Are you experiencing jaw pain—or perhaps pelvic discomfort—and wondering if they might be connected? In many cases, they are. As the owner of one of the nation’s top Pelvic Physical Therapy clinics and a dual board-certified specialist (WCS and PRPC), I’ve seen firsthand how these two seemingly unrelated areas can significantly impact each other. Your jaw (or temporomandibular joint, TMJ) and pelvic floor are linked through an intricate network of muscles and fascia running from head to pelvis. By understanding how tension travels along these fascial pathways, you’ll see why clenching or misalignment at the jaw can trigger a ripple effect that ultimately affects pelvic floor function. In this blog, we’ll delve into the fascinating relationship between TMJ and the pelvic floor, and explore how seemingly unrelated aches and pains can share a common root cause.

1. TMJ and Pelvic Floor: Understanding the Connection

The Body’s Fascial Network

If you’ve ever felt tension radiating from your neck into your shoulders or the front of your head, then you’ve experienced how interconnected our muscles and fascia truly are. The human body has continuous fascial “chains” linking different areas, including the jaw and pelvis. One such chain, called the deep front line, runs from the jaw down the neck and spine, through the diaphragm, and into the pelvic floor.

When tension builds in one area—such as clenching the jaw—it can trigger a chain reaction of pulling and tightness along this fascial pathway, including the pelvic floor. Because muscles often function in groups rather than isolation, this tension can cascade through various regions, ultimately affecting the muscles and connective tissues around the pelvis. Over time, it may manifest as:

• Pelvic pain or discomfort

• Urinary urgency or frequency

• Pain with intercourse (dyspareunia)

• Bowel movement difficulties

2. How TMJ Dysfunction Can Lead to Pelvic Floor Issues

Postural Changes

Tense or painful jaw muscles often alter how you hold your head, neck, and shoulders. Over time, these subtle postural changes can shift your center of gravity, placing extra stress on your lower back and hips. Already sensitive to shifts in posture, the pelvic floor may tighten or weaken in response, leading to discomfort and dysfunction.

Breathing Patterns and the Diaphragm

Many individuals with jaw tension breathe shallowly, relying on chest and neck muscles instead of proper diaphragmatic breathing. The diaphragm and pelvic floor work in tandem with each breath, and when diaphragmatic movement is restricted, the pelvic floor may become overly tense or dysfunctional.

Stress and Muscle Tension

Stress is a key driver behind TMJ issues, as clenching or grinding (bruxism) often occurs subconsciously when we’re anxious or overwhelmed. Chronic stress can cause a heightened sympathetic (fight-or-flight) response, increasing tension in both the jaw and pelvic floor as part of the body’s protective mechanism.

• A study by van der Velde et al. found that involuntary pelvic floor muscle activity occurred in people with and without vaginismus when exposed to threatening situations, suggesting that pelvic floor clenching may be part of a broader defense response. (1)

By managing stress and using relaxation techniques for both the jaw and pelvic region, you can reduce muscle tension throughout the body. Pelvic Physical Therapy excels here by addressing the muscular component (through manual techniques, stretching, and strengthening) and calming the nervous system to prevent both areas from remaining in a continuous holding pattern.

3. The Illinois PT Practice Act: TMJ’s Special Mention

One noteworthy aspect of TMJ treatment in Illinois is that the Illinois Physical Therapy Practice Act specifically mentions the temporomandibular joint (TMJ). Under certain conditions, Physical Therapists can evaluate and treat TMJ-related issues directly, provided they adhere to scope-of-practice and referral guidelines. This explicit mention underscores the importance of promptly addressing TMJ dysfunction.

Why is this so significant? Because it removes barriers for individuals seeking immediate care for jaw problems—issues that can easily have a ripple effect on other body regions, including the pelvic floor. Early treatment of TMJ discomfort greatly reduces the risk of long-term musculoskeletal imbalances and subsequent pelvic floor dysfunction.

4. Pelvic Physical Therapy: A Holistic Solution

Head to Toe Evaluations

Pelvic Physical Therapy goes beyond Kegel exercises. During your visit, a specialized therapist will evaluate not only your pelvic floor but also your entire alignment, movement patterns, and muscle function. This includes how you stand, sit, breathe, and even how you move your neck and jaw. Such a thorough approach ensures any TMJ dysfunction contributing to pelvic issues is identified and managed.

