TMJ and Pelvic floor Connection: Do They Really Impact Each Other?

YES! The connections between the pelvic floor and the TMJ (temporomandibular joint) are fascinating and complex. While these ideas have gained more traction in the current years, the interrelationship between the jaw and the pelvis has been studied for decades. The relationship from the jaw to the pelvis helps to demonstrate the interconnectedness of the human body. As a physical therapist, understanding this connection has broadened my scope and improved my holistic treatment approach.

Lets get into how they are connected:

Embryologic Development: The Gastrulation Phase

During the gastrulation phase (Day 15) of embryonic development, the ectoderm, the outermost layer of the embryo, differentiates into various structures, including the mouth and anus. This early development sets the stage for the body's longitudinal axis and establishes a fundamental connection between the two ends, hinting at the interconnectedness of the body's systems from the very beginning.

Nervous System: The Connection Highway

The nervous system features a 'highway' of nerves that connects the pontine area of the brainstem to various parts of the body. The pontine region, particularly the periaqueductal gray (PAG) and the nucleus retroambiguus (NRA), plays a crucial role in coordinating activities that involve the pelvic floor muscles, such as sexual functions, along with the muscles that control vocalization, and the pressure changes that occur during breathing and abdominal movements. This network illustrates how signals from the brain can influence both the TMJ area and the pelvic floor, linking functions like jaw positioning, breathing, and core stability.

Diaphragms, Breathing, and Pressure Systems

The human body has several diaphragms, including the cranial base (affecting the TMJ), the respiratory diaphragm, and the pelvic floor. These diaphragms work together to regulate pressure within the body. Adjustments in jaw and tongue position can affect the body’s pressure, influencing breathing patterns and tension in the pelvic floor. For instance, a closed throat might increase tension in the abdominal and pelvic regions, while an open throat and relaxed tongue position can lead to a sense of relaxation throughout the body, demonstrating the direct impact of TMJ function on breath, posture and stability. Dysfunction or tension in one area, such as the TMJ, can disrupt the balance and function of other areas, including the pelvic floor, due to changes in intra-abdominal and intrathoracic pressures.

Fascial Connections: From Head to Toe

The body's fascial network is an extensive system of connective tissue that envelops and connects muscles, bones, and organs. There are specific fascial lines, such as the deep front line (proposed by Neil Asher), that connect the pelvic floor to the upper body, including areas around the TMJ. Tension or dysfunction in one part of this fascial line can transmit and manifest in another part, linking TMJ issues with pelvic floor disorders.

Muscle Reflections and Kinetic Chain Relationship

The body operates as a kinetic chain, meaning dysfunction or misalignment in one area can affect seemingly distant or unrelated parts of the body. Poor posture or alignment issues involving the TMJ can lead to compensatory changes elsewhere in the body, often observable in the pelvis. This can happen from either direction, up or down the kinetic chain. Meaning asymmetry in the jaw can lead to asymmetry in the pelvis and vice versa. In a recent study by Gartska, Et all 2022 it was shown that the position of the pelvis, head, and spine affected both the occlusion of the mandible along with tension in the masseter and the temporalis muscles. These recent studies are helping to demonstrate statistical significance of the jaw to pelvis relationship.

Hormonal System

The majority of estrogen receptors are found in and around the reproductive tissues. Along with being found in reproductive tissues, there is a significant presence of estrogen receptors in the salivary glands points and the masseters which points to a hormonal influence on TMJ health. Individuals with higher estrogen levels, often those with uteruses, may experience changes in TMJ function and symptoms in relation to hormonal fluctuations. This can manifest as gum recession during pregnancy or variations in TMJ symptoms in response to the hormonal changes associated with the menstrual cycle, menopause or amenorrhea.

Emotional Connection

The body's response to emotional stress can have a profound impact on physical health, including TMJ function and pelvic floor health. Stress and feelings of insecurity can lead to unconscious clenching of the buttocks, back, pelvic floor, jaw, and shoulders. This physical manifestation of emotional tension can exacerbate TMJ symptoms and contribute to pelvic floor dysfunction. Feeling a lack of safety and security can lead to tension in the pelvic floor and can reflect deeper feelings of insecurity or a lack of safety, highlighting the importance of addressing emotional well-being as part of physical therapy. Similarly, TMJ dysfunction can be related to emotional repression or the reluctance to express oneself verbally, further underscoring the interconnectedness of emotional health and physical symptoms.

Conclusions

Given these deep connections, it's clear that understanding the interplay between the TMJ and the pelvic floor is essential for a holistic approach to health and therapy. For those experiencing issues in either area, finding a treatment partner like Connection Physical Therapy is essential. Creating tailored treatments plans that consider the body's interconnected nature is my speciality. My goals is to help you find the root causes of discomfort or dysfunction, not just the symptoms​​.

Reach out to learn more.

References

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