Technique Highlight: TMJ Manual Techniques | Modern Manual Therapy Blog

Technique Highlight: TMJ Manual Techniques

Here are my basic go-to techniques for the TMJ.

This goes well with this case.

TMJ Distraction

  • Pt: Supine
  • PT: sitting superior to pt's cranium
  • Tech: 
    • rotate pt's head away from the side you are mobilizing
    • use ipsilateral 2nd digit pad on the mandible condyle to palpate for movement
    • use contralateral thumb on the top of the pt's lower molars with pad on rearmost molar
    • have pt lightly close on your thumb - important to emphasize the light part!
    • light wrist extension for the TMJ distraction, palpate for condyle distraction
    • perform 6-10 reps (the 6 is a nod to the man Dr. Rocabado!)
  • Improves all mandible ROM, intracapsular space
TMJ Lateral Glide

  • Pt: Supine
  • PT: sitting superior to pt's cranium
  • Tech: 
    • rotate pt's head away from the side you are mobilizing
    • use ipsilateral 2nd digit pad on the mandible condyle to palpate for movement
    • use contralateral thumb on the medial side of the pt's lower molars with pad on rearmost molar
    • have pt lightly close on your thumb 
    • light wrist extension to promote TMJ lateral glide, palpate condyle for lateral translation
    • 6-10 reps
  • Improves mandidble contralateral lateral excursion (mob left side, improves lat excursion right)
TMJ Medial Glide
  • Pt: Supine
  • PT: sitting superior to pt's cranium
  • Tech: 
    • rotate pt's head away from the side you are mobilizing
    • ipsilateral hand on the apex of the cranium with fingers on the temporal side
    • use contralateral thumb on the medial side of the pt's lower molars with pad on rearmost molar
    • have pt lightly close 
    • stabilize the mandible with one hand, the other hand 
    • mobilize cranium over the mandible condyle laterally, which is a relative medial glide
  • improves mandible ipsilateral lateral exucrsion (mob left side, improves lat excursion left)
Masseter Release
  • Pt: supine
  • PT: sitting slightly to the treating side above pt's cranium
  • Tech
    • mob hand assesses for tone, TrP, restriction in proximal to distal direction from zygomatic arch to angle of mandible
    • assist hand may drag tissues in the opposite direction to promote further stretch
    • slow progressive depth of treatment to reduce tone, proximal to distal to promote mandible depression
    • perform 3-5 minutes or until released
  • improves all mandible motion, HA
Temporalis Release
  • Pt: supine
  • PT: sitting slightly to the treating side above pt's cranium
  • Tech
    • mob hand assesses for tone in anterior temporalis (hard to release the rest under hairline unless they have a shaved head
    • assist hand may drag tissues in opposite direction to promote further stretch
    • light slow treatment from proximal to distal to promote mandible depression
    • perform 3-5 minutes or until released
  • improves all mandible motion, HA


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