Let’s talk TMJ dysfunction

Hello and welcome to our November blog! The end of 2019 is fast approaching which means soon there will be an influx of social gatherings, work Christmas parties and family get togethers coming our way. What do we do at these gatherings? We talk, eat, drink… And maybe have a good catchup or two! Therefore, it’s very important that you have a good functioning jaw right?! Do you get jaw pain or clicking? Do you also suffer from headaches or neck pain? This month we’re focusing on our jaw joints - what we use them for, how these joints can cause issues and what we can do to help.

 

A bit of anatomy…

The jawbone (or mandible) is the bone which hangs from your skull, creating the lower part of your head. It houses the lower teeth and attaches either side of the head just in front of the ears. Put your fingers just in front your ears in line with the ear holes, gently open and close your mouth and you will be able to feel movement at these joints. These joints are called the temporo-mandibular joints, or TMJ. Movement at these joints occur when we open and close our mouth during activities such as eating and talking. As well as opening and closing our jaw, we can move it side to side and forwards and backwards!

Movements of the jaw, such as chewing, are controlled by various muscles. Three main muscles close our mouth, and one main muscle aids with opening it. This makes sense when you think about gravity's effect on the body. We need a bit more help to close our mouth and bite into our food than we do to open it and let it hang.

Problems with the TMJ

A common jaw condition us osteo’s treat is TMJ dysfunction. This is a relatively broad term we use to describe an issue with this specific joint which affects women twice as much as men. Problems can arise from many structures in and around the joint, including the muscles, joint surfaces and a small disc which sits inside. Muscle imbalances are common and can lead to stiffness or pain (or both) when opening and closing our mouth. Tightness in the surrounding muscles could be a result of trauma to the jaw (like with being punched or hitting your chin after a fall), clenching when sleeping (known as ‘Bruxism’), a neck dysfunction/restriction, or from dental problems such as having an uneven bite. People who are highly stressed will often clench their jaw in their sleep, which may lead to waking up with a sore jaw or headaches.

Inside the joint itself is a small disc which slides and moves during jaw movements. Sometimes this disc can become ‘displaced’ and may not slide and move as smoothly as it should. This may often lead to a jaw that clicks or cracks when opening the mouth. For the most part, the click is painless, however some people may experience pain alongside a click. In some severe cases the jaw may temporarily lock, which as you can imagine would be quite distressing to experience. Pain from the jaw joints can sometimes also present as ear pain.

Osteopathic treatment for TMJ dysfunction

Treatment for TMJ dysfunction will greatly depend on the cause of the dysfunction. A simple muscle imbalance may be corrected by soft tissue release of the jaw muscles, joint mobilisation, and corrective mobility and strengthening exercises. It is rarely that simple though. More often than not, a TMJ dysfunction will come hand in hand with a problem in the neck and shoulders, be it restriction of movement or poor stability and strength in the region.

An osteopathic approach to treating TMJ dysfunction will include a thorough assessment of the head, jaw, neck, shoulders and mid-back (and quite possibly further afield than that!). Because of the proximity of the jaw and neck, you rarely get dysfunction in one without the other. Your osteo will question you about your occupation, sleeping habits, hobbies, and current stress levels - all of which may be playing a part in your condition. If your osteo believes your TMJ issues stem from a dental issue, they may advise a visit to the dentist for a check-up as sometimes problems can be resolved with input from both professions. If clenching is an issue, you may find it useful to wear a gum shield or mouth guard to bed to alleviate pressure on the jaw and teeth. We appreciate it’s not the best look in the world, but it can be a game changer! Stress management including breathing, relaxation and mindfulness techniques can also be a great way to beat that stress in your life. Don’t worry, your osteo will have some tricks up their sleeve for this too. Always let them know if you feel like you need help with this aspect of your life.

If you think you might have a jaw problem, then don’t keep it tight-lipped. Open up that mouth and reach out to us (by talking we mean!). We’ll have you ready for copious amounts of food, drink (we say copious, but we mean in moderation, of course) and chin-wagging in the upcoming festive season before you can say ‘temporo-mandibular joint dysfunction’… Don’t worry, we struggle with that one too :) #tonguetwister

Fatigue - When to Worry?

Experiencing tiredness is not uncommon for a lot of us. Many of us have busy lives, juggling family, work and staying active. It’s hard and it’s tiring. Our bodies are pretty resilient, but there will always be a point where the body needs a break, giving you a sign to slow down and step back. This often results in the BEST night's sleep of your life and you wake up feeling refreshed and ready for it to all begin again.

But are you experiencing an extreme tiredness that no amount of sleep seems to remedy? If this is the case, then you are possibly suffering from fatigue relating to a medical condition. There is every chance you are experiencing some other symptoms too. Luckily, we are about to educate you on some of the common causes of fatigue, so you know what to look out for, and can nip it in the bud quick time…

1.     IRON DEFICIENCY ANAEMIA: A common condition where you tire very quickly, feel heavy in the muscles, have a sore tongue and may develop brittle nails. Women with heavy periods are especially prone to this condition.

