TMJ Ligamentous Sprain

TMJ Ligamentous Sprain

According to my Injury classification system, TMJ sprains is considered Level 3 Injury, as per the three structures compromised, the alignment, muscles/tendon, and the ligaments. The overall alignment of the Jaw and to a lesser extent the muscles are key structures involved and responsible for maintaining the health and resilient of the ligamentous support. When the Jaw is misaligned or a visible deformity is presence, certain ligaments becomes overstretched, and in an attempt to maintain the joint apposition leads to further deformation and injury.

TMJ sprains tends to cause significant jaw pain and inflammation as per the number of tissues being damage and compromised from the trauma. Morning stiffness and reduced joint overall movement are common symptoms reported by patients.

Common TMJ misalignments and the corresponding ligamentous injury.

Anterior – inferior (AI) TMJ misalignment usually compromised the Sphenomandibular and Stylomandibular ligaments due to the maintained overstretch position of the TMJ caused by this pattern of dysfunction

Externally (EX) Rotated TMJ misalignment generally occurs as a compensation misalignment due to an AI TMJ. This pattern of dysfunction tends to compromise the Lateral ligament.

The Hyoid is a bone located below the jaw and is an important anchor point for several muscles of mastication. Dysfunction on this bone may predisposed to several TMJ problems.


Lateral misalignment of the Hyoid  tends to cause of an overstretch of the Stylohyoid Ligament and if untreated may develop into a condition called Eagle syndrome which is characterized by a calcification of the ligament.

TMJ Chronic Instability is a condition that is predisposed by the presence of chronic ligamentous injuries which leads to a deformation of the elastic properties of the ligaments resulting in compromised bone apposition causing the overall instability.

Is important to note that for the ligament to become injured, the previous defence mechanism have to have failed to allow the biomechanical stress to damage the ligament, therefore, the treatment care must aim to restore the health of the entire TMJ protective structures.


Assessment Protocol

Clinical assessment to identify the key joint dysfunctions of the jaw and the associated muscles compromised.

Anterior – Posterior (AP) neck/jaw view is essential to analyse the level and direction of the different patterns of TMJ misalignments


TMJ MRI is essential for visualizing the extent of injury on the muscle/tendon and ligamentous layers.

Locate the exact injury point; Allows the treatment to be more specific during the application of the treatment modalities

Identify the extent of tissue damage and the presence of scar tissue; Provides valuable information regarding prognosis and the application of friction soft tissue modalities to aid on scar tissue removal.


Treatment protocol

Specific jaw adjustments followed by a rehabilitation regime to strengthen the entire soft tissue support of the TMJ.

Application of Low-level Laser and PEMF to aid on the cellular level of heling as well as improving the microcirculation for the area.

Friction soft tissue therapy helps to reduce dysfunctional scar tissue

Specific selected essential oil application to enhance healing

Depending on level of misalignment and chronicity a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this deformity.