TMJ - ear - fascia connection

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TMJ - ear - fascia connection

Postby renauddv on Thu Aug 26, 2010 6:38 am

I had a client present the other day that posed an interesting situation/find.
She booked for low back discomfort and mentioned she has persistant TMJ discomfort on the left side an slight clicking on the right. She discovered when her 2yr old pulled on her left ear that she heard a pop and had momentary relief. She then demonstrated, and I could feel the "pop" and she said as long as she held it out the TMJ pain was gone, but slowly returned after release. There is no similar pop on right side.
I'm curious if anyone has experienced a similar situation, or can shead some light on what may be occuring.

Darren
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Re: TMJ - ear - fascia connection

Postby WaltFritz on Mon Aug 30, 2010 6:56 am

Darren,

Little space separates the ear canal and back of the TM joint. Ear pulls are a typical part of my treatment for TMJ disorders. Give it a try!
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Re: TMJ - ear - fascia connection

Postby renauddv on Mon Aug 30, 2010 8:53 am

Thanks Walt,

I certainly will. I'm curious if the TMJ inflamation over time creates facia changes, or adhesions to the ear structures. I haven't been able to find much in the way of ear/TMJ inter-relationships, and most of my TMJ work has been using acupoints, and Tui Na techniques.

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Re: TMJ - ear - fascia connection

Postby WaltFritz on Mon Aug 30, 2010 11:08 am

You may want to check out some of Upledger's Craniosacral literature. To me, it may be a chicken or egg relationship. Did the TMJ get inflamed first and spread to the ear, or did underlying tightness/cranial asymmetry lead to an imbalance at the TMJ. OR, to create a chick/egg/omlette relationship, did an asymmetrical pelvis cause the other two?
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Re: TMJ - ear - fascia connection

Postby JasonE on Thu Sep 02, 2010 9:47 am

WaltFritz wrote:Darren,

Little space separates the ear canal and back of the TM joint. Ear pulls are a typical part of my treatment for TMJ disorders. Give it a try!


You might also try working the temporalis, SCM attachments, anterior and posterior auriculars, and submandibular/suprahyoid muscles. I've seen some great results from GENTLY working the smaller muscles under/around the mandible.
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Re: TMJ - ear - fascia connection

Postby renauddv on Tue Sep 07, 2010 5:43 am

Thanks Jason,

I see this client next week, and will certainly GENTLY dig in :) and see where it goes.

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Re: TMJ - ear - fascia connection

Postby pueppi on Wed Sep 08, 2010 8:19 am

I do quite a bit of TMJ work in my practice with good effective protcols. Regarding ears: One thing I do on most all of my TMJ clients is to work arond the entire ear. A few clients will also need work in the inside of the ear at the anterior region. I wear a finger cot for this work.

I will spend one hour for the TMJ/head and neck on a TMJ case, with about 30 mins. just for the TMJ joints and the rest of the time scattered in the other areas. As Jason said... the small muscles can usually benefit and I would like to add in that this work can be done very slowly and in very very small incriments to get some great benefit.

Of course, that is just how I work. Someone else may be able to use larger sweeping techniques. But, for me, I find small, specific and slow work to be the best fit for my practice.




09/10/10: edited for a typo
Last edited by pueppi on Sat Sep 11, 2010 2:10 am, edited 1 time in total.
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Re: TMJ - ear - fascia connection

Postby JasonE on Wed Sep 08, 2010 7:40 pm

I'm with you, Pueppi. Slow and thorough. I've found positional release techniques very helpful for the pterygoids and submandibular muscles, too. An added bonus is that I don't have to glove up for intraoral work. It blends right in to the rest of the session's flow.
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Re: TMJ - ear - fascia connection

Postby pueppi on Sat Sep 11, 2010 2:13 am

Do you know a book or video that shows some of that positional release work for the pterygoids? I'd like to look into that. It sounds like a wonderful fit for what I do. I do some pterygoid work with "Nimmo", but would like to look closer at what you are doing.

If no book/vid... then who you might know that offers classes? I know you have something going on in your neck of the woods. Do you have a link to anyone who provides seminars in the Texas or California regions?

Thanks!!! :)
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Re: TMJ - ear - fascia connection

Postby JasonE on Sat Sep 11, 2010 6:59 pm

pueppi wrote:Do you know a book or video that shows some of that positional release work for the pterygoids? I'd like to look into that. It sounds like a wonderful fit for what I do. I do some pterygoid work with "Nimmo", but would like to look closer at what you are doing.

