1.Comprehensive Health History & Fascial System Review
• Client Intake: Gather a full history of:
*Dental work (orthodontics, surgeries, appliances
*History of jaw trauma, clenching/grinding, facial injuries
*Symptoms such as jaw pain, neck pain, tension headaches Sleep quality, breathing patterns, and chronic oral habits (e.g., nail biting, mouth breathing, gum chewing)
• Fascial Considerations: Educate on how restrictions in the fascial system, especially through the neck, jaw, and head can influence posture, muscular tension, and jaw mobility.
2. TMJ Anatomy & Functional Overview: Review the structure and motion of the temporomandibular joint (TMJ), including:
• Key structures: Mandibular condyle, articular disc, temporal bone
• Involved musculature: Masseter, temporalis, medial/lateral pterygoids, digastric, suprahyoid group, platysma
• Movement patterns: Observe and assess opening/closing, lateral movement, and protrusion. Note quality, smoothness, and presence of deviation or asymmetry.
3. Neuromuscular Influences on TMJ Function:
• Identify muscular habits and patterns that may contribute to dysfunction:
*Low or forward tongue posture Open-mouth rest posture or lip incompetence.
*Chronic overuse of accessory muscles (e.g., SCM, mentalis, platysma)
*Muscle tension patterns originating from neck and upper thoracic structures.
*Evidence of tethered or restricted soft tissue affecting mobility (to be referred out for further evaluation if needed)
4. Range of Motion & Muscle Assessment
• Measure Functional ROM:
*Track measurements of: Mouth opening (comfortable vs. max).
*Lateral excursion (side to side)
*Jaw protrusion
•Palpation Techniques (as tolerated):
*Extraoral: Masseter, temporalis, SCM, suprahyoids.
*Intraoral (gloved and consented): Medial/lateral pterygoids, floor of mouth.
•Muscle Mapping:
Note any:
*Trigger points or tenderness
*Restrictions or hypertonicity
*Imbalance between sides
5. Review of Treatment Plan & Home Education
• Manual Therapy Objectives:
*Reduce muscular hypertonicity
*Improve fascial glide and circulation
*Restore neuromuscular coordination of jaw movements
• Therapist-Guided Home Program May Include:
*Self-massage techniques for jaw and neck.
*Postural awareness (jaw rest position, relaxed tongue position).
*Gentle breathing retraining (nasal, diaphragmatic focus).
*Movement-based cues to discourage clenching and bracing patterns.
•Collaboration & Referral Network: When appropriate, coordinate with dentists, ENTs, bodyworkers, or other professionals for integrated care (e.g., orthodontic support, airway concerns, myofunctional therapy, etc.)
• This session is also designed to help determine what further treatment may be needed and whether common trigger points are contributing to your TMJ pain.