TMJ and Shoulder/Head Position

I have had people come in with complaints of jaw pain. There can be many reasons for this discomfort. It may come from sudden trauma like impact to that area. It may be from a recent visit to the dentist with work being done or simply having the jaw open for a long period of time. Trigger points (focused hyper-irritable points) in the muscles that move the jaw can refer pain to that area. There has been one consistant factor that I have noticed with people with jaw discomfort and it is the position of the shoulders and head in relation to the rest of the body. Most often the shoulders are rolled in and slightly forward and the head is also in a forward position.
There is an important relationship with head position and jaw position. The more the head is forward, the more the jaw will move back. Do a test on yourself. Gently close your teeth with your jaw relaxed and gently let your teeth touch each other so everything is relaxed and natural. Now jut your head forward slowly until it stops and your lower teeth should feel like they are moving back in relation to the upper teeth. At this point, the jaw joint (just in front of your ear) is being compressed in the same manner that if you were sitting and someone pushed your shoulders down, your spine would be compressed. Keeping the jaw compressed will doing simple actions like talking and chewing can put low grade strain on the joint and eventually causing problems down the line. This all ties in with the general benefits of good posture.
There is an interesting biomechanic that is not well known with the jaw as well. The joint is made up of two parts. One part has small forward and backward motions and the other is the “hinge” type movement that does the main opening part. When the jaw opens, first there is a slight forward movement, the the second joint hinges open (similar to a hinge in a door). The first forward movement is critical for good movement and if there is a “head forward – jaw back” presentation, then the jaw will not be able to make that first crucial jaw forward movement.
A “shoulder forward – head forward – jaw stuck in back position” can start often in the mid to upper back with tissue tightness and joint fixations that can be literally holding a person there making it very difficult for a person to get themselves in a position where they should be. That is where I come in to remind a patient where they should be and release the tissues and joints and give them home care to make it possible for them to be where they should be.
The biggest comment that I get when I reposition a patient to their optimal position is “that just feels weird” but often at the same time, there is better range of motion and less pain. So I tell them to use that as a beacon rather than the weird position that they feel in. Go where there is reduction of symptoms.
Watch out for things that draw your head forward. It is okay for short periods of time but things like computer use and work positions should have some attention paid to them.
Here’s a link to some good pictures of the jaw joint and some of the surround tissue that can become inflamed in the process.

http://www.google.ca/search?q=pictures+of+jaw+joint&ie=UTF-8&oe=UTF-8&hl=en&client=safari#biv=i|17;d|AGhp8EGhpOON2M:

It’s kind of a chicken and egg scenario. In my case, I assume it’s both the chicken and egg and cover both bases. Release the muscles and surrounding connective tissue, make sure the joint is positioned well and moving properly during it’s movement, ensure that the body is positioned well enough that the jaw is not forced into a position and will affect good motion and empower the patient to maintain that good position.

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