- Hi everybody, it's Dr. Blake
from Kalkstein Chiropractic,
your Baltimore area chiropractor,
and we're gonna show you the best chiropractic
and soft tissue techniques for jaw pain.
(upbeat music)
We've got Anna in the office.
Anna is rocking her Thursday Ravens gear
as you guys can see.
Go ravens, first place AFC North.
They're not a good team, but they're still in first place.
- I agree, they're fun to watch.
- They're fun to watch.
Let's talk about jaw pain and what we need
to do to help jaw pain in the office.
So if we're looking at the anatomy of the jaw bone,
we've got the mandible that comes down across like this.
And we've got this big muscle,
it's kind of like two fingers wide
that sits right on top of the jaw.
We call that the masseter muscle.
Can you tighten that up, tighten your jaw?
Right there, you can feel it right there.
That's gonna come up across the jawline.
Then on top, we've got the temporalis.
It's like this big clamshell.
It's this really thin muscle that comes down into here
and attaches up top here.
So those are the two primary muscles that we focus on
when doing soft tissue work for the jaw.
There's one secret muscle that's called the pterygoid
that's on the inside of the jaw
that we can also work on too as well.
And we'll show you that soon.
So we've got the two muscles.
we've got this one here, we've got this one here.
The masseter and temporalis,
the pterygoid which is on the inside.
And then we also wanna focus on the joint itself,
but also we wanna look at the top two vertebrae of the neck
because these joints talk to the muscles all through here.
And so if we can work on the joints here,
we can affect what's happening up here.
So we may do some soft tissue work on the suboccipitals,
we may do some soft tissue work here and here.
We'll definitely do some soft tissue work on
that secret pterygoid muscle
and then we're gonna adjust the jaw on the upper cervical.
I like this soft tissue technique the best
because you can do it at home if you're having jaw pain.
So we're gonna do it on Anna and then we're gonna teach Anna
how to do it so you guys can do it at home.
Then we're gonna show you that pterygoid release
and we're gonna show you some suboccipital stuff,
then we're gonna adjust the jaw and the neck.
So two fingers, Anna two fingers, nails look good.
- Thank you.
- We're gonna come right on the outside of the jaw
on both sides and we're gonna take some flat hands,
pressure in and then up.
So with the mouth closed, pressure in and then up.
From here, we're gonna have Anna open her mouth
as wide as she can.
Good and down.
And then we're gonna, so we started here at the very bottom,
the pressure is on my finger pads here,
I'm not poking in like this, like I normally do.
I'm gonna come here right off the edge,
pressure in and up.
Open.
(bone pops)
We heard a little pop there.
Anna's got some clicking and some grinding
and we're gonna show you how we assess
that before we adjust her.
Pressure in and up.
Good, open
and close.
Was that a little uncomfortable, Anna?
- Mm-hmm. - Yeah.
So you wanna have a little bit of pressure on there
where it is uncomfortable on the muscle.
So I like to do this three times a day and three sets.
So we go, we go one here,
we go one here
and then we go up a little bit higher
and we get on the top part of the masseter.
So this is all work on the masseter.
Go ahead, open up and close.
So I start here, I start here and I start here.
Those are the three levels.
I'll do that one, two, three.
One, two, three.
Three times a day.
That's the three by three method
for stretching the masseter muscle and it's really effective
and something you guys can do at home to help with jaw pain.
So Anna, fingertips flat on the bottom of the jaw.
We're gonna push in and no,
we're gonna push in and up.
And now you're gonna open up and close.
Good.
And we're gonna go a little bit higher in and up.
Open.
Close.
And then we're gonna go one more up, in and up.
Open.
Close.
So three times a day, three sets each time,
the three by three masseters exercise.
So flat fingertips is important, we don't wanna poke in.
That's the masseter.
Now we can do the same technique with the temporalis.
But remember the temporalis is not two fingers wide,
it's like a big clamshell that takes up the whole top part
of this temporalis muscle, the temporal bone.
And so we're gonna use all four finger pads.
We're gonna come wide like this,
pressure in and then up and then open up.
Good.
And we can go here, here, here on all parts of the muscles.
Open.
Close.
Open.
Close.
Open, close.
You guys will feel this when you do this at home.
The masseter's pretty thick.
I can put some pressure on there
and get some tension in there.
The temporalis is a very thin muscle
so I don't need a lot of depth or pressure.
I really just wanna take my fingers here,
in and pull up, open.
