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C O M T M J for AAMT MYOFASCIAL MYOFASCIAL TMJ for AAMT ADVANCED ADVANCED p. i References & Resources................................................................................. X-18 Answer Keys.................................................................................................... X-20 References & Resources................................................................................. X-18 Answer Keys.................................................................................................... X-20 Adv. Myo. Techs: SUPPLEMENTAL TECHNIQUES (on DVD)................................................... X-01 Bilateral Jaw Release....................................................................................... A-08 Ear: External Acoustic Meatus......................................................................... B-06 SUPPLEMENTAL TECHNIQUES (on DVD)................................................... X-01 Bilateral Jaw Release....................................................................................... A-08 Ear: External Acoustic Meatus......................................................................... B-06 © 2015 Advanced-Trainings.com TMJ CORE SEQUENCE..................................................................................B-01 Mandibular Condyle Tracking...........................................................................B-02 Masseter (Intra-oral)......................................................................................... B-03 Medial Pterygoid / Mandible............................................................................. B-04 Lateral Pterygoid.............................................................................................. B-05 SI Release: Anterior/Posterior.......................................................................... B-08 TMJ CORE SEQUENCE..................................................................................B-01 Mandibular Condyle Tracking...........................................................................B-02 Masseter (Intra-oral)......................................................................................... B-03 Medial Pterygoid / Mandible............................................................................. B-04 Lateral Pterygoid.............................................................................................. B-05 SI Release: Anterior/Posterior.......................................................................... B-08 p. i TMJ SLEEVE SEQUENCE.............................................................................. A-01 TMJ Tracking....................................................................................................A-03 Sleeve/Core Differentiation: Neck/Jaw............................................................. A-04 Temporalis & Masseter.................................................................................... A-05 Digastric: Anterior Bellies (“Bulldog”)............................................................... A-06 Digastric: Posterior Attachments...................................................................... A-07 TMJ SLEEVE SEQUENCE.............................................................................. A-01 TMJ Tracking....................................................................................................A-03 Sleeve/Core Differentiation: Neck/Jaw............................................................. A-04 Temporalis & Masseter.................................................................................... A-05 Digastric: Anterior Bellies (“Bulldog”)............................................................... A-06 Digastric: Posterior Attachments...................................................................... A-07 Adv. Myo. Techs: BEFORE (and after) YOUR COURSE: Course Preparation and Supplementary Study...................................................... ii BEFORE (and after) YOUR COURSE: Course Preparation and Supplementary Study...................................................... ii © 2015 Advanced-Trainings.com CONTENTS NOTE ORGANIZER: TMJ Excerpts for AAMT (2015) CONTENTS NOTE ORGANIZER: TMJ Excerpts for AAMT (2015) RECOMMENDED RESOURCES for Preparation or Review RECOMMENDED RESOURCES for