Episode 47: How the TMJ and Pelvic Floor Are Connected and Why It Matters Clinically

In this episode of TMI Talk with Dr. Mary, we dive into one of the most overlooked full-body connections: the link between the jaw (TMJ) and the pelvic floor. If your clients are dealing with jaw tension, clenching, or TMJ issues—there’s a good chance they’re also holding tension in the pelvic floor. And if you’re only treating one site, you're likely missing the full picture.

 What You’ll Learn:

• Why tight jaws often mean tight pelvic floors
• The fascial connection from tongue → diaphragm → pelvic floor
• How diaphragmatic restriction leads to compensatory jaw and pelvic tension
• The role of the autonomic nervous system in clenching, grinding, and guarding
• Why HRV and breathwork are clinical tools, not just wellness fluff
• How digestion, posture, and stress all play into this loop

00:00 Introduction to TMJ and Pelvic Floor Connection

01:55 Understanding the Fascial Connection

05:51 Nervous System's Role in TMJ and Pelvic Floor

12:41 Impact of Digestion on TMJ and Pelvic Floor

15:49 Conclusion and Final Thoughts

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I’ll see you in a week!

Transcript

mary: 0:00

Welcome back to TMI talk with Dr. Mary. I'm your host, Dr. Mary. Today we're gonna be talking about a hot topic and the TMJ and pelvic floor connection. Many people are really fascinated about this connection because it's not in the same areas, and I always find this fascinating because the full body is connected and that is gonna be something I'm gonna be preaching all the time. I. I believe we often miss as clinicians and even movement professionals and understanding how the full body is connected. And so in this episode, we're gonna be talking about how the TMJ and pelvic floor are connected and how this applies to us as movement professionals or clinicians working in rehab or even in the healthcare industry. We're gonna go over the three main ways this happens and how we can address it in the clinic. So without further ado, we'll go ahead and jump into the episode. Welcome back to TMI talk with Dr. Mary where we dive into non-traditional forms of health that were once labeled as taboo or dismissed as Woo. I'm your host, Dr. Mary. I'm an orthopedic and pelvic floor physical therapist who helps health. Movement and rehab professionals integrate whole body healing by blending the nervous system into traditional biomechanics to maximize patient outcomes. I use a non-traditional approach that has helped thousands of people address the deeper roots of health that often get overlooked in conventional western training. And now we are gonna be starting our next episode. Alrighty, yes, the TMJ and pelvic floor, such a hot topic. Every time I talk to my clients about this and saying, oh, if you have jaw pain, you likely have pelvic floor pain or pelvic floor tightness. Their minds are blown. So wanted to dive in on why this matters and, and how we can approach this. So the first way that the pelvic floor is related to the jaw is gonna be through the fascial connection. So if you've ever looked at Tom Meyer's work, you can see that the tongue has fascial connections all the way to the pelvic floor. So through the diaphragm and into the pelvic floor. It also goes all the way down to the feet. But we're gonna be just talking about the Pel. Floor and jaw connection. And so that's a fascia, right? And so if we don't know that and we're treating the pelvic floor and somebody is having TMJ tightness as well, usually they correlate with each other. And so what that means is, well, if we know there's a fascial connection from the jaw all the way down to the pelvic floor with a diaphragm in between looking at the diaphragm, when we're looking at treating the jaw and pelvic floor, because a few different things happen. First, if our diaphragm is restricted so the diaphragm can become restricted because we're hunched over in this. Fight or flight position typing on a computer all day, and then our eyes are looking forward and oh, we're only looking at one object. And so our primal instinct goes attack, right? If we're slouched over not breathing efficiently and we're staring at a singular object, our primal instinct is to think that we are defending ourselves. And so what can happen there is the diaphragm almost gets stuck. I mean, it's still there. But the fascia around the diaphragm, the rib mobility especially, we need that 360 rib expansion when we're doing diaphragmatic breathing. And with that, we need thoracic mobility. We need fascial mobility along the entire thorax, so along the ribs, along especially the front aspect of the abdomen doing a diaphragm release. If you're not sure exactly what that is. I can always talk about that on another episode. But basically you're going under the ribs just slightly and slowly along the rib cage to help release that diaphragm. And when we do that, what happens is we also have fascia all along the front of our chest too. So if we're not looking at the fascia, I know we used to think like, oh. That's just non-contractual tissue. We know that's not the case. Now. It's directly interconnected with the nervous system. So the more we stay up to date with fascia, the more we stay up to date with how much faster we can get results for our clients. And so now if the diaphragm isn't pumping that