Massage Today
Massage Today dotted line
dotted line

dotted line
Share |
  Forward PDF Version  
Massage Today
July, 2010, Vol. 10, Issue 07

TMJ: Self-Care for Your Masseter

By Judith DeLany, LMT

Today, as many people try to get more done in the day than the minutes allow, you might discover that you are clenching your teeth, even during the daytime. This is a common reaction to stressful situations, and even more common when the stress is unrelenting and the pressures of time management unyielding.

Many of us clench our teeth without being aware of it and very often have tight temporomandibular joint (TMJ) muscles, without necessarily displaying any overt symptoms.

Location and Function

The temporomandibular (TM) joints are located just anterior to the opening of each ear and are involved in chewing, talking and displaying a wide range of facial expressions, all of which goes on practically unnoticed. It is rather remarkable that jaw movements occur in most people without any problem, especially considering the incongruent and naturally unstable design of this joint. Temporomandibular dysfunction (TMD) may develop, with symptoms that include headache, in a variety of patterns including: migraine (Fig. 1), toothache (Fig. 2), burning or tingling sensations in the face, tenderness and swelling on the sides of the face, clicking or popping of the jaw, reduced range of motion, ear pain without infection, hearing changes, dizziness, and sinus-type responses.

trigger point target zone of masseter - Copyright – Stock Photo / Register Mark Figure 1: The trigger point target zone of masseter includes a headache similar to a migraine pattern. If caught in the early stages, dysfunction might be avoided by simply becoming aware of habits of clenching and/or grinding of the teeth, especially as associated with stress, and by reducing muscular pressure on the joint and its articular disc.

Spotlight on Masseter

A number of muscles act upon the TM joint. Masseter, capable of exerting hundreds of pounds of pressure, is the most powerful. It is comprised of three layers, stacking upon each other and filling out the region of the lateral cheek. It is involved primarily with chewing, clenching, strong closure of the jaws, and, to some degree, postural positioning and balancing the jaw, particularly when head position changes. It is overworked by habits of daily life, particularly chewing gum, clenching and grinding the teeth, as well as internalizing emotional distress.

Treatment is indicated for masseter when the range of opening of the mouth is restricted or when there is pain or other sensations in areas of the TM joint and trigger point target zones of referral. However, even when no symptoms exist, releasing masseter can immediately produce a feeling of lightness in the face and the resultant feeling of stress relief.

Additional trigger point referrals - Copyright – Stock Photo / Register Mark Figure 2: Additional trigger point referrals for masseter include pain and sensitivity in the upper and lower molars. NMT Intraoral Masseter Release

A complete intraoral protocol is part of the Neuromuscular Therapy training for temporomandibular dysfunction. It is strongly recommended that practitioners receive appropriate training before working inside the mouth of clients/patients. However, it is easy to following these steps for a personal experience of releasing your own masseter. After releasing the first side, pause to open and close the mouth and to feel the (sometimes extraordinary) relaxation of the face on the side that has been treated.

Although a glove can be worn for self-application, a thoroughly scrubbed, bare finger is acceptable in one's own mouth. A protective barrier should always be worn when treating someone else. Nitrile or vinyl (full-hand) gloves are better choices than latex, which often causes allergic reaction.

  1. Place a gloved index finger inside the mouth, resting just inferior to the zygomatic arch with the pad of the finger facing toward the cheek and the fingernail surface resting against the outside surface of the upper molars. Clench the teeth gently to contract the masseter's deep portion for identification and then relax the jaw for treatment.

  2. TMJ - Copyright – Stock Photo / Register Mark Figure 3: Releasing masseter can produce a light, relaxed feeling in the face. Use the externally placed thumb of the same hand to apply static pincer compression against the internally positioned finger. (Fig 3) Use enough pressure to match the tension found in the muscle and hold the pressure for 18-20 seconds. The amount of pressure to use is that which causes a medium level (7 on a 1-10 scale) of discomfort within the compressed tissue. The discomfort should begin to fade and the tension in the tissue should begin to subside within the prescribed time. While many tissues respond to compression within 8-12 seconds, masseter may require the suggested longer compression of 18-20 seconds.

  3. Move the finger one finger-width down the muscle and press once again in a similar manner. Continue working down the muscle as far as possible, one fingertip at a time, until the mandibular attachment is reached. This treatment line has a vertical orientation.

  4. Place the treating finger again at the starting point just under the zygomatic arch and apply compression in a similar manner as described. This time apply compression at fingertip intervals to the tendon attachment of masseter along the inferior surface of the zygomatic arch. This treatment line has a horizontal orientation.

  5. Repeat steps 1-4, two or three times, as needed. There is often a profound change in the tension of masseter when a thorough (not aggressive) treatment is applied. You may note an appreciable difference when comparing the side that has been treated with the one that has not been touched.

  6. Be sure to repeat these steps to the second side in order to maintain balance between to two sides. Never treat just one side of the TMJ muscles.

Editor's Note: Proper training of Neuromuscular Therapy should be completed prior to working on a client. As stated in the article, the author is not advocating working inside the client's mouth before proper training. For more information on Neuromuscular Therapy and Judith DeLany go to: www.nmtcenter.com.


Judith DeLany serves as director of NMT Center, writes textbooks for Elsevier Health Sciences, and lectures internationally in the field of neuromuscular therapy. For more information regarding her work, visit www.nmtcenter.com or call toll-free at (866) 571-7942.

 

Join the conversation
Comments are encouraged, but you must follow our User Agreement
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.
comments powered by Disqus
dotted line
No Prescription Cialis To Buy Viagra Viagra Patent Europe Viagra Best Buy Diet Pills Keyword Buy Viagra Online Cheapest Price For Cialis Can I Buy Viagra Edinburgh Uk Viagra Tid Cfm Erectile Dysfunction Cures Levitra Online Us Pharmacy Viagra Sale Online Cialis Levitra Pharmacy Viagra Cost Of Cialis Levitra En Espanol Silagra 100 Counter Drug Over Viagra Cheap Viagra Cialis India Buy Cialis Where Uk Viagra Sales Viagra Overnight Buy Cheap Sale Viagra Rx Pharmacy Generic Viagra Viagra Cialis Canada Viagra Samples For Free Viagra 100mg For Sale Generic Viagra Trial Pack Cheap Generic Viagra No Script Cialis Prescriptions