TMJ in Joint by Joint

….asked where the TMJ joint would fit into Coach Boyle’s Joint by Joint Theory….

I don't know what Neuromuscular Dentistry is, but it probably makes a whole lot of sense.

I will have to look at the algorithm, but my impression is that the jaw is a stable joint.

Here’s why, and it’s just semantics because the fact of the matter is that all joints require both mobility and stability.
Using Sahrmann as a foundation, pain abounds from something that moves too much. So when we consider “stable” joints, these are the joint systems (not always just 1 joint) that have problems when there is hypermobility. Stability can be defined as control of a segment in the presence of potential change. That does not mean lockdown isometric mid-range “stability.” Based off the hypermobility prevalence of TMJ, I would consider it a stable joint system.

And if we use the O-A joint as mobile, the TMJ is supposed to be stable.
The cervical spine is really debatable, and it simply lends to the credence that the Joint by Joint is more a theory and constructive way to think more than a steadfast biomechanical map.
But the fact of the matter is that it does work out in the alternating fashion almost any way you crunch it.

  • October 31, 2010

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Erik Dalton Reply

Hey Charlie:
The joint-by-joint strategy works for me but the theory is destined to encounter predictable kinks, i.e., feet = stable platform (stability); ankles = mobility; knees = stability; hips = mobility; SI joints = stability ??; low back = stability; thorax = mobility; typical cervical = stability??; upper cervical complex = mobility.

Good job of keeping this fascinating inquiry moving forward.

Charlie Reply

It’s just a theory and something to guide thought. Reply

The Joint by Joint Approach is an excellent guide. Very similar to Janda’s Layer (Stratification) Syndrome of the alternating areas of hypo or hypertonus that the body lays down as typical reactions of musculoskeletal stress. Some joints like the knees, lumbar spine & shoulders needing stability are quite obvious. Others like the mid-thoracic needing mobility are equally apparent. I assume & please correct me if I have this wrong. Areas needing mobility benefit primarily from mobilization & stretching & those needing stability from strengthening.

So in your model the TMJ would be an area needing primarily mobilizaton & muscle inhibition strategies?


Charlie Reply

Doc – Your understanding of the Joint by Joint is correct. I typically wouldn’t use those terms of stretching and strengthening, but you have the concept.

When you consider a stable joint like the TMJ, it first requires optimal mobility followed by ideal timing of stablizers.
While it complicates the lay explanations, indeed “stable” systems require mobility first.

Charlie Reply

Doc, this explains why “stable” systems need mobility first.

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