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My jaw locks, clicks, pops

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What’s causing that jaw pain?

If you ever had jaw pain, you will know how uncomfortable it is. A pain that stops you from eating anything that’s not blended isn’t much fun. A TMJ Physiotherapist may be able to help. 

The temporo-mandibular joint (or TMJ) is made up of 2 bones the mandible and temporal, both having round surfaces mated together with a disc in between.

You might be wondering why two round surfaces? Wouldn’t it be very unstable…well that is true, but if you think about it when you yawn, eat, chew and talk, the jaw has to be very mobile. The downside to this is that the TMJ can get messed up very easily. When you have bad teeth, grinding habits, poor bite patterns, neck or posture issues the joint and disc can get very angry.

Check out what exactly happens when you open and close your mouth.

So what are the signs of temporo-mandibular pain?

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  • Shifting, clicking, clunking or locking of the jaw
  • Pain localised in the jaw joint or diffuse pain around the side of the head or neck
  • Mouth feels tight when opening or unable to open fully
  • Headache around the temples or side of head
  • Jaw doesn’t appear midline / asymmetry of the face
  • Ear aches

If you don’t have any of these signs but still have TMJ issues, book yourself in with a TMJ physiotherapist for an assessment.

So what are the different types of TMJ pain?

  • Myogenic or muscle related, when there is weakness, tightness or there is poor control of the jaw muscles. When there is tightness the jaw will get pulled towards that side. When there is weakness or poor control the jaw won’t open and close like it should.
  • Arthrogenic or joint/disc related, when the disc does not glide normally when opening or closing the mouth. The disc can shift out of place “sublux” or dislocate causing locking issues. In other words it feels like the disc rides over a speed hump when opening or closing the mouth creating a click or clunk.
  • Growth issues: where there is uneven jaw growth issues causing one side to be asymmetric.

What causes it?

In most cases there are a few factors that often lead to jaw problems. An expert in jaw pain can explain which ones you have after doing an assessment.

Over the years working as a physiotherapist I have noticed an increase in TMJ related issues with my patients. Why? I believe it is partly due to the environment we live in today.
1. In this era, technology surrounds us. We are constantly in front of a computer screen, the younger population are glued to there phones. Research shows that the average person checks there phone 11 times an hour!
This has led to forward head postures which places our jaws into poor positions. Can this be changed? Think of how your spinal posture can change with stretching and strengthening (excluding actual structural scoliosis issues). The jaw position can also change too! There has been an influx of younger clients, usually in their developing years, with TMJ issues. And it could possibly be due to being exposed to technology all there life.

When a person has poor posture, the head and neck tend to move forward and bend downwards, which can cause the chin to protrude and the lower jaw to move forward. This can result in a misaligned jaw, leading to tension and stress on the temporomandibular joint (TMJ) and its surrounding muscles. Poor posture can also contribute to a condition known as forward head posture, in which the head is shifted in front of the body’s center of gravity, leading to tight and fatigued muscles in the neck, shoulders, and back.

You can test to see if one side of your neck or shoulders are tight by standing with your back and head against the wall and place your hands on your shoulders. Try to feel if one side feels tighter. If it is very obvious then you may have postural issues. If you need help contact our TMJ physiotherapist for an assessment.

Good oral posture

Also known as correct tongue posture or mewing, refers to the proper positioning of the tongue and other oral structures at rest. It involves the following:

-Lips: The lips should be gently closed, but not tightly pressed together. The teeth should be slightly apart and the jaw relaxed

-Tongue: The tongue should rest gently against the roof of the mouth, with the tip of the tongue touching the area behind the upper front teeth. The sides of the tongue should rest against the upper molars

-Breathing: Breathing should be done primarily through the nose, with the mouth closed. This allows for proper humidification, warming, and filtering of the air, and helps to prevent dry mouth.

-Swallowing: Swallowing should be done with the tongue against the roof of the mouth, and not by pushing the tongue against the front teeth.

