The Perfect Match

The pelvic floor and the jaw may seem unrelated, but these two areas are more connected than previously thought. Bone, soft tissue, and nerve connections make the jaw and pelvic floor close partners, which can lead to dysfunction in these areas being closely related.

Simultaneously receiving care for these two areas can be the perfect match to maximize the benefits of your physical therapy appointments.

There are three main reasons why the pelvic floor and jaw have a close relationship: the bony anatomy of the spine, their soft tissue attachments, and their relationship to stress.

The spine is made up of bony segments, called vertebrae, that run from the base of the skull down to the tailbone. In neutral, vertebrae line up to create the neutral curves and structure of our spine. A long-term disruption in the neutral spine positioning (such as scoliosis) affects the entire length of the spine. Bony spine changes create both a twist in the pelvis (which can influence pelvic floor function) and a twist at the connection between the neck and base of the skull. Jaw joints, although not part of the spine, are situated close to the highest neck bones. Any spine changes in the neck also change the position of the jaw and can influence jaw function.

Our bones are useless to us without their soft tissue attachments. Soft tissue covers most parts of the body that are not bone or cartilage, including muscles, ligaments, tendons, nerves, and fascia. The jaw and pelvic floor are connected through over 100 short and long spinal muscles, as well as the abdomen and chest muscles. There are also strong fascial connections directly between the jaw and pelvis. Fascia are sheets of web-like tissue that wrap our body parts together. Issues at one end of these soft tissue chains cause rippling negative effects to the other end of these chains.

Muscles that react most to stress are in the upper shoulders, neck, and face. The pelvic floor is also affected. Long-term stress can cause hormonal changes, poor breathing, overactive muscles, and nerve issues. If stress relates to jaw clenching and upper shoulder tension, you may also hold tension in your pelvic floor muscles without noticing.

Jaw and pelvic floor dysfunction are common for many. Some people have lived with these issues so long that they seem normal. Only later do they realize how these areas should work.

Jaw dysfunction can present as:

– Headaches

– Neck pain

– Difficulty taking large bites of food, chewing, or talking

– Pain with dental care, including daily brushing and routine dentist appointments

– The jaw gets “stuck” closed or open.

Pelvic floor dysfunction can present as:

– Urinating or having bowel movements very often or very little

– Losing control of when you urinate or have bowel movements

– Pain or loss of function with sexual intercourse

– Pain throughout the pelvis, groin, abdomen, or low back.

– A feeling of organs “falling out” of the pelvic floor openings.

For a more detailed screening for jaw concerns (named temporomandibular dysfunction (TMD)) and women-specific pelvic health concerns, visit Freedom Physical Therapy’s page of free screening tests here.

An important note—Pelvic health care education and treatment are often directed toward women, but many men have pelvic floor concerns, too! Men can highly benefit from receiving treatment for pelvic floor dysfunction.

Physical therapists are one of the main providers for jaw and pelvic floor care.

Jaw care and pelvic health care are often considered specializations that physical therapists choose. Some physical therapists are trained in both specialties, but you may have two physical therapists—a jaw specialist and a pelvic floor therapist—involved in your care. Both therapists will strategize together on how to comprehensively address your concerns. These specialists know how the jaw and pelvic floor interact, and the combination of their individualized training can be the ultimate key to improving your pain, daily function, and quality of life.

Treatment strategies can include:

– Massage and trigger-point release techniques to reduce muscle tension

– Range of motion exercises

– Stress management strategies

– Muscle activation retraining

– Using unique tools to help regain better function through the jaw and pelvic floor

– Home exercise programs to make the most of your care plan.

If you think you may be struggling with both jaw and pelvic floor dysfunction, talk with your physical therapist about how you can make the most of your time and receive care for both!