Preparation or Review © 2015 Advanced-Trainings.com TMJ & Jaw Issues DVD Discounts in class or online at: http://a-t.tv/tmjdvd © 2015 Advanced-Trainings.com TMJ & Jaw Issues DVD Discounts in class or online at: http://a-t.tv/tmjdvd p. ii Bones and Bony Landmarks: • Hyoid Bone • Mandible • Maxillary Process of Temporal Bone • Sacroiliac Joints • Styloid Process of Temporal Bone Bones and Bony Landmarks: • Hyoid Bone • Mandible • Maxillary Process of Temporal Bone • Sacroiliac Joints • Styloid Process of Temporal Bone Adv. Myo. Techs Connective Tissue Structures: • Cervical Superficial Fascia • External Acoustic Meatus of the Ear • TMJ Joint Capsule • TMJ Articular Disk and Suspensory Ligaments Connective Tissue Structures: • Cervical Superficial Fascia • External Acoustic Meatus of the Ear • TMJ Joint Capsule • TMJ Articular Disk and Suspensory Ligaments p. ii Muscles: • Anterior Digastric • Lateral Pterygoid • Masseter • Medial Pterygoid • Posterior Digastric • Temporalis Muscles: • Anterior Digastric • Lateral Pterygoid • Masseter • Medial Pterygoid • Posterior Digastric • Temporalis Adv. Myo. Techs Before your course, please be sure you are familiar with the location and function of the following anatomical structures: Before your course, please be sure you are familiar with the location and function of the following anatomical structures: TMJ Online Study Guide Free, or for-credit option. http://a-t.tv/st Anatomy Review List Anatomy Review List TMJ Online Study Guide Free, or for-credit option. http://a-t.tv/st BEFORE YOUR COURSE: Course Preparation and Supplementary Study BEFORE YOUR COURSE: Course Preparation and Supplementary Study • Specific techniques for common structural and functional complaints • Relieving pain, restoring lost function, and getting lasting results • Utilizing both active and passive movement to enhance effectiveness • Precision in working with specific tissue types and body layers • Combining indirect or subtle work with deep or direct work • Tracking subtle psychophysiological and nervous system responses • Ways to work sensitively, safely, and comfortably at very deep levels. The Advanced Myofascial Techniques workshop series presents a comprehensive system for working with the body in its entirety, encompassing over 20 session sequences and more than 200 techniques, tests, and procedures. Workshops in the series may be taken individually, or combined in any order. The five principle courses include: • Arm, Wrist, & Shoulder • Legs, Knees, & Feet • Pelvis, Hip, & Sacrum • Neck, Jaw, & Head • Spine, Ribs, & Low Back Specialty courses include: • Whiplash (2 days) • Sciatica & Disc Issues • TMJ • Myofascial Essentials • Adv Ilia & Sacrum (2 days) • Specific techniques for common structural and functional complaints • Relieving pain, restoring lost function, and getting lasting results • Utilizing both active and passive movement to enhance effectiveness • Precision in working with specific tissue types and body layers • Combining indirect or subtle work with deep or direct work • Tracking subtle psychophysiological and nervous system responses • Ways to work sensitively, safely, and comfortably at very deep levels. The Advanced Myofascial Techniques workshop series presents a comprehensive system for working with the body in its entirety, encompassing over 20 session sequences and more than 200 techniques, tests, and procedures. Workshops in the series may be taken individually, or combined in any order. The five principle courses include: • Arm, Wrist, & Shoulder • Legs, Knees, & Feet • Pelvis, Hip, & Sacrum • Neck, Jaw, & Head • Spine, Ribs, & Low Back Specialty courses include: • Whiplash (2 days) • Sciatica & Disc Issues • TMJ • Myofascial Essentials • Adv Ilia & Sacrum (2 days) Advanced-Trainings.com Adv. Myo. Techs p. iv Advanced-Trainings.com Adv. Myo. Techs Organizer and In-service inquiries invited p. iv Completion of the 5 principle courses plus electives leads to optional Certification in Advanced Myofascial Techniques (CAMT). Completion of the 5 principle courses plus electives leads to optional Certification in Advanced Myofascial Techniques (CAMT). Organizer and In-service inquiries invited These courses are intended for trained practitioners and students of hands-on body therapies (for example, Bodyworkers, Physical Therapists, Rolfers, Chiropractors, Structural