Acute care for your Temporal Mandibular Joint Pain and Dysfunction

April 9, 2019
We have previously discussed Temporal Mandibular Joint (TMJ) Pain and Dysfunction in more detail (click here for previous article).  In this article, we want to review some acute care procedures you can do at home to help care for this problem.  

First, lets remind ourselves how to accurately feel where your TMJ is on our skull.  If you place your hands on the side of your face, just in front of your ear, your hand should be right over your TMJ (see diagram below).  To test if you are on the right spot, slowly open and close your mouth.  You should feel your mandible move downwards and you may feel a slight gapping at the joint.  If your joint clicks or pops out on oneside like mine, you will feel more movement.  

Next, let us feel for our masseter and temporalis muscles.  If you slide your hands slightly lower than the TMJ you should be on the masseter muscle.  You can check this by clenching your teeth together.  This causes the masseter muscle to contract and your fingers will pop out or move with the contraction.  The masseter works with the temporalis muscle to close the mouth.  There are other muscles involved in opening and closing the jaw, but to keep it simple, we will only discuss self care for the masseter and temporalis.  To find the temporalis, move your hands above the TMJ.  To accurately feel this broad, flat muscle, you often need to clench your teeth.  As you clench, the muscle should contract and pop out a bit.  This is the temporalis muscle.  


At rest, your tongue should be placed behind your front teeth and your teeth should be slightly separated and lips closed.  Is yours?  If your tongue is not rested in this position, one or more muscles around the TMJ, tongue or neck may be too tight.  

If you are experiencing pain or tension around the face, neck or TMJ you may be clenching your teeth resulting in uneven forces acting on the jaw.  Self treatment may consist of : self massage, ice, heat, pain medication, use of a mouth appliance or the application of various pain creams or medications. 

Now that you know how to accurately feel for the anatomical structures that are involved in the function of the TMJ, you can apply some self massage techniques.  Try taking a slight downward tension on the masseter muscles and slowly open your mouth.  Repeat this a few times to your comfort level.  The same treatment can be applied to the temporalis muscle but this time take an upward tension on the temporalis.  Slowly open your mouth as the muscle glides under your fingers.  Repeat again, to your comfort level.  If you notice any swelling or the pain becomes intense at the TMJ try applying some cold, in the form of either ice or a cold gel pack (if using actual ice, make sure there is a layer of cloth between your skin and the ice).  Apply cold therapy for 15min, off for 30min and then repeat 2 or 3 times.  

There are some exercises that can assist with improving proper TMJ biomechanics.    
  1. Practice keeping your tongue on the roof of your mouth or just behind your front teeth, lips together, teeth slightly apart.  This is the normal resting position.   
  2. Maintain adequate head posture:  avoid forward head posture, which causes increased upper cervical spine extension and stresses muscles in the front of your neck and jaw that open the jaw.  
  3. Practice actively opening your mouth using your finger to guide your chin in a straight line
  4. Practice gentle isometrics by resisting jaw motion.  Using your hand on the side of your jaw, push your jaw into your hand without letting your jaw move.  Do the same with opening your jaw but placing your hand under your chin.  To resist closing, place one or two fingers on your lower teeth and try to close against resistance.  The key to isometrics is to activate the muscles that would be involved in doing the motion, but not allowing any motion to occur.  
If you are experiencing any TMJ or jaw pain, speak to your healthcare provider regarding care.  This could be your dentist, family doctor, massage therapist, chiropractor or physiotherapist.  And remember that often more than one healthcare provider needs to be involved in treating TMJ issues.  Both Jen Fleming, RMT and myself, Dr. Marnie D'Andrea, have extensive knowledge and experience in treating TMJ related pain.  Please contact us if you have any questions.  
 

Tabata Workouts

March 2, 2019


Most people have one of two relationships with cardiovascular exercise... tolerate or hate. It's hard to refute the benefits of cardiovascular exercise for heart health. If you are in the hate category, Tabatas might be the right fit for you. Tabata exercises were created by Dr. Izumi Tabata, who researched new approaches to training the Japanese Olympic speed skating team. He created a 4 minute cardio workout that involves 20 seconds of work and 10 seconds of rest for 8 cycles. His research ...

