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TMJ CONVERSATION FROM FACEBOOK  

11/1/2012

1 Comment

 
Note, The original post from Michele Doyle's FB, you can go there for the full discussion or add to this, I really do not know what is proper etiquette, attribution, etc!


Michelle:
I've often wondered about the connection of TMJ and pelvic pain and dysfunction, and got this answer from Dr. Sheila Laws. 

"I've been told that the TMJ is the 'pelvis of the skull', and since the head "rules" the body, so does the TMJ rule the body's pelvis. In other words, as the TMJ goes, so goes the pelvis. I've seen it hundreds of times." Thank you, Sheila K. Laws!

So is this some kind of wild compensatory pattern or what?


Jerry Hesch reply:
The degree to which one structure affects another is an individual phenomenon, based on that person's presentation. This ignores the all people are the same and leans towards the "all are similar", at least for now. I very frequently encounter clients who have altered upper cervical (occipito-atlantal and atlas-axis) fixations that are unilateral or bilateral. The eyes achieve horizontal, (another theory being cerebral blood flow) yet there are asymmetries in tone that impact the TMJ. The distal inciting event is the subtalar joint more so than talocrural, a restriction that is incongruent with that person's body template. Same for supinatory pattern of multiple joints (Hesch Type II Cuboid Syndrome) or any pattern in lower extremity, hip, pelvis.

Aligning the lower body with the body template reflexively, on the table releases the distal upper cervical/TMJ phenomenon. So it can also be a bottom up phenomenon. When we encounter the lower body phenomneon and the upper body pattern is not there, it is then detective work; as Jeff implicated another diaphragm area, the cervicothoracic/1st rib area, sometimes slightly lower, that can be a fun detective work. This does not negate that treating the TMJ or upper body first may change things below. The key is to discern which one is primary that gives the most bang for the buck. If today I treat the TMJ and or upper cevical and the tight hip rotators (every one of them forget there ever was a piriformis.....(too much isolated focus on that one :)  ), I have to then
test the rest of the body to discern that which did not reflexively release.

If I fall and strike my mandible, all bets are off, that of course is a fresh isolated TMJ injury so presently an unknown what the rest of the body says or needs. Lastly before my next 120z of slept in coffee, if there are rules of coupled motion in the jaw for mobilization, they are arbitrary and again; test the individual. That is the best I can do. All above letter singular or group biased based on my world view, experience, limited education and experience, extensive experience and education, limited caffinated consumption, sleep deprivation, and apoplectic computer key pounding. g' morning! MIss y'all.
Thank you for inviting me in the discussion. Also the key for me in knowing it is NOT
top down is that it is so rigid, so unalterable that I know it is reflexively engaged.


1 Comment
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    Jerry Hesch, MHS, PT, DPT(s) – Las Vegas Physical Therapy

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    Dr. Jerry Hesch, DPT, MHS, PT

    Married with 4 grown kids.  Earned my Doctorate at A.T. Still University in Tempe, AZ, MHS at the University of Indianapolis and my BS PT at University of New Mexico.  I enjoy working with my hands and particularly making glass objet d'art.

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