Exercises for the Jaw to Shoulder - Release Your Kinetic Chain. Dr. Brian James Abelson DC.

a kinetic chain perspective, the movements of your jaw, neck, and shoulders are directly linked. For example, the activation of the neck and jaw muscles occurs in concert with movements of the TMJ, cervical spine, and the atlanto-occipital joints.¹

      (Atlanto-occipital refers to the joint that lies between the base of the skull (occiput) and the C1 vertebra (atlas)).

      Thus, any injury to the neck or shoulder muscles can directly affect jaw function. Problems in one area of your kinetic chain can rapidly cascade to structures in adjacent areas. This is a key concept to keep in mind when evaluating problems with your jaw, since the source of the problem could originate from neck, shoulders, and even your core!

      When you keep the inter-relationships of this kinetic chain in mind, it becomes much easier to resolve jaw problems. This is the logic we apply when prescribing exercises to our patients for the jaw, neck, and shoulder. By integrating an appropriate combination of jaw, neck, and shoulder exercises, we are able to achieve a greater beneficial effect for our patients.

A Case Study...Jaw to Hips!

      Let me give you an example about the importance of looking at all the structures of your kinetic chain. One of my patients, an ardent golfer, presented with chronic TMJ problems. She had already tried every exercise program and medical treatment that she could find, but obtained only minimal or short-lived results.

      This particular patient golfed a minimum of 4 to 5 times a week, as well as during every additional spare moment that she could find.

      Upon completing my physical examination, not surprisingly, I found numerous areas that needed to be addressed from her TMJ, to her neck, and shoulders. Even more interesting was discovering just how weak and unbalanced her core was.

      To my patient’s surprise, what started as a TMJ analysis transformed into a golf-swing analysis. On observation of her golf swing, it was easy to see that there were major restrictions in her hip which inhibited her ability to perform a full golf swing. To compensate for her restricted hip, her shoulders were forced to over-rotate, resulting in increased tension in her shoulder muscles. This tension then cascaded through her neck and into her jaw!

      Previous treatments had only focused on her jaw. But, keeping in mind the kinetic chain restrictions we had identified, we chose to address all areas of restriction – from her hips, into her core, and up into the shoulders, neck, and jaw.

      Although the jaw treatment techniques we used (Active Release Techniques) were very similar to those used by other practitioners, it was by combining the treatment of restricted structures throughout the jaw–neck–shoulder–core kinetic chain with appropriate exercises that gave her the result she was looking for! It wasn’t long before we saw some very substantial and positive changes.

      Within a few weeks of treatment and exercises, we were able to completely resolve her long-standing jaw problem. By releasing the restrictions in her hips and core we were able to resolve a long-standing problem in her jaw! Not only did her pain disappear, but to her delight, she was also able to realize a substantial improvement in her golf game!

      Sometimes it is just that simple! In this case the weak link in her kinetic chain was her hip! By correcting that problem, we were able to also resolve problems in her shoulders, neck, and jaw!

Your Neck’s Kinetic Chain

      Your neck is a remarkable piece of engineering. It must be strong enough to support the weight of a small bowling ball, yet remain flexible enough to bend, flex, extend, and rotate with precision.

      Think of your neck as a mast on a sailboat, surrounded by the rigging lines which control and stabilize the mast.

      In your case, these rigging lines are made up of the muscles, tendons, ligaments, and connective tissues of your neck. These ‘lines’ work remarkably well as long as you maintain a fine balance of strength and flexibility.

      Your neck’s rigging (the lines of soft tissue that connect into your neck) make up part of your neck’s kinetic chain. It is incredibly interesting to see just how far these ‘lines’ run, and just where many of the structures that connect into your neck insert or originate.

      Your neck consists of the top seven vertebrae of your spine, the muscles and soft tissues that support and move your neck, and the blood vessels and nerves that pass from your brain to the rest of your body. A normal, healthy neck should be strong, flexible, balanced, and provide great motor control.

      An understanding of this anatomical organization will give you a much better picture of your neck’s kinetic chain. Consider just two of the neck’s soft tissue structures:

       Levator Scapula Muscle: This posterior neck muscle connects into the transverse processes of the top four vertebrae of your neck. This muscle also attaches into the top inside corner of your shoulder blade (scapula).

       Trapezius Muscle: This large triangular muscle inserts right at the base of your skull (occiput). However, if you follow this muscle, you will see that it also runs all the way from your mid/lower back (T12 vertebra), attaches to your shoulder blade (scapula), and extends over your shoulder to the lateral one-third of your collar bone (clavicle).

      Now, consider how restrictions in any part of these structures can detrimentally affect the function of your neck. By seeing these connections, we start to understand how restrictions in distant parts of your body can affect the function and pain felt by your neck! Now let’s take a look at these examples from a kinetic chain perspective:

      Since the Levator Scapulae muscle connects directly into your shoulder blade, any restrictions that affects scapular rotation will have an immediate effect on your neck. For example, restrictions in the Serratus Anterior (which runs from your ribs to the lateral aspect of your shoulder blade) affects the function of the Levator Scapulae muscle by causing abnormal scapular rotation. This in turn increases tension in the Levator Scapulae muscle. This type of abnormal scapular motion is known as “scapular dyskinesis”. Scapular dyskinesis is often a cause of chronic neck and shoulder pain.

      The Trapezius (as an adductor) and the Serratus Anterior (as an abductor) help stabilize the shoulder. The trapezius muscle also connects into the shoulder blade (acromion of the scapula).

      Again, any abnormal motion or tension in muscles that attach to the shoulder blade will cause tension in the trapezius muscle.

      Each muscle in the neck is affected not only by its adjacent structures but also by the total symmetry of all the other soft tissue structures that surround the neck.

      An understanding of these key kinetic chain relationships is fundamental to injury resolution, otherwise even the best treatments and exercises will only provide symptomatic relief instead of addressing the root cause of your problems.

Neurological Impact of the Neck’s Kinetic Chain

      In addition to the immediate kinetic chain connections that we can see with adjacent soft tissue structures, we must also consider how the nervous system in the affected area of the kinetic chain directly impacts the function of the entire body.

      Whenever an injury occurs in your neck (such as a sprain/strain), it damages not only the ligaments, tendons, and muscle fibres,