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98 m a s s a g e & b o d y w o r k j a n u a r y / f e b r u a r y 2 0 1 7 technique MYOFASCIAL TECHNIQUES Gentle Techniques for the Jaw and TMJ By Til Luchau There is much we don't know about temporomandibular joint dysfunction (TMD or TMJD). Although sometimes clearly the result of an injury, in most cases, we don't know what causes TMD and its associated pain, tenderness, and movement issues. Although an estimated 40–75 percent of adults show at least one TMD sign at some point in their lives (for example, about 50 percent of adults have nonpainful jaw noise or asymmetrical movement), we don't know why only about 33 percent of those adults ever experience pain or dysfunction. We don't know why people over age 60 very rarely complain of TMD, or why the most severe sufferers are up to nine times more likely to be female than male, or why many TMD patients experience other systemic conditions that also affect more women than men, such as chronic fatigue syndrome, fi bromyalgia, generalized pain conditions, rheumatoid arthritis, interstitial cystitis, vulvodynia, endometriosis, or irritable bowel syndrome. 1 TMD symptoms often occur together with migraine, tinnitus, or vertigo. Note: the temporomandibular joint's articular disc (yellow) and its proximity to the ear canal (violet), the brain, and the nerves of the head. The inner ear's semicircular canals are also visible. Image courtesy Primal Pictures, used by permission. 1 Cross section of the head, at the level of the temporomandibular joints' articular discs (yellow) and the ear canals (violet). Image courtesy National Library of Medicine, Visible Human Project, used under license. 2