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TMJ disorder: Facts you should know by Physiotherapist Kelly Lai Cheong

Kelly-Lai-Cheong

Do you find it uncomfortable to chew, yawn or even talk? This could be a condition clinically known as the temporomandibular joint (TMJ) disorder.  Physiotherapist Kelly Lai Cheong talks to Aufait Santé about TMJ disorder and ways to manage it.

Kelly Lai Cheong graduated from the University of Queensland with a degree in physiotherapy and member of the Australian Physiotherapy Association, she has a broad range of experience in the musculoskeletal field, having worked with the largest health group in Australia.

Kelly Lai Cheong talks to Aufait Santé about TMJ disorder known as the temporomandibular joint (TMJ) disorder. TMJ disorders are commonly managed by physicians and dental practitioners, and are now studied through a biopsychosocial model thanks to advances in research.

What do we know about the TMJ disorder?

Kelly Lai Cheong: TMJ disorder is the dysfunction or pain in the jaw joint or muscles that control jaw movement. Symptoms vary and include jaw movement limitation, tinnitus (ringing in the ear), headache and pain when opening your mouth.

There are many causes for this condition but symptoms primarily arise from:

  1. Muscular issues as a result of an uneven bite, teeth grinding or jaw clenching;
  2. Internal joint derangement such as a displaced or dislocated disc, which produces a clicking sound as you open or close your mouth;
  3. Arthritis i.e. degeneration of the joint;
  4. Referral pain from the neck; or
  5. Chronic stress.

How to find your TMJ?

Kelly Lai Cheong: Try to find this joint by placing one finger below your sideburns. You should feel a small dent as you open and close your mouth – this is where the jawbone connects to the skull.

jawbone connects to the skull

How to treat the TMJ disorder?

Kelly Lai Cheong: Symptoms may be cyclical and usually relieve over time but it is important to seek medical help where symptoms persist.

TMJ disorder is commonly managed by physicians through the prescription of anti-inflammatory medication or by dental practitioners with the help of stabilisation splints (bite guard) or braces.

With advances in research, it is now known that an optimal treatment incorporates a biopsychosocial model, in which there is more than one health care provider involved in the management of the TMJ disorder. These may include psychologists for management of stress and physical therapists for exercises, advice on posture and self-care practices.

To help with your jaw pain, I recommend the following program called the Rocabado’s 6×6 exercises:

Rocabado’s 6×6 exercises

The Rocabado program was proven to result in significant improvement in TMJ disorder symptoms. The program consists of 6 exercises, each to be performed in 6 repetitions, 6 times daily.

1. Resting position of the TMJ

Move your tongue to the roof of your mouth by saying the letter “N”. Keep your tongue on your hard palate and move your upper teeth slightly away from your bottom teeth, without any attempt to fully open the mouth.

Rocabado’s 6x6 exercises

2. Controlled opening

From the resting position described above (with your tongue on your hard palate), slowly open your mouth as much as you can. You should feel your tongue gradually pressing against the roof of your mouth.

3. TMJ rhythmic stabilisation exercise

Place your thumbs under your chin and press gently upwards. Try to keep your mouth in the same position while resisting the pressure of your thumbs. Aim to maintain contraction for up to 10 seconds.

Rocabado’s 6x6 exercises

Use your hand to apply a slight pressure to the right side of your jawbone. Resist the pressure by trying to keep a neutral jaw position. Hold for 10 seconds and repeat on the other side.

Rocabado’s 6x6 exercises

4. Posture correction

In a comfortable sitting position, squeeze your shoulder blades together by pulling your shoulders back. Avoid shrugging your shoulders. Hold for 5-10 seconds per repetition.

Rocabado’s 6x6 exercises

5. Chin tuck

Bring your chin back as if making a double chin. Keep your eyes straight ahead. Relax and repeat.

Rocabado’s 6x6 exercises

6. Stabilized head flexion

Place your hands behind your neck. Then nod your head down as if you are attempting to make a chin tuck (as above). You should feel a gentle pressure into your hands. Relax and repeat.

Rocabado’s 6x6 exercises
Rocabado’s 6x6 exercises

Note: The purpose of this article is to provide you with a guide to better understand the TMJ disorder, its causes and the different treatment options available.  If symptoms continue to interfere with your daily life activities, please seek a comprehensive evaluation and personalised treatment plan from a health professional.