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The temporomandibular joint (TMJ)

The temporomandibular joint (TMJ) is one of the most used, yet ignored joint in the body.
The TMJ should be evaluated for all patients presenting…
  • With headaches (especially in the temples)
  • With reports of local pain and clicking in the TMJ
  • With reports of ear pain, sensation of “fullness” in the ear and/or tinnitus
  • With reports of upper neck pain and stiffness
  • Post motor vehicle injuries
TMJ dysfunction can be caused by…
  • Trauma to the joint
  • Anxiety, stress or depression
  • Posture of the head and neck
  • Grinding teeth or forced clenching during sleep or during the day
  • Habitual chewing of gum, nails, necklaces, pencils etc.
Physical therapy assessment should include…
  • Posture and neck mobility
  • Palpation of the joint during opening to assess proper mechanics
  • Palpation of muscle activation including proper timing of muscle activation
  • Range of motion of the jaw and deviations and improper patterns
  • A detailed history to determine habits that could lead to TMJ dysfunction
After a thorough evaluation a treatment plan will be established with the patient which may include…
  • Education for posture and ergonomics at workplace
  • Upper neck mobilizations
  • Mobilizations of the TMJ
  • Home exercise program to correct muscle imbalance
  • Referral to a dentist for a night splint or a mouth guard
  • Education regarding habits that are causing the pain