Tag Archives: posture

Physiotherapy for Temporomandibular Joint Disorder

Temporomandibular joint disorders (TMD) is a broad term that encompasses various disorders of the temporomandibular joint (TMJ). If you experience jaw pain with chewing, jaw clicking/popping, facial pain, or frequent headaches, you might have a TMD. Physiotherapists can diagnose and treat TMD.

Temporomandibular Joint (TMJ) Anatomy and Function

The TMJ is composed of two articulating bones: the temporal bone (part of the skull) and the condyle of the mandible (jaw bone). There is an articular disc located between the two bones. The disc is firm but flexible, and its purpose is to reduce friction and cushion the repetitive force between the two bones during chewing, talking, and any other joint movement.

During jaw opening, the condyle of the mandible and the articular disc normally slide forward in unison. The muscles surrounding the joint are responsible for moving the mandible and the disc in sync. If the condyle and the disc are out of sync with each other, this is called disc displacement and is characterized by pain and clicking sounds when opening the mouth.

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Symptoms

Symptoms of TMD can include the following:

  • Jaw pain when opening the mouth wide or chewing
  • Locking of the jaw
  • Limited range of motion, or unable to fully open the mouth
  • Painful clicking or popping when opening or closing the mouth
  • Tooth wear and tear from grinding or clenching the jaw
  • Facial pain
  • Headaches
  • Ringing in the ears

Causes of TMD

Often, there is no single cause of TMD. There is usually a combination of factors which predispose a person to TMD.

Poor posture of the neck, head, and shoulders contributes to muscular tension and strain. Poor posture may cause muscle imbalance and changes in muscle length in the neck and shoulders. These muscles pull on the jaw and can alter the resting position of the mandible in the joint, resulting in increased stress on the TMJ and disc. After prolonged time, the joints in the neck and back may become stiff and cause associated symptoms such as neck pain, limited range of motion, and headaches.

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In addition, jaw clenching or teeth grinding may contribute to the development of TMD. When the jaw is clenched, the muscles are under increased tension and may pull the disc out of position. It normally happens while the person is asleep, so they are unaware they are doing it. Clenching or grinding can also result from being under stress (e.g., at home or at work) for a prolonged period of time.

Finally, trauma or injury to the TMJ (such as a broken jaw) may predispose a person to TMD.

Treatment for TMD

Physiotherapists assess and treat TMD using non-surgical and drug-free techniques. The physiotherapists at BodyTech Physiotherapy will evaluate your condition to determine the underlying factors contributing to your pain. They will prescribe an individualized exercise and stretching program based on your unique needs. Our physiotherapists are also trained to correct biomechanical changes of the TMJ and neck using manual therapy.

Other options for treatment include:

  • Relaxation procedures
  • Acupuncture
  • Dietary modification to relieve jaw pain during chewing
  • Dental orthotics or mouthguards worn at night. These help to prevent teeth grinding and jaw clenching
  • Pain relief and anti-inflammatory medications
  • Medications to relax the muscles of the jaw
  • Surgery, in rare cases

Temporomandibular joint disorder is a complex and multifaceted condition. With all the factors that can contribute to TMD it is important to visit a physiotherapist for a detailed assessment to ensure treatment is individualized to your specific issues.  If you experience jaw pain and headaches, consider seeking help from a physiotherapist.

BodyTech PhysiotherapyBodyTech Physiotherapy 519-954-6000

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The Importance of Posture

Posture types

Person A shows good posture, with a straight line going through the ear, tip of the shoulder, slightly behind the hip joint, slightly in front of the knee joint and slightly in front of the lateral malleolus (ankle) in the foot. The rest of the postures shown are incorrect, with different points of the body deviating either too far forward or too far behind the line that would indicate correct posture.

Posture is not typically on our minds until it starts to cause discomfort or injury. Today’s lifestyle regularly involves sitting or standing for prolonged periods of time, which is often sustained at the expense of proper posture. Posture refers to the position of our bodies, which is created by the different joint angles and the muscles that control those joints. Correct posture requires minimum muscular activity to maintain, which in turn minimizes stress placed on the joints. The opposite occurs with incorrect posture; muscles fatigue in attempt to maintain the altered position and joints are placed under increased stress.

There are a variety of factors that can cause or contribute to faulty posture. Correct posture may be difficult to maintain if joints are too stiff or too mobile, muscles are weak, too shortened or lengthened, or imbalanced. Over time incorrect posture will cause joint stiffness, thus causing the muscles to work harder and may result in pain. At this point, self-correction becomes difficult as it is harder to correct through joint stiffness. Joint stiffness will also result in some muscles becoming weak and others overused due to a change in the starting position of the stiff joint. Early identification of these contributing factors could prevent an injury from occurring, or from becoming a chronic problem that is more difficult to treat.

Possible consequences of poor posture include neck, shoulder, and back pain, or headaches and jaw pain from increased stress on muscles, joints, tendons and ligaments. Muscles will become shortened and tight from being in a slouched position, and the muscles on the other side of the joints will become lengthened and weak from constantly being stretched. The resulting muscle imbalance limits range of motion, changing the way the body moves, which will affect work or sport performance.

A detailed posture assessment by a physiotherapist can identify the contributing factors to poor posture, and is a smart idea for anyone wishing to be proactive and prevent future injury. Once these contributing factors are identified there a number of treatment options that will target the causes of the poor posture, prevent further injury, and help to decrease pain. A strengthening program will be designed to target weak muscles, and stretching will loosen tight muscles. This treatment combination works to correct these muscle imbalances, making correct posture easier to maintain while decreasing pain. Strengthening has the additional benefit of stabilizing loose joints, and joint mobilizations can correct stiff joints. Joint mobilization is a specific hands-on technique to improve joint movement, and can help to relieve pain and restore function. A combination of exercise, manual therapy and education will improve your course of recovery and assist with further injury prevention. Education about how to maintain correct posture in daily activities will allow you to remain pain free and prevent further injury.