Posts Tagged ‘TMJ’
12/28/11 – Am I Treating the Symptoms or the Problem? TMJ Related?
Posted by admin in Reflections on December 28th, 2011
I felt it. I knew it would happen, and it did. I am now all about the workouts! I don’t know what it is about me, but I have a very difficult time doing something until I feel like it is right. Well, folks, the time is right.
I have been to the gym more times in December than October and November combined, and I hope to continue this trend through the whole of next year.
Once again, I am rehab-ing my knee – myself this time. It was not getting better with just the strengthening of the multifidi or hip muscles. So, I have brought out the tiger tail, specific area massage with my own hands, icing and the foam roller. It is responding well, but I have to stay on top of it.
Due to the relapse in the right knee as well as the right shoulder, my thoughts this week have been largely wondering around the question of “Am I treating symptoms or the problems?” The shoulder is less of an injury than the knee, but still, why do they keep walking the line of injury? Does this mean that there is another underlying problem that I really need to look into? Am I just treating symptoms?
I am also wondering about my TMJ. Is TMJ the actual problem to almost everything else?
I have been working on relaxing my jaw at all times in combination with making sure my shoulders are pulled down and back (which has gotten easier with the strength building!). The only time I cannot for sure control the jaw clenching is during my sleep. For sleep, I was wearing a night guard, but I lost it about two months ago. I decided to try it without the guard by relaxing before sleep and reminding myself not to clench or grind when I sleep. I think some of it has been getting through as I am feeling more relaxed in my neck and shoulders, but I have a LONG way to go as more relaxed is all relative. My neck and shoulder muscles still feel like rocks, just more like sandstone rather than granite.
Over the last month, I have also been incorporating a line from a short play I saw years ago, the name of which is lost in time. The line is, “Just stop it!” In the play a psychologist tells her patient to “Just stop it!” whenever the patient brings up the crazy actions in her life. I couldn’t help but think that was so brilliant at the time, and then just last week I was talking to my massage therapist who was telling me about a man who got a massage as a gift. When he showed up, he didn’t have any knots. How is this possible? No knots, not even in his shoulders? What’s his secret? Then, the line from the play popped in my head, “Just stop having knots!” Really brain? Wait. Is it possible to just stop having knots by sheer force of will?
As a side note, my husband also has zero knots. None. Zip. Nadda. No knots. Not ever. He also has a stressful job, and works out a lot. No knots. I’ve asked him about it. Of course he has no idea. I do know that he does not ever clench his jaw. Never. How is this possible? Why do I clench and he does not?
Then, I started thinking about my TMJ. I clench and grind, and I have tight shoulder and neck muscles with tons of knots. Could this be the problem that causes my symptoms?
According to emedicine health (http://www.emedicinehealth.com/temporomandibular_joint_tmj_syndrome/page2_em.htm), TMJ can be caused by clenching of the jaw and grinding of the teeth, or bruxism (check and check). People who clench might also chew pencils, gum or other objects when not eating. The chewing reinforces the clenching at all times, and can cause TMJ because the jaw muscles are not getting a chance to relax between meals like they are supposed to. Bruxism on the other hand is grinding of teeth, which largely happens at night when someone’s bite is off; when he/she is missing a tooth; or if someone has a lot of stress or anxiety.
Now, I find this reinforcing to me as I used to be a chronic gum chewer. I would not be found dead without gum on my person and in my mouth, unless food was in my mouth. I quit chewing gum over a year ago because of the other effects chewing gum has on your esophagus and digestive tract in general (Chewing gum signals the start of the digestive process by causing the mouth to produce saliva. Then, the stomach responds by producing acid that would be necessary if food were to hit it. However, with gum, there is no food that ever hits the stomach, and then the extra acid is just sitting around causing trouble.). To find that not chewing gum also helps reduce the clenching is phenomenal! Two benefits in one!
Ok. The treatment for bruxism? Medicine Net (http://www.medicinenet.com/teeth_grinding_bruxism/article.htm) says that for teeth grinding do one or more of the following:
– Mouth guard
– Stress reduction (either by counseling or medication)
– Reduce or avoid caffeine and alcohol
– Train yourself to not clench or grind (“JUST STOP IT!”)
Well, there it is! Just stop grinding your teeth, silly. Why didn’t I think of this before?
What it turns out to be with feet (sans orthotics for nearly two whole years!) and jaws is that you have to do all the work. Sure a mouth guard will help, but what about when you lose it or forget it on a long trip? The real solution is to do the leg work yourself. Figure out how to train yourself to stop. Then, “JUST STOP IT!”
Now for my continuing experiment to meet my goal of not needing any external structures to live my life to its fullest, I will continue to work toward relaxing my jaw at all waking hours. During workouts, I press my tongue against the top of my mouth, which does two things: 1. stops me from clenching my jaws 2. activates the multifidous muscles next to the c1-4 vertebrae, which need to work some anyway. So far so good 🙂
9/13/11 – PT, My Jaw Story, and a Workout!
I am moving toward a goal of posting more, again, on the blog 😉
So, today was a visit to Travis about my right shoulder. I originally started visiting him concerning an inflamed biceps tendon, but since then, it has changed to more a slightly sore infra-spinatus. The cause seems to stem from my lifelong habit of clenching my jaws together,which I am also seeing a different specialist for.