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Spotlight on Women's Cardiac Health

February 26, 2019

March 8 is International Women’s Day and we decided to focus our newsletter on women’s heart health, an understudied, under-diagnosed and under-treated health concern for women. Though there have been incredible improvements in cardiovascular mortality rates in women, heart disease is still the leading cause of mortality in women. Regardless of age, women tend to die more frequently within 1 year of their first heart attack (at 26% vs men at 19%), and within 5 years, at 47% vs men at 36%,...


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Welcome to the gun show!

February 11, 2019

You guessed it!  The guns we are referring to are the biceps.  In this article, we will discuss proper motion, common injuries, exercises and things not to do at the gym! 

The biceps brachii have two muscle bellies and attach the shoulder to the elbow.  For those that would like to know more specific anatomy, the short head, attaches to the coracoid process of the scapula and the long head attaches to the supra glenoid tubercle of the scapula.  Together, both muscle bellies come together to ...


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Gout: Recognizing, Risk Factors and Treatment

December 5, 2018

Gout is an inflammatory arthritis caused by excess uric acid in the bloodstream.  The symptoms of gout arise due to uric acid crystals that are deposited in the joints and the body’s response to them.  The pain is often so intense, anything touching the joint involved, including clothing or socks, causes extreme pain.  The most common joint affected is the big toe, with patients often commenting that even their bedsheet hurts the toe.  As this is a potentially destructive joint disease, it ...


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Fall 2018

October 16, 2018



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Does weather really affect our joints?

October 11, 2018


How many times have you heard the statements "My ankle hurts more when rain is coming"?  Or cold weather brings ache joints.  Often we have an influx of acute neck or low back pain during a "change in seasons" period.  Is there some validity to the theory that changes in weather can bring changes in joint pain sensitivity or even pathology to joints.  Let us take a look at some of the literature on this theory.  

If you search for "joint pain and weather" in Google, the first listed website th...
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Preparing for tryout season

September 4, 2018

Back to school is around the corner and that also means tryout time for school and out of school sports teams.  In my family, our baseball season is coming to an end, but within the first two weeks of school we have tryouts for next years baseball and basketball teams.  This can be a period of extreme stress for some, particularly if they are trying out for a new team with kids they don't know and coaches that may be very different from coaches they have had in the past.  Are their athletic s...


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Natural Bug Repellents

July 8, 2018


Last month I gathered together more information than any usual citizen should sift through and read about mosquitoes, ticks and bug spray. I wanted to better understand how these insects find us, and how well different repellents work and what the safety usage guidelines were for each of them. This is a condensed version of my findings because the whole thing worked out to be 5 pages! If you're interested to know all of it, let me know as it is the basis of my Natural Bug Repellent workshop! ...


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Patellar Tendonopathy

June 4, 2018

What it is

Patellar Tendinopathy, also known as patellar tendinosis, jumpers knee, or Landers knee is an overuse injury at the knee. There is no specific injury or trauma to cause it, but the repetitive motions over time result in the tendinopathy.


Suprapatellar vs Infrapatellar tendinopathy

Supra- or superior refers to   tendinopathy above the patella (knee bone). This area is also call the quadriceps tendon. This portion of the tendon connects the quadriceps muscle and the knee. Infra...


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Movement screening to prevent injury

June 4, 2018

Some of you may have experienced some new testing that I have done to assess how your body moves.  In the fall of 2017, I began studying a method to assess movement throughout the whole body.  The Selective Functional Movement Assessment, or SFMA, is a tool that takes a patient through a series of 10 movements.  These 10 movements are then classified as being normal functioning or dysfunctional.  This assessment tool is part of the Functional Movement System, which includes other screening te...


