Temporomandibular Joint Dysfunction Case Study
14 year old male baseball player presented to Vertex with a chief complaint of left sided jaw pain that occurred after being hit on the chin by a ground ball at practice. Additionally, he complains of his jaw “locking” and “clicking” with end range mouth opening, specifically while eating.
Palpable Click with opening and 25mm left mandibular deviation (ipsilateral)
Apical breathing pattern
Decreased left upper cervical rotation (+ left cervical flexion rotation test)
Tenderness to palpation left masseter and left medial pterygoid with patient reported familiar pain
HVLAT directed to bilateral C1/C2 with + cavitations.
Upper and mid thoracic HVLAT
DN with electrical stimulation to left masseter, medial pterygoid, and joint capsule.
Manual TMJ distraction
Home Exercise Program:
Cervical SNAGs, cervical retraction with over-pressure applied to maxilla, postural resets, diaphragmatic breathing
Postural considerations; specifically with school and smart phone use consisting of spending less time in forward head posture in order to minimize mandibular retraction.
Chief complaint of “click” and “locking” resolved within session. 25mm deviation reduced to <5mm. Patient followed up 6 weeks later and maintained treatment effect.