puma

3 Posts
 
Posted - 05/05/2006 :  23:16:29  Show Profile  Reply with Quote
I am a fairly new P.T. and I just saw my first patient with TMJ problems. I also received the May issue of The Journal of the American Physical Therapy Association and read an article which discussed the various treatment approaches for TMJ dysfunctions. I was just wondering if anyone else read the article and what your thoughts are? I also wanted to learn more about anyone's P.T. experiences with treating TMJ.
Thanks
Pam

Article: http://www.ptjournal.org/PTJournal/May2006/v86n5p710.cfm
A Systematic Review of the Effectiveness of Physical Therapy Interventions for Temporomandibular Disorders
Margaret L McNeely, Susan Armijo Olivo, David J Magee

lzelman

2 Posts
 
Posted - 05/10/2006 :  17:24:40  Show Profile  Reply with Quote
I have been a PT for 6 years now and have seen a total of 3 patients with TMJ. All three patients reported improvement with their condition with participation in physical therapy. I read the article in the APTA journal and the review is consistent with my experiences. Exercises and STM/manual therapy helped(ie. massage/STM to the muscles in the mouth & joint mobilizations). I also applied ultrasound to the regions of the temporalis muscles if their was tissue irritability. Another exercise program that I used is called the Rocobado 6 x 6 program. It helps the patient learn proper mechanics when opening/closing the mouth. If you are not familiar with this program, let me know and I can post it.
Lisa

puma

3 Posts
 
Posted - 05/10/2006 :  22:06:18  Show Profile  Reply with Quote
Lisa,
Could you please post the Rocobado 6 x 6 program.
Thanks

lzelman

2 Posts
 
Posted - 05/12/2006 :  08:46:46  Show Profile  Reply with Quote
Rocobado 6 x 6 program

Addresses following postural relationships
1) head to neck
2) neck to shoulders
3) lower jaw to upper jaw

Objective for Patient
1) learn new postural position
2) fight the soft tissue memory of the old position
3) restore the original muscle length-tension relationships
4) restore normal joint mobility
5) restore normal body balance
6) initiate this exercise program whenever sx & dysfucntions return

Components of Program
1) rest position of tongue
a) make a clicking sound with tongue 6 x's
b) find normal resting position = gentlyhold 1/3rd of tongue
gently against the roof of th mouth just behind the front teeth
c) diaphragmatically breathe through nose while tongue is in
resting position x 6 breaths
2) control tmj rotation- tongue on roof of mouth and open x 6 reps
3) rythmic stabilization- key when a patient has instability =
lightly resist open, close, lateral deviation (visualization /
neuro-muscular re-education is key) - hold 6 sec
4) stabilized head flexion = upper cervical flexion (nodding) -
facilitate upper cervical flexion as most of these patients have
forward head posture resulting in upper cervical extension
deviation. Nod head x 15 degrees back and forth x 6 reps
5) lower cervical retraction = chin tuck x 6 seconds holds
6) shoulder girdle retraction = pull sholders back and down - hold 6
seconds
Edited by - lzelman on 05/12/2006 08:47:17

cdixonpta

USA
1 Posts
 
Posted - 01/14/2007 :  23:13:11  Show Profile  Reply with Quote
Lisa,

I have been looking for a clean copy of the Rocobado 6 x 6 exercises for about four years. Do you have one you could send me?
Thanks, Cathi

puma

3 Posts
 
Posted - 02/06/2008 :  09:25:41  Show Profile  Reply with Quote
I found a great link for information in regards to treating TMJ. Also has Rocobado 6 x 6.
http://www.hsedu.com/HEP/TMJExercises.pdf