Jaw Pain? Consider a Visit to Your Physical Therapist!

Temporomandibular disorder (TMD) is a disruption of the normal movement of the jaw and includes a variety of conditions associated with pain and dysfunction of the temporomandibular joint (TMJ), more commonly know as the jaw and its muscles. It is estimated that 20% of the population is affected by TMD, and only 10–20% of those affected seek treatment.1

 

Pain in the TMJ can be caused by overuse, tension, decreased blood flow, and other complications in various joints and muscles in the head, neck, and oral cavity.

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TMD may present with numerous symptoms, such as headaches, tinnitus (ringing in the ear), altered jaw movement, jaw popping or clicking, limited jaw opening, difficulty swallowing, toothache, dizziness, neck pain, and vertigo.2

 

TMD affects people of all ages. The disorder is often influenced by poor posture, poor oral habits (e.g., teeth grinding or clenching, gum chewing, and fingernail biting), and high stress levels. Stress can be defined as either conscious or subconscious stress. A conscious stress response may be due to a specific event and can result in elevated heart rate, anxiety, and inability to sleep. A subconscious stressor would be the absence of those symptoms during waking hours and is created over a period of time. It can present itself when sleeping and result in teeth grinding. Subconscious stressors are usually an internal struggle that is overlooked or suppressed.3

 

Those with TMD often present with poor posture and a greater forward head position than individuals without TMD (see the image below). Increased tension in the muscles at the base of the head (suboccipitals) caused by a forward posture can lead to muscle imbalance, pain, and decreased jaw motion and displacement, which directly affect the TMJ.4

 

Other causes of TMD include teeth grinding and/or clenching, which are involuntary behaviors. Teeth grinding is primarily a nocturnal behavior, while clenching may occur during the day or at night. In severe cases, disc displacement of the jaw and arthritis may occur and may require further medical intervention.5

 

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TMD is also caused by microtraumas and macrotraumas. Microtraumas include repetitive insult to the jaw, as seen with karate, boxing, or wrestling injuries. Macrotraumas include more forceful and direct insults to the jaw; these are often linked to jaw dislocations, which are most commonly seen in motor vehicle accidents.

 

Noninvasive, conservative treatments generally provide improvement or relief of TMD symptoms and are recommended in the initial management of the disorder. Physical therapists are frequently involved in the management of TMD, often in collaboration with dental professionals. In a survey of members of the American Dental Association, physical therapy was listed as an additional treatment among 10–17% of patients. A wide variety of physical therapy techniques – including specific joint movement and manual therapy to the jaw and neck, postural exercises to increase strength around the shoulder blade region, soft tissue massage, electrotherapy, biofeedback, relaxation techniques, and flexibility exercises for the jaw and neck – can be effective in managing this disorder. 6,7

 

If you or someone you know is experiencing TMD or symptoms related to TMD, consider talking to your dentist and reaching out to a physical therapist to see what options are available to you. For more information, contact us at info@sptny.com.

 

References:

 

 1. Pedroni CR, De Oliveira AS, Guaratini MI. “Prevalence Study of Signs and Symptoms of Temporomandibular Disorders in University Students.” Journal of Oral Rehabilitation, 30 no. 3 (2003): 283–289.

 

2. Dworkin SF, Huggins K, Wilson L, et al. “A Randomized Clinical Trial Using Research Diagnostic Criteria for Temporomandibular Disorders: Axis I to Target Clinic Cases for a Tailored Self-Care TMD Program.” Journal of Orofacial Pain 6 (2002): 48–63.

 

3. http://www.subconscious-mindpower.com/brain/the-effects-of-stress-on-the-brain

 

4. Di Fabio RP. “Physical Therapy for Patient with TMD: A Descriptive Study of Treatment, Disability, and Health Status.” Journal of Orofacial Pain 12 (1998): 124 –135.

 

5. Sturdivant J, Friction JR. “Physical Therapy for Temporomandibular Disorders and Orofacial Pain.” Current Opinion Dentistry 4 (1991): 4885–4896.

 

6. Feine JS, Lund JP. “An Assessment of the Efficacy of Physical Therapy and Physical Modalities for the Control of Chronic Musculoskeletal Pain.” Pain 71 (1997): 5–23.

 

7. Minagi S, Nozaki S, Sato T, Tsuru H. “A Manipulation Technique for Treatment of Anterior Disk Displacement with Reduction.” Journal of Prosthetic Dentistry 65 (1991): 686–691.

 

Other References:

 

8. Linde C, Isacsson G, Jonsson B. “Outcome of 6-Week Treatment with Transcutaneous Electric Nerve Stimulation Compared with Splint on Symptomatic TMJ Disc Displacement without Reduction.” Acta Odontologica Scandinavica 53 (1995): 92–98.

 

9. Conti PCR. “Low Level Laser Therapy in the Treatment of Temporo-mandibular Disorders (TMD): A Double-Blind Pilot Study.” Cranio 15, no. 2 (1997): 144–149.

 

10. Wright EF, Domenech MA, Fischer JR Jr. “Usefulness of Posture Training for Patients with Temporomandibular Disorders.” Journal of the American Dental Association 131 (2000): 202–210.

 

11. Nicolakis P, Erdogmus CB, Kopf A, et al. “Exercise Therapy for Craniomandibular Disorders.” Archives of Physical Medicine and Rehabilitation 81 (2000): 1137–1142.

