Temporomandibular Dysfunction

Temporomandibular Dysfunction

Movement Analysis, Sub-classification, Neuromuscular Retraining for Functional Movement Control for Temporomandibular Dysfunction

Course description
Temporomandibular pain is closely related to cervical spine, shoulder girdle, swallowing dysfunction, speech control and orofacial dysfunction.  Research has also implicated psychological reactions, proprioception and temporomandibular joint mechanics.  This course will cover strategies to assess and rehabilitate the sensorimotor dysfunction associated with temporomandibular pain.  Appropriate psychological screening tests will be used to assess if other health care professionals are required for management. Motor control retraining strategies will be introduced using a comprehensive and evidence based clinical reasoning process. This involves specific activation of the appropriate stability muscles to control functional head and shoulder girdle movement, and integration of these training strategies into a wider base of rehabilitation options.

It is an advantage to have taken the Cervical Spine, and Shoulder Girdle courses, but they are not prerequisites.

Course Objectives

The participant will be equipped to:

  • Make an accurate diagnosis according to the Movement Dysfunction sub-classification.
  • Be able to assess for specific motor control deficits in the cervical spine relating to local muscle activation in the control of segmental translation and control of functional head movement.
  • Understand the relationship of scapular dysfunction, cervical dysfunction and temporomandibular dysfunction
  • Learn how to apply the key concepts of motor control retraining to restore appropriate muscle activation, reposition sense and translation control for the cervical spine
  • Integrate motor control training into a comprehensive clinical reasoning framework.
  • Use movement dysfunction as a clinical reasoning  tool to help guide manual therapy and other techniques


Upper Trapezius is a Good Guy Muscle
Upper trapezius does not elevate the scapula – it has a local and global stability role for the neck and shoulder girdle. It has a major stability influence on the neck, shoulder and thoracic spine. It has an anticipatory timing pattern and is delayed with pain – similar to Transversus. It also experiences sudden atrophy – similar to Multifidus. It rarely loses extensibility so assessment and retaining needs to be specific. Lower trapezius does not pull the inferior angle of the scapula down and in. There are better ways to train lower trapezius for scapular stability!

Inferior Anterior Glenoid (IAG)
The IAG is the position the scapula orientates following pain.  This position is controlled by the stability muscles of the scapula and also helps stabilize the cervical spine.  The scapular position can significantly influence the temporomandibular joint.

The TMJ can influence the control of the cervical spine.  We will show you how to test and rehab this

TMJ & Hyoid Control
We have applied the concepts we use for motor control rehab all over the body to the TMJ and hyoid bone.

Sensory Motor Function
Oculomotor function and proprioception can show deficits with chronic neck pain.  We’ll show you how to assess and rehab this.  Similar techniques can be used to relieve the stress associated with increased muscle tension around the TMJ.

Myofascial Trigger Point Release (MTPR)
Mobilizer muscles tend to get short and/or dominate movements which contribute to faulty patterns and pain.  MTPR to the mobilizer muscles can create a good window of opportunity to change movement quality and help manage symptoms. 

Neurodynamic reactivity can significantly affect the way people move.  We’ll show how movement can be used to treat neurodynamic reactivity.

There are some great taping techniques for the shoulder girdle, neurodynamics!


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