TMJD with Kavin Dobbins
Temporomandibular Joint Disorder (TMJD) can cause a surprising host of problems ranging anywhere from clicking or popping sounds to radiating pain and headaches. The tempormandibular joint connects the lower jaw to the skull, and TMJD is a common problem affecting 5-12% of people. Curiously, its prevalence is higher among younger people and impacts twice as many women as men. Meeting with Kavin Dobbins, we went over his sixteen years of massage experience and how he approaches treating this chronic pain disorder.
Most often, TMJD comes up during the intake period before a session and the majority of patients are aware they have it, or are at least concerned about the more common symptoms like clicking or jaw pain. However, sometimes the patient isn’t aware of any jaw issue or, if they have more pressing pains, they might overlook it. In those instances, Kavin may notice some other telltale signs like the patient’s reticence or inability to open their jaw fully during conversation. He may also notice their jaw sitting askew, jutting forward or pulling back, and at that point he will ask more directed questions to see if they are experiencing some other symptoms. It may also be a contributing factor to their original reason for the visit, such as headaches.
Kavin’s routine begins with loosening the neck and upper back muscles. Starting with sternocleidomastoid, scalenes, upper traps, and pecs, he works his way up toward the temporomandibular joint. If he discovers trigger points along the way, he stops to treat those as well. During the therapeutic session, Kavin settles in to treat the suboccipitals, deep cervical rotators, and stabilizers. All of these structures connect close to or on the mandible and surrounding bony protrusions. All of these muscles and attachments contribute to TMJD in a variety of ways and, beginning from the bottom up, he addresses the problem holistically. At the masseter—the large muscle connecting the lower jaw to the cheek bone which engages the most when chewing— he uses a combination of direct friction, active stretching, and applying directional friction to the muscle. He also employs a form of resistance treatment. That last one was a new technique for me, where he uses a finger on their chin and applies light pressure against whatever movement of the jaw he directs the patient to perform. This technique is widely used by therapists on all other parts of the body and functions by forcing the natural inclination of muscles to reset positional sensors to relax and allow the muscle to stretch longer. After working on the neck and jaw muscles—and if time remains— he works along the crown and skull muscles, especially if the patient reports headaches.
Kavin has had widespread success with treating TMJD pain. Typically, after a session the patient will report immediate relief that lasts up to a week. When dealing with chronic TMJD pain that’s gone untreated for long periods of time, Kavin recommends a schedule of weekly massages for four weeks. Rarely has anyone needed anything more aggressive. Once the four weeks have finished, he recommends the patient reduce to a bi-weekly schedule if the pain relief lasts for longer than a week. In addition to doing the treatments, Kavin empowers his patients to self-treat their symptoms by providing a handful of stretches and exercises to double-up on the effectiveness of his treatments and reduce the amount of time the patient needs to come back for more sessions.
Massage has brought relief to many suffering chronic pain and headaches and research continues to support its efficacy as a pain management strategy.