2.     HYPOTHYROIDISM: Also known as an ‘Underactive Thyroid’. You may experience weight gain, constipation, dry skin and muscle weakness. This one is also more common in women.

3.     DEPRESSION: You don’t just feel low with this condition. Depression may keep you awake at night, or wake you early in the morning, disturbing your sleep cycle and leaving you feeling exhausted!

4.     ANXIETY: In extreme cases where anxiety disrupts daily life, fatigue is often experienced alongside those uncontrollable feelings of irritability and worry.

5.     CHRONIC FATIGUE SYNDROME: This is fatigue felt over extended periods of time (4-6 months +). You may also experience a general feeling of being unwell following exertion, headaches, muscle pain, sleep disturbance and loss of memory or concentration.

6.     GLANDULAR FEVER: A viral infection that can leave you feeling fatigued for months even after the infection has cleared. You may also experience a sore throat, swollen lymph nodes in the neck, swollen tonsils, headache, fever and rash. Antibiotics are usually unsuccessful in treating this infection.

7.     DIABETES MELLITUS: Fatigue is a common symptom of all types of diabetes. Other symptoms to look out for include increased thirst, hunger and urination. Weight loss is another common symptom.

8.     COELIAC DISEASE: An autoimmune disease where the body reacts to gluten in the diet, leading to fatigue, diarrhoea or constipation, as well as bloating, wind, nausea and vomiting, weight loss or gain, and anaemia.

9.     SLEEP APNOEA: Imagine being constantly disrupted while you’re trying to sleep because your throat narrows or closes, which interrupts your breathing… You can see how you’d be exhausted constantly. You may be told you snore loudly, experience morning headaches and frequently wake up with a dry mouth or sore throat.

10.  RESTLESS LEGS SYNDROME: This is the constant urge to move your legs at night, leading to poor quality sleep. Other symptoms include involuntary night time jerking, unpleasant crawling sensations and deep aching throughout the legs.

Now you know what to look out for, don’t put up with fatigue. Take notice of what your body is telling you and ultimately make sure you get your symptoms investigated through your GP. Luckily, your beloved osteo also trained to pick up on such things. We’ll make sure you get the correct referral you need if we suspect the reason for your sore muscles and joints is not just because you played a bit too hard on the weekend! Don’t worry, we have your back (no pun intended… Sort of)!

Women's Woes

Hello everyone! May is here, which means we get to celebrate those wonderful humans who brought us into the world - our Mums. And as it’s Mother’s day this month, we thought we’d dedicate a blog to common musculoskeletal conditions in women.

When it comes to musculoskeletal health, there are many conditions that females are more likely to develop. As you probably expect, this is mainly because of the differences in our bodies, both structurally and chemically. There are also certain sports and activities with higher female participation rates that leave them prone to sports-specific issues. And lastly, we need to consider that women are a lot better than men at seeking help for their health, and so we tend to know more information about what affects women (in a clinical setting). Men… Start speaking up please!

Below we concentrate on a few conditions, outline what they’re all about, and explain why women are more likely to develop them over their male counterparts. On your marks… Get set… Go!

KNEE CONDITIONS

In this example, we will focus on the patellofemoral joint, or PFJ (the joint between the kneecap and the thigh bone). The front thigh muscles (the quadriceps) run from the hip to just below the knee. The kneecap is held in place over the end of the thigh bone by the tendon of the quadriceps muscles. When all is happy and in place, this allows for smooth gliding across the joint as we bend and straighten our knees. As you walk, the joint bears about 50% of your bodyweight, but this can drastically increase to up to seven times your bodyweight when you run or squat. So it only takes something small for stress to increase at the joint and potential pain to develop. Pain associated with this joint is commonly caused by misalignment of the kneecap as it crosses the joint.

In women, common factors that may lead to this issue include:

•   A wider pelvis

•   Increased inward twisting of the thigh bone, and outward twisting of the shin bone

•   Inwards collapsing of the knees and feet

•   Increased laxity (looseness) of the ligaments around the knee

When we treat this issue, we aim to reduce pain and correct the alignment of the joint. We do this by strengthening the buttock, hip and thigh muscles, as well as stretching of the back chain of muscles down the leg. Temporary taping or bracing may help the patient to stay active doing what they love!

OSTEOPOROSIS

Osteoporosis is a condition that affects the density of our bones, weakening the internal structure, and ultimately leaving us prone to fractures. It commonly affects the elderly population, but may also affect younger people. Unfortunately for women, they are four times more likely to develop this condition than men. Not fair, right?! Blame menopause. This is when women stop producing Oestrogen - a hormone responsible for maintaining bone mineral density throughout life.

