Could your jaw (TMJ) issues be related to your pelvic floor dysfunction?

The jaw and pelvic floor may seem like two unrelated regions of the body, but they are actually connected in a surprising way. I see many patients who have a lot of tension in the jaw and the pelvic floor muscles, leading to a range of health problems.

The jaw, also known as the temporomandibular joint (TMJ), is a complex joint that connects the jawbone to the skull. Its role is in the movement of the jaw during opening and closing such as talking, chewing, and yawning. When the muscles that control the jaw become tight or tense, it can lead to a condition known as TMJ disorder, or TMD. Symptoms of TMD include pain and/or clicking in the jaw, pain in the face, neck, and even headaches.

On the other hand, the pelvic floor is a group of muscles that support the organs in the pelvis, including the bladder, uterus, and rectum. When these muscles become tense, it can lead to pelvic floor dysfunction (PFD) and lead to symptoms such as incontinence, pain during sex, and pelvic pain.

Fascial Connections

Now, how are these two seemingly separate areas of the body connected? First, think of fascia! Fascia is the vast network that helps link various tissues. Fascia is a type of connective tissue that surrounds and supports every muscle, organ, and bone in the body. It acts like a web, bonding different parts of the body together. It contains and interacts with many nerves and can contract and tighten like muscles. When one part of the fascia is tight or tense, it can pull on other parts of the fascia, leading to tension and pain in other areas of the body. Of note, there is an important fascial line connection between the jaw and pelvic floor muscles.

Embryologic Connections

The connection between the jaw and pelvic floor is both anatomical and functional, even while you were still a forming fetus! During embryologic development, around the third week, two dimples form next to each other. One of these will become the opening for the mouth, while the other becomes the openings (or exits) for the urethral, anal, and reproductive organs. These two areas of the body remain connected even as you develop further. Think about it: what comes in, must come out. What you eat/drink through the mouth opening will be processed and voided later through the urethral and anal openings.

Dural Connections

Also, the dural tube, or dura mater, is a type of casing around our central nervous system (CNS), which starts at the brain and descends through the skull (cranium) to anchor at the sacrum and bottom of the tailbone (coccyx). Tension in the jaw can translate to the dural tube and, therefore, affect the pelvic floor, and vice versa.

Stress and tension-holding patterns can cause people to unknowingly hold tension in their pelvic floor muscles. For example, it is common for people to hold stress and tension in their jaw by clenching or grinding their teeth or shrugging their shoulders. Research has shown that contraction of the jaw muscles and pelvic floor muscles usually occurs together. On the other hand, studies have shown that when the jaw is relaxed, the pelvic floor muscles also relax and lengthen.

Research has demonstrated that stiffness in the jaw muscles can cause tension in the pelvic floor muscles, and vice versa. A study found that women with TMJ disorder were more likely to have pelvic floor dysfunction compared to women without TMJ disorder. Another study found that treating TMJ disorder in men with pelvic pain resulted in significant improvements in their pelvic pain symptoms.

Moreover, studies have shown that manual therapy focused on releasing jaw muscle tension improved mobility in the hips for people with history of chronic pain - without even touching the pelvic area! Therefore, if you notice you are grinding your teeth or clenching your jaw, take a big slow exhalation through the mouth and let that tension go! Your pelvic floor muscles will thank you for it too.

So, what can you do if you are experiencing tension in both your jaw and pelvic floor muscles? Find a pelvic floor physical therapist to work with you to help release tension in both areas of the body through a variety of techniques such as manual therapy, exercises, and relaxation techniques.

1.    Shireen, S. R., & Bhat, S. G. (2016). A study to compare the incidence of temporomandibular joint disorder in patients with and without pelvic floor dysfunction. Journal of Indian Prosthodontic Society, 16(3), 265-270.

2.    Huggins, K., & Levin, L. (2019). Interrelationships between temporomandibular disorders, headaches, and cervical pain: implications for physical therapy management. Journal of manual & manipulative therapy, 27(1), 1-9.

3.    Al-Saleh, M. A., Al-Madi, E. M., & Al-Qahtani, M. (2019). Temporomandibular disorder symptoms in patients with pelvic floor muscle dysfunction. Journal of Physical Therapy Science, 31(6), 494-498.

4.    Bishop, B., McCormack, H. M., & Liao, J. (2020). Manual therapy and exercise for temporomandibular disorders: A systematic review and meta-analysis. Journal of Bodywork and Movement Therapies, 24(3), 129-136.

5.    Wise, C. H. (2019). Integrating dental and pelvic health care: interdisciplinary care for the female patient with chronic pelvic pain. Dental Clinics of North America, 63(4), 631-640.

6.    Kalamir, A., Bonello, R., Graham, P. L., & Vitiello, A. L. (2020). The Relationship Between Jaw and Pelvic Floor Muscle Function: A Pilot Study. International Journal of Therapeutic Massage & Bodywork, 13(2), 11-17.