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Jaw Pain Part 2: How do we approach TMD?

If you or someone you know has jaw issues or TMD, then this post is definitely for you. In the video below, Martin outlines how we typically approach assessing and managing TMD when someone presents to our practice with it.

As you can see, due to how frequently we deal with clients with TMD, we had to develop an assessment protocol to determine first of all, are we the right people to address your issue? If so, what exactly is wrong and what is the most efficient way to get this person on track?

If you’re still unclear exactly what TMD is, please feel free to watch the first video in this series where Martin answers “What is TMD?

As always, the video has been transcribed below for those of you who like blogs in a more old school format.

Hi, Martin here from Align Chiropractic what I wanted to talk to you about today was our approach in dealing with people who have TMD or temporomandibular disfunction. 

TMD is a really common condition, very commonly, in fact it's four times more likely and women and it's typically more common in people who are in that age group about 20 to 40, It is often painful, the jaw is often clicking and it can affect overall ability to open or even close the jaw properly.


When you have TMD, it often has wide-ranging effects because it effects eating, speaking, sleeping and exercising, so basically, lots of things that affect all aspects of our life; Our social life, our work life, our hobbies and really any activities that we love to do. 

So it’s something that you really want to get handled! 

Our approach is to take quite a comprehensive view. We certainly have a look at the jaw itself and we'll be measuring your ability to open your jaw, and you should be able to open your jaw around about 40 millimetres. 

We also assess a thing called lateral glide which is essentially your ability to move your jaw one way and then the other, and that should be equal left and right. We're also measuring it with special callipers to just see that it should be about 10 millimetres. 


The jaw doesn’t work in isolation though, so we'll also be looking at your overall posture. There's a really common association with forward movement of the head increasing the likelihood or has a strong association with jaw issues. Also the way that the neck joints work can have an interplay with the way the jaw works and so we also make sure that we do an assessment of the way that your jaw is working. 

As well, we’ll do some palpation, some hands on feeling of the muscles around your jaw which actually extend all the way up into the temporal area and extend down into the upper neck of the front. 

Then if we feel like we can help you, we will formulate a plan to get you back on track in terms of how your jaw is working and get you back to doing the things that you love to do, or that you have to do that the jaw is making it harder for you to do.  

Now, typically in terms of that hands-on care like all problems it's a 50/50 process there's certainly some hands-on things that we'll be doing to gently encourage more movement and less tension in the jaw, but we'll also be having exercises and home care that you can do to make sure that you get the best results as quickly as possible.

So if you're having trouble with jaw issues, whether it's popping clicking pain or just feeling out of balance, then please give us a call and let's get you back on track as quickly as possible.

HOW TO TRAIN WHEN YOU HAVE AN UPPER BACK INJURY FOR THE CROSSFIT, F45 AND HIIT ATHLETE

If you are a cross fitter, f45…er, boxer or just love that type of high intensity training and you have an injury then this post is for you.

At align we know that getting back to exercise is likely your number 1 priority!

Please watch our video or read the transcript below the video to get our tips on getting you back on track as soon as possible and learn how to maintain your gains despite injury.

As we said in our last posts on back pain and neck pain, taking time out of training is boring and can seriously impact on the gains that you have made.

When you have put the time and effort into your training to a level where you are really enjoying your high intensity exercise, taking time out for recovery can be tedious but can also hold you up on your way to achieving your goals.

The reality is, the better you allow your body to heal, the quicker you can be back to 100% and the less likely you are to have recurring injury, and the rehab is going to take some effort on your part, so what CAN you do to get back into it at full speed?

The first thing to work on is recognising that just like gains you have made, THERE ARE NO SHORT CUTS in healing your injury.

It is important to know what you CAN do to stay moving and enjoy your HIIT training without setting yourself back.

In the video below, Martin outlines some of our possible recommendations for managing upper back injury while still keeping up your training.

As always, if you have any concerns, upper back issues, be they old or new, or just want to get the most out of your training, we are here for you so don’t hesitate to get in touch!

Hi, I'm Martin here from Align Chiropractic and today's video what I’m going to talk about is a really common thing that we see in our practice which is: people who love doing high-intensity exercise. 

