All of the trigger points (TrPs) for TMJ are located in the TMJ muscles and not in the temporomandibular joint (TMJ) capsule.
The very definition of a TrP is an extremely tender spot which lie in discrete taut bands of hardened muscle. Depending on whether they are active or latent, they may produce localized or referred pain to surrounding areas. It is often mistaken as a toothache.
Since trigger points originate from muscles, they're alternatively referred to as myofascial trigger points. Sometimes they can also be called other names such as:
Muscle knots
Pressure points
Consequently since they originate from and are located in muscles, the TMJ itself cannot be the source for any trigger points. The temporomandibular joint consists of just a disc and two pieces of bone.
However the TMJ does not move all on its own because there are four TMJ muscles which move the joint. These four muscles are the source of TMJ trigger points since TrPs reside within muscle. They're also known as the muscles of mastication.
Trigger Points for Masticatory muscles:
TMJ trigger point for temporalis muscle
Temporalis trigger points may be located anywhere along the fibers of the muscle. As its name implies, the temporalis muscle can be found around your temples and it is shaped like a fan.
However the muscle covers a much larger area of your skull than what you may have initially expected. In order to find all of the pressure points you will need to understand where the muscle originates and inserts.
Temporalis muscle attachments:
Origin - Temporal fossa
Insertion - Coronoid process of mandible
How to find the muscle knots
Start at the top of your head.
With firm pressure, start pressing into the muscle.
Follow the direction of the muscle fibers and proceed pressing downwards.
Repeat for each strand of muscle fiber.
Basically you want to trace out the entire temporalis muscle.
The location of these muscle knots are highly individual so that means they'll be unique to you. No two people will have the trigger points in the same spot. What this means is that you'll need to explore and find them all on your own by palpating the entire length of the temporalis.
You'll know when you've found the trigger point because it'll feel very tender. Note where the knot is located but make sure to explore the entirety of the muscle because you can have more than one TrP.
How to release pressure points in the temporalis
Once you've found the pressure point in the temporalis, this technique will be used to release the muscle knot at its source. For now, keep your mouth closed while you do this.
Apply firm pressure with your fingers into the temporalis trigger point.
Hold for 10-20 seconds (you can rub slightly up and down).
Release and rest for a minute.
Repeat steps 2-3 two more times.
After you release the middle of the source, you should try to release any taut bands of muscle around the periphery of the trigger point. This will be more of a TMJ massage.
Apply pressure into the trigger point for the temporalis.
Instead of holding it there, start making circular motions along the periphery.
Do the circular motions for 10-20 seconds.
Release and rest for a minute.
Repeat all of the steps two more times.
Last but not least, you need to also release the muscle in its stretched position. Basically what you want to do is keep your mouth open and then try to massage out this TMJ muscle.
Repeat the entire process for releasing the muscle knot at its source.
Repeat again for releasing the pressure point at the periphery.
You can release the muscle in this fashion 2-3x a day. However you should be aware that doing it too much such as the entire day will not be helpful. The entire purpose is to release the knot and get blood flow into the area. The rest is up to your body to do its job healing it.
TMJ trigger point for masseter muscle
Masseter trigger points can be located along the entire belly of the muscle. This muscle basically starts right underneath your cheek bones and runs obliquely to the corner of your jaw near your throat.
If you have trouble finding it, place both of your hands on your jaw like you're saying "oh my god". Clench your teeth together and you should feel the masseter muscle contract.
Masseter muscle attachments:
Origin - Zygomatic arch (right underneath your cheek bones)
Insertion - Angle and lateral surface of ramus of the mandible (corner of your jaw)
How to find the masseter's muscle knots
Start right underneath of your cheek bones.
Apply firm pressure and keep pressing as you follow the muscle fibers down.
Go all the way down to the corner of your jaw.
Repeat for each muscle fiber of the masseter.
In our experience, there are usually two common locations for where the trigger points for masseter are located.
Inferior location - this is usually the most prominent knot and it is near the angle of the mandible. In other words, near the corner of your jaw. It also tends to be extremely painful when you press on it.
Superior location - this one is close to underneath the cheek bone. This one tends to be more painful when you have your mouth open.
However everyone is different so some people may only have one pressure point. The unfortunate ones may have more than two!
How to release pressure points in the masseter
Once you've found the pressure points in the masseter, you will need to release the muscle knot at its source. Keep your mouth closed while you do this.
Apply firm pressure with your fingers into the masseter's trigger point.
Hold for 10-20 seconds (you can rub slightly up and down).
Release and rest for a minute.
Repeat steps 2-3 two more times.
After you release the middle of the source, you should try to release any taut bands of muscle around the periphery of the trigger point. This will be similar to a TMJ massage.
Apply pressure into the trigger point for the masseter.
Start making circular motions along the periphery of the muscle.
