TMJ Assessment

I recently had a lecture on Temporomandibular Dysfunction (TMD) and the huge impact physical therapy can have on these patient's lives. Prior to the lecture, I had never thought about the high prevalence of TMD (painful or not), but it is everywhere! The Temporomandibular Joints are similar to many other joints in the body: once you begin looking for impairments, you will surely find them. 

Currently, there are 4 Orthopedic Residents at Harris Health & each one of us had some degree of Temporomandibular Dysfunction. Of the 4 of us, there was 1 C-curve, 1 S-Curve, and 2 capsular mobility with neuromuscular control deficits. Below I will outline the C-curve and S-Curve.

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C-Curve
-This occurs secondary to hypomobility due to an internal derangement.
-The mandible deviates to the involved side during the mid-range of motion before the jaw returns back to the center.
-In the example below, a C-curve is noted to the Right with the dysfunctional TMJ being on the Right.

S-Curve
-Occurs secondary to hypermobility due to poor neuromuscular control of the muscles of mastication.
-Structures causing the dysfunction can include the masseter, temporalis, disc, and lateral ligaments.

-In the example below, an S-curve is present.

For a more in depth analysis of the TMJ that reviews anatomy & kinesiology, examination, and treatment options for TMD, check out a recent post on the TSPT webiste written by author Chris Fox. 

-Jim Heafner PT, DPT