 

12. Nicolakis P, Erdogmus CB, Kollmitzer J, et al. “An Investigation of the Effectiveness of Exercise and Manual Therapy in Treating Symptoms of TMJ Osteoarthritis. Cranio 19, no. 1 (2001): 26 –32.

 

13. Michelotti A, Steenks MH, Farella M, et al. “The Additional Value of a Home Physical Therapy Regimen versus Patient Education Only for the Short-Term Treatment of Myofascial Pain of the Jaw Muscles: Short-Term Results of a Randomized Clinical Trial.” Journal of Orofacial Pain 18, no. 2 (2004): 114 –125.

 

What is Snapping Hip Syndrome?

Have you ever been running and heard snapping in your hip every time you try to change direction or take a stride? While it may be a pain-free snapping sensation, it is an annoyance that should be addressed so it does not interfere with your function and take you off the road! There are various causes for this condition, which should be evaluated and treated by your physical therapist. PTs are specialists in determining movement impairments.

 

Snapping Hip Syndrome

 

Snapping hip syndrome can be categorized into two main groups:

 

1.) Internal snapping: may be caused by the iliopsoas tendon, which is located in the front of your hip, abnormally sliding over internal structures of your hip.

 

2.) External snapping: primarily caused by the subluxation (or abnormal movement) of the iliotibial band over the side aspect of your hip.

 

Those who are at the highest risk of developing snapping hip syndrome often include athletes who engage in repetitive rotation and cutting movements, weight lifters, and runners usually between the ages of 15 and 40 years old. Physical findings usually include hip weakness, mechanical and musculature imbalances, and overtraining. Conservative management with physical therapy that includes exercise, stretching, and hands-on therapy resolves most cases.

 

In rare cases when conservative care isn’t effective, lengthening of the tendon can be performed arthroscopically. That’s why listening to your body’s first symptoms and seeking proper treatment are so important – though often very difficult for avid runners and athletes. Taking these steps is critical to reducing the risk of further injury and avoiding surgery.

 

For more information on snapping hip syndrome, contact us at info@sptny.com.

 

What to Expect on Your First Visit to Sports PT of NY

Some of the Sports PT Staff

Your first physical therapy appointment can be intimidating. But it shouldn’t be! Here’s what you can expect when you arrive at Sports PT of NY.

 

Expect us to live up to our mission, which is: “To be the premier provider of quality physical therapy services in a positive, professional, and compassionate environment.” That’s our culture with every patient, every time. Let’s explain what you can expect to experience.

 

First call: When you make the first call, you will be warmly greeted by one of our patient services coordinators (PSCs) who will help schedule your initial evaluation appointment to your convenience. We will obtain information about your injury, as well as insurance information so our experts can verify insurance benefits. We want to support you in every way, so you can focus on your care.

 

First visit: On your first visit, you will be welcomed by one of our PSCs, and your paperwork will be thoroughly reviewed. Many patients prefer to fill out the required paperwork at home, which you can do by downloading the forms from our website at www.sptny.com (under “Forms and What to Bring”). If you choose to complete this paperwork at our office, it typically takes about 10–15 minutes to fill out. The PSC will go over your insurance coverage with you and can answer any other questions you may have.

 

Your physical therapist (PT) will be delighted to meet you, and you will be welcomed into an evaluation room. This is where your PT will seek to learn more about your injury and determine a diagnosis and treatment plan. The evaluation is thorough, combining discussion and hands-on assessments. Comfortable clothing is recommended, and clothing that allows access to the injured area is preferred. First, your PT will ask questions for about 10–15 minutes regarding your symptoms, goals, and medical history. After this discussion, your PT will perform the physical evaluation to determine what needs to be addressed in physical therapy. Often there are areas of tightness and weakness that a PT will assess. The objectives of physical therapy will be to help restore your normal activities and to achieve your goals! If for some reason your injury or condition requires a different healthcare provider, a referral to that provider will be facilitated that day.

 

Working with a Patient at Sports PT

 

Education: We are committed to patient education, which includes: injury education, prognosis, and treatment plan. Our PTs will use medical resources such as posters, models, computer videos, and demonstration to help you understand your injury and why/how physical therapy can help. The PT will make a recommendation as to how many times a week you should attend physical therapy and what the main focus of your treatments will be. Most patients attend physical therapy two to three days per week, depending on the condition. Sometimes it’s more, sometimes less.

 

Treatment: Many times, the PT will perform some type of hands-on skilled care to help restore motion or to help reduce pain. You will have the same PT for the majority (if not all) of your visits to maximize your consistency of care. In most cases, on your first day of physical therapy, you will be given between one and three exercises (with photos and clear instructions) to perform at home.

 

Day One Is Complete! What’s Next?

After the evaluation, treatment, and hands-on care, your PT and PSC will coordinate appointments with you. The average first visit lasts a little over an hour. After your visit, the PT will write up your initial evaluation note. If an MD referred you, that evaluation will be sent to him or her.

 

This begins your physical therapy journey with us! Thank you for choosing Sports PT of NY. We are committed to clinical excellence and outstanding customer service in a fun environment.


For more information, or to schedule your first appointment, visit us at www.sptny.com.