When I speak with a patient who is consulting with me about a long-standing TMJD it is not uncommon for them to feel devastated when they speak about their jaw. “My dentist said my TMJ disc is dislocated.” “ I have degenerative joint disease of the TMJ.” “I have trismus.” These are all terms for medical diagnoses; however, they do not determine your outcomes.
This is the best way I can put it. If you lived your entire life free of pain with a great quality of life and when you were on your deathbed at 90yrs old after living a full life your doctor says, “Mrs. X you have a congenital lung disease, and your lungs were never like normal lungs and there was nothing that could make them normal.” Would you give a shit? NO! You lived your life not aware of it and felt happy and healthy. This is why I do not care about medical diagnosis when it comes to treating any musculoskeletal disorders. We care about pain, function, and quality of life. Many diagnoses cannot be changed but these three can.
Do not get fixated on diagnosis instead concentrate on these 5 pillars of TMJ health (and truthfully all health) so you can thrive no matter what the diagnosis says.
Breathing: Without proper breathing, there is no human life. We teach breathing through the nose both with inhalation and exhaling. Into the diaphragm so the belly expands and out bringing the ribs downward. Most clients I see with neck pain, TMJ pain, LBP, and headaches have disordered breathing patterns. The statistics are 60-90% of people in the US have disordered breathing.
There are different beliefs about the amount of time you should breathe in and out. I teach 3 seconds in and 6 seconds out but don’t get too technical about the time. Just breathing in and out through the nose with about 2x as long to breathe out as it took to breathe in.
Proper mouth and tongue posture. Start this immediately. This is the easiest thing to do. Tongue on the roof of your mouth in the “No position” when you are hanging on the “N” sound. Your teeth should be slightly apart, and your lips closed. When you are not talking, eating, or singing this is where your mouth and tongue should be the rest of the time. This position places the TMJ in a relaxed centric position. This decompresses the joint and puts the muscles at relative rest. You’re welcome...
Good neck posture. This is accomplished through proper mobility of the upper neck, Mid neck, trunk, and shoulders. This is honestly the most difficult to address because some of us have permanent bony changes that make it more challenging ie) (Kyphosis, scoliosis). “However, do not let perfection get in the way of progress.” Steve Jobs said this, and it is great advice for us. No one gets perfect posture, however, we can all get better and sometimes a millimeter in the right direction does great things for pain and function. Good posture involves working on mobility so that you can get into the posture and habit changes to teach yourself how to hold a position.
Pain and stress management. These 2 can be addressed by some simple cognitive techniques. I highly recommend the curable app https://www.curablehealth.com/clara. They are dedicated to pain science for a few bucks. It can make a big difference in your life if you have chronic pain and associated anxiety. If you can’t do it on your own see a therapist (a head shrink). You need to get your mind in the right place to heal.
Strength and endurance of the spine neck and shoulders. This is what allows you to maintain that good posture. In a world full of technology, we are constantly pulled forward. The muscles in the back part of the shoulders and spine are weak and overstretched/underactive and our buttocks muscles are crushed and underactive. We need a good strength program to maintain the function of those muscles.
You don’t need to accomplish it all today. Just begin something today. Put one foot in front of the other. We will be here on the journey. Spend time doing things you love with people you care about. Dr. Josh
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