Do the circular motions for 10-20 seconds.
Release and rest for a minute.
Repeat the steps two more times.
Last but not least, you need to also release the muscle in its stretched position. Hold your mouth open and then try to massage out the muscle.
Repeat the process for releasing the muscle knot at its source.
Repeat again for releasing the pressure point at the periphery.
You can do all three of these releases about 2-3x a day. Any more than that wouldn't really be that beneficial. It is preferable that you separate it out into multiple days instead of doing a TMJ massage marathon on a single day.
Here is a video of how to massage the masseter and release all of its pressure points:
The video is just a visual for some of the steps but you should follow what we have outlined since it is more comprehensive than the video.
Trigger point for the lateral pterygoid muscle
Finding and releasing the trigger points for the lateral pterygoid may be difficult for most people. What sets it apart from the temporalis and masseter is that in order to find and release this one, you need to put your finger in your mouth.
Yes, you read that correctly. You need to massage this muscle from the inside of your mouth because that is the only way to reach this hidden TMJ muscle.
Muscle attachments:
Origin - superior head (infratemporal surface of sphenoid bone); inferior head (lateral pterygoid plate)
Insertion - superior head (anterior side of mandibular condyle); inferior head (pterygoid fovea)
How to release muscle knots in the lateral pterygoid
In order to release the pressure points in the lateral pterygoid muscle, you must be able to locate it first. In our experience, there is usually just one trigger point for this TMJ muscle but the challenge is being able to reach it.
How to find it:
Stick your right pointer finger inside your mouth with the finger nail facing your teeth. The fleshy part of your finger should point out towards your ear.
Slide your finger against the upper teeth and all the way towards the last molar.
Slide it further back beyond the last molar.
Press straight backwards and also curl your finger in a massaging motion towards your ear.
If the lateral pterygoid is tender you should feel it immediately in one particular spot.
How to release it:
Once you've found the lateral pterygoid's pressure point, you can hold the pressure with your finger for 10-20 sconds.
Alternatively you can also make massaging motions by curling your finger.
Release and rest for 1 minute.
Repeat the exercises two more times.
After you're done with one side, move to the other side with your other finger.
There isn't as much variation for this muscle as opposed to the larger temporalis and masseter since it is much smaller in surface area. The entire palpable area of the muscle inside your mouth is less than inch.
Its small size and location inside the mouth will make it difficult for you to find and release the muscle knot. If you're not able to, you may need to see your dentist, physical therapist, or massage therapist in order to get to it. They'll teach you and guide you on how to find it.
Trigger point for the medial pterygoid muscle
Finding the trigger points for the TMJ muscle, the medial pterygoid is probably the most elusive and difficult to do. The major reason is because the muscle is located inside your mouth. You will have to stick your finger inside your mouth in order to massage it and it may activate your gag reflexes if you have a strong one.
The photo above is showing where the medial pterygoid is located if you look from behind and underneath a person's skull. The muscle is literally located within the skull and not on the outside. This means you won't really be able to find it by massaging the exterior of your face.
Here is a different image of where this TMJ muscle is located. This is with the mandible or jaw bone cut away which exposes the location of the muscle. Once again we are stressing that it is located on the inside of your mouth. In order to get to these muscle knots, you will have to go inside of your mouth.
Muscle attachments:
Origins - Deep head (medial side of lateral pterygoid plate); superficial head (pyramidal process of palatine bone)
Insertions - Medial angle of the mandible
How to release muscle knots in the medial pterygoid
The majority of the muscle is located on the inside of the mouth but you can reach a small portion of it on the outside. There are 3 ways release the medial pterygoid's trigger points.
How to release the pressure points from the outside:
Find the angle of your mandible (corner of the back of your jaw).
Hook your thumb under and up into the jaw.
Lightly massage to find any pressure points. It may be uncomfortable so do it very gently.
How to release the pressure points from the inside:
Using your opposing pointer finger and hover above the chewing surface of the teeth.
Keep sliding it back until you hit bone.
Slide your finger further back until you reach a fleshy part with your finger.
Lightly massage up and down.
How to release the trigger point from below the bottom back teeth:
Using your opposing pointer, follow the chewing surfaces of the back teeth to the last molar.
Drop your finger and slide it down below the teeth.
Move your finger further back until you find the muscle.
Lightly massage it.
The medial pterygoid is very difficult to find and release. We do recommend watching this video for visual demonstration.
Takeaway
The temporomandibular joint (TMJ) does not have any trigger points since it consists of just a disc and two bones. However the TMJ muscles which act on the TMJ can develop muscle knots from overuse. It is due to the trigger points in the TMJ muscles which refer pain to the joint.
Therefore the only way to release these muscle knots, you will need to find and massage each individual TMJ muscles. There are four of these muscles and they're also known as the muscles of mastication. Basically they control the jaw whenever you open and close.
