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Cranial Connections

By Don McCann, MA, LMT, LMHC, CSETT

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The Transformation of the TMJ Imbalance

Everyone has some TMJ imbalance which can lead to pain and dysfunction. This imbalance can be as minor as a slight shifting of the jaw when fully open, or as major as a full dislocation and inability to open the jaw more than ½ inch. The greater the imbalance in the temporal mandibular joint the greater the pain, dysfunction and degeneration.

There are many challenges involved in effectively treating TMJ. Often, the most misunderstood factor is the cranium. We usually think of the TMJ imbalance as being only in the soft tissue of the temporal mandibular joint, the muscles actually involved in moving the joint. This is short sighted. What is usually overlooked is the imbalance in the cranial bones and cranial motion. This imbalance in the cranial bones leaves an imbalance in the TMJ regardless of the soft tissue. Furthermore, this imbalance in the cranium is the cranial core distortion that is responsible for the core distortion in the entire body. If the imbalance of the cranial motion and resulting misalignment of cranial bones is not addressed first, then working the actual muscles that move the jaw is going to be minimally effective and won't address the root cause of TMJ dysfunction.

Case Study

Sally, a 30-year-old dentist, came for sessions and was suffering from severe headaches, jaw pain and an inability to open her jaw more than the width of one finger between her front teeth. This problem developed in dental school and got progressively worse with orthodontic treatment including braces and grinding down back teeth to balance her bite. She was limited in what she could eat due to her inability to open her mouth and pain when chewing. She also had right carpal tunnel issues that were making the practice of dentistry difficult.

Structural evaluation indicated that she was in the core distortion with left ilium rotated anterior, right ilium rotated posterior, sacrum tilted, exaggerated curvatures in the spine, unequal leg lengths, a twist in the thoracic area, anterior/posterior shoulder rotations, internally rotated right arm, neck forward and tilted to the right and head tilted back to the left. Further evaluation using applied kinesiology, showed weaknesses when opening the mouth, turning eyes to the left and rotating head to the right. Additional testing throughout the body using functional kinesiology tests verified the core distortion. The Cranial/Structural Core Distortion Release (CSCDR) was then applied to address the imbalance in the cranial bones and cranial motion to unwind the cranial imbalances.

TMJ - Copyright – Stock Photo / Register Mark This resulted in immediately restoring the range of motion and balance in the cranium and the temporal mandibular joint. Again using kinesiology, her open mouth now tested strong, the pain was diminished and she could open her mouth wide enough for two fingers between the front teeth. Additional cranial/structural work was applied to be sure that the facial bones would move in harmony with the vault cranial bones. At this point, a specialized soft tissue protocol was applied to further release the structural imbalances in the head, neck and shoulders that were part of the core distortion. Sally left the session without a headache, improved range of motion for her bite and very encouraged as this was the first real positive change since the condition had worsened. Sally was scheduled for weekly sessions.

At Sally's second session she reported having only one headache which was less severe than usual, chewing was less painful and she could start to eat food she had given up due to the difficulty in chewing. Structural evaluation showed an improvement throughout her body from the release of the core distortion. A cranial evaluation showed that the CSCDR had produced enough change for weight bearing support throughout her body. However, due to the severity of the initial cranial imbalance, the CSCDR was applied a second time along with facial bone releases to bring the cranium more into balance and unwind soft tissue associated with her TMJ issue. Another specialized soft tissue protocol was applied to further release the shoulders backward, reduce the forward and tilted position of the neck to bring the head to a more level posture and release holding patterns of the core distortion in the soft tissue associated with the jaw. Sally felt relief from the pain in her head, neck and shoulders and noted that her jaw opened and closed more easily. She was excited that she was continuing to have positive changes.

