As you know, physical therapy for TMD patients is quite involved and very complex. Before we refer any patients for physiotherapy, we ask a series of questions of the therapist which include:

1. How much manual therapy do you use? Modalities?
2. Do you work as low as pelvis checking on torsion and tilt?
3. Then work total spine for flexibility? Balance?
4. Do you search for cause of present pain rather than treat area of patient complaint (this provides only temporary relief)?
5. Do you assess then address the whole trunk including hips and shoulders before treating the TMD?
6. Do you work both sides of the body?
7. Do you dismiss in “gradient” fashion?

- Must be familiar with the need to refer patients to relevant medical specialists (eg: neurologist)
- Must be familiar with the interrelationship of posture with dental occlusion and hence the need to refer for ongoing bite plate adjustments following every third chiropractic adjustments
- Should complete a minimum of 12 hours per year of specific temporomandibular joint related continuing education
- Should have close familiarity/formal training in osteopathy techniques.
- Should have a formal qualification (or be working towards one) in the “St. John’s Seminars Neuromuscular Therapy” massage techniques.

For more information on treatment protocols for physiotherapy for whiplash sufferers/motor vehicle accident victims, please refer to Dr. Terry O’Shaugnessy’s website www.dro-tmjorthoexpert.com and go to publications. Look for the article titled:

BASIC TREATMENT PRECEPTS INCLUDING PHYSICAL THERAPY ESSENTIAL TO PARALLEL TREATMENT OF CERVICOGENIC/CRANIOFASCIAL / TEMPOROMANDIBULAR COMPLAINTS ENSUANT TO A FORCED HYTER-EXTENSION/HYPER-FLEXION TRAUMA EPISODE