Studies show that 30% of the population has at least one TMJ (tempromandibular joint) disorder symptom, and 3-7% of those people have symptoms serious enough to seek care. Symptoms of a TMJ disorder include pain in the jaw, temple, or face with tenderness to the touch, or pain in the jaw or temple during maximal jaw opening. A clicking sound upon opening, closing, or side-to-side movement of the jaw may also be a common symptom. Individuals usually ask their dentists about the best way to treat TMJ disorders and are given medications or a night guard to help decrease grinding of teeth. Often times, though, people don’t realize that a physical therapist can help with certain types of TMJ disorders, including ones that occur due to overuse of the muscles in the jaw and face, postural impairments, or arthritis of the joint itself.
A physical therapy examination for TMJ disorders would include a thorough history to determine the causative factors of the issue. A physical therapist will also be able to perform a general health screen as well as a screen for other potential factors. Finally, a physical exam will be conducted, and should include a postural screen, observation of jaw and neck motion, assessment of jaw and neck muscles, and assessment of the actual TMJ mobility. Once the initial examination has been performed and the physical therapist has a better idea of what is causing the TMJ pain, the PT will then be able to create an individualized program that includes a combination of hands on therapy to the joint and surrounding soft tissues, as well as exercises that target posture, range of motion, control of neck muscles, stretches, and aerobic activities.
Chronic headaches can be extremely debilitating and difficult to treat, but one treatment pathway most people haven’t tried is physical therapy. There are 3 main types of headaches, which include migraines, tension-type, and cervicogenic (originating from the neck) headaches. During a physical therapy evaluation, it can be determined which type of headache you have by taking a history of symptoms, and figuring out the pattern and behavior of the headache. Tension-type and cervicogenic headaches are the 2 that may benefit the most from physical therapy since they both have involvement from either the muscles in the neck and head or are aggravated by head postures and neck movements. Although other issues often cause migraines, they too can benefit from physical therapy since there may also be neck involvement with this type of headache.
Once the type of headache has been determined, a physical therapist can assess cervical (neck) mobility, the mobility of vertebrae in the neck, strength/ endurance of the neck muscles, and tightness of muscles in the upper back and neck. It is important for a physical therapist to assess the shoulder and upper back areas since it is very common for headaches to originate in these areas.
Studies have shown that hands on therapy (deep tissue massage, spinal mobilizations/manipulation, stretching) paired with exercise targeting endurance training of the upper neck muscles is the most effective physical therapy treatment for cervicogenic headaches. It has also been shown that individuals with tension-type and migraine headaches have found relief with these therapies if they have similar symptoms and impairments as the ones previously discussed.
Statistics show that 10-35% of adult Americans, up to 40% of older adults have an involuntary loss of urine, or incontinence. It is also estimated that up to 14% of children (ages 5-11), greater than 50% of nursing home residents, and 80% of individuals with a spinal cord injury or multiple sclerosis also deal with incontinence issues. Out of all these individuals who suffer from incontinence, only a small percentage of them seek help from a physical therapist. There are two types of incontinence and the first type is called stress incontinence, and occurs when the pressure in the bladder exceeds the amount of pressure that can be maintained by the urethra. With this type, leaking may occur from coughing, sneezing, laughing, or lifting. The second type of incontinence is urge incontinence, which is the feeling of needing to use the bathroom more than 8 times per day or more than 1 time/ night.
During a PT examination, the physical therapist will do a general health screen and be able to rule out any serious pathology. The therapist will also assess strength of the core, hips, and legs and certain specialty physical therapists will be able to assess the strength of the actual pelvic floor muscles. Strength testing is important when it comes to continence because weak pelvic muscles are unable to support the bladder. The physical therapist will then be able to implement an individualized exercise program that strengthens the pelvic muscles, as well as the surrounding muscles of the hips and lower legs. Specialty physical therapy clinics may also offer the ability to use biofeedback, which is a probe or electrode that is placed on a specific pelvic muscle and plays a sound when the muscle is activated. Often times, people have a difficult time controlling and activating the muscles of their pelvic floor and using biofeedback can help someone know when they have correctly contracted the muscle. For more information visit www.totalperformancept.com.