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Degenerative Disc Disease (DDD) vs Degenerative Joint Disease (DJD)

June 4, 2018

Have you been given one of these diagnoses DDD or DJD?  Depending on how specific your healthcare practitioner is, you may have heard these terms before as the source of your spine pain.  Degenerative disc disease or DDD can be the cause of many different symptoms resulting in localized pain or pain that radiates down the leg.   Degenerative joint disease or DJD is very different, but can have overlapping symptoms with DDD.  We will discuss both of these conditions a little more thoroughly so...


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Stretching: A guide to becoming the most flexible you

April 15, 2018

Static Stretching

Static stretching is the most common type of stretching we think of when we hear the word stretch.

This type of stretching increases muscle extensibility, in turn, increasing that joints' range of motion (ROM).

Following a short jog, a few jumping jacks or even a heating pack to increase muscle temperature, complete the recommended stretches holding the stretch for 10-30 seconds feeling a light tingle or slight discomfort. Consider a scale from one to ten, one being barely a...


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Travelling with Acute Pain

March 7, 2018
Pain alone, is enough to have to worry about and deal with.  Now add in the travel component and this could make for some very aggravated pain episodes, not to mention the irritated travel companions.  The following is a list of things to consider and some tips for dealing with your pain while on the go.
  1. Explain your injuries to your travel companions.  Nothing is more awkward then letting your frustration make the best of you while with your travel companions that know nothing of your current...

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Travel Tummy Tammer: An Aromatic Remedy

March 7, 2018

I've done enough trips away from home to have learned my belly just doesn't like it. Whether it's the stress and worry about sleeping away from home, eating unfamiliar foods or drinking unfamiliar water, I have learned the value of having a travel kit for my gut.

Without getting into all the ugly details, colic and bowel upset are awful, especially when you are supposed to be away having fun. Emergency trips to walmart to buy tea, metamucil, or jumping off the bus to gnaw on a raw lump of gi...


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Orthotics

February 8, 2018

For some people, orthotics are the only device that provides any relief from pain.  For others, congenital deformities in the foot or toes prevent them from having a normal gait.  Whether you are experiencing pain or just looking for cushioning, orthotics can be very helpful for many.  

At MMD Chiropractic Health Centre, Dr. D'Andrea uses a foam mold to cast a patient for orthotics.  Orthotics are made by a local Chiropodist, Robert Nekrasas, and come in a wide variety of choices.  If you requ...


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Laser Therapy

February 8, 2018

The laser we use at MMD Chiropractic Health Centre is the Theralase therapeutic laser.  Theralase therapeutic laser treatments provide patients with a safe, effective and painless therapy that uses the body's own natural healing systems to relieve pain, increase joint mobility, increase tissue integrity and promote cell regeneration.

Theralase lasers work by supplying energy to the body in the form of billions of photons of light. The body absorbs this laser light on a cellular level and trans...


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Recognizing Clinical Depression in Youth

January 31, 2018

The teenage years are often a busy and trying time for both kids and their parents.  Teens are learning to deal with more adult situations as their bodies continue to take on an adult size and their brains are developing to their full potential (anatomically and chemically).  Their parents are dealing with their babies now making different choices and often choices that they don’t necessarily agree with.  But no matter what the events are that occurring, as parents, we need to recognize whe...


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Assessing Posture

January 31, 2018


What Causes Poor Posture

Poor posture can result from a combination of 5 reasons:

  1. Central nervous system disorders,

  2. Peripheral nervous system disorders,

  3. Eye problems,

  4. Ear problems,

  5. Musculoskeletal system problems.

In terms of Chiropractic, chiropractors focus more on the musculoskeletal system and its relation to the nervous system. Many musculoskeletal problems can affect posture, but in terms of the effects of posture, the most common problem is decondit...


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Aromatherapy Part 2

October 1, 2017

By Jennifer Fleming, RMT
In the last article we discussed a little bit about what aromatherapy is, what essential oils are and some of the ways they have been used and why people are turning to them today.  This article I want to focus on some basic need to knows about acquiring essential oils.
Currently there are many of resources and a lot of conflicting information about what the best sources of essential oils are.  The aromatherapy community is in agreement about one thing though; we want o...


