TMJ Dysfunction and Forward Head Posture

TMJ Dysfunction and Forward Head Posture

If you suffer from TMJ (Temporomandibular joint) syndrome, you probably already know the pain that can be associated with TMJ disorder. The symptoms of TMJ disorder can be many, and include:

  • Headaches
  • Broken, ground-down or cracked teeth
  • A misaligned jaw
  • Shoulder and back pain
  • Difficulty eating

Discovering TMJ Syndrome

Many people first learn about TMJ dysfunction after a dental appointment. They will come in with TMJ pain and show cracked or worn teeth. They will often talk about headaches and trouble eating their favorite foods, like chewy pizza crusts or crunchy carrots and celery. Dentists will offer solutions like a special mouthguard to be worn in your sleep and to help realign your jaw. This may help, but it often doesn’t get to the root of the problem.

Understanding the Cause of TMJ Dysfunction

TMJ syndrome is known as a symptom complex, which is a disease or disorder that is described by a series of symptoms instead of a cause. Like many symptom complexes, the cause is not fully understood, and often comes from a number of sources, often at the same time. This includes:

  • Stress
  • Dental Issues
  • Autoimmune Diseases
  • Infections
  • Poor Posture

The last one, poor posture, is especially true if you spend a lot of time hunched forward and you find that your head is in a permanently forward position. The stress on your body of this is large, as the eight-pound head cannot easily support itself on your much smaller neck unless it is perfectly balanced on top. However, it is this cause that is one of the least expensive and easiest to treat if you are willing to commit the time to the realignment of your spine.

What Leads to Forward Head Posture?

A forward-leaning head is caused by doing work where you are constantly hunched over. If you are doing corrective exercises, it can help to prevent the worst of this. However, poor posture while sitting, working and walking can lead to a complete change in the curvature of the neck. If this happens, it will take a lot of time and effort to realign the spinal area. This leads to TMJ pain issues like migraines, stress headaches, plus pain in the back and shoulders.

How do You Fix Forward Head Posture?

There are two main steps to fixing forward head posture. You must do rehabilitation exercises and change the behaviors that led to the problem.

Preventing Forward Head Movement

Posture is an important part of avoiding forward head positions and the resulting risk of TMJ dysfunction. This can be a hard thing to fix if you work hunched over a computer or table. Ergonomic solutions like standing desks can help to avoid issues, along with good core and posture exercises and regular breaks to realign the back.

Healing Forward Head Position

Depending on where you go, realignment of your spine can come from a number of places. Chiropractors will work on spinal realignment. Massage therapists will work on breaking fascia buildup that holds you in the wrong position. Physical therapists can help strengthen core muscles to make proper positioning natural to hold. Occupational therapists can help ensure your daily activities can be done without hunching forward. A combination of these can be very helpful in spinal realignment.

One simple exercise you can do at home is to stand with your back as flat as possible against a wall. Place a rolled towel at your neck and a second at your lower back. Hold for 5 minutes, rest for one, and repeat.

Does Solving Your Head Position Solve TMJ Disorder?

Spinal alignment may not completely solve TMJ alone, but it can reduce the symptoms and make it easier to treat. In some cases, fixing your head posture is all that you need for complete relief from all symptoms.

Since posture is one of the cheapest and easiest things to fix, it should be one of your first steps in healing TMJ. Treatment is slow if you want it to work. It takes daily exercise and positioning for months to a year in order to become normal to your body. Once your spine is correctly aligned, you can begin to seek other treatments if you need them.

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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