The Ripple Effect (Regional Interdependence)

I once had a patient that came to me desperate due to severe headaches, 10/10 that would put him down for up to a week if he did anything that was strenuous like exercise, yard work or even intimacy with his loved one. He had seen all kinds of specialists in neurology, neurosurgeons, chiros, Physical therapists. No one could help him for over 10 yrs. He came to me because I specialized in TMJ and PT treatment for the neck. What in the heck was I going to do for him!! He already saw all of the best minds in the area for headaches. He did not have TMJ that we knew of. I was overwhelmed by the thought that this guy was banking on me to try something. So, I did an extra thorough evaluation. I found lots of the usual problems, upper back and neck tightness. Weakness of the neck flexors, etc. Oh and I found his hamstrings were really tight, I mean snare drum tight. So I treated his neck and facial head tension and tenderness for 2 weeks with no results. He felt the same. I sat with him and said “I don’t know Mr. X, I only have one more shot in the dark. Those Hammies are tight as all heck so let’s try moving them and see if you get any results.” Next visit he comes back and exclaimed “It worked!” My jaw dropped to the floor. By stretching his hamstrings and gliding his sciatic nerve which runs from the lower spine down to his toes it released tension on his central nervous system. After a few more weeks he had a great recovery, he could do anything strenuous and his headaches would not get worse than 2/10. Now I tell you this to give an extreme example of the idea of regional interdependence. As a physical therapist specializing in the treatment of TMJ disorders, I often encounter patients who have tried multiple interventions without success. This is because TMJ dysfunction is a complex issue that is often influenced by various factors throughout the body. This is where the concept of regional interdependence comes in. Regional interdependence refers to the idea that dysfunction in one area of the body can lead to symptoms or impairments in another seemingly unrelated area. The further from the body part in question, the less likely it can affect it but the chances are not 0% as you saw above. This is particularly relevant when it comes to the TMJ, as dysfunction in the jaw can lead to symptoms such as headaches, neck pain, and even shoulder pain and vice versa. For example, if a patient has an imbalance in their neck muscles or stiffness in their upper back, this can affect the positioning of their jaw and contribute to TMJ dysfunction. Similarly, if a patient has poor posture or limited mobility in their hips, this can lead to compensatory movements in the jaw and contribute to TMJ symptoms. By addressing these underlying issues through techniques such as manual therapy and corrective exercises, you can improve overall function and reduce TMJ symptoms. Manual therapy techniques such as soft tissue mobilization and joint mobilization can help to restore proper joint mechanics and reduce compensatory movements in the jaw. Corrective exercises, such as strengthening or stretching, can help to address muscle imbalances and improve overall function. Functional training is also an important aspect of TMJ treatment, as it can help patients to develop proper movement patterns and reduce the risk of future injuries. This can include exercises such as deep nasal breathing or practicing proper posture throughout the day. In addition to these techniques, we may also recommend other interventions such as stress management or relaxation techniques. This is because stress and anxiety can contribute to TMJ dysfunction, and addressing these underlying issues can help to reduce symptoms. Overall, the concept of regional interdependence is a valuable tool for us when we are treating TMJ disorders. By recognizing that dysfunction in one area of the body can contribute to symptoms in the jaw, physical therapists can take a more holistic approach to treatment and improve overall function and quality of life for their patients. Long story short if you have headaches make sure you stretch your hamstrings!! Get outside and enjoy some time with people you love, Josh Hubert