TMJ Disorders and Treatment

The Temporomandibular Joints (TMJ) connect the upper jaw or maxilla, to the lower jaw called the mandible. These joints, located both on the left and right side of your jaw, are the most frequently used joints in the entire body and exert an average of 160 pounds of pressure! These powerful joints are used with chewing, talking, laughing and swallowing. When the TMJ is painful or makes noise that sounds like clicking or popping, it is called temporomandibular joint dysfunction or TMD. Pain from TMD can extend to other parts of your body and can affect the jaws range of motion, your sleep and even your diet.

TMD can be caused by trauma to the head and neck (sport-related, motor vehicle accident, post-operative, concussion, etc.), dental work/painful teeth, clenching or grinding the teeth, gum chewing, nail biting and arthritis.

Symptoms may include:

• Pain in the jaw
• Stiffness with yawning
• Clicking
• Popping
• Locking open
• Locking closed
• Headaches
• Neck pain

We can help provide natural TMD relief.
Our Physical Therapists have advanced training in assessment and treatment of TMJ Dysfunction. Your visit will begin with a one-on-one evaluation to assess the cause of pain or dysfunction, and a postural assessment. Appropriate joint mobilization of the cervical spine and TMJ, including soft tissue mobilizations, and therapeutic exercise can greatly improve symptoms. We also teach intra-oral manual therapy techniques to further decrease pain and restore function. TMD does not have to be a life-long problem. Our therapists get you on the road to recovery and show you how to maintain pain-free temporomandibular joints. Call us today for an appointment and get relief, naturally.

Keeping Kids Busy (and active).

Thinking of new and creative ways to entertain young ones can feel like a full time job. It’s important though, for kids to be active, creative, and to get some time out of doors. The American Academy of Pediatrics recommends a minimum of one hour of exercise each day for children ages 6-17 years of age, at least 180 minutes of physical activity throughout the day for children ages 3-5. As adults, we should spend 150 minutes per week getting cardiovascular exercise and incorporate some form of strength training twice a week. Following these recommendations help everyone maintain a healthy weight, happier moods, and healthier cardiovascular systems. Here are some great ideas for keeping the little ones engaged with creativity, activity, and exercise.

Schedule a daily nature walk or bike ride. Make it a scavenger hunt for items like beetles, snails, lizards, flower types, bird type, squirrels, tree types. Give kids a camera or cell phone to take a photo of an object to document it rather than pick it up. This is a good way to teach the concept of ‘leave no trace’ which keeps kids safe and protects natural habitats. Check out online Junior Ranger Programs from the National or State park systems as a resource. Give a bonus for finding (with a glove on) a piece of trash to throw out, and/or an animal not on the list or any other item that the adult does not know so you both have to look it up. Use an app to identify items found, like FieldLog, iNaturalist, or Plants, Cats & Dogs.

Make an obstacle course in the backyard or near your house in the neighborhood. Use a stopwatch to time them tracking improvement from the first time going through the course until the 3rd (or more) times. Set a goal–see how many laps they think they can do in a week and switch it up each week.

If they like a sport – give them a challenge! Try improving on things like juggling a soccer ball, number of free throws or catching a ball with a bounce back. Use laundry baskets, trashcans, buckets or boxes as goals. Got a ping pong table? Set it up to hit against a backboard, or use a portable badminton net for games like prisoner or volleyball, in addition to badminton. Chart activity or goals each day and make a fun prize for the end of the week. Think skipping a chore, buying a coveted kit for a project, a book, or new ball, hula hoop, or scooter. Older kids can be motivated by competition. If you win, they do a chore for you!

Bring back an oldie but a goodie…Red light-green light for young ones, hula hoops for older ones, hopscotch for all. If there are enough of you and a big enough space, play Red Rover, Red Rover or capture the flag for older ones.

The most important thing is to create connection, and to make this an opportunity to champion and encourage your kids. The outcome can be more insight and conversations with your kids, better health, and a great way to HAVE FUN! Research shows that play and creativity are foundational to learning, and our kids are learning a lot right now, about the world, about themselves, and how to navigate some pretty serious situations. So get outside, be creative, and keep those kids active!

Experiencing Pregnancy During the Time of COVID19

Within a mere two months, people around the globe have come to share one common feeling: anxiety. Initially, it was the fear of how this virus could spread, who was at risk, and how we could prevent getting exposed. Then as the numbers grew, it became the deep worry for not just ourselves, but our aged and immunocompromised loved ones. As the months passed, the economic burden on our communities have kept our stress levels elevated. Physicians and practitioners have increased discussions with patients about not only the health concerns of this virus, but the spiritual and mental impact as well. There is one particular population that we want to recognize who have a unique situational stress: the expectant mother.

