TMJ Physio Approach
TMJ Physio is a unique Physiotherapy practice, dedicated to the diagnosis, treatment, rehabilitation and prevention of Temporomandibular dysfunction. TMJ disorders are often associated with headaches, neck pain, migraines and as such, at TMJ Physio, our expertise is in the treatment and management of all aspects of your condition. Our problem solving approach utilises the most effective assessment procedures and treatments to get to the bottom of your jaw problems. At TMJ Physio, we will give you all the knowledge and support that you need to completely understand and best equip you to effectively manage your condition as we strongly believe that prevention is better than cure.
At TMJ Physio, we use the most effective management plans and ensure a holistic approach through the incorporation of adjuncts to Physiotherapy as detailed below. As a Specialist TMJ Physiotherapist, Helen also is a highly skilled musculoskeletal Physiotherapist having completed extensive post graduate training to gain membership to the Musculoskeletal Association of Chartered Physiotherapists (MACP). Helen is a skilled acupuncturist with extra post graduate training in specific TMJ Acupuncture and a member of the Acupuncture Association of Chartered Physiotherapists (AACP). Helen is a fully certified Pilates Instructor and member of the Australian Physiotherapy and Pilates Institute, Pilates principles are always incorporated into your TMJ management plans as at TMJ Physio, we recognise the strong link between postural dysfunction and TMJ dysfunction.
These professional memberships and expertise allow Helen to provide you with the most effective treatment plans with the inclusion of manipulation, acupuncture and Clinical Pilates as part of your treatment plan.
MANAGEMENT OF TMJ
There are numerous treatments that are effective for the management of TMD. Physiotherapy treatment and management of TMD can be broadly categorised;
• Manual Therapy
• Myofascial Release
• Electrotherapy Modalities
• Exercise Therapy
Myofascial manual therapy techniques involve applying digital pressure or accupressure to masticatory muscle trigger points and are beneficial in reducing pain in TMD. Mobilisation of the selected muscle promotes lengthening and release of tight areas within the muscles which can develop. Myofascial techniques are used with the muscles of mastication and also the neck muscles which commonly become tight in TMD.
Laser is an acronym of "light amplification by stimulated emission of radiation", and the use of these beams in treatment is known as low-level laser therapy (LLT). Low-level laser therapy is widely used in TMD and may increase pain tolerance by increasing the blood supply to assist with healing. Laser can also be used over specific acupuncture points instead of the use of needles and using laser in this way is beneficial for nervous patients and patients who cannot tolerate acupuncture needles.
The prescription of exercises to strengthen, lengthen and facilitate control and stability around the TMJ are essential in the management of TMD. Muscle retraining through prescribed exercises is crucial in restoring mobility of the jaw bone (mandible). Specific exercises also assist with restoring normal and smooth TMJ movement.
Postural re-education through Pilates based exercises are beneficial in the treatment of TMD as there is a strong association between TMD and postural dysfunction in particular a forward head posture.
Acupuncture has been used for the treatment of TMD and is well evidenced. The precise mechanisms underlying the action of acupuncture remain unknown, but are thought to reduce pain by stimulating the brain and spinal cord to produce natural pain-relieving chemicals such as endorphins, melatonin (which promotes sleep) and serotonin (to promote well-being). These chemicals assist the body's natural healing processes and provide pain relief.
Acupuncture forms part of traditional Chinese medicine (TCM). This ancient system is based on a holistic concept of treatment which regards ill health as an imbalance in the body’s energy. Re-establishing a correct energy balance is the aim of TCM.
There are different methods in which to use acupuncture;
Traditional acupuncture involves the use of single-use, pre-sterilised disposable needles that pierce the skin at the acupuncture points along a selected meridian. Numerous needles may be used during each treatment, and these are typically left in position for between 20 and 30 minutes before being removed. Needles may be inserted around the TMJ and neck and also points away from the area of pain such as in the hands or feet may be utilised to stimulate specific pain relief channels.
Trigger Point Acupuncture or Dry Needling
Trigger point acupuncture is used to facilitate relaxation of the muscles of mastication and muscles within the neck or face. This acupuncture approach is used to increase muscle length in order to aid stretch and rehabilitate. The needle is inserted into the selected muscle until the tissue is felt to relax under the needle, which is then removed. DN involves inserting an acupuncture needle into a specific point in the muscle known as a trigger point. DN specifically reduces the spasm and trigger point within the muscle into which the needle is inserted and therefore promotes not only healing of the muscle, but relaxation. It is common to have a twitch of the muscle when using DN and may feel uncomfortable.
Manual therapy aims to restore the normal joint movements and biomechanics that occur in the TMJ. Manual techniques mimic the natural movement that occurs at the joint assisting with the movement of synovial fluid within the joint and also mobilising the soft tissues that attach into and around the TMJ. Manual techniques can help to reduce adhesions that occur particularly in disc displacements.