Integration Practitioners, Massage Therapists, Neuro-Muscular Therapists, and other somatic practitioners, etc.) These courses are intended for trained practitioners and students of hands-on body therapies (for example, Bodyworkers, Physical Therapists, Rolfers, Chiropractors, Structural Integration Practitioners, Massage Therapists, Neuro-Muscular Therapists, and other somatic practitioners, etc.) • Scoliosis (2 days) • Advanced Knee Issues • Headaches • Myofascial Mastery • ...and others. Since 1989, this popular series of seminars presents practicing somatic therapists and qualified students with advanced and little-known myofascial techniques which can be easily incorporated into existing personal styles. Drawing on a wide range of disciplines, the focus is on unusual, interesting, and fresh approaches that will both expand technique repertoire and inspire creativity and innovation. Potential topics include: Since 1989, this popular series of seminars presents practicing somatic therapists and qualified students with advanced and little-known myofascial techniques which can be easily incorporated into existing personal styles. Drawing on a wide range of disciplines, the focus is on unusual, interesting, and fresh approaches that will both expand technique repertoire and inspire creativity and innovation. Potential topics include: • Scoliosis (2 days) • Advanced Knee Issues • Headaches • Myofascial Mastery • ...and others. The Advanced Myofascial Techniques Series The Advanced Myofascial Techniques Series A-01 TMJ SLEEVE SEQUENCE Intentions / Goals: • Release the larger, more 1. ______________ structures affecting jaw alignment and balance, in 2. ______________ for deeper work. Indications: • • • • TMJ 3. _________ or noise; 4. _________ issues 5. ______________ ; Vertigo 6. ______________ Postural issues, especially 7. ______________ posture. A-01 TMJ SLEEVE SEQUENCE Intentions / Goals: • Release the larger, more 1. ______________ structures affecting jaw alignment and balance, in 2. ______________ for deeper work. Indications: • • • • TMJ 3. _________ or noise; 4. _________ issues 5. ______________ ; Vertigo 6. ______________ Postural issues, especially 7. ______________ posture. A-03 TMJ Tracking dem TMJ nachspüren P,D,I Instructions / Intentions / Feel or Watch For: From straight above client’s head, watch for side-to-side deviation with gentle opening and closing. Feel for and release any asymmetrical restrictions or contraction in superficial fascia, Temporalis, and Masseter muscles, usually on same side as deviation. Movements / Cues: Gentle opening and closing of jaw; protrusion/retraction. Difference between supine and seated or standing tests indicates role of postural issues. Notes: If deviation persists, check and release: a. opposite-side Lateral Pterygoid (particularly if deviation happens upon initiation of movement); b. opposite-side Medial Pterygoid; c. same-side Digastric. Deviation in protrusion: work any/all of above, particularly same-side Digastric and posterior Temporalis (since horizontal fibers help retract jaw). Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-03 TMJ Tracking dem TMJ nachspüren P,D,I Instructions / Intentions / Feel or Watch For: From straight above client’s head, watch for side-to-side deviation with gentle opening and closing. Feel for and release any asymmetrical restrictions or contraction in superficial fascia, Temporalis, and Masseter muscles, usually on same side as deviation. Movements / Cues: Gentle opening and closing of jaw; protrusion/retraction. Difference between supine and seated or standing tests indicates role of postural issues. Notes: If deviation persists, check and release: a. opposite-side Lateral Pterygoid (particularly if deviation happens upon initiation of movement); b. opposite-side Medial Pterygoid; c. same-side Digastric. Deviation in protrusion: work any/all of above, particularly same-side Digastric and posterior Temporalis (since horizontal fibers help retract jaw). Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-04 Sleeve/Core Differentiation: Neck/Jaw Differenzieren von Kern / Hülle: Hals / Unterkiefer P,D,I Instructions / Intentions / Feel or Watch For: Gentle friction on superficial (”sleeve”) structures of neck with soft fist. Supporting hand helps head and neck stay aligned along a vertical (to client) line of rotation. Work both left and right sides; on side of any jaw deviation, use jaw movements, feeling for connection and release into superficial structures of neck. Movements / Cues: Active or passive head rotation with jaw depression/elevation, protrusion/retraction, and/or lateral movements. Cues: “Let your head turn slowly to the side.” “Gently open your jaw.” “Slowly slide your jaw forward.” Notes: Ida Rolf’s classic neck technique. Use care not to put pressure on deeper structures: stay in superficial layers; monitor client’s comfort. Illustration courtesy estate of John Lodge, used by permission. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-04 Sleeve/Core Differentiation: Neck/Jaw Differenzieren von Kern / Hülle: Hals / Unterkiefer P,D,I Instructions / Intentions / Feel or Watch For: Gentle friction on superficial (”sleeve”) structures of neck with soft fist. Supporting hand helps head and neck stay aligned along a vertical (to client) line of rotation. Work both left and right sides; on side of any jaw deviation, use jaw movements, feeling for connection and release into superficial structures of neck. Movements / Cues: Active or passive head rotation with jaw depression/elevation, protrusion/retraction, and/or lateral movements. Cues: “Let your head turn slowly to the side.” “Gently open your jaw.” “Slowly slide your jaw forward.” Notes: Ida Rolf’s classic neck technique. Use care not to put pressure on deeper structures: stay in superficial layers; monitor client’s comfort. Illustration courtesy estate of John Lodge, used by permission. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-05 Temporalis & Masseter Temporalis & Masseter D Instructions / Intentions / Feel or Watch For: In combination with client’s movements, use fingertip pressure in both cephalad and caudal directions. Release local contractions in lateral soft tissue structures: Temporalis, Masseter, superficial fascia, TMJ capsule, etc. Use “Jaw Tracking” technique to monitor any mandible deviation. Generally, work restrictions on same-side as any deviation. Movements / Cues: Jaw movements: depression/elevation; protrusion/retraction; lateral movements. Notes: Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-05 Temporalis & Masseter Temporalis & Masseter D Instructions / Intentions / Feel or Watch For: In combination with client’s movements, use fingertip pressure in both cephalad and caudal directions. Release local contractions in lateral soft tissue structures: Temporalis, Masseter, superficial fascia, TMJ capsule, etc. Use “Jaw Tracking” technique to monitor any mandible deviation. Generally, work restrictions on same-side as any deviation. Movements / Cues: Jaw movements: depression/elevation; protrusion/retraction; lateral movements. Notes: Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-06 Digastric: Anterior Bellies (“Bulldog”) Digastricus: anteriore Bäuche D Instructions / Intentions / Feel or Watch For: Release Anterior Digastric attachments and floor of mouth, working posteriorly from chin. Movements / Cues: “Allow your jaw to fall back.” Variation: add active jaw protraction: “slide your jaw forwards.” Useful for chronic mandibular retraction (under bite). Notes: Use caution around glands: stay on muscle and connective tissue. (Anatomy image © Primal Pictures) Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-06 Digastric: Anterior Bellies (“Bulldog”) Digastricus: anteriore Bäuche D Instructions / Intentions / Feel or Watch For: Release Anterior Digastric attachments and floor of mouth, working posteriorly from chin. Movements / Cues: “Allow your jaw to fall back.” Variation: add active jaw protraction: “slide your jaw forwards.” Useful for chronic mandibular retraction (under bite). Notes: Use caution around glands: stay on muscle and connective tissue. (Anatomy image © Primal Pictures) Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-07 Digastric: Posterior Attachments Digastricus: posteriore Anheftungen D Instructions / Intentions / Feel or Watch For: Gentle pressure into attachments of posterior Digastric bellies on the anteriomedial aspect of the Mastoid Processes. Movements / Cues: Jaw depression/elevation; protrusion/retraction; lateral movements. Notes: Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-07 Digastric: Posterior Attachments Digastricus: posteriore Anheftungen D Instructions / Intentions / Feel or Watch For: Gentle pressure into attachments of posterior Digastric bellies on the anteriomedial aspect of the Mastoid Processes. Movements / Cues: Jaw depression/elevation; protrusion/retraction; lateral movements. Notes: Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-01 TMJ CORE SEQUENCE Intentions / Goals: • Release and 1. _____________ the functioning of local and intra-oral structures affecting the jaw; • 2. _____________ and 3. _____________ deeper work. Indications: • (Same as Sequence A). B-01 TMJ CORE SEQUENCE Intentions / Goals: • Release and 1. _____________ the functioning of local and intra-oral structures affecting the jaw; • 2. _____________ and 3. _____________ deeper work. Indications: • (Same as Sequence A). B-02 Mandibular Condyle Tracking den mandibulären Kondylen nachspüren P,D Instructions / Intentions / Feel or Watch For: With pad of both little fingers facing anteriorly (opposite of photo) just inside the ear canal, use client’s active jaw movement to feel for symmetrical anterior and posterior glide of mandibular condyles at the TMJ. Movements / Cues: Jaw depression/elevation; protrusion/retraction; lateral movements . Notes: See “TMJ Tracking” technique for more detail on structures that affectjaw tracking. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-02 Mandibular Condyle Tracking den mandibulären Kondylen nachspüren P,D Instructions / Intentions / Feel or Watch For: With pad of both little fingers facing anteriorly (opposite of photo) just inside the ear canal, use client’s active jaw movement to feel for symmetrical anterior and posterior glide of mandibular condyles at the TMJ. Movements / Cues: Jaw depression/elevation; protrusion/retraction; lateral movements . Notes: See “TMJ Tracking” technique for more detail on structures that affectjaw tracking. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-03 Masseter (Intra-oral) Masseter (intra-oral) D Instructions / Intentions / Feel or Watch For: Feel for and release tightness in Masseter belly between inside and outside fingers. Work throughout Masseter. Inside finger placement: Finger between Masseter and upper teeth. Movements / Cues: Clench and release jaw; Protrusion/retraction; Lateral movements of jaw. Notes: Lower photo shows use of fifth finger, which is sometimes preferable on smaller clients. Not visible in lower photo is outer hand, which is releasing outer side of Masseter, as in upper photo. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-03 Masseter (Intra-oral) Masseter (intra-oral) D Instructions / Intentions / Feel or Watch For: Feel for and release tightness in Masseter belly between inside and outside fingers. Work throughout Masseter. Inside finger placement: Finger between Masseter and upper teeth. Movements / Cues: Clench and release jaw; Protrusion/retraction; Lateral movements of jaw. Notes: Lower photo shows use of fifth finger, which is sometimes preferable on smaller clients. Not visible in lower photo is outer hand, which is releasing outer side of Masseter, as in upper photo. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-04 Medial Pterygoid / Mandible Pterygoideus medialis / Mandibula D Instructions / Intentions / Feel or Watch For: Work: A. attachments of Medial Pterygoids and B. floor of mouth ...from both inside and outside the mouth. Movements / Cues: A. Jaw elevation/depression, protrusion/retraction, lateral glide. B. Gentle movement of tongue. Notes: Indicated in TMJ pain, as well as for jaw deviation (work Med. Pterygoid on opposite side of deviation). The Medial Pterygoid elevates of the mandible; it contributes to lateral mandible movement to the opposite side; and to protrusive movements. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-04 Medial Pterygoid / Mandible Pterygoideus medialis / Mandibula D Instructions / Intentions / Feel or Watch For: Work: A. attachments of Medial Pterygoids and B. floor of mouth ...from both inside and outside the mouth. Movements / Cues: A. Jaw elevation/depression, protrusion/retraction, lateral glide. B. Gentle movement of tongue. Notes: Indicated in TMJ pain, as well as for jaw deviation (work Med. Pterygoid on opposite side of deviation). The Medial Pterygoid elevates of the mandible; it contributes to lateral mandible movement to the opposite side; and to protrusive movements. