TEMPOROMANDIBULAR DISORDERS AND PRINCIPLES OF REHABILITATION

tmjkapak

PRINCIPLES OF EXERCISES, MOBILIZATION AND MANIPULATION IN TEMPOROMANDIBULAR DISORDERS

Özlem Küçülmez

Başkent University, Faculty of Medicine, Alanya Education and Medical Research Center, Department of Physical Medicine and Rehabilitation, Antalya, Türkiye

Küçülmez Ö. Principles of Exercises, Mobilization and Manipulation in Temporomandibular Disorders. In: Coşar SN, Afşar Sİ editors. Temporomandibular Disorders and Principles of Rehabilitation. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.89-101.

ABSTRACT

Temporomandibular joint disorders are quite common in the population and involve issues with the masticatory muscles, the jaw joint, and related structures. Temporomandibular joint disorders may arise from either joint dysfunctions or issues within the masticatory muscles, and patients may present with headaches. Common joint pathologies include arthritis, osteoarthritis, arthralgia, disc dysfunction, hypomobility, hypermobility, osteonecrosis, chondrolysis, and neoplasms. Causes of masticatory muscle dysfunction include myalgia, myositis, tendinitis, spasms, orofacial dyskinesia, oromandibular dystonia, contracture, hypertrophy, and neoplasms. The prevalence of temporomandibular joint disorders is 31% in adults and 11% in children and adolescents. The most common cause is disc displacement with reduction, which occurs in 25.9% of adults and 7.4% of adolescents. Temporomandibular joint disorders may significantly impact daily activities, such as eating and speaking, and affect patients? quality of life. For successful rehabilitation, a detailed patient history must be obtained. This includes inquiring about pain in the jaw and temple area over the past month, whether the patient experiences pain or stiffness upon waking, factors that exacerbate or alleviate the pain, any accompanying headaches, and factors that worsen or relieve the headaches, as well as whether the patient experiences jaw locking. Examination should include assessing passive mandibular range of motion, mouth opening, lateral and protrusive movements, and any deviations. The temporomandibular joint and surrounding tissues should be carefully palpated, and the examination must include postural analysis as well as cervical and thoracic vertebral examination with palpation of the cervical muscles. The examination should conclude with a neurological assessment. Therefore, diagnosing and treating temporomandibular joint disorders is of great importance, as most of the patients respond well to conservative treatment methods. In temporomandibular joint disorders, identifying the underlying cause, patient education, and the application of individual treatment protocols and combined treatment methods are crucial. Recent studies have shown that patient education, exercises, and manual therapy are essential components of the treatment protocol. Undoubtedly, the importance of exercise, mobilization, and manipulation among conservative treatments cannot be denied.

Keywords: Exercise; Manipulation; Chiropractice; Temporomandibular joint; Temporomandibular joint disorders

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