The TMJ and a Whole-Horse Approach to Knowledge

Article by Becky Tenges, Certified Practitioner, Instructor and Certification Block 3 Mentor ~

Since becoming certified as a Masterson Method Practitioner and Instructor, I have been on a continuing education quest to become a better bodyworker by learning more about anatomy, biomechanics and possible primary causes of discomfort in my horse clients.

For a couple of years I have been watching the teaching schedule of Dr. Kerry Ridgway, a long-time equine veterinarian who takes a whole horse approach to medicine combining integrative veterinary medicine with conventional medicine on order to provide the best care and to address the horse’s many functional and musculoskeletal problems, which are often associated with issues such as dental problems, improper shoeing or trimming, and saddle and tack induced problems.

Dr Ridgway’s teaching schedule takes him periodically to Northern California and regularly to venues in South Africa, Australia, and the United Kingdom.  This September, I was one of the fortunate few to have had the opportunity to catch him teaching his intensive Integrative Veterinary Medicine Seminar near his home in Aiken, South Carolina.

For me, processing the information he imparted during our lectures and the following practical sessions was a bit like trying to take a drink of water from an open fire hydrant…way more information flowing from Dr. Ridgway than I could process at the time.  Fortunately, Dr Ridgway’s teaching materials are terrific and I have since been able to review them at an easier pace.  Recently, I was studying one of Dr. Ridgway’s lectures entitled: “Hyoid Muscle Hypertonicity – Relationship to Performance Problems”.

The good news was that I knew where the hyoid bones are located (in the head between the horse’s cheeks). I even knew what they looked like (Image 1 below).  I knew what hypertonicity meant  (extreme muscle tension).  And because of the Masterson Method, I knew that the horse’s tongue is attached to the hyoid and that during 5 Day Advanced Courses, we are taught a Tongue Release technique that can help the horse to release tension in his poll through his mouth and tongue.

In Dr Ridgway’s lecture he told us that he had had “an Ah-Ha Moment” regarding the connection between the high incidence of temporomandibular joint (TMJ) pain (about 70% of the horses he sees) and the musculature of the hyoid bones, where there are long muscles that connect the hyoid to the horse’s scapula and to its sternum .  As I looked at his materials, I had my own “Ah-Ha Moment” when I realized that the hyoid bones make a sort of focal point connecting the three main junctions that we focus our work on with the Masterson Method: the Poll, the Neck-Shoulder-Withers and the Hind End Junctions. To see this, look at Image 2 below where I have taken Jim’s depiction of the three main junctions of the body that most affect performance (from page 5 of his book) and have added the Hyoid bones (in brown in the highlighted oval); the Omohyoid Muscle (which connects by fascia from under the Scapula to the Hyoid); the Sternothyroid and Sternohyoid Muscles (connected from the Sternum to the Hyoid) and the Occiptohyoid Muscle (connected between the Hyoid and the Occiput).  I then colored in the location of the Nuchal and Supraspinous Ligaments.

As you can see above, we connect all three main junctions of the horse through the bones of the hyoid in the horse’s jaw when we connect the muscles from the scapula and the sternum up to the hyoid; then from the hyoid to the occiput and finally from the poll to the nuchal ligament which then connects with the supraspinous ligament.

So, why the big Ah-Ha…what’s the big deal to have realized that there is a direct, linear connection between all three junctions?  For me, two things jump out at me.  First, I have a new appreciation of and can visualize the truth that Jim teaches and that practitioners experience: ‘when we work with the horse in one area of the body, we are also working in another area of the body’.  Here’s a specific example.  If you have taken our Weekend Seminar course or have read Jim’s book, then you will be familiar with the Under Scapula Release.  It never really dawned on me that when we do this technique, we are directly accessing the horse’s poll (through the omohyoid muscle which connects between the scapula and the hyoid).

Second, I have a new understanding that when I encounter TMJ pain in one of my horse clients (which is in at least 70% of the horses I see, as is Dr Ridgway’s experience), it is not ‘just a pain in the jaw’.   As Dr Ridgway presented it to us, muscle pathology of the long hyoid muscles “goes beyond just TMJ pain, it affects the entire balance of the body.”  Specifically, he clarified for us that a contracted omohyoid muscle results in the following:  it retracts the tongue back into the throat; interferes with the bit; locks the horse’s jaw; limits lateral flexion; interferes with shoulder freedom and range of motion; and interferes with balance and proprioception. . (The Omohyoid muscle is depicted in Image 3 below. And the Sternohyoid and Sternothyroid muscles are depicted in Image 4 below.)

When these long muscles are contracted, they mimic the body’s response to fear—they are a part of the Fright and Flight Muscle Groups.  Dr. Ridgway reminded us that when humans react to emotional stress, we tighten our neck muscles, clench our teeth, and hunch our shoulders.   It’s the same with horses.

Much is known about TMJ Syndrome in humans.  Pain in the TMJ can interfere with everyday activities, and can lead to or co-exist with other problems like headaches, back and neck pain, and stress.  Sometimes TMJ pain in humans can lead to problems that don’t seem related to the jaw, such as neck pain, pain in or around the ear, ringing or buzzing in the ears, muscle spasms in the face and neck, a sensation of pressure in the sinus area and dizziness.

As with the potentially far-reaching implication of TMJ Syndrome in humans, Dr Ridgway clarified for us the performance implications of strong TMJ reaction in horses as follows:

Balance may be impaired

Ability to perform lateral movements will be impaired

Range of motion of the cervical vertebrae will be impacted

Contraction of the long hyoid muscles can put other muscles into spasm and tension

The horse wants to ‘go behind the bit’ to relieve tension in the muscles between the hyoid and the scapula and/or the sternum

It sets the stage for a hollow back

It shortens the horse’s stride

That’s a pretty amazing list of performance implications relating to a pain response in the TMJ. So, what can we do to help the horse?  The great news is that all of the Masterson Method techniques taught in Jim’s book will help you to find and release tension throughout the horse’s body.  And some of the techniques will specifically help the horse to release tension in and around the hyoid. These are Head Down, Head Up, Lateral Cervical Flexion, and Under Scapula Release.  If you are a certified practitioner, then the Tongue Release will also directly work to reduce restriction and tension of the muscles attached to the bones of the hyoid.

It’s also amazing how things begin to come together, both for the horse and for the human seeking to increase its understanding of the horse, when we look at the horse from the perspective of the big picture.

If you need more information about the Masterson Method of Integrated Equine Performance Bodywork and how it can be learned and used to find and release tension in the horse, then check out the many opportunities for learning available on this website, including Jim’s book, DVD’s, Online Courses, and Seminars offered in the US and Europe.