Integrating Japanese Eastern medicine with Western medicine.

Mariano Rocabado Trained Synovial Temporomandibular joint(TMJ) Therapist

TMJ Tempromandibular joint

Discover Relief from Temporomandibular Disorders(TMD) and Craniofacial Pain with Rocabado Trained therapist at FuncPhysio Physical Therapy in New York.

Did you know that approximately 75% of Americans have experienced signs or symptoms of Temporomandibular Disorder (TMD) and Craniofacial Pain (CFP)? While most TMD symptoms come and go on their own, about 5-10% of individuals in the U.S. require professional treatment. TMD and CFP are complex conditions, often involving multiple symptoms and causes. The pain can appear suddenly due to trauma, can develop gradually, and/or can appear suddenly due to tissue damage by repetitive stress over time. Simple clicking sounds in your Temporomandibular joint (TMJ) may suddenly become a severe TMD condition.

The Signs and Symptoms of TMD are as Follows but not Limited To:

  • Jaw discomfort or soreness (often most prevalent in the morning or late afternoon)
  • Headaches
  • Pain spreading behind the eyes, in the face, shoulder, neck, and/or back
  • Earaches or ringing in the ears (not caused by an infection of the inner ear canal)
  • Clicking, popping, or gliding sound of the jaw
  • Locking of the jaw
  • Limited mouth motions
  • Clenching or grinding of the teeth
  • Dizziness
  • Sensitivity of the teeth without the presence of an oral health disease
  • A change in the way the upper and lower teeth fit together

Possible Causes of Temporomandibular Disorders (TMD)

  • Poor posture, straight neck posture
  • Neck and upper back restriction, tight facial/mouth muscles/myofascial trigger points
  • Trauma or whiplash
  • Maloccution and your bite habit
  • Clenching or grinding
  • Mouth breathing
  • Parafunctional habits: nail biting, frowning, chewing on pencils, biting ice cubes, etc

How do Rocabado trained physical therapists at FuncPhysio in New York can help your TMD condition?

Dr. Rocabado treatment

The good news is that you don’t have to suffer in silence. At FuncPhysio Physical Therapy in New York, we specialize in providing effective, conservative (reversible) therapy for TMD and CFP. Scientific research shows that over 50% of TMD patients treated with conservative management experience significant relief, with few or no ongoing symptoms.

We work with our dentists who took Mariano Rocabado’s course and/or PRI course and understand a holistic view of your jaw. Our multidisciplinary integrative approach will address not only your jaw and teeth but also your craniofacial, craniovertebral, thoracic cage, and pelvic function to restore TMJ function. Most patients suffering from TMD achieve good long-term relief with holistic conservative therapy with an interdisciplinary approach by dentists and physical therapists.

Mariano Rocabado, Yohei Takada, and dentist friends.

In order to manage TMJ condition, Rocabado therapists understand and provide the treatment for Craniocervical & Craniomandibular biomechanics and pathophysiology. This holistic approach to Craniocervical & Craniomandibular joint is the only solution to TMJ issues. This means the multidisciplinary approach by orthopedic manual therapists and dentists is necessary to help your Temporomandibular disorders.

Rocabado trained therapist is to make an effort on the alignment of your cranium and mandible with the cranial base. You might have heard of centric relation in your teeth, however, you also have to have craniovertebra centric relation. Craniovertebral centric relation describes the exquisite equilibrium between the Atlas and Axis vertebrae. This harmony is vital, as it impacts 50% of your craniocervical unit’s function. If you do not have the craniovertebral centric relation, it is impossible to achieve the true centric relation of your teeth because your cranium is asymmetrically balanced.

Centric relation of craniocervical joint and TMJ: Picture from Rocabad seminar 11-2-2023

In physical therapy, restoring craniovertebral centric relation becomes very important and it will be the foundation for your TMJ function. The three-dimensional balance between your cranium and upper cervical spine gives you a stable position for the condyles of the occiput over the Atlas, creating an ideal balance for your head and neck.

Our focus is on achieving that perfect craniovertebral centric relation and ensuring congruency in your upper cervical spine and your occiput, which gives the balanced functional position for your TMJ. This Craniovertebral centric relation must happen for your functional TMJ and the true centric occlusion of your teeth.

