This goes well with this case.
TMJ Distraction
- Pt: Supine
- PT: sitting superior to pt's cranium
- Tech:
- rotate pt's head away from the side you are mobilizing
- use ipsilateral 2nd digit pad on the mandible condyle to palpate for movement
- use contralateral thumb on the top of the pt's lower molars with pad on rearmost molar
- have pt lightly close on your thumb - important to emphasize the light part!
- light wrist extension for the TMJ distraction, palpate for condyle distraction
- perform 6-10 reps (the 6 is a nod to the man Dr. Rocabado!)
- Improves all mandible ROM, intracapsular space
TMJ Lateral Glide
- Pt: Supine
- PT: sitting superior to pt's cranium
- Tech:
- rotate pt's head away from the side you are mobilizing
- use ipsilateral 2nd digit pad on the mandible condyle to palpate for movement
- use contralateral thumb on the medial side of the pt's lower molars with pad on rearmost molar
- have pt lightly close on your thumb
- light wrist extension to promote TMJ lateral glide, palpate condyle for lateral translation
- 6-10 reps
- Improves mandidble contralateral lateral excursion (mob left side, improves lat excursion right)
TMJ Medial Glide
- Pt: Supine
- PT: sitting superior to pt's cranium
- Tech:
- rotate pt's head away from the side you are mobilizing
- ipsilateral hand on the apex of the cranium with fingers on the temporal side
- use contralateral thumb on the medial side of the pt's lower molars with pad on rearmost molar
- have pt lightly close
- stabilize the mandible with one hand, the other hand
- mobilize cranium over the mandible condyle laterally, which is a relative medial glide
- improves mandible ipsilateral lateral exucrsion (mob left side, improves lat excursion left)
Masseter Release
- Pt: supine
- PT: sitting slightly to the treating side above pt's cranium
- Tech
- mob hand assesses for tone, TrP, restriction in proximal to distal direction from zygomatic arch to angle of mandible
- assist hand may drag tissues in the opposite direction to promote further stretch
- slow progressive depth of treatment to reduce tone, proximal to distal to promote mandible depression
- perform 3-5 minutes or until released
- improves all mandible motion, HA
Temporalis Release
- Pt: supine
- PT: sitting slightly to the treating side above pt's cranium
- Tech
- mob hand assesses for tone in anterior temporalis (hard to release the rest under hairline unless they have a shaved head
- assist hand may drag tissues in opposite direction to promote further stretch
- light slow treatment from proximal to distal to promote mandible depression
- perform 3-5 minutes or until released
- improves all mandible motion, HA
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