Information for Manipulative Therapists

General points for any manipulative therapist working in the area of TMJ:

1. Recent literature and 30 years experience has shown that conventional physiotherapy delivered by a physiotherapist to the TMJ area has little or no worthwhile effect (ie. therapy provided in the “usual” physiotherapy office). Some therapeutic modalities are very useful such as sonophoresis and pulsed radio frequency and we deliver these in-house. The vast majority of physiotherapy offices do not possess the equipment we need and use.
   
   
2. Traditional physiotherapy is excellent for neck, shoulder, and back injuries in MVA/TMD situations.
   
   
3. Traditional hi-velocity chiropractic manipulations are not recommended for TMJ/neck injuries. Some “light force” approaches (special training needed) can be of use, however, in my experience these are of little benefit long term benefit.
   
   
4. Massage therapy by a registered practitioner (with appropriate training and good communication with our office) continues to be (in terms of experience and literature) the most effective adjunctive form of treatment and certain techniques such as neuromuscular therapy (provided by a practitioner certified in this technique) is extremely valuable.
   
   
5. Any manipulative therapist needs to have a comprehensive approach with a working knowledge of balance, gait, and posture (both static and dynamic).
   
   
6. Great care should be taken (especially by RMT’s) to ensure diagnostic issues are fully investigated (when needed) by an appropriate referral to a specialist (MD, Neurologist, etc.) this protects the patient and the therapist.