Prof. Mariano Rocabado is assessing upper cervical spine on Yohei Takada

Anatomy and Biomechanics of TMJ and Craniovertebral Joints

Understanding the temporomandibular joint’s intricate details, especially the synovial joints and their relationship with the cranium, is paramount. It’s all about keeping your head level in both the sagittal and coronal planes, ensuring the TMJ disc sits horizontally. This understanding helps us place the condyle correctly in relation to the disc and within the fossa for optimal function.

Prof. Rocabado explains the disc/condyle relation and it’s pathologies

The disc’s concave surface is the key to stability in a joint with two convex surfaces facing each other. This stability matters because 50% of your TMJ function relies on the inferior synovium and 50% on the superior synovium.

Dr. Rocabado emphasizes on restoring the craniovertebral angle between C2 and the base of the occiput. This angle should be between 96 to 106 degrees for your TMJ to function appropriately.

Craniovertebral Angle: a picture from Rocabado lecture 11-2-2023

Also the craniovertebral angle in front veiw is also very important as it give you uneven base for your occiput and temporal bone. This angle create the TMJ deviation with 1:3 ratio (one mm of atlas angle create three mm of TMJ angle: CANT)

Our job as a physical therapist is to restore this angle in sagital, frontal and horizontal planes. Orthopedic manual therapy and exercises are very useful in treating craniovertebral positional issues.

Rotation of Atlas affecting TMJ: picture from Rocabado course 11-2-2023

Why do patients with TMD have the symptom of headache, facial pain, dizziness, and/or ear ringing?

Many patients who suffer from TMD develop the symptom such as neck pain, headache, facial pain, dizziness, and/or ear ringing. This is because that when TMJ is out of alignment or damaged, that often adds pressure on the trigeminal nerve . The trigeminal nerve root is located to just next to the TMJ and it provides sensory innervation to the face. TMJ malfunction often compress and irritate the trigeminal nerve. When it happens, person may develop the symptom such as neck pain, headache, facial pain, dizziness, and/or ear ringing(often refer as trigeminal neuralgia).

The upper cervical spine issues also create the same type of pain because the trigeminal cervical nucleus is situated in the upper cervical spinal cord. Therefore it could produce the same pain but with different causes; one is due to upper cervical spine issue and one is due to TMD.

With our team dentists, we’re committed to helping you restore harmony in your craniovertebral region and craniofacial region ensuring that you find relief from TMD symptoms. Rocabado trained physical therapist at FuncPhysio Physical Therapy in New York, our therapist specialize in helping patients find comfort from Temporomandibular Disorder (TMD).

Rocabado Trained Physical Therapist in New York City

Dr. Mariano Rocabado at Synergy Orthodontic Seminars

Dr. Mariano Rocabado

Prof. Marioano Rocabado

Mariano Rocabado is a renowned physical therapist and educator who has made significant contributions to the field of craniofacial and temporomandibular joint (TMJ) therapy. His work is highly regarded for its holistic approach to treating various conditions related to the head, neck, and jaw.

Dr. Rocabado, DPT is currently Dean of the Faculty of Rehabilitation Sciences University Andres Bello, Santiago of Chile. Further, he is Professor of Head Neck Biomechanics. Post Graduate Program, Faculty of Rehabilitation Science, University Andres Bello, Santiago, Chile and Director of CEDIME (Centro de Estudios de las Disfunciones Músculo Esqueléticas).

He is the author of a number of books including on head and neck biomechanics and pain, and exercise. He is an Honorary Member of the American Academy of Orofacial Pain and the American Academy of Craniofacial pain, Founder Member and past President of the Chilean Academy of Craniomandibular disorders and facial pain. He is also a Founder and Honorary Member of the Brazilean Academy of Craniomandibular, Craniocervical  Disorders and Facial Pain. Furthermore, Professor Rocabado is a Founder Member and Past President of the Iberian Latin American Academy of Head Neck and Facial pain. He was a Founder Member of the Italian Craniomandibular and Orofacial pain Academy.

Professor Rocabado is an Honorary Member of the Argentinean Association of Physiatry and Kinesiology, the Colombian Physical Therapy Association, and the Chilean Orthodontic Society. He is a member of the American Academy of Orthopedic Manual Therapy and Patron of the Norwegian Manual Therapy Group, Australia.

He is an editorial board member of the craniomandibular practice journal, Cranio and Orthopedic and Manual Therapy.

PTs and dentists at Mariano Rocabado’s seminar