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-05 Lateral Pterygoid Pterygoideus lateralis D Instructions / Intentions / Feel or Watch For: Have client laterally deviate jaw to same side to access the lower head of the Lateral Pterygoid, which is just medial to Temporalis tendon / Coronoid Process of Mandible. Indicated in TMJ pain, and for jaw deviation (to opposite side), especially when deviation is most obvious upon initiation of opening. Movements / Cues: Movements: 1. Lateral deviation to access Lateral Pterygoid; 2. Gentle protrusion, retraction, further lateral deviation to locate and release Lateral Pterygoid. Notes: The Lateral Pterygoid assists in opening the jaw by pulling forwards the mandibular condyle and the articular disc of the TMJ. It is also involved in protrusion and in lateral movements of the mandible. The anterior aspect of the TMJ capsule can sometimes be palpated here. You may encounter sensitivity, trigger points, or dense tissue from anesthetic injections in this region. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-05 Lateral Pterygoid Pterygoideus lateralis D Instructions / Intentions / Feel or Watch For: Have client laterally deviate jaw to same side to access the lower head of the Lateral Pterygoid, which is just medial to Temporalis tendon / Coronoid Process of Mandible. Indicated in TMJ pain, and for jaw deviation (to opposite side), especially when deviation is most obvious upon initiation of opening. Movements / Cues: Movements: 1. Lateral deviation to access Lateral Pterygoid; 2. Gentle protrusion, retraction, further lateral deviation to locate and release Lateral Pterygoid. Notes: The Lateral Pterygoid assists in opening the jaw by pulling forwards the mandibular condyle and the articular disc of the TMJ. It is also involved in protrusion and in lateral movements of the mandible. The anterior aspect of the TMJ capsule can sometimes be palpated here. You may encounter sensitivity, trigger points, or dense tissue from anesthetic injections in this region. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-08 SI Release: Anterior/Posterior Lösen der ISG: anterior / posterior P,D,I Instructions / Intentions / Feel or Watch For: Use Squish Test to determine tighter side. Lift on one side of sacrum from under client, while applying counter-pressure on ASIS; feel for anterior/posterior release. Movements / Cues: Notes: Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 06.99 Adv. Myo. Techs: TMJ/Headaches B-08 SI Release: Anterior/Posterior Lösen der ISG: anterior / posterior P,D,I Instructions / Intentions / Feel or Watch For: Use Squish Test to determine tighter side. Lift on one side of sacrum from under client, while applying counter-pressure on ASIS; feel for anterior/posterior release. Movements / Cues: Notes: Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 06.99 Adv. Myo. Techs: TMJ/Headaches A-08 Bilateral Jaw Release Bilaterales Lösen des Unterkiefers P,D,I Instructions / Intentions / Feel or Watch For: Feel for local tissue texture of masseter, temporalis, and for release of jaw tonus. Movements / Cues: Passive depression. Notes: Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches A-08 Bilateral Jaw Release Bilaterales Lösen des Unterkiefers P,D,I Instructions / Intentions / Feel or Watch For: Feel for local tissue texture of masseter, temporalis, and for release of jaw tonus. Movements / Cues: Passive depression. Notes: Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-06 Ear: External Acoustic Meatus Ohr: äusserer Gehörgang D Instructions / Intentions / Feel or Watch For: Using gentle posterior traction of the meatus or concha, feel into the TMJ capsule. Use jaw protrusion and lateral motion (active or passive) to counterstretch the articular disk’s membranes anteriorly, away from your finger’s posterior traction. Movements / Cues: Use all jaw movements: depression/elevation; protrusion/retraction; lateral movements (active or passive). Notes: Variation: Temporal decompression. By “hooking” the posterior rim of the meatus, decompress the temporal bones with steady lateral traction (no active client movement). . Possible awareness cues: “Allow your head to widen.” “Let your eyes sink back into this space.” Etc. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches B-06 Ear: External Acoustic Meatus Ohr: äusserer Gehörgang D Instructions / Intentions / Feel or Watch For: Using gentle posterior traction of the meatus or concha, feel into the TMJ capsule. Use jaw protrusion and lateral motion (active or passive) to counterstretch the articular disk’s membranes anteriorly, away from your finger’s posterior traction. Movements / Cues: Use all jaw movements: depression/elevation; protrusion/retraction; lateral movements (active or passive). Notes: Variation: Temporal decompression. By “hooking” the posterior rim of the meatus, decompress the temporal bones with steady lateral traction (no active client movement). . Possible awareness cues: “Allow your head to widen.” “Let your eyes sink back into this space.” Etc. Advanced-Trainings.com www.advanced-trainings.com info@advanced-trainings.com +1 303/499-8811 © 09/06 Adv. Myo. Techs: TMJ/Headaches © Advanced-Trainings.com © Advanced-Trainings.com p. X-18 Rocabado Seaton, Mariano & Iglarsh, Z. Annette. The Musculoskeletal Approach to Maxillofacial Pain. NY: Lippincott Williams & Wilkins, 1990 Rocabado Seaton, Mariano & Iglarsh, Z. Annette. The Musculoskeletal Approach to Maxillofacial Pain. NY: Lippincott Williams & Wilkins, 1990 Adv. Myo. Techs Lippold C, Danesh G, Schilgen M, Derup B Hackenberg L. Relationship between thoracic, lordotic, and pelvic inclination and craniofacial morphology in adults. Angle Orthod. 2006;76:779-85. Lippold C, Danesh G, Schilgen M, Derup B Hackenberg L. Relationship between thoracic, lordotic, and pelvic inclination and craniofacial morphology in adults. Angle Orthod. 2006;76:779-85. p. X-18 “Postural changes of the cervical region can cause TMD, modifying the orientation of the head and consequently the mandibular position.35” “Postural changes of the cervical region can cause TMD, modifying the orientation of the head and consequently the mandibular position.35” Adv. Myo. Techs “Patients with idiopathic scoliosis show higher frequencies of malocclusion than control patients.” “Patients with idiopathic scoliosis show higher frequencies of malocclusion than control patients.” Cuccia A, Caradonna C. The relationship between the stomatognathic system and body posture. Clinics 2009;64 (1):61-6. http://www.scielo.br/pdf/clin/v64n1/a11v64n1.pdf Cuccia A, Caradonna C. The relationship between the stomatognathic system and body posture. Clinics 2009;64 (1):61-6. http://www.scielo.br/pdf/clin/v64n1/a11v64n1.pdf “Several studies have shown that patients with TMD present an excessively forward head position,26,27 usually associated with the shortening of the posterior cervical extensor muscles (suboccipital, semispinalis, splenii, and upper trapezius muscles), as well as shortening of the SCM.28” Cailliet, Rene. Neck and Arm Pain (Pain Series). F.A. Davis & Co, 1991 Cailliet, Rene. Neck and Arm Pain (Pain Series). F.A. Davis & Co, 1991 “Several studies have shown that patients with TMD present an excessively forward head position,26,27 usually associated with the shortening of the posterior cervical extensor muscles (suboccipital, semispinalis, splenii, and upper trapezius muscles), as well as shortening of the SCM.28” REFERENCES & RESOURCES REFERENCES & RESOURCES • TMJ 3. pain or noise; 4. bite issues • 5. Tinnitus; Vertigo • 6. Headaches • Postural issues, especially 7. head-forward posture. TMJ CORE SEQUENCE Intentions: • Release and 1. coordinate the functioning of local and intra-oral structures affecting the jaw; • 2. Balance and 3. integrate deeper work. Indications: • (Same as Sequence A). © Advanced-Trainings.com • TMJ 3. pain or noise; 4. bite issues • 5. Tinnitus; Vertigo • 6. Headaches • Postural issues, especially 7. head-forward posture. TMJ CORE SEQUENCE Intentions: • Release and 1. coordinate the functioning of local and intra-oral structures affecting the jaw; • 2. Balance and 3. integrate deeper work. Indications: • (Same as Sequence A). © Advanced-Trainings.com p. X-20 Indications: Indications: Adv. Myo. Techs • Release the larger, more 1. superficial structures affecting jaw alignment and balance, in 2. preparation for deeper work. • Release the larger, more 1. superficial structures affecting jaw alignment and balance, in 2. preparation for deeper work. p. X-20 Intentions: Intentions: Adv. Myo. Techs TMJ SLEEVE SEQUENCE ANSWER KEY, TMJ TMJ SLEEVE SEQUENCE ANSWER KEY, TMJ
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