A family friend was recently given a running, jumping hug by a 7 yo. It turns out little girls are a perfect mandible striking height when an adult is crouched. For almost 1 month she had difficulty opening and eating due to TMJ and facial pain.
She finally called my wife asking if I would see her at our house. I saw her yesterday and this is what her painful and limiting opening looked like.
There was an audible early intra-articular click in the left TMJ with mandible deviation to the left until reduction. Depression was limited to about 50% with pain. She had been eating soft foods and had difficulty opening due to pain for 4 weeks with only slight improvement via time.
A quick evaluation revealed mild forward head posture, along with increased tone in the left mandible elevators compared to the right. After light IASTM to the left masseter in a proximal to distal stroke for 2 minutes then a light medial pterygoid functional release, mandible depression had much less pain, no deviation, and a very light click.
Clinical Pearl Time
I realized I had no gloves at my house! We're close, but not that close!
|Using right hand to grasp left mandible and left lower molars|
|My adapted grasp of her right hand so I could mobilize her TMJ|
|Side view with left hand index on the mandible condyle palpating for light movement|
This reduced the disc derangement completely and she now had full pain free motion with no deviation for the first time in 1 month. For HEP, I instructed her on self TMJ distractions on the left and cervical retractions to make sure the mandible does not retract excessively. I plan on following up with her next week, but she was able to go out to Panera Bread to catch up with my wife immediately after our little emergency visit!
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Keeping it Eclectic...