The jaw is a joint that we use constantly: to talk, eat, yawn, or even breathe. When you experience jaw pain, clicking, or locking, these simple everyday movements can quickly become uncomfortable.
Pain related to the temporomandibular joint (TMJ) is relatively common and can be caused by various factors: muscle tension, joint problems, poor posture, or teeth grinding.
Physiotherapy specializing in TMJ can identify the source of the problem and offer tailored solutions to reduce pain and improve jaw mobility.
What is the temporomandibular joint (TMJ)?
The temporomandibular joint connects the mandible (lower jaw) to the temporal bone of the skull. It has an interesting feature: a single bone—the mandible—works with two joints, located on either side of the face.
Inside the joint is an articular disc, a soft tissue similar to the meniscus in the knee. This disc plays an essential role in improving the fit of the joint surfaces, absorbing forces, and helping to stabilize jaw movements.
Several muscles are also involved in the functioning of this joint. The main ones are:
- the masseter, located in the cheeks, which can be felt when clenching the teeth
- the temporal, an important muscle in closing the mouth
- the medial and lateral pterygoids, deeper muscles that contribute to jaw movement and stability
In normal situations, the mouth generally opens between 40 and 50 mm, which is approximately the space between three fingers. Lateral movements are smaller, approximately 10 to 12 mm, and should be smooth and symmetrical.
Why can the jaw deviate or produce cracking sounds?
When opening the mouth, the jaw should move in a coordinated manner, without significant deviation or noise. However, certain situations can disrupt this movement and cause symptoms.
Several factors can explain these problems.
One possible cause is a difference in mobility between the two joints. If one is stiffer or, conversely, more mobile than the other, the jaw may deviate when opening.
Asymmetrical muscle tension is also common. The jaw muscles can become tighter on one side, creating an imbalance in movement.
In some cases, it may also be due to a lack of muscle control, which sometimes gives the impression that the jaw opens in an “S” shape or makes small clicking sounds.
Finally, the problem may also originate in the articular disc. This disc can move forward and then snap back into place, often causing a clicking sound when the mouth is opened. Sometimes, this displacement can also limit the opening of the mouth.
How is the jaw assessed in physical therapy?
The assessment of a TMJ problem is usually very thorough. The physical therapist will start by asking several questions to better understand the patient’s symptoms and habits.
The questions may include:
- pain in the face or jaw
- headaches or neck pain
- discomfort near the ears
- noises or cracking in the jaw
- teeth clenching or grinding habits
- Next, a physical assessment is conducted to observe posture, neck mobility, and jaw movement. The physical therapist also palpates various muscles to identify areas of tension.
In some cases, certain muscles can be evaluated inside the mouth, which allows for better targeting of the source of the problem.
Possible treatments for TMJ disorders
Treatment always depends on the cause identified during the assessment. In physical therapy, several approaches can be used to reduce pain and improve jaw function.
The physical therapist may, in particular:
- improve joint mobility if it is too stiff
- work on control and stability in cases of hypermobility
- release significant muscle tension
- correct certain postural habits
Home exercises are usually part of the treatment plan. They may include jaw mobility exercises, posture exercises for the neck and shoulders, and muscle self-relaxation techniques.
Certain breathing exercises may also be recommended to reduce nervous system tension and decrease teeth clenching, especially in the evening.
The link between posture and jaw pain
Posture directly influences jaw mechanics. A head that is pushed forward, such as when spending long periods of time in front of a computer or phone, can increase pressure on certain structures of the joint.
This position often encourages teeth clenching, which can lead to tension in the jaw muscles.
The connection between the neck and jaw is also important. For example, the sternocleidomastoid muscle, located in the neck, attaches to the temporal bone of the skull, which is part of the temporomandibular joint. Tension in this muscle can therefore influence jaw pain.
In many cases, working on posture and neck mobility can help improve symptoms.
Other techniques used in physical therapy
When tension is severe or persists despite exercise, certain complementary techniques may be used.
For example:
- dry needling to release deep muscle tension
- therapeutic laser to reduce inflammation
- specific exercises to reduce bruxism (teeth grinding)
These approaches are generally combined with exercises and personalized advice to achieve better results.
An interdisciplinary approach for better results
Jaw pain is often influenced by several factors. That is why an interdisciplinary approach can be particularly beneficial.
Depending on the situation, different health professionals may collaborate, including:
- Physical therapists
- Chiropractors
- Massage therapists
- Dentists
By working together, these professionals can address different aspects of the problem, such as posture, muscle tension, or certain habits that contribute to the symptoms.
When should you seek medical advice for jaw pain?
It may be advisable to seek medical advice if you experience:
- pain in the jaw or face
- cracking or locking when you open your mouth
- difficulty chewing or opening your mouth fully
- headaches associated with jaw tension
- teeth clenching or grinding
A physical therapist trained in temporomandibular rehabilitation can assess your situation and suggest a suitable treatment plan.
-
Anick Paquin
Physiotherapist