Anyway, over the weekend I had to get a massage to relieve my shoulder pain due to excessive clenching, which causes a chain reaction of my levator scapula getting tight and causing a downward rotation on my shoulder blade, which then causes the rest of the rotator muscles- that are already a little too weak – to work super hard to get the upward rotation on the shoulder blade. The end result is an inflamed small muscle or tendon in my shoulder and a very tight neck and top of shoulder area. Argh.
The massage enabled me to run the 5K Iron Girl on Sunday, but by today, I was already super tight again and feeling some discomfort in my shoulder. Travis, being the incredibly knowledgeable PT that he is, did a very specific massage, which loosened up the muscles enough so that we could actually do some exercises. He, then, took it fairly easy on me due to the inflammation of the new area.
I also told him what I had learned about my jaw from the specialist at UW. It goes something like this:
I broke my only crown, which I had had for 10 years, in January of this year and had it replaced in February. After the replacement is has hurt and continually extruded (or pushed up). My dentist filed it down three times before determining that it was probably something more serious and sent me to an endodontist due to my long tooth roots.
Cut to endodontist: She determined that I had a cracked tooth, which had been held together with the old crown, and opened up with the new crown, which equals a ROOT CANAL! Yay! The root canal was supposed to solve the problem and stop the tooth extrusion.(She also measured my tooth roots b/c I was wondering how long they were and why they were considered so long. It turns out my tooth roots are 25mm long, and a normal tooth has roots approx. 22mm long. And now you know….)
Note: this whole time I am wearing my night guard religiously each night. My night guard is basically a mold of my teeth with some kind of plaster built up on the front part to keep my teeth from touching in the back. The only teeth that touch are the front ones, and boy can I feel it in the morning on the front teeth when I’ve had an exceptionally clench-filled night.
Well, the root canal on August 16th did not stop the tooth from continuing to extrude. My endodontist even did a file down to help ease the discomfort about one week later.
In the mean time, I set up an appointment with the TMJ specialist at UW. I explained the whole process to him, and he immediately was impressed that I knew how long my tooth roots were. 🙂 I’m such a nerd sometimes. Anyway, the result of the dissertation I made and the observations he made were that my night guard was causing the tooth to extrude. WHAT?! The freakin’ night guard that I dislike anyway is causing this entire catastrophie?! ARGH!
Here’s what was happening. He said that it is well known and thought of that a tooth on the top of the mouth without a tooth to oppose it on the bottom will overtime extrude because it does not have any force to oppose it and keep it in place. It is still known, but not really thought of (as in it is not the immediate conclusion) for bottom teeth, which is what my tooth is. So, my bottom tooth was inflamed, which means that the bone is building up around the root to help protect it, and the tendon surrounding the roots are working overtime to try and get the inflamed object to go away (i.e. extrude). Normally, after the root canal the tooth has a chance to calm down and stay in place b/c at some point in the day, it will hit the opposing upper jaw tooth and stay in place. However, due to my unfortunate nightguard, my back teeth NEVER touched, and my poor inflamed tooth was able to continue to push out each and every night.
He told me to throw out my nightguard because he was going to give me a new one (the temporary is a simple sports self-mold model – this thing is huge, but all of my teeth can touch the bendy plastic substance it is made out of). His theory was that with the touching of the teeth on something, the back tooth would begin to intrude, which it has, happily, done! Woohoo!
The second part of my treatment is all behavioral, i.e. I have to change my clenching habits during the day. I also learned that your teeth do not actually touch when your jaw is in a resting position. Many of you already knew that – lucky for you. I had no idea! I’ve been clenching my whole life thinking I was relaxed! No wonder my shoulders are like rocks.
So, my homework is to continually remind myself to relax my jaw – keep the tongue resting behind the front teeth while the teeth remain slightly apart to give the jaw joint space. I have been completely amazed by how often and how severely I clench during the day, even. It’s crazy! I especially clench during upper body (specifically shoulder) exercises. I also clench when I run, get really stressed at work or just sit and read facebook. My day now consists of me checking the status of my jaw and relaxing constantly.
I told Travis all this today, and he also added that the levator scapula is very tight possibly due to weakened multifidi on the C1-4 vertebrae. So, I now am working in pushing my tongue against the roof of mouth to fire those extremely tiny muscles along my spine. Woohoo! I’m just afire with crazy crap to keep up with.
Travis also finished analyzing my running video that we made several weeks ago. Due to the file size, I will not have it in my possession until I am able to get a thumb drive to him to download them. I will save his findings for the video.
I also ended my day with a workout from Melissa. Woohoo! I’ve gotten it all in this week. I’m going to try and run tomorrow as it will be day three after the race, which should be enough time for recovery, maybe.
Things are very exciting right now. I really believe if I can tame my jaw clenching, then I will see a huge reduction in my various discomforts and ailments. Never underestimate how connected the entire body is.
p.s. Travis measured the flexibility of the achilles tendon by measuring how far away from the wall I can stand and touch my knee cap to the wall. I’ll explain why in the video post, but for now the numbers – so I don’t forget them.
The right foot (big tow) was 5.5cm from the wall, and the left foot (big toe) was 7cm from the wall. These numbers are new measurements that I look to improve to the goal of 10cm for each foot over time.