Understanding TMJ from the Massage Table | Triune Wellness
- Ashlee Mayo LMT
- Jun 29
- 7 min read
(TLDR: The TMJ (jaw joint) is connected to the rest of your body. Chronic clenching, grinding, or tightness here can radiate as headaches, ear pain, neck/shoulder tension & poor sleep. The jaw is also a major site for stored emotional tension, so releasing it can sometimes bring more than physical relief. Great results come from combining modalities: massage, chiropractic, and acupuncture.)
What Is the TMJ and Why Should You Care?
The temporomandibular joint, or TMJ, is one of the most complex and frequently used joints in the entire body. Located just in front of each ear, where the lower jaw (mandible) meets the temporal bone of the skull, this joint is responsible for every bite, every word, every yawn, and every silent clench you’ve made today. And yet, it’s one of the most overlooked structures in whole-body wellness.
As a massage therapist, I work with clients who come to me for neck tension, headaches, shoulder tightness, or even earaches — and more often than not, when I ask about their jaw, they pause. “Hm. Actually, yes. It does click.” Or: “I wake up with sore teeth.” Or simply: “I didn’t know that could be related.” It always can be.
TMJ dysfunction (sometimes called TMJD or TMD) occurs when the joint, the surrounding muscles, or the disc that cushions it become irritated, inflamed, imbalanced, or overworked. The result is a cascade of symptoms that can feel completely disconnected from the jaw itself — which is exactly why so many people suffer for years without answers.
The Muscles of the TMJ: A Team Effort
The temporomandibular is supported, moved, (and sometimes overloaded by) a group of powerful muscles in the face and neck. Understanding these muscles is at the heart of how I approach working the jaw with Massage Therapy.
(Click to expand for more info)
Masseter Muscle
This is the primary muscle for chewing. It runs from the cheekbone down to the angle of the lower jaw. When someone is a chronic clencher or grinder, this is often the first muscle to become rock-hard and tender. I regularly find clients who didn’t even know their masseter was tight until I press on it and watch their face change. It can refer pain directly into the jaw, teeth, ear, and temple.
Temporalis
Is a wide, fan-shaped muscle that sits across the side of the skull (i.e. the temporal region) and attaches to the lower jaw. It closes the mouth and retracts the jaw. Temporalis tension is one of the most common contributors to headaches and is frequently missed because people don’t think of the side of their head as a jaw muscle location. When I do scalp or head massage, I am always checking this muscle.
Pterygoid Muscles
These are the deep muscles of chewing, located inside the mouth. They control the lateral (side-to-side) and forward movements of the jaw. Dysfunction here can contribute to the jaw being 'out of place', clicking, and the sensation that the jaw “locks.” Intraoral massage (performed with gloves inside the mouth) is one of the few manual therapy techniques that can directly address these muscles, and it can be incredibly effective for clients with chronic, unresolved jaw pain.
Digastric and Suprahyoid Muscles
These smaller muscles just under the chin help with opening the mouth and swallowing. Tension here often goes completely unaddressed and can contribute to throat tightness, swallowing difficulty, and a sensation of something being “stuck” in the neck or throat.
Sternocleidomastoid (SCM) and Upper Trapezius
While not primarily jaw muscles, these neck muscles are still connected to how the TMJ functions. Tension in the SCM refers pain into the jaw, face, and behind the eye. The upper trapezius contributes to forward head posture, which directly alters the position and mechanics of the TMJ. For this reason, I always address the neck when working with the jaw.
It’s Never Just the Jaw
Here is what I want every client to understand: the TMJ is a structural, neurological, and postural keystone. When it’s out of balance, nothing above or below it is truly at ease.
Postural Influence
The position of the jaw directly influences the position of the head, which influences the neck, which influences the back... and so on down the body. When the jaw is pulled forward, clenched, or asymmetrical, it creates tension patterns of compensation throughout the entire body. I have seen chronic low back pain improve when we finally addressed long-standing jaw tension. The body is one connected system.
Neurological Significance
The trigeminal nerve (the largest cranial nerve in the body) supplies the muscles for chewing and carries sensory information from the face, scalp, sinuses, teeth, and gums. When the TMJ is chronically irritated, the trigeminal nerve can become sensitized, contributing to facial pain, headaches, tinnitus (ringing in the ears), and even dizziness. This is why TMJ dysfunction can mimic so many other conditions and why it can be misdiagnosed.
Impact on Sleep and Breathing
The position of the jaw during sleep affects the airway. For some clients, TMJ dysfunction and sleep-disordered breathing are interconnected. Clenching and grinding at night (aka 'bruxism') are often the body’s attempt to reopen a partially collapsed airway.
Clients with TMJ dysfunction frequently report combinations of: tension headaches or migraines, ear pain or fullness, neck and shoulder tightness, sinus pressure, eye pain, difficulty concentrating, and disrupted sleep.