At the third session, Sally reported a week without headaches which was a huge relief, chewing and eating was almost pain free, except when she had to bite down hard and her carpal tunnel was improving with easier control of her hand and less pain. Structural evaluation revealed the head more in alignment with her neck and the forward curvature of the neck was significantly reduced. Cranial evaluation revealed some restriction on the left side which was released with cranial/structural therapy. With the improvements in the head, neck and shoulder area and in the TMJ, a pelvic balancing soft tissue protocol was applied to release the imbalances in the soft tissue from the anterior/posterior rotation of the iliums and resulting long leg/short leg imbalance. This further unwound the original core distortion pattern throughout the body and supported the changes in her head, neck and shoulders.

At the fourth session, Sally was satisfied as she had finally found something that worked and lasted. Structural evaluation indicated major improvements from the initial imbalances of the core distortion throughout her structure. Sally was maintaining the ability to open her jaw with two fingers between her teeth and could chew 90% of her food without pain. Headaches that had been three to four times a week were gone. Carpal tunnel symptoms had disappeared and strength and flexibility were restored in her right hand. Additional cranial evaluation revealed structural sub patterns which were released with additional cranial/structural work to fine tune and further balance the cranium. The specialized head, neck and shoulder soft tissue protocol was again applied, along with specific work to release the connective tissue and muscles of the temporal mandibular joint.

It was now time to do the intraoral work on the soft tissue restrictions associated with the TMJ. This intraoral work is very specific and can be very intense. As stated above, the initial imbalance of the TMJ is principally a core distortion issue both in the cranium and the structure of the body, so by first releasing the imbalances of the core distortion throughout the whole structure you minimize the amount of intraoral work. The deep intraoral muscles are the smaller stabilizing muscles that have less influence than the larger muscles of the jaw and head, neck and shoulder area. This intraoral work increased the range of motion of Sally's jaw to where three fingers could be inserted between the teeth. This was the first time in years that Sally could fully open her mouth, let alone be out of pain.

Sally had four more sessions scheduled once every two weeks. Each session began with a cranial evaluation and cranial/structural releases. This was followed by specialized soft tissue protocols focusing on the head, neck and shoulder area for two sessions, and then two sessions releasing the soft tissue core distortion throughout the rest of her body to support the changes in the head, neck and shoulders and temporal mandibular joint. Sally no longer suffered from TMJ pain and dysfunction and her rehabilitation was complete and long lasting.

The following five points were key in understanding and treating the source of Sally's TMJ dysfunction so successfully:

  1. The TMJ imbalance was a direct result of the core distortion imbalance found in her cranium and applying the CSCDR to bring the cranial motion and cranial bones into balance.
  2. The cranial imbalance was reflected throughout her body in structural distortions with the most important area being the rotation of the iliums and lack of weight bearing support for the spine. If the weight bearing support had not been restored in the pelvis and the base of the spine with the CSCDR, then long term structural changes could not have been maintained for supporting balance in the TMJ.
  3. Having the tools to evaluate and treat the cranium, temporal mandibular joint and sub-patterns of the cranium to fine tune and balance the temporal mandibular joint.
  4. Viewing TMJ dysfunction in relationship to the structural distortions of the core distortion in the body, especially in the head, neck and shoulders area, not just the soft tissue attached to the temporal mandibular joint.
  5. Knowing specialized soft tissue protocols to release the core distortion in the soft tissue for the head, neck and shoulders area including the temporal mandibular joint and for the pelvis and lower body to support the structural changes in the head, neck and shoulders for long lasting maximum rehabilitation of TMJ dysfunction.

Other significant relationships between the cranial bones and the structure of the body that affect the core distortion imbalance of TMJ are the temporal bones and the iliums, the maxilla and the pelvic floor, the sphenoid and the ASIS, the occiput and the PSIS and the zygomas and the shoulders.

As you can see, successful long term rehabilitation of TMJ pain and dysfunction necessitates releasing the core distortion throughout the entire body using cranial/structural techniques integrated with specialized myofascial soft tissue protocols for long lasting support and balance.

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