There are however, many other causes of Osteoporosis, including alcoholism, anorexia, kidney disease, and long-term steroid use. As a female, having your ovaries removed as part of a partial or full hysterectomy also leaves you prone to developing this condition.

Treatment usually consists of a combination of calcium and vitamin D supplementation, a structured exercise regime, and especially for the elderly, minimising risks of falls around the home by removing unnecessary furniture, carpets, rugs and mats. Some menopausal women opt for hormone replacement therapy (HRT), which helps to maintain bone mineral density following menopause. This has unfortunately been seen to increase risk of breast cancer and heart disease, so not all women choose this pathway.

SPINAL CONDITIONS

There are a few spinal conditions that active women in particular are prone to developing. Take your average dancer, gymnast or figure skater (all activities with a majority female participation rate) and what do you think of? Flexibility, right? These types of activities commonly involve movements to the extreme limits, such as over-arching through the back. People who constantly subject their spine to these types of loads and forces are more likely to develop a stress fracture in a small part of one of their vertebrae. This particular type of stress fracture is called ‘Spondylolysis’.

Spondylolysis is characterised by a dull ache, usually in the low back region, which is made worse by the same overarching movements of the spine. They can vary in severity from a partial stress fracture, through to a full thickness fracture, which can then develop further into a slippage of one vertebrae on another, called a ‘Spondylolisthesis’ (bit of a mouthful right!).

If suspected, your practitioner may refer you for imaging to confirm. Otherwise treatment consists of a combination of rest from the aggravating activity whilst undergoing a rigorous core stabilisation exercise programme. The good news is, most people can return to their chosen activity once they are pain free and feel strong again! Awesome!

So spare a thought for the women in your life - especially your mumma! More importantly though, if you are female and think you might have one of the above conditions, or are experiencing pain of any kind, please contact your local osteo and they will be able to chat it through, assess you thoroughly, and put you on the path to staying happy, healthy and active.

OK men… You are also allowed to contact us. SO PLEASE CALL US!!!!!! (We aren’t yelling… Much.)

7 Reasons Why You Shouldn't Skip Your Warm Up!

Just How Important is Warming Up?

Get the most out of your work out and assist in preventing injuries!

Do you regularly incorporate a warm-up in your exercise regime? Or are you the type to jump headfirst into your work out?

The purpose of a warm-up is to prepare the body for exercise. Your warm up will be determined by the type of exercise you are going to be doing. It should be done immediately prior to exercise, and produce some mild sweating without fatigue.

Clinical studies have shown that a structured warm-up program can reduce the risk of injury by at least 50%. If that isn’t a good enough reason to spare the time to warm up before you start, then I don’t know what is! Because in the mind of any exercise enthusiast, the last thing we want OR need is to fall victim to injuries.

Here are some of the many benefits of a proper warm-up prior to exercise…

1. Increases your body temperature – as more blood pumps around your body, the muscles become warm, and they have more elasticity and reduces the likelihood of strains
2. Increases muscle temperature – a warm muscle contracts and relaxes quicker, works more efficiently and decreases the risk of injury
3. Blood vessels dilate – allows more blood to reach your muscles and decrease resistance to blood flow and less stress on your heart to pump the blood
4. Increased range of motion of joints as they and the surrounding muscles become warm
5. Dynamic exercises decrease muscle stiffness
6. Allows heart rate to get to a workable rate for the start of your session
7. Mental preparation and increasing focus on the task ahead

What type of warm up should I be doing?

Your warm up should be determined by the type of exercise you are about to undertake. For example, if you are about to go for a run, you should include a slow jog for 5-10 minutes, specific running drills, and dynamic stretching to get your heart rate slowly up and blood pumping around your body and get those lower limbs muscles firing.

If you are doing a weights session, 5-10 minutes of brisk walking on the treadmill/riding on the bike followed by some easy mobility work using the muscles and joints you are using in your session to ensure the joints/muscles are primed and ready to be used. You also can include a set of non-weighted reps to allow the body to prepare for the heavier load and make sure those muscles are switched on.

Don’t forget about the COOL-DOWN!

A very important aspect to ones work-out that is often neglected or forgotten! All too often I’ve seen people finish their work-out and then rush off, rarely sparing the time or thought to adequately cool-down (I, myself are guilty of this far too many times).

It doesn’t have to be time-consuming affair, just 10- 15 minutes at the conclusion of the session. Active recovery is important because it flushes the lactic acid from the circulation. A simple way to do this is 5 minutes of brisk walking or riding the bike.

Other components of a cool-down can include some stretching and using a foam roller over the muscles that have been used in that work-out. Static stretching is best suited for post-exercise (stretch slowly and gently, hold for 30-60 seconds, stretch to the point of tension but never pain, repeat 2-3 times as needed).