Did you know that clenching your teeth can give you a headache? That the muscles around your temples help to close your mouth when chewing, talking or clenching? That there is a soft disc (sort of like a knee meniscus) in the jaw joint?
That jaw joint is referred to as the Temporal (of the temples) Mandibular (the lower jaw bone) Joint or TMJ. It’s the very important joint that connects the lower jaw to the skull, right in front of the ears on each side of the head. Though TMJ is the term that refers to the joint itself, it’s also often used as shorthand for the group of TMJ disorders. The soft disc in the joint (on either sides of our jaw) moves forward a bit with normal chewing or talking, but can get pushed too far during clenching—that is, when the jaw is very tightly closed. That forward movement can sometimes cause the jaw to lock up, similar again to what can happen with the knee meniscus. It’s not only painful but it’s sort of hard to walk around with your jaw locked up! I know because it has happened to me.
Sometimes we aren’t aware that we clench; we may even we do it at night when sleeping. Whether we’re aware or unaware of clenching, it’s the repetition that creates muscle fatigue and temporal headaches. Part of the problem may be that our teeth don’t close evenly, so we may grind at night. But before we rush to our dentist, it’s worth trying a simple exercise to alleviate our headaches.
As a physical therapist with a special interest in TMJ disorders, I have seen simple strategies be successful in resolving not only headaches, but other issues as well. For example, some people hear ringing in their ears (tinnitus) or the sound of water. Others may have pain in their ears, even though they don’t have an ear infection. Others may feel a bothersome sense of pressure in the ear. All of these symptoms can result from TMJ problems.
As with changing any habit, the first step is observation of our behavior. So, here, the first step is to notice when and how often we clench. Focusing on this question sometimes leads people to very interesting information. Clenching often happens while people are driving, studying, participating in a meeting, feeling tense, thinking hard at the computer, enjoying an exciting sports game or even just feeling cold. If we clench or grind our teeth at night, we can notice our cheek muscles and temporal muscles feel tired and we may have a headache or some of the above symptoms upon awakening.
Put the tip of the tongue up gently onto the roof of the mouth (palate) as if saying “nuh.” Leave it gently at that spot, and breathe with your jaw relaxed. That can change EVERYTHING.
The next step is to replace one behavior with another—one that’s not harmful.
Put the tip of the tongue up gently onto the roof of the mouth (palate) as if saying “nuh.” Leave it gently at that spot, and breathe with your jaw relaxed. That can change EVERYTHING. It’s called the “rest position,” and is commonly used in Tai Chi, and eastern medicine to “balance the flow of chi.” In physical therapy, we do it to immediately stop clenching; it’s adding a new habit that interferes with our habit of clenching.
Can it be that easy? Ask one of my patients who was going crazy with the sound of water flowing in her ears and was then able to stop the sound in one week using this strategy. This new habit truly can decrease frequency and severity of headaches and a lot of the other ear symptoms mentioned above. Best of all, it’s an exercise that nobody will know you’re doing! It becomes the new normal position of the tongue.
When it works, people do it more and more, almost unconsciously, even as they fall asleep. But, speaking of sleep, sometimes we grind so hard that a night guard—a special device made by your dentist—is needed. Your physical therapist and dentist can evaluate that need with you.
Of course, there is often more to the story, such as a blow to the head in sports, a whiplash injury or a really complicated occlusion issue. All of these situations require a thorough physical therapy evaluation. We’ll often use manual therapy skills to assist in resolving TMJ issues, mobilizing the jaw to ease it open and allow it to move more freely.
So headaches beware! If you are a clencher, you may be well on your way to comfort by simply creating a new habit, as described above. It’s not often that such a small action can ease our symptoms of headaches and other pesky symptoms.
Keep that chi flowing!
~ Martha Torrey PT
P.S. An extra bonus for the anatomically curious: you might find this animation helpful to understand what normal TMJ function looks like: