Issue link: https://www.massageandbodyworkdigital.com/i/766890
We do know that TMD often seems to have mechanical aspects, referred to as axis I in the most common diagnostic system—the Research Diagnostic Criteria for Temporomandibular Disorders. 2 These physical aspects include tissue inflammation, disc displacement, excessive laxity or tightness of the joint, and the most common axis I feature—myofascial pain. 3 Just as importantly, we know that TMD is frequently correlated with psychological factors (axis II) such as anxiety, depression, mental or emotional stress, or sympathetic (fight-or-flight) autonomic nervous system (ANS) arousal. 4 As a result, there is wide agreement that TMD assessment and management should include both physical and psychological support. 5 Although chronic TMD sufferers may respond best to an integrated approach combining multiple disciplines (since TMD can involve many factors), several large-scale studies show that manual therapy can often help TMD, alone or in combination with other methods. 6 In our Advanced Myofascial Techniques approach at Advanced-Trainings.com, we have found that hands-on work can frequently help TMD in several ways—both by skillfully addressing the above-listed axis I mechanical contributors, and through the nonmechanical effects of hands-on work. These effects include increased proprioceptive refinement, shifts in pain perception, and promoting relaxation and nonpainful body awareness through calming effects on sympathetic ANS arousal (such as stress responses, mental agitation, posttraumatic stress disorder, etc.). I described several techniques for working with the anatomical and mechanical contributors of TMD in the three-part series "Working with TMJ" (Massage & Bodywork, July/August, September/October, and November/ In the "Fly Landing" variation of the Jaw Proprioception Technique, the lightest possible touch is used to draw the client's proprioceptive awareness to any jaw tension. Image courtesy Advanced-Trainings.com. 3 In the "Horseshoe Grip" variation of the Jaw Proprioception Technique, cradle and motion-test the occiput and mandible with a very soft grip, encouraging relaxation and easy breath. Further instructions are in the sidebar, page 101. Image courtesy Advanced-Trainings.com. 4 Watch Til Luchau's technique videos and read his past articles in Massage & Bodywork's digital edition, available at www.massageandbodyworkdigital.com, www.abmp.com, and on Advanced-Trainings.com's Facebook page. "Jaw Proprioception Techniques" C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 99