Question: Can you give me advice on how to educate clients about the jaw? I understand working with perception and coordination, but how can I do that with the jaw?

Answer: When we talk about the jaw we must include the temperomandibular joint (TMJ) and the rest of the mouth: the teeth and tongue. Actually, your question is so important that it deserves a more elaborate answer than the one I can give in the space for this column. But for now, let’s play a little with self-help for the jaw. Research shows that nowadays we are chewing ten times less than a hundred years ago (our food has become too soft), so our jaws are not exercising as much as they were designed by nature to do. On top of that, we are sitting too much, instead of walking an average of twelve kilometers per day as our ancestors used to do, and then we slouch, thus projecting the head forward with consequences for the cervicals and TMJ.

I don’t know that we can tell clients to eat more raw food and exercise more, but we can educate them to sit properly, not on the ischial tuberosities but slightly in front of them. To understand the relationship between poor sitting and added stress to the TMJ, try this: sit as slouched as you can and close your mouth, locking the teeth. Then, while keeping them locked, change your position and sit slightly in front of the ischial tuberosities. Now notice how the relationship between the jaw and the maxillae changes, and how the slouched position was putting extra stress on the temporalis/masseter complex.

It is also very important that you educate clients about correct positioning of the whole mouth: lips should be closed, upper and lower teeth slightly separated, the tip of the tongue lightly touching the hard palate right behind the incisors, and breathing through the nose. If the person is not used to this correct positioning of the tongue, he will at first feel very awkward and not be able to relax at all to do it. This is a learning process that sometimes requires the expertise of a speech therapist. It is not correct to let the tongue spread and occupy the whole mouth – that is one reason for the collapse of the core. Neither is it correct to place the tip of the tongue against the teeth, which will force them out and affect the bite.

There are many self-help techniques to help release accumulated tension in the TMJ area. Here are my favorite ones. 

1. With the client sitting properly, have him place his thumbs on his mastoid processes so that the thenar eminences are slightly under the jaw, cradling it, index and middle fingers right above the TMJs, and the fourth and fifth fingers away from the face. The client’s lips should be closed, upper and lower teeth slightly separated, with the tip of tongue lightly touching the hard palate right behind the incisors. All the client has to do now is to think that his head is being suspended from the ceiling while the weight of his elbows, through the thumbs, puts a light traction on the posterior aspect of temporalis muscle (behind the ears) and the index and middle fingers put a light traction on the distal attachment of the temporalis and the proximal attachment of the masseters. Hold this position for two to three minutes. Have him do this two or three times a day, but especially before sleeping.

2. Teach the client to gently but firmly massage the temporalis, about two inches above the uppermost tip of the ears, moving the scalp (and superficial fascia of the head) in small circles.

3. With the client sitting properly, teach him where the distal attachment of the masseters is in the jaw and teach him to massage it, doing small circles with the proper pressure. Too little pressure will not release the masseters and too much pressure will make them react with more pain. Have him do this three times a day, for about three minutes each time.

4. With the client sitting properly, have him place the fingers of his left hand just below the right TMJ, “sticking” to the local fascia and weighing it down, thus putting some pressure over the masseter while telling it to let go. Meanwhile, have him use the tips of the fingers of his right hand to work in an upward direction starting on top of the right cheek bone and going towards the right temporal bone, thus opening the TMJ. Have him do this three times a day, for about three minutes each time.

Tension in the Jaw and How to Release It with Specific Movement Exercises[:]