TMJ can affect many aspects of your singing including the ability to open your mouth freely, restrictions around the larynx, neck tension, shoulder tension, your posture, and even your breathing! This article will detail many of these aspects.
What exactly is TMJ?
Temporomandibular joint (TMJ) disorder (also sometimes referred to as TMJD or TMD) is characterized by pain and/or restriction in jaw movements. You may experience difficulty opening the mouth, clicking noises in the jaw, or a zig-zag motion when the jaw opens. All of these things are indicative of the jaw not moving through the joint properly and/or improper tonus in the muscles of the jaw. Tinnitus (ringing in the ears) often occurs along with TMJ disorder.
What causes TMJ disorder?
The causes of TMJ disorder are many, and can include things such as mouth breathing, improper dental work, uneven weight bearing on the feet, or even stress. In the case of stress, we tend to clench our teeth, over-activating the muscles which hold the jaw closed. Chronic stress creates too much tonus in these muscles, thus making it difficult to open the mouth. Excessive gum chewing can also lead to TMJ disorder, as it tends to put more stress on one side of the jaw compared to the other.
How does TMJ disorder affect my body and my singing voice?
Once TMJ disorder is present, it tends to work together in the entire head and neck region as a ripple effect. The head tends to be held more forward (forward head posture) as the jaw gets restricted. This tends to over-activate the muscles which hold the jaw closed in addition the neck muscles, particularly the scalenes and sternocleidomastoid. In an attempt to prevent the head from falling too far forward, the levator scapula goes into a state of tension. This is sometimes how shoulder problems tie in with TMJ disorder. If you mouth breathe and/or hold the head forward, not only do you get restriction in the sub-occipital region (C1 and C2 vertebrae), but you also get tension in the suprahyoid muscles as a result! The suprahyoids and ligaments that connect to jaw to the skull go into a tense state to prevent the jaw from falling further forward.
All of these things together are how TMJ disorder ties in with your singing voice. In order for efficient singing to occur, we need to be able to open the mouth freely, maintain freedom and mobility in the neck, and allow the larynx to move uninhibited. TMJ disorder prevents all three of these things from occurring. If our neck muscles can’t deactivate, then we end up using them when breathing instead of relying more on our diaphragm. When the mouth can’t open freely, the posterior portion of tongue tends to get tense in addition to the back of the throat tensing. In the case of the larynx, when the suprahyoids are excessively tensed, the larynx cannot lower without further tension. All three of these things just create a vicious cycle which inhibit the free production of the singing voice.
How do I treat TMJ disorder?
Since the causes of TMJ are often multi-factorial, the treatment plan must also be multi-factorial. It will likely include a combination of manual therapy to release restricted tissues in addition to modifications of behavioral habits. There will be more on all of this in future articles.
In the meantime, here are some articles which will allow you to do further reading on the topic.
- Dentist Justin Glastier details the connection between breathing, TMJ disorder, and the upper cervical spine in this article from the Journal of International Dentistry – African Edition: Temporomandibular dysfuction and systemic distress
- Thomas Myers, author of Anatomy Trains, discusses how restrictions in the upper cervical spine tie in with levator scapula restriction in an article entitled The Dreaded Levator Scapulae from Massage Bodywork Magazine.
In the chapter entitled “The Deep Front Line” from Anatomy Trains, Myers discusses the relationship between the tongue, jaw muscles, laryngeal muscles, pharyngeal constrictors, the lungs, the diaphragm, and your pelvic floor muscles, all muscles which are important for the act of singing. Here is a video showing the interconnection of the structures of the Deep Front Line. If seeing a dissected cadaver bothers you, please do not watch this video!
The Deep Front Line (YouTube) - Angela Caine, voice teacher and vocal researcher, has demonstrated in many journal articles the relationship of jaw misalignment and the profound effect it has on the singing voice. Below are two such articles:
Structural Misalignment: Its Affect on Performance
Voice loss in performers: a pilot treatment programme to show the effect on the voice of correcting structural misalignment - Manual therapist Erik Dalton discusses the profound impact forward head posture and TMJ disorder can have upon the entire body in this two part article series entitled “Strategies to Address Forward-Head Postures”:
Part One: Sacrificing Complexity of Movement for Stability
Part Two: Bringing the Body Back into Balance
