Patient A came in to see me for chronic headaches. Tight tension headaches along the base and sides of the head that were worse in the morning and at the end of the day.
Patient B for chronic neck tightness. Was taking up to 3 Aleve a day, had tried acupuncture, massage, and rolfing with limited relief.
Patient C had ear congestion. First episode of a feeling of fullness in the ear started 10 years ago. In the past two years, however, these episodes lasted weeks and months, and the patient was starting to experience tinnitus. At one point, testing revealed hearing loss, but later testing (thankfully, but also confusingly) found it to be back to normal.
I gave them all very similar core treatments. Not because I’m a crappy acupuncturist. These three seemingly different issues actually come from the same culprit: the overworked jaw muscle. Specifically, the masseter muscle, and its two back-up singers, the SCM and the temporalis muscle.
The masseter muscle is the major chewing/clenching muscle and is one of the strongest muscles in the whole body. When it's overworked, you're likely to feel the pains and strains elsewhere in muscles that aren't as powerful - eg, your neck, the sides of your head (temporalis). So while the connection between a clenched jaw and tension headaches seems intuitive, the masseter muscle is often overlooked. Without treating the masseter, though, the relief is superficial and never really resolved.
The link between the jaw and ear issues (Patient C) is less intuitive. When a muscle is clenched and knotty, there's inflammation involved and circulation of blood and fluids is compromised. That's what causes pain. The inflammation and poor circulation also sets off a domino effect of tension and blockage of associated structures. This is what was going on with Patient C - tightness in the jaw can interfere with sinus draining and even refer ear pain and ringing.
In fact, if you’re experiencing any tension in your head and neck, or sinus congestion - and definitely if you have jaw tension or TMJD - explore these muscles and see if you discover any exquisitely tender areas that are begging to be worked. Some of these muscles rarely hurt until you start probing.
(1) The masseter muscle is attached to the underside of the cheekbones. The muscle is most vulnerable to tension where it attaches to bone, so it'll feel nice to use your thumb to dig and trace under your cheekbones.
There are two points of access to the masseter that you should work:
A. At the highest point of your cheek bone (if you drew a line down from your eyeball).
Place your hand over your face as if you’re palming your nose, fingers resting on your frontal hairline. This hand position should put your thumb in a good position to work under your cheekbone. Dig your thumb inwards and slightly upwards. Explore for tender areas - maybe move medially towards your teeth and nose. When you find a particularly tender area, slowly open and close your jaw - the movement doesn’t have to be big as your jaw is a small joint. This pins the muscle while you stretch it, to deepen the stretch.
B. There's a notch on the underside of your cheekbone about an inch in front of your ears. Your thumb will fit into it nicely. If you press firmly inward and upwards with your thumb (as if you're aiming towards your eye), you'll feel a nice ache. This notch can take a lot of pressure, so lean into your thumb with the weight of your head, or dig in there with a knuckle. You’ll often find me digging into my jaw muscles while I’m in front of the computer.
(2) The SCM
It's that ropy muscle that runs down the side and to the front of your neck.
Gently squeeze the muscle between your thumb and index finger - make sure you go up and down the length of the muscle from behind the ears to your clavicle and linger on the areas that are more tender. Read more about the SCM here.
(3) The temporalis muscle
The temporalis is a wide, fan-shaped muscle on each side of the head by the temples.
Use your thumbs, your fingers, or a lacrosse ball. If using a lacrosse ball, I’d throw it in a sock so the rubbery-surface of the ball won't pull your hair. And just roll the ball around your temples.
Bonus: Release the gnarliness at the occiput, the muscles at the base of your skull.
You can put two lacrosse or handballs in a sock, tie the sock so that the balls are close together and lie down with it placed right at the base of your skull where your neck/shoulder muscles meet your head. Relax and allow gravity + the weight of your head to dig into those muscles. Rock your head from side to side to find and get into the tender areas.
Each of the cases I mentioned above had other complicating issues going on - eg, the headache case had stress and postural issues to work on (forward head!), and the case of the congested ear had an underlying imbalance of dampness - but releasing and stretching these greatly (if not entirely) relieved what was going on.