way, right, so say it's restricted, we're gonna be using a lot of our accessory muscles. And now if we're using our accessory muscles, so our neck muscles, then we're gonna be overusing our jaw, right? And then if we're slouched forward. Our neck is in this forward position, so it's further away from the back. So now our jaw is in this awkward position, so it's not as easy to open and close. And so we can get to some dysfunction there. Now, from the aspect of the pelvic floor, if our diaphragm isn't pumping efficiently, so if you think about the diaphragms, an upside down bowl and the pelvic floor is an up, uh, uh, bowl that's right side up. Okay. They, they have an inverse relationship. So as the diaphragm comes down, the pelvic floor lengthens, it's almost like this little sump pump. So the more that we get that moving, the more it tells our body we are in safe mode. We are, we are. Okay. So it tells the body it's safe to go into the parasympathetic nervous system, which is that rest and digest. And so that can do two things. One, just that movement of lengthening the pelvic floor, but then also the pelvic floor muscles are going to relax when the body knows that it's safe. So that's one major way that the pelvic floor and jaw are connected. The second are gonna be from a nervous system standpoint. I mean these all overlap, but the second is gonna be from the nervous system standpoint. A majority of patients that I've seen for TMJ dysfunction. It is not related directly to the TMJ. And side note, a lot of people say, I have TMJ instead of I have TMD, tempo Mandibular Joint Disorder. Even clinicians will say it, they'll say, I have TMJ. And I'm like, yeah, we all, we all have uh, TMJ. I find that interesting that that's just kind of taken off. But, so if we have TMD, so if we have temporomandibular dysfunction. A lot of times I've seen it's this clenching motion, it's this protective pulling down. It's this needing to control what's going on, so the body just almost absorbs it. And so if somebody doesn't have just an outright, a lot of times people have more just. Jaw tightness because of chronic fight or flight. And so they're likely grinding their teeth at night. And so that can also be something to think about from what they're doing before going to bed. Are they on their phone? Did they have a difficult conversation? Did they watch a scary show? Like these are things to notice because as they go into sleeping. If their nervous system is heightened at that point, it's going to stay heightened at night. So that's something to think about. So think about it as this, if you are running from a bear or a lion or whatever animal you wanna picture, um, the last thing your body wants to do is eat or poop. Okay. It's the last thing it wants to do. The blood is diverted away from the gut and into the arms and legs. So from a nervous system standpoint, these are beginning of digestion and end of digestion. And so with that is the body just does not think it's safe. So it's gonna clench to close our mouth and close our butt and close our, if we have a vagina, the vagina. And so. Working so much on the nervous system with this, right, and so this goes back to the first one. If we, we can work on someone's jaw and pelvic floor and hip muscles and back muscles all day. But if we're not understanding why they're chronically in fight or flight and they might not even know that they're in it. So that's another massive piece that I've seen in the clinic. So. First we have to get them to identify that they're in it. Most people, have some form of a fitness tracker, and if they don't, that's okay too. They can measure it in other ways, but. I find that most people with an Apple Watch or any of these other fitness watches, they're tracking it and they don't actually know that they're tracking it. So they have a ton of data. So the best way that I've seen to help people start to recognize that they're in this fight or flight is to track their HRV, and I can do a whole nother episode on HRV, but basically if your heart rate variability, so the heart rate measures. So that it measures the heart rate variability. So the time in between each beat is a variable. And what that means is if your heart is going, beep, beep, beep, beep, beep, beep, beep, beep, beep, beep. You have less time in between each beep. Now if it's more of beep beep. Beep, you have more time. So it's actually counterintuitive when we think of HRV, we might think a lower number is better when actually we want a higher number. So you can actually start to see on their records or on their, in their system. Of their Apple watch or whatever, uh, gadget that they have, they ha might have all this data that they didn't even know that they had. And so they can start correlating when those moments of stress have happened. And so basically HRV is gonna be looking at all those things as a variable. So the quicker we go from beep, beep, beep, be beep to beep. Beep beep. That's gonna give us a higher heart rate variability. So it's varying in those different aspects. So if we're staying in that really quick beat all day, we're gonna have a lower heart rate variability'cause it's staying the same. And so. It is impossible not to be in fight or flight. It's just part of our human nature. I've seen way too many people saying, oh, we should never be in fight or flight. That's denying the