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Introduction to Aromatherapy

September 11, 2017

By Jennifer Fleming, RMT

It's no secret today, thousands of people are trying out new (and old) ways to self manage their health and wellbeing.  As a health care provider, I think this is great.  One of the things I try to encourage my patients to do is take their health into their own hands when they can.  Of course, I recommend they have some qualified guidance in doing so, after all it is their health and I bear responsibility for it.

What is Aromatherapy?

Aromatherapy is the use of plant der...


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The Chiropractic Adjustment

June 27, 2017

By Dr. Marnie Mabee D’Andrea

“What is that popping sound”?  In my last article, I discussed the examination that happens on the first chiropractic visit.  After an examination or assessment is completed, the chiropractor will give you a treatment.  One form of treatment is an adjustment.  An adjustment is used to correct a restricted joint, or rather, to apply motion to the joint to make the joint move better.  An adjustment can be given through several different techniques.  The one t...


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The Chiropractic Initial Visit

June 27, 2017

By Dr. Marnie Mabee D’Andrea

Welcome to the Chiropractic Clinic!  In my last article, I wrote about why you should choose chiropractic care and some of the injuries we treat.  Here, I will discuss what you should expect on your first visit. 

Most chiropractic offices will book your initial visit for 30 minutes to an hour, as every chiropractor has their own initial visit procedures.  At our office, we book the initial visit for 1 hour and 15 minutes.  This gives you time to fill out the r...


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Why choose chiropractic care?

June 27, 2017

By Dr. Marnie Mabee D’Andrea

Low back pain?  Neck pain?  Shoulder pain?  Have you considered seeing a chiropractor for these problems? 

Chiropractors are licensed healthcare practitioners.  Chiropractors undergo several years of postgraduate training, after obtaining an undergraduate degree, in order to obtain their Doctor of Chiropractic degree.  Training is similar to that for Doctors of Medicine; however, a much larger focus on radiology and muscle/skeletal courses and less focus on p...


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Intra-Oral Massage Therapy: Your First Appointment

November 29, 2016

Your jaw has been in pain for some time now.  Your dentist has outfitted you with a new mouth guard to protect your teeth at night.  While you can be assured your teeth are ok, you still wake up with pain and stiffness in your jaw and headaches are becoming more regular than you can stand.  As the stress in your life ratchets up, your ability to put on a happy face dwindles.  You've heard about seeing a massage therapist for stress, know it can help the tension in your shoulders and neck.  A ...


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Phases of Spinal Degeneration

November 29, 2016

We have recently added some "Chiropractic" info posters to our office, which have sparked some interest among many of our patients.  In particular is the poster on Spinal Degeneration.  This poster was not meant to scare you, but educate you on the phases of spinal degeneration and the anatomic and symptom changes that occur at each phase.  Let us take a closer look

https://gallery.mailchimp.com/b057ce90715848b3183cfbd7f/images/d7c07cd1-c62b-4f02-b666-c09fdc7073f9.jpg

Phase 1 or Dysfunction Phase

During phase 1, we will see the initial effects of repetitive micro trauma with minor small tears in ...


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A Dull Grind: Treating Bruxism and Clenching with Massage Therapy

November 29, 2016

Many of us, at some point in our lives have or will experience TMJ dysfunction.  Perhaps you have discovered that you clench or grind your teeth at night, or maybe your jaw is an on-going source of entertainment at birthday parties and work functions.  Everyone likes a good "weird body" trick once in a while, but when it starts to hurt or hinder your everyday life, it's time to call in a pro.  We all know to seek a dentist or other oral doctor when trouble in our mouths comes up, but did you ...


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Ten Reasons to Stretch

November 29, 2016
Stretching pumps irritants and inflammation away from muscles, and increases the blood supply and flow of nutrients to muscles and joints. This process promotes tissue healing and injury repair. Here are some more reasons why stretching can be beneficial:


1.  Reduces muscle soreness after exercise
2.  Accelerates tissue healing
3.  Improves balance and co-ordination
4.  Improves Posture
5.  Promotes muscle relaxation
6.  Boosts your energy levels

7.  Relieves back and joint pain
8.  Reduces the likel...

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