Osteopathic Manipulative Treatment: Facial Muscle Energy, Direct MFR, and BLT Procedure – for TMJ Dysfunction

Excerpt

Muscle Energy Technique (MET) is an active technique of osteopathic manipulative medicine that engages restrictive barriers without stressing the system. The patient voluntarily applies a precise muscle effort from a specific position in a specific direction opposite to a counterforce. MET can lengthen the spastic and weakened muscles and mobilize restricted joint motion in the temporomandibular joint (TMJ) area. The required amount of force ranges from minimal to maximum contraction. Myofascial release (MFR) is a passive maneuver applied to the TMJ that requires stretching and reflexing the soft tissues and joint restrictions. The physician twists, truncates, and compresses the TMJ while repetitively palpating the tissue and joints, which eventually converts tightness and looseness. Balanced ligamentous tension (BLT) is both a passive and active technique that exaggerates the TMJ dysfunction; the ligaments guide temporomandibular muscle movement, and BLT utilizes this fundament to restore order. MET, MFR, and BLT techniques are sparsely reported in medical literature and successfully minimize TMJ and affiliated regional pain.

Dentists have reported TMJ dysfunction in dental literature since the 1950s, initially termed temporomandibular dysfunction; it involved malocclusion of the teeth (imbalance between the upper and lower teeth). Experts later discovered that this mechanism alone was not enough to account for all clinical findings found in the condition. About 20 years later, in 1979, it was conceptually designated as an orthopedic condition. TMJ disorders are still coined temporomandibular disorders (TMD), containing all TMJ problems and related structures. OMT (osteopathic manipulative therapy) mobilizes the compromised TMJ through the dysfunctional pathologic barrier (not after its usual physiological barrier), leading to low injury reports off OMT procedures. This review explores the usage of OMT in treating TMD.

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