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Trigger Point Therapy - Treating Temporalis

Posted by Judith Winer on

The neck, face, and head muscles are as important to global muscle function as the core (lumbopelvic-hip complex).

The temporalis and masseter are synergists. An overdeveloped upper trapezius can be an overlooked contributor to problems associated with these muscles. A short temporalis leads to teeth clenching, which can damage the sensitive proprioceptive covering on the teeth. Temporal dysfunction can ensue, with loss of balance, vertigo, nausea, hearing difficulties, tinnitus, trigeminal neuralgia, and optical problems. Habits such as chewing gum can cause repetitive stress and strain.

One must appreciate the chain effect that an inhibited masseter could have on this muscle. The temporalis and masseter may develop myofascial trigger points in an effort to provide much-needed tension.

A forward-head posture is most likely the evident posture

Pain passes upward and over the forehead on the ipsilateral side. Pain spills over just above the ear and into the nuchal line of the occiput. The temporalis should be considered in all headache patients. Pain in the upper or lower teeth and gums is the most common pain pattern with this muscle.

A deep pain is typically reported over the eyebrow and occasionally into the same side and back of the head. The treatment of other muscles on the basis of their pain referral patterns, if associated with this area, should also be carried out as part of the myokinetic chain.

 

 Trigger Point Therapy - Temporalis 

Temporalis - Common Trigger Point Sites

 

The neck, face, and head muscles are as important to global muscle function as the core (lumbopelvic-hip complex).

The temporalis and masseter are synergists. An overdeveloped upper trapezius can be an overlooked contributor to problems associated with these muscles. A short temporalis leads to teeth clenching, which can damage the sensitive proprioceptive covering on the teeth. Temporal dysfunction can ensue, with loss of balance, vertigo, nausea, hearing difficulties, tinnitus, trigeminal neuralgia, and optical problems. Habits such as chewing gum can cause repetitive stress and strain.

A forward-head posture is most likely the evident posture

One must appreciate the chain effect that an inhibited masseter could have on this muscle. The temporalis and masseter may develop myofascial trigger points in an effort to provide much-needed tension. A forward-head posture is most likely the evident posture. Pain passes upward and over the forehead on the ipsilateral side. Pain spills over just above the ear and into the nuchal line of the occiput. The temporalis should be considered in all headache patients. Pain in the upper or lower teeth and gums is the most common pain pattern with this muscle.

A deep pain has also been reported over the eyebrow and occasionally into the same side and back of the head. The treatment of other muscles on the basis of their pain referral patterns, if associated with this area, should also be carried out as part of the myokinetic chain.

ORIGIN

Temporal fossa, including parietal, temporal, and frontal bones. Temporal fascia.

INSERTION

Coronoid process of mandible. Anterior border of ramus of mandible.

ACTION

Closes jaw. Clenches teeth. Assists in side to side movement of mandible.

NERVE

Anterior and posterior deep temporal nerves from the trigeminal V nerve (mandibular division).

BASIC FUNCTIONAL MOVEMENT

Chewing food.

 

 

Trigger Point Therapy - Temporalis

Temporalis - Common Referred Pain Patterns

 

Trigger Point Therapy - Temporalis

Temporalis - Common Referred Pain Patterns

 

 

REFERRED PAIN PATTERNS

Upper incisors and supraorbital ridge. Maxillary teeth and mid-temple pain. TMJ and mid-temple pain. Localized (backward and upward).

INDICATIONS

Headache, toothache, TMJ syndrome, hypersensitivity of teeth, prolonged dental work, eyebrow pain, headaches, bruxism, sinusitis pain, trismus (lockjaw), tingling in cheek area.

CAUSES

Chewing gum, tooth grinding/ bruxism, prolonged dental work, stress, emotional tension, jaw/ bite alignment, nail biting, thumb sucking.

DIFFERENTIAL DIAGNOSIS

Temporalis tendonitis. Polymyalgia rheumatica. Temporal arteritis, or giant cell arteritis (GCA).

CONNECTIONS

Upper trapezius, SCM, masseter.

BITE PLATES/BLOCKS/ OCCLUSAL SPLINTS

Opinion varies as to efficacy, type, and duration of use for occlusal devices. An evidence base suggests they can be beneficial.

POSTURE

Head forward or upper crossover patterns can be treated by a range of manual and trigger point therapies.

ADVICE FOR PATIENTS

Avoid gum chewing or hard substance chewing. Tongue position. Air conditioning in car/at work. Correct the head-forward posture. Stretch.

COMMONLY APPLIED TREATMENT TECHNIQUES

Deep Stroking Massage No
Compression  Yes
Muscle Energy  Yes
Positional Release Yes
Spray and Stretch No
Dry Needling No
Wet Needling No

 

SELF HELP

Self-massage techniques can be helpful. Balls and pressure tools may be used, as the muscles are superficial.

GENERAL ADVICE TO CLIENTS

Avoid high-heeled/ at shoes. Regular stretching with hot and/or cold. Strapping/ankle support. Use of heel wedges and/or orthotics. Posture and gait advice. Examine shoes.

  

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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.


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