Where Massage, Chiropractic, and Acupuncture Meet
One of the things I love about working with the TMJ is that it is a genuinely collaborative
treatment where different modalities each bring something different to the healing process.
As a Massage Therapist, my primary approach is the soft tissue: the muscles, fascia, and connective structures that hold and move the jaw. My work focuses on releasing tension, addressing fascial restrictions through myofascial release, and, when appropriate, performing intraoral techniques to reach the pterygoids directly. This work is often slow, methodical, and deeply felt both physically and emotionally.
Chiropractors can address misalignments in the atlas and axis (the vertebrae at the base of the skull) that directly influence how the jaw functions. When these are out of alignment, the muscles that attach to both the neck and the jaw are working overtime. Chiropractic adjustments can remove that underlying structural issue, making the soft tissue work I do more effective and longer-lasting. Chiropractors can also perform specific TMJ adjustments, working to restore proper movement within the joint itself. In my experience, clients who work with both Massage and Chiropractic often see faster and more sustainable results.
Acupuncture offers something additional: the ability to release endorphins and address the body’s energetic and nervous system simultaneously. Acupuncture points along the face, jaw, and scalp are used to reduce local inflammation, relax muscle tension, and calm the nervous system at a systemic level.
When these three modalities are used together: massage releasing the tissue,
chiropractic restoring structural alignment, and acupuncture regulating the nervous
system and energy, the results can be profound.
What have you tried for TMJ?
Massage Therapy
Chiropractic
Acupuncture
I suffer in silence
The Emotional Connection: What the Jaw Holds
This is the part of TMJ work that I find most fascinating: in somatic and body-mind frameworks, the jaw is understood as one of the primary sites where we hold back: we clench when we’re angry but can’t speak, we tighten when we’re holding ourselves together emotionally, and we grind when stress has no other outlet.
The jaw is a gatekeeper between the inner world and the outer one, between what we feel and what we say.
Dr. Peter Levine, in his work on trauma and the nervous system, describes how unresolved
stress becomes encoded in the body’s tissues. The jaw is a primary storage site for that unprocessed emotion.
Some emotional patterns associated with TMJ tension, include:
Unexpressed anger or frustration: the literal clenching of what cannot be said
Chronic anxiety: the jaw is one of the first places the nervous system braces
Perfectionism and control: the constant tension of holding everything together
Grief: particularly what has not been fully expressed or witnessed
I have held space for clients who began to cry unexpectedly during jaw work because something released. Stored grief came to the surface, unspoken words found an outlet along with the long-held tension of keeping it all in. This is one of the most consistent and meaningful things I witness in this work.
What You Can Do
Here are my recommendations for anyone dealing with TMJ tension:
Pay attention to your habits. Are you clenching at your desk? Holding your breath
when stressed? Resting your chin in your hand? Small, repetitive habits can have cumulative effects on the TMJ.
Notice the emotional layer. When does your jaw tighten? What were you holding back?
Mindfulness is a great assistant for diagnostic tools.
Be patient. TMJ dysfunction is rarely a quick fix; it usually develops over time, and so it unwinds over time.
Get it worked on. It's difficult to fully release TMJ on your own with self-massage and jaw stretches, so having some help - with Massage, Chiropractic, or Acupuncture - can literally get into those places we can't easily access by ourselves.
Ready for relief from Jaw Pain?
CALL US: 508-810-0220
If you’ve been living with tension headaches, neck pain, ear symptoms, or that low-grade jaw ache you’ve learned to ignore, or new jap pain from a recent dental cleaning...
Your TMJ may be the reason!
Frequently Asked Questions
How do I know if my headaches, neck pain, or ear issues are actually coming from my jaw?
It's surprisingly common for TMJ dysfunction to show up as something else (tension headaches, ear fullness, sinus pressure, or neck/shoulder tightness) without any obvious jaw pain. If you clench, grind your teeth, or notice jaw clicking, that's a strong clue.
What actually happens during a TMJ-focused massage session?
It starts with assessing the muscles of the jaw, face, and neck. When appropriate, intraoral work (inside the mouth, with gloves) may be used to reach the muscles inside the jaw directly, since they're hard to access any other way. Sessions are usually slow with gentle pressure to start. It can feel weird since it's different, but it's still done within the context of a relaxation massage.
Should I see a massage therapist, chiropractor, or acupuncturist first for TMJ issues?
There's no strict order, it just depends on what's driving your symptoms. If structural misalignment in the neck is contributing, chiropractic can help first. If it's primarily muscle tension, massage is a great starting point. If stress and nervous system regulation seem to be the bigger piece, acupuncture may be a great place to start. Many people end up combining modalities since they each address a different layer of the problem.
Have questions about TMJ?
Or call our office: 508-810-0220
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