Question: I am planning for extensive dental work that will include implants and help with TMJ. The dentist has suggested myofascial release as an adjunct to treatment. She says it will help me with pain management and healing. What is it? What should I expect if I follow through with the recommendation? Who are qualified practitioners, and how would I find someone to treat me?
Answer: The word “myofascial” means “the target muscle tissue of treatment, the fascia.” The fascia is the white tissue that surrounds individual muscle fibers that combine to attach to the bone as a tendon. Myofascial release uses pressure from a skilled practitioner to lengthen these connective tissues. The body’s fascia shortens due to trauma, repetitive use, prolonged tension, poor posture, or scar tissue formation.
“After careful diagnostics, including palpation of the problem area, the therapist may use both superficial and deeper massage pressures and motions to get a lengthening — called a release — of the fascia,” says Roger Klicrease, a physical therapist in Atlanta whose practice includes myofascial release. “An experienced therapist should always work to the comfort level of the client, because the intervention can cause some initial discomfort. Post-treatment, a client should expect an improved quality of motion with greater ease and a decrease in pain with improving function.”
He says that with TMJ and dental issues, expect your therapist to use a gloved hand to release chewing muscles inside your mouth. To find a practitioner, look for physical therapists who are trained to work with TMJ, dental, and oral issues. (Not all physical therapists are.) Credentials and referrals can be accessed through apta.org, the website of the American Physical Therapy Association. Bodywork structural integrators, such as experts in Hellerwork (hellerwork.com) and Rolfing (rolf.org), are also trained in head and oral structural issues.
Our expert: Jackson Rainer is a board-certified clinical psychologist who practices with the Care and Counseling Center in Decatur, Georgia, helping people living with chronic illnesses. He consults with a variety of experts to answer a selection of readers’ questions in each issue of Pain-Free Living.
Have questions about living with and managing chronic pain? Email questions to [email protected]. Please put “PFL Q&A” in the subject line.