Dr. Samantha TMJ: December 2020 Newsletter
TMD & Vestibular Physical Therapy
Happy December friends! I hope you’ve been enjoying the holiday season so far! I apologize for not getting a November newsletter out to you- I was a little preoccupied with our wedding! It was the best day every & we are so grateful. But now I’m back and ready to provide you with all the latest TMJ & wellness info :)
This month I felt it was a good idea to give you a general anatomy overview of the jaw region. This way you can get better oriented with the area and so we are all on the same page! Your December wellness topic discusses one of the most valuable aspects of our health: sleep. I get into the importance of sleep as well as how TMD relates to sleep apnea & how physical therapy can help with both.
What makes up the TMJ?
The TMJ or temporomandibular joint, connects your skull at the temporal bone to your jaw at the mandible. A fibrocartilaginous disc like the meniscus sits in between the two bones; this disc naturally slides back and forth with opening and closing of the jaw. Problems arise when this disc gets out of place (for a variety of reasons) and this is when you will often experience clicking/popping or pain in the joint.
The muscles of mastication, or chewing, are also important when it comes to TMD, because abnormalities of these muscles often influence the jaw. Key players include: masseter, temporalis, and medial/lateral pterygoid. Masseter is a large, thick muscle on either side of your jaw that is primarily responsible for closing your mouth. This muscle is commonly over-active in clenchers and grinders. Temporalis originates on either side of your skull and inserts in your mouth connecting to the jaw. It also assist with closing of the mouth. Medial pterygoid assists with closing of the mouth, whereas lateral pterygoid is the primary opener and also moves the jaw side to side (lateral deviation). Another interesting fact about lateral pterygoid is that is attaches to the disc in the TMJ. Therefore, addressing restrictions/tightness in this muscle can help resolve disc dysfunctions. Even more interesting, lateral pterygoid is not easily palpated (hard to touch with your fingers) BUT you can dry needle it! Pretty cool benefit of physical therapy- I’ve seen significant success from dry needling lateral pterygoid in reducing pesky clicking/popping and often makes a patient’s bite feel centered again!
I go more in depth on anatomy and mechanics in my eBook if you’re eager to learn more for a better understanding of your symptoms! (^click “eBook” above to purchase!)
The importance of sleep
Sleep is our time for recovery. The value of this cannot be underestimated. To learn more in depth about really every aspect of sleep you can imagine, check out the book: Why We Sleep. This book is a real eye-opener on so many aspects of sleep you’d never even think of and most of all why would should make it a top priority.
There are though, many sleep disorders out there. And some of you might be saying, yes I get that sleep is important and I want to be a good sleeper- but I’m not. I hear you too! It’s a delicate subject because there are SO many factors that can be influencing your sleep. If you’re really struggling, I’d suggest educating yourself on sleep, maybe by using the resource I mention above or talking to experts to help find your individual needs for a good night’s rest.
A common problem I encounter with patients and their sleep in my line of work is sleep apnea- primarily obstructive sleep apnea where there is a physical barrier (usually the tongue) that is blocking your airway at night while you sleep, restricting your ability to take in oxygen. Of course a common line of defense is a CPAP, which works great for some! But for many it’s a tough adjustment, and the problem may actually be more mechanical. By mechanical I mean, the alignment of your jaw, which may be influenced by tight muscles or other postural abnormalities, may be in fact causing an obstruction of your airway as you sleep. Or chronic stress has lead you to nighttime clenching causing overactivity of your masseter muscle and an abnormal resting position of your tongue, again contributing to an obstructed airway.
All of this to say, sleep is critical to our health and proper healing. If you’re getting frustrated by sleep apnea, maybe taking a closer look at stress management and your TMD symptoms would lead you to some solutions and decreased dependence on a CPAP. Having a PT help you relieve muscle tension and improve your postural strength can go a long way with sleep quality!
Wishing you health & happiness always!
Dr. Samantha TMJ
email me: email@example.com