September 25th, 2017
This post comes with mixed feelings as I announce my retirement on 30th September 2017 from Canopy Integrated Health. I would like to take this opportunity to say how much I have enjoyed being part of my patients healthcare and happiness.
Leaving my profession and interest in TMD, will not be entirely easy.For the last 30 plus years, I have genuinely enjoyed helping people manage and control their Temporomandibular disorder.
Poorly modulated proprioceptive input between the jaw and rest of body can cause a complex break down in any part of the nervous system, myofascial or articular systems. This makes TMD a challenge to diagnose, understand and treat. Therefore, I would like to thank all the physiotherapists and other health professionals that have helped me over the years tackle this complex disorder.
I can be reached by Email Address if you have any questions. In addition, please let me know if there is anything I can do to facilitate getting help in the future for people suffering from TMD.
However, I do intend to spend more time with grandkids,family, friends & travel.
I have always felt that medecine adds “days” to life. Physiotherapy adds “life” to days and retirement!
July 17th, 2017
Temporomandibular Dysfunction –options for fixed closed lock of TM Joint (jaw)
Possible history: For years you have had a click in one of your TM Joint while eating /yawning. You may have had a deflection when you open your mouth for months.
Suddenly after eating hard/chewy food, a night’s sleep, and or yawning, your mouth is unable to open more than 1 finger which is placed between your front teeth.
It would be a good idea to seek medical treatment for this immediately . As a first step the dentist might suggest any of the following strategies:(brux/night guard, muscle relaxants, soft diet and physical therapy). If this does improve vertical opening the clinical diagnosis could be:
“An acute persistent closed lock of the Temporomandibular Joint”. This is caused by a dislocation of the articular disc without reduction, often accompanied with pain, reduced chewing ability and extreme reduction in vertical maximum mandibular opening to 25mm.
Action: Immediately get a referral to an Oral & Maxillofacial surgeon from your dentist or doctor and also seek out a physiotherapist specializing in TMD.
An MRI can help confirm a fixed disc displacement.
Consultation with a Maxillofacial surgeon:
Possible options could be given:
1.Physiotherapy. This should provide:-education on cause and management of dysfunction in TM Joint, stress management techniques, soft tissue massage(intra and extra oral), manipulation in combination with muscle relaxants and exercises to improve vertical opening. Neck, thoracic,& pelvis manual therapy as everything is connected! ie:Central nervous system and musculoskeletal system. (I have read a study that found 96% of people with increase in Masseter tone have increased tone in hip flexors and 76% of people have increased tone in adductors of the hip!)
2. Surgery: This is called “An Arthrocentesis and lavage with manipulation which is the best option if physiotherapy is unsuccessful to improve the vertical mandibular opening more than 25mm and makes eating/swallowing more painful. This is a procedure that is usually done under general anaesthetic so muscles relax, allowing easy manipulation. A needle is placed in the upper joint space to inject saline or water. A steroid is often added to dampen any inflammation. After that patients will often feel bruised and bite may feel spongy due to effusion.
This procedure should put the disc into the anatomical correct position but the disc attachments (eg: fascia and ligaments) need a LONG time to heal.
Main Fact to remember when considering surgery: “Time is the healer so there are no magic short cuts.” Soft tissue takes about a year. Expect set backs as healing tissue can tear…18 months recovery is not unusual.
Management post surgery: Take anti inflammatory medicines, use local heat pads, soft diet and active jaw opening/stretching exercises guided by a physiotherapist.
No wide opening: so yawn with chin on chest.
No kissing and especially not with tongues!
No hard foods, even if cut up: apples, nuts, raw carrots, pizza and steaks etc.
Options of food to eat: Smoothies, Fish, chicken & pasta
The surgeon will advise you on “Standard risks of surgery”
Personal thoughts: If you can function without pain, I would recommend physiotherapy.
The success rate of the surgery is high. However, you have to maintain the jaw opening by doing exercise prescribed by physiotherapist, avoid chewing/eating hard food.etc as mentioned above… Soft diet is a must for a 1 year -18 months !
April 09th, 2017
Cathy’s course is very informative and includes a lot of opportunities for hands on practice. After completing her course, I am much more comfortable assessing and treating the TMJ. She has provided me with a solid understanding of the TMJ and I would definitely recommend her course. -Jordan, Physiotherapist
“This course combines several important concepts in physiotherapy and applies them to the treatment of the TMJ. I appreciate learning many techniques that I was able to instantly apply to my patients in the clinic.”
