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CMD?? TMJ pain, clicking & masseter tightness

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(@haesslicherspast)
Posts: 10
Topic starter
 

A couple weeks ago, I started experiencing jaw joint pain - primarily left-sided.

After watching more Dr Mew videos about tongue posture, I realized I had been doing it wrong. I was pushing the tongue against the palate in a way like when swallowing, which overworked my masseters (and jaw joint). Doing this for about nine months intensely, it caused me TMJ pain (especially in the left side and after chewing), clicking when opening the mouth and tightness in my masseter and temporalis area. I did change the way of  pushing my tongue against the palate after realizing my mistake and watching a speech by Dr John Mew, who said the tongue should be exerting a NEGATIVE PRESSURE against the palate. I had been applying a positive pressure till that point, which overworked my chewing muscles and jaw joint. So I started doing it as Mew suggested and my pain and other issues went away almost completely. Till last week, when I begun implementing a very moderate chewing routine - nothing extreme. It's a very cautious routine, working my way up from just chewing one piece of regular gum for about 30-45 min and increasing the amount of pieces by just one more piece after a good rest period. I started chewing no more than once a day for about 30-45 min with regular off-days to recover. I wanted to slowly work my way up to more pieces of gum to get used to it and not cause any (more) harm to my jaw joint. Unfortunately, mewing wrong for nine months before seems to have caused me CMD-like issues which are worst after chewing even normal hard(erish) food. The TMJ pain, clicking and tightness returned and are very annoying right now.

Does anyone know how to resolve or improve this without having to adopt a liquid diet and let my lower third hang like a lazy mouth-breather (I'm only 22)? Unfortunately, I can not afford an alternative dentist/orthodontist/orthotrophic orthodontist. My teeth are very straight. Doing thumb facepulling (/-pushing) helps a bit reducing tightness around the TMJ but I don't think this is the answer either. I learned that "mewing" on one's own without personal guidance by a professional might be stupid and even dangerous for (predisposed) people.

Your experiences, suggestions, research etc. will be greatly appreciated! 


 
Posted : 20/02/2019 2:56 am
(@alex1000)
Posts: 8
 

when  you say negative pressure are you talking about a suck hold ? 


 
Posted : 20/02/2019 3:42 am
(@haesslicherspast)
Posts: 10
Topic starter
 

Kind of. Instead of pushing the tongue up (like during a swallow), the tongue pushes the lower jaw down - pushing from the palate. I don't always push that hard though, because the masseter (and the jaw joint in general) then has to create too much effort keeping the mouth closed properly. 


 


 
Posted : 20/02/2019 5:59 am
(@zosogg)
Posts: 87
 

I think too much on this forum has been given to the idea of "pushing". Pushing is an active movement. What myofunctional therapy and mewing is really all about is maintaining proper posture and function. Function being swallowing, and posture being resting mouth posture. Your tongue should be resting on your palate, not pushing. Remember, bones react to slight, continuous pressure, not large, abrupt pressures. I don't think it's healthy to be pushing aggressively. It really is just a very light resting posture. 


 
Posted : 20/02/2019 7:23 pm
(@haesslicherspast)
Posts: 10
Topic starter
 

Big thanks to you, zosogg! I realized this the hard way, lately. Pushing the hell out of my tongue has caused me these CMD like issues. Now I suffer from the symptoms described above. I stopped doing intense pushing when I got these problems. The thing is, sometimes forcing it was neccessary to even get the tongue into the desired resting position at all. It still positively affected my facial structure - forward growth, straighter teeth, less sunken-in under-eye area, improvement in cheekbones, hollowing of the cheeks, philtrum more forward etc. but at the cost of significant problems. Now, I wake up in pain and all this started suddenly and unexpected. I wish there were more logically-thinking people like you are, to warn others about the risks of this whole "mewing" hype when done wrong. Do you have any suggestions on how to relieve the tension in my facial muscles and recover for good? Right now, even chewing soft food exacerbates my condition and this isn't a good place to be - especially at my age. I will also see an orthodontist if it doesn't get better or gets worse. 


 
Posted : 21/02/2019 10:05 am
(@zosogg)
Posts: 87
 

Sorry to hear about all that. Unfortunately I'm not an expert in this stuff nor can I really even give advice if I wanted to since I don't know exactly what situation you're in. The only thing I can tell you is maybe my two favorite myfunctional exercises to try and see if it can help your posture. Number 1) the cave, which is where you suck your tongue up on the roof of your mouth, like before you make a tongue clicking noise, while opening your mouth as wide as you can, creating a visible "cavern" with your tongue. This will help strengthen your tongue and get it in the habit of resting on the palate instead of floor of mouth.

