Top 5 Fridays! 5 TMJ Triggers to Avoid | Modern Manual Therapy Blog

Top 5 Fridays! 5 TMJ Triggers to Avoid



Part of treating TMD is not only education on pain science, stressors, and the manual therapies/exercises, but avoiding the triggers. We use our mouth/facial muscles much more than you think throughout the day and minimizing triggers is a good way to desensitize this area.

Here are 5 TMJ Triggers to Avoid when in the beginning and middle phases of rehab

1) Thinker pose
  • just look at the cover pic for this post
  • it's such a common pose, and often done unilaterally
  • the TMJ is not typically a WB joint and this can further irritate an already sensitized joint
  • it can also cause subluxation of intra-articular discs, and the repeatedly clicking can also irritate the joint
  • solution: avoid it or use fingers on the forehead and zygomatic arch to have a similar pensive pose, but not directly load the TMJ

2) Unilateral Chewing
  • out of habit many people chew on one side more than the other
  • this could either cause ipsilateral irritation or contralateral due to the tilting effect unilateral chewing has on the opposite side - may be moving the involved side too much
  • solution:  evenly distribute food on both sides, or chew on the side that does not irritate you

3) Hard/Chewy Foods
  • this is an important early phase - no chew for very sensitized TMJs progressing to soft chew
  • the graded exposure to normal meals starting with 1 a day
  • use an analogy of acutely sprained ankle, in needing to avoid WB for a week or so to allow for healing/desensitization
  • solution: avoid hard/chewy, raw foods, make lots of healthy smoothies, give the joints time to calm down


4) Talking on phone with head tilted

  • another common habit, I once had a patient who couldn't figure out what set back his progress about once a week - he finally figured out it was talking to his friend long distance once a week with his head tilted to the same side
  • tilting head to the left causes TMJ compression to the left and distraction on the right, either side being potentially sensitized if after prolonged periods
  • solution: use a bluetooth or wired headset, switch sides periodically for long conversations, use speakerphone and while you're at it, walk around for the entire phone call

5) Nail/pen biting
  • again, another habit that patients don't realize is further irritating the sensitized TMJ
  • it's just another trigger that adds up throughout the day when combined with some or all of the above
  • solution: mindfulness to stop the "addiction" of nail/pen biting, place pens/pencils out of reach, necessitating to get up to when you have to finally use one



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