Thanks again Cathy.
Cathy’s TMJ course is full of useful information and treatment techniques. I immediately started using her techniques on my patients the next day. Thanks Cathy! Reza, Physiotherapist
June 14th, 2016
In the 15 years that I have been taking post graduate continuing education courses, this may have been the best course that I have ever taken. I have read that praise means more when it is specific, so let me be specific.
- You came with no ego. You didn’t tell us how unique or skilled or good that you are. You let us conclude that for ourselves (and we did)
- The classroom was stocked with enough supplies and beds for all of us to work on. We didn’t have to makeshift anything or “pretend” that we had equipment.
- The classroom was close to food sources for lunch. We had a long enough lunch break to actually eat lunch
- the class size was small enough for us to ask questions and for you to give attention to each one of us
- we did more hands on work than lecture. We left with skills that we could use in real life situations that we could relate to.
- you were not afraid to say ” I don’t know” or “here’s a big word, how about that”
- you gave us ideas about how to market ourselves to dentists what they want to know so that we can help them
- yo repeated yourself throughout the course so that we learned and could retain those points that were important
- you brought equipment so that we could easily identify the anatomy of the jaw that we were supposed to be working on
- Your skills with treating muscles was superb!
- you kept the course on time and started when it was scheduled to start, not when all students were present. This respected those of us who were present
Thanks Cathy! I learned a lot and feel much more confident helping the people in my community who suffer from TMD symptoms! It was a phenomenal course, and you did a superb job presenting it.
With much appreciation
April 27th, 2016
I have had chronic TMD for years. After my first visit to see her I left feeling “I had a spa treatment for my jaw!” RM
“Life has been very stressful recently and I am just so happy to be able to take the time to breathe. I have not done this for years!” Cathy has been guiding me through some simple exercises to learn better breathing and how that ties into my posture and mood
“Cathy has shown me how to started breathing again.Walk and Breathe at the same time …that will take a lot longer !” LH
“The only good thing about TMD is you lose weight!” CR
April 26th, 2016
I have benefited from your instruction with enhanced understanding and new techniques to try. I was able to apply these techniques in the clinic immediately. I was also pleased to find that I have been following an approach very similar to yours with the TMJ patients that I treat, which has given me increased confidence. I also appreciated the size of the group and the close instruction you provided for hands -on practise.All in all-an excellent weekend for me! Thank you so much -Cathy
Lynn B Registered PT
“Cathy’s TMJ course really gave me an opportunity to review and correct some of my basic assumptions about the assessment and treatment of TMJ problems. It was an excellent opportunity to learn more in depth about joint mechanics, cervical interplay, joint mobilizations as well as soft tissue release techniques. If you are interested in furthering your TMJ knowledge I highly recommend taking this course. Cathy is an engaging speaker and the small class size ensured lots of opportunity for one on one instruction”. Jennifer Kelot PT
April 25th, 2016
My expectations which were fully met to demystify and understand the complexities of TMD. The course was extremely helpful and enjoyable. The hands on part was specific and useful. Bridgette (Physiotherapist)
Cathy is a wonderful and passionate speaker. It was great listening to her and attend the hands on session. A rewarding experience. Rajan (Dentist)
August 25th, 2015
“Twice, I have enjoyed hearing Cathy speak on TM Disorders. A knowledgeable enthusiastic speaker, her passion about her focus area is apparent. Each of her talks, a little different–each time, more valuable, practical knowledge to take away.
Her evolving work experience with “TMJ Syndrome” clients have taught her there is more than what seems textbook obvious.
She presents to equip the dental audience additional insights from a physiotherapy/craniosacral point of view. Inter professional collaboration towards optimal patient health care is the ultimate.”
March 13th, 2015
Anyone interested in a hands on course that I would run, where the Dental profession can learn how to assess, and teach self care TMD exercises to your clients.
This would be invaluable in my opinion, as having TMD can be debilitating, progressive and affect lifestyle
March 13th, 2015
Currently I am on medical leave. However I have started a monthly “TMD” Study club. Currently this is for Physiotherapists who have attended my UBC courses in 2013 and 2015. The idea behind this club is to allow physiotherapists to practice the techniques they were shown on the course.
I will be running a level two course which will be advertised through PABC hopefully in 2016. I will announce this on my web site too when it will run