We're talking people who do CrossFit, people who do f45, and all the other versions of HIIT like boxing those type of things where the whole idea of it, is that it's something that people love doing and they want to do it regularly and obviously, it's something that you're doing at a high level of intensity so does create some pretty specific demands on your body.

Sometimes people have an injury and then they've got this sort of challenge where, they want to keep training, they don’t want to lose the gains in fitness that they've created but they’re also managing an injury and our experience is that there's a lot of things you can do where you can keep getting a lot of that metabolic effect, you can keep losing weight, can keep your cardiovascular fitness and you can keep a lot of your muscle mass by keeping training while you're having the injury addressed through chiropractic care. 

So one of the areas that we commonly see are people who have an injury in the upper back, so it might be that the vertebrae are jammed up there, which is a really common thing we see, can be a problem with the way rib is joined onto the vertebrae, can be a problem with the muscles in the area, there's a bunch of different things, a bunch of different types of injuries that you could have there but the common thing is that it makes a lot of high intensity movements uncomfortable and can actually be exacerbating the injury by doing certain movements. 

So there are things that we suggest you don't do to manage these injuries. Firstly you’re not doing things where it's really high highly dynamic, so burpees can be really uncomfortable, box jumps can be really uncomfortable, anything with jarring can be uncomfortable as well as things where you’re demanding a lot of range of motion from your upper back that you don't necessarily have. 

Within a CrossFit context, kipping pull-ups, within F45, battle ropes and those sort of things where there's a lot of movements for in that area that isn't moving properly it can create a demand that your body's not able to correct. 

The sequence that we look at is that early on if you've got an injury and we're actively trying to get things back on track we’re going to get a shift focus to doing a lot of the lower body exercise because you can work your lower body without having that impact on your upper body. 

For most people, air squats are completely comfortable and lunges are really good and that’s because of that single leg aspect to it it's a really good opportunity to develop that sort of balance and stability in your lower body when you're taking the load off your upper body. 


As far as not losing all your upper body strength, often what most people notice is while overhead stuff, pushing overhead and pulling overhead can be really uncomfortable, often reducing the load and going horizontally so we’re talking things like really slow controlled push-ups or a dumbbell press chest press or even a barbell chest press can be okay as long as you’re super conscious of your posture. 

We’re making sure that a head is staying over our shoulder because often the reason that people end up with these mid-back injuries is that it's not from the exercise it's from too long spending time at the computer in this crappy posture. 

Therefore, if you're wanting to maintain some upper body stuff we're going to do some horizontal pushing and we might do some horizontal pulling as well. 

In doing those actions, we’re going to work on pulling our shoulder blades back by doing actions like a ring row, where you’re lying down when you're pulling back towards yourself or you doing them with a machine, some sort of rowing exercise. So rowing is good and also push-ups can be good.  

The next level up from there let's say we've got some improvement but things aren’t 100% in terms of function and we're not out of the woods yet but once we've got some improvement and movement in that area, and we're starting to change in overall posture, we can start reintroducing some things. 

So what we might do in the early phase, while we've taken out jarring activities like box jumps out, we might get back into doing a step up or we might go back to doing some pull-ups.

Pull ups are where we are going overhead and doing a pulling movement, but rather than doing a more dynamic movement, like kipping pull-ups, we will make it a little less dynamic and only do strict pull-ups - even if that means that we are applying a band.

Another option that we could look at is some overhead pressing movement with a dumbbell but we're not going to have the dynamic ones where we're using momentum and that faster cadence that we might normally use in high intensity training. So we are just going to slow things down focus on very slow movements that are a little bit easier to stabilise through that area. 

The bottom line with this video is that - yes you love your training and yes it's inconvenient to have an injury but for most people they can maintain the momentum, they can maintain their gain, if they just tweak a little bit what they do, shift focus to the lower body, shift focus to slow controlled movements, cut out the overhead work initially and keep going when you training when you’re managing an injury. 

I hope you found the video interesting leave a comment if you've found it valuable, and we hope to catch you soon.