Good.
Do you feel the difference there, Anna?
- [Anna] Mm-hmm.
- This is a light, an easier stretch on it.
You definitely feel this a little bit more,
but both are important for working on TMJ pain.
I almost got, I was like the next we're gonna do
is gonna put a quarter in your mouth, no.
The next thing we're gonna do
is gonna show you the pterygoid,
that secret pterygoid release muscle.
So when we're dealing with jaw pain,
always want to use a glove if you're a practitioner.
It's kinda hard to do this one at home
because you need a little bit of leverage.
But what we're gonna come do here is,
the pterygoid sits kind of behind the masseter
on the inside along the outside of the teeth.
So we're gonna come along the outside of the teeth.
Open, don't bite me, close.
So I'm on the outside of the teeth
and I'm gonna go straight back and then there's
that little lift there, you feel that?
- Mm-hmm. - Yeah.
So we're gonna go, we go straight back along the teeth
and then we curl up and underneath
and we apply the pressure that way, like that.
And then Anna's gonna open her mouth.
Good, close.
Are you wearing mascara?
- Mm-mm. - No.
So sometimes if you're wearing mascara and do this one,
it's a little uncomfortable and you get some...
Go ahead.
Of all the jaw exercises and jaw stretches
and soft tissue that we do,
this is by far the most uncomfortable,
or can be the most uncomfortable
because it's often ignored when we're treating TMJ pain.
Good, uncomfortable?
- Mm-hmm. - Yeah.
And each time she opens and closes,
I'm gonna go a little bit deeper
and a little bit more pressure as we start
to soften that tissue up.
Go ahead, open.
Good.
We wanna balance it out,
we wanna get the other side too Anna, okay?
- [Anna] All right.
- Anna will you swing around and put your head the other way
so we can, I don't have to reach over you.
- Yeah.
- Good, so scoot towards me please a little bit.
Good.
So open and I close.
Don't bite me please.
This side's a little bit tighter than the other side.
Open.
Good, close.
Just close your eyes, okay?
Open.
Close.
Open.
Close. (door knocking)
One second.
Open.
Good, right there.
Which side was harder for you?
- This side actually.
- The other side was harder?
- Yeah. - Okay, all right.
So those are sort of the
two most common muscles everybody works on,
that easy stretch for you guys to do at home
and that secret pterygoid that not many people,
that most people ignore when they're treating jaw pain.
So that's the soft tissue.
We can also do some soft tissue work on the suboccipitals,
but you guys have seen that before.
We also adjust the suboccipitals, the C1 and C2 vertebrae.
But today we're gonna show you
how we adjust the jaw and how we assess the jaw.
So Anna, hop on up and have a seat right here for me please.
Good.
So well I really want Anna to relax in her shoulders
and her neck here, please.
And I'm gonna come and I'm gonna take two fingers,
I'm gonna put them right over the joint line
and I'm gonna ask Anna to open wide
and close.
Open wide
and close.
And what I'm feeling for is, we call it least and last.
What joint opens, on either side,
the least amount and which one opens last.
Go ahead, open again.
Close.
Some other things you may wanna look for,
is there any deviation when her mouth opens?
Does one side look like it's not opening far enough?
Open.
Close.
You see how that kind of like comes back
and kinda zigzags back in, do you feel that?
- Yeah. - Yeah.
So what I feel is, this side here opens least and last
and this side opens more and most.
So when I find that,
I always want to adjust the stuck side first
and then the other side second.
The way we do this is, relax your head back to me
and then come this way a little bit.
And what I'm gonna do is
I'm gonna kinda lock out the vertebrae.
So it's the motion comes from the jaw and not the neck.
(bone pops)
And a freebie over there.
Slightly open your mouth
and it's just a push motion, it's not a big thrust.
Just like that.
Open slightly, a little tension on the jaw.
And that moved really nice through there,
both of those were really good.
So after we've done the soft tissue,
after we've adjusted, we always reassess.
Open
and close.
And look at that, she lost that zigzag right there.
Go ahead again
and close.
Pretty cool.
So we use that, we may combine it
with some dry needling on the masseter if it's really tight.
We may throw some class four laser on there,
help speed up the healing tissue.
But those right there are the most effective treatments,
soft tissue-wise and adjustment, for TMJ jaw pain.
If you guys have any questions about how we treat jaw pain,
leave a comment below.
As always, thanks for watching.
(upbeat music)