All About the TMJ - My Perspective

As a manual and movement therapist, I am always keen on giving my patients the full treatment package. This systematic review by Herrera-Valencia et al. (2020) further emphasizes the added value of manual therapy to the therapeutic exercise program. With this being said, one must also respect the clinical reasoning behind treatment choices.

The temporomandibular joint (TMJ) is a highly functional synovial joint, with a unique structure and mechanics. The joint has a clear connection with cervical spine articular, neural, and myofascial structures. Understanding the aetiology, symptoms, and classification of temporomandibular disorders (TMD) as well as the connection with the cervical spine is essential to enable a clinician to identify and manage patients with TMJ dysfunction.

When teaching my students, I make it simple: "What are you doing, how are you doing it, and why are you doing it?"

Applying any treatment method to the TMJ requires-

a. Knowledge of the functional anatomy, physiology, and biomechanics of the temporomandibular joint and cervical spine.

b. Understanding of the etiology, differential diagnosis, and clinical classifications of temporomandibular disorders.

And throughout my career, I could never help but notice that the addition of a hands-on element to my patients' treatment plans almost always gives them the feeling of security: "The expert has his hands on me - this MUST be good."

But before any of this, it's always best to give the patient the confidence that they can resolve their problem on their own. Patient education is key. If a few repetitions of the right exercise make a difference right away, we've both won. If not, then a little push with hands-on therapy shouldn't hurt. Any mobilization should do the job.

For colleagues who are fussy about mobilization techniques, I do not have anything to apologize for.