Good oral posture can help to promote healthy development of the jaw, teeth, and facial bones, as well as support proper breathing and swallowing function.

 

2. Diet. Nowadays fast food is prevalent and we are living fast lives. We eat things fast, we get to places in a rush, we expect things fast. How diet plays a role is because;
-we chew our food too fast, barely enough to form a proper bolus (where the food is properly chewed down), heck we may even chew whilst scrolling through our phones in poor postures.
-constantly eating soft foods weakens the jaw. However if you do have TMJ issues sometimes it is recommended to go on a soft diet to reduce the amount of strain on the jaw joint and surrounding muscles. However once the jaw pain subsides it is recommended to strengthen the jaw with harder foods. Think of how our ancestors ate; they hunted animals for meat, fish, fruits, vegetables, and nuts which are much tougher than today’s modern fast food diet. You can also see how their facial structures were more developed and it is partly due to the food they had.
Weak jaw and weak posture is on the rise and so is jaw pain.
3. Sinus issues and mouth breathing. Exposure to air pollutants from the city traffic, allergens such as dust can cause block nasal airways causing you to breathe through the mouth. How can mouth breathing cause jaw issues?
-Altered jaw position: Mouth breathing can cause the lower jaw to drop down and the tongue to rest in a lower position, which can alter the position of the jaw over time and lead to malocclusion.
-Change in facial shape: Mouth breathing can cause changes in the muscle and bone structure of the face, which can lead to a long, narrow face shape and a receding chin.
Some more common examples are:
  • Chewing on one side too much causing muscle imbalances in the jaw. tmj physiotherapist, TMJ, TMD, temporomandibular disorders, jaw pain, jaw joint, Canley Heights Physiotherapy
  • Poor jaw development when growing up
  • Incorrect myofunctional habits – mouth breathing, open mouth postures, biting your lips, chewing nails / pencils
  • Holding your head tilted too much such as playing the piano or always on the phone
  • Resting your hand on one side of your face – you are putting pressure on your TMJ and squashing your disc.
  • Sleeping on your jaw – again you are putting pressure on your disc.
  • Poor neck posture, poor oral posture, poor tongue posture.
  • Grinding your teeth during sleep (can be from stress and anxiety or poor teeth contact points)
  • Dental issues
  • Poor bite pattern

-TIP: Lightly tape a small piece of hypoallergenic tape or micropore surgical tape (highly breathable tape) from the top lip to bottom lip, encouraging the lips to seal. This will promote breathing through the nose especially useful if you breathe through your mouth when you sleep.

-TIP: If one side of your nose is blocked try using a finger to close one nostril and try breathe deeply in and out 10 times through the blocked side. Take your finger off and see if you can breathe easier.

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TMJ physiotherapist can help.

The first step is identifying and addressing the factors above. A TMJ physiotherapist can provide treatment to restore normal muscle and joint function such as:

  • Functional massage of the jaw muscles: temporalis, masseter, lateral and medial pterygoids
  • Correction of neck posture
  • Trigger point release techniques
  • Manual therapy techniques: joint traction, compressiontmj physiotherapist, TMJ, TMD, temporomandibular disorders, jaw pain, jaw joint, Canley Heights Physiotherapy
  • Motor control training
  • Mobilisation with movement
  • Acupuncture to relax tight muscles, read our post acupuncture/dry needling to find out how it works!
  • Corrective exercise for imbalanced / dysfunctional jaw muscles – mewing techniques, swallowing technique, proper oral posture.
  • Self – massage and self stretching techniques for you to do at home

Typically you should get less pain or improved opening ability from the first physio session. We will let you know if you may need to also see a dentist for further intervention such as getting custom fitted splints.

TMJ pain is awful, but you don’t have to suffer forever! When you visit us at Evolution Health Clinic we will provide options for treating and correcting your jaw. Speak with one of our TMJ physiotherapist and live a better you today.

Leave us a comment below if you suffer from jaw pain and what you have done to help ease it.

Author: Colin Sau (TMJ Physiotherapist, Evolution Health Clinic)

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