If no book/vid... then who you might know that offers classes? I know you have something going on in your neck of the woods. Do you have a link to anyone who provides seminars in the Texas or California regions?

Thanks!!! :)


The best-known form of positional release is Strain Counter-Strain as developed by Lawrence Jones, DO. The Jones Institute has classes and literature worth checking out. Here's their web site: http://www.jiscs.com/Article.aspx?a=0 You can download the pre-course required reading (free!) on their home page; it's a great overview of positional release that you should be familiar with before attending one of their classes.

The SCS book by Jones is available via a number of sites. It's a good read, but some of it is clearly outdated now. Here it is on Amazon: http://www.amazon.com/Jones-Strain-Coun ... 0964513544

A newer book on Positional Release (SCS-style) that was strongly recommended to me is this one by D'Ambrogio and Roth. I like it a lot and it provides a more systematic approach to applying SCS in practice. Here it is on Amazon: http://www.amazon.com/Positional-Releas ... 0815100965

As expected, Leon Chaitow, DO has written a book on Positional Release. It's not great for practical applications, but it provides a much more comprehensive overview of positional release methods, similarities and differences, and hypotheses about how each works. It includes a DVD supplement, but it's not really a how-to like many other videos on other topics. There are now several online Positional Release distance learning courses based on this text, usually worth 20 CE hours. Here it is on Amazon: http://www.amazon.com/Positional-Releas ... 509&sr=1-2 The AMTAmassage.org site has one of the distance learning courses available.

Leon Chaitow has also written a good long article on positional release here: http://www.healthy.net/scr/article.aspx?Id=581

I found this DVD by Diana Haynes, but I have not seen it and can't say anything about it. Here it is: http://www.amazon.com/Positional-Releas ... 975&sr=8-1

There is a one-day course on "Neuromuscular Re-Education" available through Cross Country Education. It was an overview of Muscle Energy Technique and Positional Release taught by a PT. It was a good basic course heavy on practical application. We didn't do jaw work, but it was very helpful for clarifying the basic concepts and providing some very practical hands-on client assessment and treatment methods that I have used many many times since.

Hope that helps! :D
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Re: TMJ - ear - fascia connection

Postby pueppi on Mon Sep 13, 2010 9:19 am

JasonE, thanks for taking so much time to write such a well thought out post. It is really too bad that I am only most familiar with PNF stretching (proprioceptive muscular facilitation). I'd like to do some active study regarding the PR in the future.

As a side note, if someone has a few thoughts off the top of their head regarding any similarities or differences between PNF & Positional Release, that may be helpful. I apologize that I don't personally have the time to dedicate to some nice research in this area, right now. However, I'll attach this to my list of things to do, and get back to it in the future, when I can. :)
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Re: TMJ - ear - fascia connection

Postby JasonE on Tue Sep 14, 2010 7:54 am

pueppi wrote:JasonE, thanks for taking so much time to write such a well thought out post. It is really too bad that I am only most familiar with PNF stretching (proprioceptive muscular facilitation). I'd like to do some active study regarding the PR in the future.

As a side note, if someone has a few thoughts off the top of their head regarding any similarities or differences between PNF & Positional Release, that may be helpful. I apologize that I don't personally have the time to dedicate to some nice research in this area, right now. However, I'll attach this to my list of things to do, and get back to it in the future, when I can. :)


In a nutshell, they are completely different. :smt002

In PNF (aka Muscle Energy Technique, depending on who you ask) the client is active. They contract and relax tissues as directed by the practitioner, with post-isometric relaxation being the traditional explanation for why tissues lengthen. However, PNF/MET can also be used to improve tissue innervation, improving strength and function, so it's not "just stretching" depending on how you use it. (Chaitow's book on Muscle Energy Technique and Kit Laughlin's books/videos on PNF are excellent.)

In general, PRT doesn't require the client to do anything during the treatment. The practitioner locates tender points based on palpation and client feedback, then positions them so that the tenderness completely disappears, even when palpated. The position is maintained for a period of time, then the client is returned to a starting position. The tenderness should remain mostly/completely gone. There are many approaches to PRT, including Strain Counterstrain, Orthobionomy, Functional Positional Release, etc. Kinesiotaping and Bowen technique are considered by some to be forms of PRT. (Chaitow's book is probably the best overview.)
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Re: TMJ - ear - fascia connection

Postby pueppi on Wed Sep 15, 2010 2:47 am

Many thanks for you time! :)
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