human experience, and that's almost gaslighting. So I've seen this on the other side of the healing industry, is that we're being told that, and that's just actually completely wrong because there's so many factors that come into play with the nervous system. We have so many. People that are being oppressed by the systems that we have. This can be women, people of color. We have different communities that are suppressed. Different religions, different cultures, different sexes, different genders, all of the different things. And so. We have to be conscious of when we are talking to people about their nervous system, being very sensitive to the fact that their stressors might or might be different than your stressors. So if you are talking to a single mom of four children, it's gonna be a lot harder to help them get to take the time for themselves because they don't have the resources. Meanwhile, if you have somebody that doesn't have children and ample resources. You know, they may have the ability and more time and bandwidth to be able to regulate their nervous systems. We wanna be sensitive to that. And on top of that, just thinking about what our body is doing when we are in fight or flight. So making sure that if you know that you have a patient or a client that has pelvic floor tightness and their jaw is tight, two, diaphragmatic breathing, starting to get them to the track, their HRV, if you do jaw work, great upper cervical work is. Crucial to treating the TMJ. If we're not treating the upper cervical spine or thoracic spine, we're missing major components because the mechanics of the jaw shift forward when we shift forward. So it's supposed to of go down and forward when we open our jaw, the the TMJ and a lot of times we're already forward, so we're not getting that kind of down and forward motion from the jaw opening as efficiently. So we have to be looking at posture with the jaw, which then directs it. Directly affects the pelvic floor, and third is gonna be the beginning and end of digestion. So again, these all interplay with each other, but the beginning and end of digestion is so if somebody potentially is not chewing their food as efficiently up here. Then what happens is we're not getting enough saliva and we're not getting enough saliva. That doesn't tell the GI system that we're digesting. So what happens is we just start kind of swallowing things whole. And then what happens is when we do that, it takes so many ti, so much more time and resources for our gut to slowly digest that food. So what happens is the gut can start slowing down because we have not. Adequately chewed our food completely. The getting that saliva is crucial to starting to break down the food, so the rest of the body. So we've got the esophagus and the stomach and the small intestine, and then the colon. Those don't have to work as hard, so. If somebody isn't fully chewing their food and they're experiencing constipation, this is something we wanna consider.'cause constipation can cause pelvic floor tightness and pelvic pain simply because there's not much space in the pelvis. And so this also goes back to the diaphragm as well. So if they are not breathing as efficiently, we're not getting that kind of downward pumping motion through the gut. And then on top of that, we're not telling the nervous system that we're safe. So it's important that we're looking at all of that too. In addition, uh. Dental health is super important. You're gonna start seeing more of this come out If somebody is not brushing their teeth regularly, if they are not flossing regularly, or sometimes people change and they use mouthwash. I know mouthwash can be controversial. Um, depending on who you talk to have, you can have your clients gonna do their own research, but some people say, can. Um, affect the microbiome. I haven't dove as much into that, but I'm just sharing you with some information. If you're with somebody that's just feeling super constipated and you're not really sure why, I find most people that are constipated, which is I have a ton of people that are constipated regularly and they think it's normal. Constipation is not normal. Um, but what happens is we need to be sitting down and. Fully chewing our food to applesauce. Consistency. Hey, I'm, I don't do this all the time, but then I notice I'm bloated or I don't feel well after. So just being aware of how all of that coexist together, because it can be pretty massive with your clients. So dental, health, and then sitting down and chewing to applesauce. Consistency when you can. Because that's gonna help with that digestion and then water as well. It's gonna help everything flow more fully. You can do all of the gut cleanses in the world. You can do all the different things, but if we're in fight or flight when we're eating, it's just, it's gonna be an uphill battle for the body to digest. So in summary, I really hope this helped looking at all of these things together because. It really can transform your practice and help your clients get to a whole nother level. And, and it's so cool because they often get really excited to know how the body is connected and you're teaching them. And when you teach them that they feel so empowered and this builds such strong rapport for you and your clients. So I hope you enjoyed this episode.

16:14

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