Beyond the Jaw and Mouth: ATM lessons for those Suffering from TMJ Disorders
Tuesday, December 19, 2017
by: Rose Silberman, GCFP

Section: Professional Develpment




When I began teaching Awareness Through Movement® lessons to patients suffering from TMJ disorders at a progressive dental practice four years ago, I diligently studied all the ATM® lessons that contained movements of the jaw and mouth. I promptly discovered that those ATM lessons might not be the best place to start. However, I did discover some strategies that have worked well.

Many of the patients/students I see have a lot of pain when they move their jaw. So, in Feldenkrais®-like fashion, I begin with movements that do not cause any pain and which alleviate the strain off the jaw and allow for ease of movement. One of the first things I focus on is carriage of the head; many of my patients/students do not support their heads well in standing or sitting. This has proven to be an effective place to start. Improving carriage of the head from the feet up in standing and the pelvis up in sitting not only gives relief to patients’ jaw pain but facilitates their jaw to move more freely. Being given permission to explore standing and sitting without tensing and holding muscles or locking joints is revolutionary for many of my patients/students. They have often been told to lift their chest, pull their shoulders back and suck their belly in, all of which make TMJ disorders worse.

Neck pain and headaches often accompany jaw pain, so another successful strategy has been to choose ATM lessons involving flexion, extension, side bending, or rotation of the spine with no relative movement in the head and neck. This almost always leads to patients being able to move their neck and jaw more freely afterward. AY #110 and #103 are two examples of this type of lesson. Including eye movements in the 
spine lessons has proven to be very helpful for neck pain and reduced neck mobility as well. I have also found eye resting and moving ATM lessons, such as AY #10 and #15, to be helpful for those suffering from headaches.

ATM lessons involving moving the head, neck and shoulder girdle, including differentiating the collar bones on the sternum and exploring possibilities of movement of the shoulder blades also yield reduced neck and jaw pain for many patients/ students. These kinds of lessons also increase range and ease of movement in both the neck and jaw. “Arm Reach and Roll” from Frank Wildman’s Intelligent Body recordings and AY #18 are examples.

I introduce jaw movement ATM lessons only when jaw pain is no longer acute or has been significantly reduced. These lessons are wonderful because patients/students learn how a healthy, functional jaw moves. I find the variations in the lessons where one moves the skull relative to the jaw especially effective for improving jaw mobility. And for those who still have some jaw pain, those variations can often be done pain-free. Variations of moving the eyes with and opposite the jaw are also useful. I utilize the recordings for TMJ Health by Mark Reese and David Zemach-Bersin and Chapter 9 in their book, Relaxercise.

Teaching ATM lessons at a dentist office could be a great opportunity for practitioners looking to build their practices. I have the great fortune to teach at a dental practice that includes acupuncture and massage in their treatment modalities. I did not seek out this opportunity. It happened quite serendipitously. I have a full time, flourishing Feldenkrais practice, and I have been teaching since I graduated from my training in 2000. Four years ago, one of my students introduced me to his massage therapist who also happened to manage this dental practice. As I was describing the Feldenkrais Method® to her, I mentioned there were several movement lessons that address functional movements of the jaw. The next thing I knew, I was giving a presentation and ATM lesson to the dental staff as well as the other practitioners. Afterward, the lead dentist asked me to join the team.  

So, for the last four years, I have been teaching ATM classes for dental patients including those with TMJ disorders. Currently, I teach two classes a week that are complimentary for staff and all dental patients. Patients with TMJ disorders are especially encouraged to attend. I have taught private lessons there as well, but mostly group classes. Patients range in the manifestation as well as the severity of TMJ disorder symptoms. Many of them have whiplash and other severe injuries as a result of a car accident. Patients/participants come and go. Some take one or two classes. Others attend more often. A few have been attending class regularly since I started. Having a mixture of new and experienced students can be a challenge, but I have learned to adapt the lesson to whoever shows up on a given day. Plus, long-time attendees share with the new attendees what they have learned in classes and how it has helped them.

I keep a list of the ATM lessons that I have taught. I categorize them by theme and cycle through themes. I have also developed simple handouts on comfortable sitting and standing, jaw movements, eye patterns, shoulder-head and neck patterns, moving the thoracic area, movement patterns for vestibular health, computer ergonomics, awareness of tension habits, breathing, and isometrics for the neck to support the learning in class.

Finally, I apply what I learn by working with TMJ disorder students to students in my general Feldenkrais practice. Many people who have pain or tension in their jaw can benefit by learning healthy functional movements of the jaw and of all the full body coordination and relationships that make functional jaw movements possible.

Rose Silberman, GCFP, is passionate about movement education. After graduating with a BA from Colorado College, she coached swimming professionally for 7 years. Rose then became one of the first certified Pilates and Gyrotonics in Colorado. She taught group and private exercise at The Phoenix Center for Health Excellence in Denver for 15 years. In 2000, Rose became a Guild Certified Feldenkrais Practitionercm. Since then, she has been an active and successful practitioner, teaching private and group Feldenkrais lessons at her studio. For the last 4 years, Rose has as also been working with TMJ patients at Raabe Family Dentistry in Denver.
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Comments (1)
Valerie
1/2/2018 9:36:26 AM
Thank you so much for your insight, especially on which ATMs you have found useful.
Can you give an example of what your handouts included?


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