Physical Therapy and Manual Release of the Masseter Muscle in Individuals with Hypermobility Syndrome/Ehlers-Danlos syndrome (EDS)
The masseter muscles — responsible for “mastication,” or chewing. Our masseter muscles are also part of a bigger, more complex muscular network that links to many other muscles in our bodies. Masseter muscles help keep the head on the spine, the joints of the head and neck in place, and stay in communication with other sets of muscles which reach to the sides and top of our heads, and down our necks, backs, and chest.
Because the masseter muscles are involved in countless daily activities and are the main muscles that keep the TMJ joint in place, they often contribute to chronic headaches, jaw and neck pain, and much more. Manual therapy and specialized physical therapy exercises can be incredibly beneficial at helping keep pain levels down, and muscle spasms to a minimum — especially if someone is also working to not clench his/her jaw as well.
Research articles and resources on the TMJ and manual therapy, as well as the role masseter muscles play pain and other problems related to hypermobility, are listed below.
“Function
The masseter is one of the four muscles of the masticatory apparatus. It elevates the mandible causing a powerful jaw closure. The contraction of the superior part which runs diagonally to the front moves the mandible forward (protrusion). Furthermore, the muscle helps stabilize tension of the articular capsule of the temporomandibular joint.”
Read more by going to https://www.kenhub.com/en/library/anatomy/masseter-muscle
‘Interaction between Trigger Points and Joint Hypomobility: A Clinical Perspective’
“The relationship between muscle trigger points (TrPs) and joint hypomobility is frequently recognized by clinicians. Among different manual therapies aimed at inactivating muscle TrPs, ischemic compression and spinal manipulation have shown moderately strong evidence for immediate pain relief. Reduction of joint mobility appears related to local muscles innervated from the segment, which suggests that muscle and joint impairments may be indivisible and related disorders in pain patients. Two clinical studies have investigated the relationship between the presence of muscle TrPs and joint hypomobility in patients with neck pain. Both studies reported that all patients exhibited segmental hypo-mobility at C3-C4 zygapophyseal joint and TrPs in the upper trapezius, sternocleidomastoid, or levator scapulae muscles. There are several theories that have discussed the relationship between TrP and joint hypomobility. First, increased tension of the taut muscular bands associated with a TrP and facilitation of motor activity can maintain displacement stress on the joint. Alternatively, it may be that the abnormal sensory input from the joint hypomobility may reflexively activate TrPs. It is also conceivable that TrPs provide a nociceptive barrage to the dorsal horn neurons and facilitate joint hypomobility. There is scientific evidence showing change in muscle sensitivity in muscle TrP after spinal manipulation, which suggests that clinicians should include treatment of joint hypomobility in the management of TrPs. Nevertheless, the order in which these muscle and joint impairments should be treated is not known and requires further investigation.”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700496/
Additional Resources on TMJ and PT:
‘Temporomandibular joint disorders: Physiotherapy and postural approaches’ (2016)
http://www.sciencedirect.com/science/article/pii/S2213653316300611
‘Temporomandibular disorders and Ehlers-Danlos syndrome, hypermobility type: A case-control study’ (2016)
http://www.sciencedirect.com/science/article/pii/S2213653316300581
‘Temporomandibular disorder and generalized joint hypermobility: Electromyographic analysis of the masticatory muscles’ (2011)
Additional PT & EDS Resources:
Jan Dommerholt’s slide presentation on PT and EDS from 2015 EDNF Conference – http://ehlers-danlos.com/2015-annual-conference-files/Dommerholt.pdf
Victor Chang’s Slide Presentation from 2015 Moving Naturally with Hypermobility Seminar – http://movingnaturallywithhypermobility.com/wp-content/uploads/2015/07/Moving-Naturally-with-Hypermobility-copy.pdf