Tailored Treatment Plans

No two bodies are the same, so Pelvic PT is never a one-size-fits-all approach. After a complete assessment, your therapist will design a plan tailored to your needs:

1. Manual Therapy Techniques

   • Gentle methods for the jaw, neck, abdomen, and pelvic floor

   • Options like myofascial release, visceral mobilization, dry needling, or cupping to reduce muscle tightness

2. Breathing and Relaxation Exercises

   • Diaphragmatic breathing to reduce stress on the jaw and pelvic floor

   • Possible incorporation of stretching, vagus nerve stimulation to activate your “relaxing” nervous system, or guided imagery to decrease clenching

3. Postural Strengthening and Stretching

   • Exercises addressing jaw and neck alignment, shoulder stabilization, and pelvic floor support

   • Deep core work and stretching to improve posture and reduce compensatory patterns

4. Lifestyle and Ergonomic Modifications

   • Stress management techniques like mindfulness and sleep hygiene

   • Ergonomic adjustments (e.g., monitor height, seating position) to alleviate strain

Why Pelvic PT is an Easy, Accessible Option

• Non-Invasive: You can often alleviate pain without medication or surgery.

• Holistic: Addresses the root causes, rather than just masking symptoms.

• Evidence-Based: Supported by research in musculoskeletal and women’s health journals.

• Collaborative: Physical therapists frequently partner with dentists, physicians, and other health professionals to maximize outcomes.

5. The Evidence for Treating TMJ Beyond the Jaw

Research confirms that TMJ issues rarely remain isolated to the jaw; they can affect posture, movement, and even the pelvic floor. One study (Garstka et al., 2022) demonstrated that proper jaw alignment can improve standing and walking, highlighting the jaw’s role in overall body mechanics.(2) Another study (Fischer et al., 2009) found that jaw clenching restricted hip movement, whereas a relaxed jaw allowed freer hip motion. (3) Because the hips and pelvis work in tandem, TMJ dysfunction may lead to tension or imbalance in the pelvic floor.

Additionally, organizations like the American Physical Therapy Association advocate for a whole-body approach, reinforcing the idea that jaw-pelvis interconnections matter. If your jaw is tight or misaligned, it can trigger a domino effect that impacts your posture and pelvic health. A comprehensive treatment plan—one that addresses both TMJ and pelvic floor concerns—is key to achieving lasting relief.

Conclusion

Recap and Key Takeaways

• Jaw-to-Pelvis Connection: TMJ dysfunction isn’t just about jaw pain; tension in the jaw can radiate along fascial lines and impact the pelvic floor.

• Postural Influence: Subtle changes in head and neck posture can shift your center of gravity, increasing stress on the lower back and hips—which, in turn, affects the pelvic floor.

• Holistic Approach: Pelvic Physical Therapy provides a thorough, non-invasive way to assess posture, muscle tension, and stress factors, offering a sustainable solution for both TMJ and pelvic floor issues.

If you’re experiencing TMJ-related discomfort and suspect it may be influencing your pelvic health—or vice versa— contact us today and consider scheduling a Pelvic PT evaluation. Early intervention can help you avoid prolonged discomfort and create lasting improvements in daily function.

Remember, even small changes to your alignment or muscle tension can spark powerful, positive shifts throughout your body. By giving attention to both your jaw and pelvic floor, you’re taking a vital step toward total-body wellness—ensuring you feel your best from head to pelvis.

Written By,

Dr. Jana Richardson, PT, DPT, WCS, PRPC, CIDN
Dual Board Certified Pelvic Floor Therapist and Owner of Chicago Pelvic Health

Dr. Jana Richardson is a highly accomplished pelvic floor therapist with dual board certifications and extensive experience in treating complex pelvic floor dysfunctions. As the owner of Chicago Pelvic Health, Dr. Richardson is dedicated to providing personalized and effective care for her patients. With a Doctorate in Physical Therapy, and specialized certifications in Women’s Health and Pelvic Rehabilitation, Dr. Richardson is a leading expert in her field. She is also certified in Integrative Dry Needling, further enhancing her ability to offer comprehensive treatment plans. Dr. Richardson’s commitment to patient-centered care and her passion for helping individuals achieve optimal pelvic health make her an invaluable asset to the community.

References:

1. van der Velde J, Laan E, Everaerd W. Vaginismus, a component of a general defensive reaction. an investigation of pelvic floor muscle activity during exposure to emotion-inducing film excerpts in women with and without vaginismus. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(5):328-31. doi: 10.1007/s001920170035. PMID: 11716000.

2. Garstka AA, Brzózka M, Bitenc-Jasiejko A, Ardan R, Gronwald H, Skomro P, Lietz-Kijak D. Cause-Effect Relationships between Painful TMD and Postural and Functional Changes in the Musculoskeletal System: A Preliminary Report. Pain Res Manag. 2022 Feb 28;2022:1429932. doi: 10.1155/2022/1429932. PMID: 35265232; PMCID: PMC8901334.

3. Fischer MJ, Riedlinger MD, Gutenbrunner C, Bernatek M. Influence of the temporomandibular joint on range of motion of the hip joint in patients with complex regional pain syndrome. J Manipulative Physiol Ther. 2009; Jun;32(5):364-71. doi:10.1016/j.jmpt.2009.04.003.