only way to treat it!

So let’s get started with your TMJ Physiotherapy today.