As these women proceed through their days, working or caring for their families, they are also physically supporting a growing life. Pregnant women will likely have frequent thoughts of this virus and what they need to do to protect their child. In addition, they are not sure of who can attend the birth and how day-to-day life will look after they bring the infant home. Studies have shown that higher levels of cortisol, a hormone released by the body in times of stress, have been linked to preterm labor, low birth weight, and miscarriage, as well as mood and metabolic disorders in the child later in life (Dewar, 2008). Expectant moms and even concerned dads-to-be can be supported with good communication, encouragement to stay engaged in healthy habits, and increased awareness of signs and symptoms of stress, anxiety, or depression. A phone call, check-in, or quick e-mail can keep moms at risk of feeling overwhelmed instead feel grounded and supported.

Ways we can help this special population now (or anytime really):

Emotional support–let them know you care

Continued routine prenatal care–encourage keeping appointments, help with transportation

Education of employers on the additional risks of stress and pregnancy so unnecessary risks can be avoided in the workplace–share information with HR departments to facilitate company awareness

Education of spouses to help with understanding and support–keep talking to one another!

Education of Pediatricians to be aware of the increased stress on expectant mothers during this “corona-generation” and increase surveillance for mood disorders in the children

Networking/support groups on-line for pregnant women to share ways to relieve stress and anxiety during this time–encourage joining a group or forum to create community

If you or a loved one are pregnant and experiencing concerning levels of stress, please call and make a telemedicine appointment with your PCP so we can help you navigate this challenging time.

Great resources for pregnant women and those who help support them:

American College of Obstetrics and Gynecology: Corona Virus, Pregnancy, and Breastfeeding

Tips on Coping with a New Baby During COVID-19

Parenting: Tips to Stay Calm at Home

Breastfeeding during COVID-19

Working ergonomically can relieve pain.
These are unprecedented times setting some unprecedented work environments, and we are now seeing more patients with neck and back pain related to poor posture. So many of us are unexpectedly working from home with poor desk setups, leading to back and neck pain, headaches and overall tightness and fatigue. Everyone can benefit from proper ergonomics when working from home.

Here’s a list with some tips and tricks, as well as a downloadable handout with exercises to improve your posture and awareness:

Create a dedicated workspace – no laptops on the bed or on the couch!

Raise your monitor or laptop to eye level with a pile of books, an upside-down bowl, or small stool.

Use an external mouse and keyboard for more flexibility. It’s a small investment that can have big benefits.

Use a supportive chair and raise your seat, or try using a pillow so that you are eye level with the monitor.

Be sure your feet are still firmly on the floor or use a small foot stool.

Set a timer to get out of your seat every 30 minutes and stretch for just a few minutes.

The single worst thing you can do for your posture is to work from your laptop in bed or slouched on the sofa. Again and again in physical therapy we see patients get great relief from pain by moving from the bed or sofa to an ergonomic desk set up.

Our Physical Therapists can help with a virtual work space evaluation. Using a computer or your phone, a Physical Therapist will evaluate your work environment to achieve a proper ergonomic arrangement. If you would like a virtual work space evaluation by one of our Physical Therapists, call SDSM Physical Therapy at 858-793-7862. We will set you up with a virtual appointment at your convenience.

Virtual work space assessments are available for $95.

Social Distancing and RE-opening San Diego
As restrictions are lifted for stay at home orders, we urge you to remain mindful of the continued risk of COVID-19. It has not gone away, and a key to our success of limiting the spread in San Diego has been proper social distancing. Please wear a mask in public to protect others, and continue to practice good social distancing habits. COVID-19 is a disease with high rates of transmission and can be curtailed by simply wearing a face covering or mask, hand washing frequently, and maintaining at least 6 feet of distance from non-household members. We like to think of it this way:

By wearing a face covering,
I protect you and your family,
and you protect me and my family.

If you missed prior videos we’ve shared on how COVID-19 is spread via micro-droplets, please take a moment to view the videos below. Using black light and laser technology to measure the movement of micro-droplets, they demonstrate the need for continued diligence.
Coronavirus: New Facts About Infection
How Easily Germs Can Spread

SDSM is open and available to help you. Our offices are thoroughly cleaned and disinfected between each patient interaction and ongoing throughout the day. We can see you in person for general physicals, annual health assessments, management of chronic conditions, treatment of injuries, and treatment of illnesses other than cold/flu/COVID-19 symptoms.

If you have cold, flu or other respiratory illness symptoms, call our office. We can provide care for you safely through Telehealth. If you are at higher risk due to chronic conditions and need to stay at home, our providers can help manage your health conditions through Telehealth as well. Remember if you have diabetes, asthma, COPD, heart problems, impaired immune function, difficulty getting enough sleep, or are experiencing high levels of stress, it is important to call us. Working together, we can keep you healthy and safe.