The other one is to take 2 rubber bands (tiny ones, or anything else thats safe to put in your mouth), and put one on your tongue and the other in between your lips. Just focus on trying to keep the rubber band on the "spot", and the rubber band between your lips. It seems super basic I know but do that 30mins-1 hr (or really as long as you can) per day and it will really start driving into you the habit of keeping the tongue resting on the roof of your mouth.

If any of these hurt your jaw at all then stop doing them. I'd probably see an expert at that point you might need to get imaging done or something to diagnose what's wrong. Anyway hope that maybe helps


 
Posted : 21/02/2019 12:48 pm
(@haesslicherspast)
Posts: 10
Topic starter
 

Thanks. The first exercise really helps with getting the tongue onto the palate without much effort. Opening the mouth seems to drive my tongue there automatically. Why doesn't Dr Mew explain it like this? Very simple yet effective. 

I don't really understand how to perform the second exercise though. Where and how exactly should I place the rubberband on my tongue and lips? I suspect I'd need a really small rubber band for this. A video would be helpful if such existed. 

Right now, pretty much everything hurts, even yawning or doing nothing, so the pain probably isn't the best indicator for if what I'm doing is bad or not. 

Thanks a lot, again. This really helped! May I ask you what your "facial routine" is and for how long you have been doing it? Results? 

 


 
Posted : 21/02/2019 1:33 pm
(@shakti_om)
Posts: 157
 

I had a similar experience with TMJ issues a while back. At the time I thought it was wisdom tooth pain, but looking back on it I'm pretty sure it was TMJ. Thankfully mine went away in about a week. It was pretty horrendous as I went through it.

At least for now I would maintain your tongue posture with your teeth slightly separated. I've heard both Dr. Mew and myofunctional therapist Sarah Hornsby, recommend this. I switch back and forth between soft contact and a slight separation, and find that a slight separation of the teeth can be beneficial. This will help keep your jaw relaxed.

Here are a couple YouTube videos with some exercises you might find helpful...

https://youtu.be/mo_T0qkNDwM

https://youtu.be/zxXyge1EfnQ

I find the jaw tracking exercise to be very useful. In the second video I like the monkey face exercise. It is the one after the "mild monkey face". He doesn't explain it very well, but you fold your tongue over the front of your bottom front teeth. It stretches your jaw forward, and releases the pressure in the joint. It feels really good to me. One  exercise I do not like so much in the second video, is the around the world. Just doesn't feel very good on my jaw joints.

Something else I like to do on a regular basis to release tension in my face and jaw, is to open my mouth wide, and stick out my tongue as far as I can.

One last piece of advice, is to just focus on swallowing correctly, especially while you are going through this pain. Don't worry about maintaining proper tongue posture, just focus on activating the back posterior third of your tongue without using your facial muscles.

I am not an expert, but this is what I would try if I were you. Hope it helps.


 
Posted : 21/02/2019 3:05 pm
(@zosogg)
Posts: 87
 

They are tiny rubber bands I got from my myofunctional therapist, if you've ever had braces theyre the same ones used in othro treatment. Most dental offices have them. It's not important that theyre rubber bands, its just important that its some tiny unobtrusive object you can put in your mouth. The reason for this is that it uses kinetic feedback to your brain so that it is constantly reminded whether or not you are using correct tongue posture, i.e., if you are feeling the rubber band between your tongue and the alveolar ridge (the spot), then your tongue is in the right place. Likewise with your lips, so that you know your lips are truly sealed. The rubber bands are thin enough so that you have to really be putting your tongue and lips in the right spots or  you would not be feeling the rubber band. 

It's also a good exercise to truly make sure that for AT LEAST 30 mins out of your day, you can maintain a constant tongue posture/ lip seal. Before doing this, I thought this exercise was trivial and stupid but it makes you realize how much you really are NOT keeping your tongue in the right place subconsciously, even when you think you are. 

To advance further, you would want to use 4 rubber bands. One for the lips, and 3 at different spots on the tongue, each one going farther back towards the posterior part of the tongue than the other. This just helps you put the tongue not only on the "spot", but also further back towards the posterior end of the tongue. You can do this if you feel youve "mastered" the first exercise.


 
Posted : 21/02/2019 4:39 pm
(@alisonnorth80)
Posts: 1
 

Hey all! My bruxism is caused by chronic stress and CPTSD due to childhood trauma. I am currently in therapy and working on my trauma, so I know that my TMJ will get a bit better after that. With the state of the world as it is right now, I (like a lot of people) have been a lot more stressed and as a result, my clenching and grinding has gotten a lot worse. What’s your go-to pain relief strategy to provide me some short term relief while I work on things in the long term? I can barely open my jaw right now and could really use some tips.
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Posted : 20/11/2020 3:49 pm

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