TEMPORALIS

Proximal attachment: Lateral skull in front of and above the ear in the temporal fossa.

Distal attachment: Coronoid process of the mandible.

Action: Elevation of the mandible, closing the jaw; posterior fibers act in retraction of the mandible. Acting unilaterally: deviation of the mandible to the same side.

Palpation: To locate the temporalis, spread the fingers across the muscle just posterior to the temples and above the ears. Gentle compression of the rear teeth will produce contraction of the muscle, which will be easily experienced under the palpating hand

Palpate temporalis moving caudal to its attachment at the coronoid process of the mandible. With the mouth relaxed and open, identify trigger points in various portions of the belly of the muscle using a cross-fiber palpating technique. Trigger points that occur at the junction of the muscle fibers and its distal attachment may be found approximately 1 inch above the zygomatic arch.

Pain pattern: Temporal headache and maxillary toothache. Pain extends over the temporal region to the eyebrow, the upper teeth, and occasionally to the maxilla and the temporomandibular joint (TMJ). Trigger points can refer pain, tenderness, and hypersensitivity of the upper teeth to hot, cold, and pressure. Patients rarely complain of restricted jaw movement.

Causative or perpetuating factors: Excessive forward head posture; overuse of the muscle due to gum chewing, jaw clenching, or bruxism; chronic overuse due to an anteriorly displaced temporomandibular joint disc; direct trauma to the muscle caused from a fall or impact to the side of the head; secondary to trigger points in the sternocleidomastoid or upper trapezius.

Satellite trigger points: Contralateral temporalis, ipsilateral masseter, trapezius, sternocleidomastoid.

Affected organ system: Digestive system.

Associated zones, meridians, and points: Lateral zone; Foot Shao Yang Gall Bladder meridian; GB 3–7.

Stretch exercise: Spread the fingers across the muscle, just posterior to the temples and above the ears. Open the mouth as wide as possible and inhale. On the exhale, press upward along the fibers of the muscle.

Strengthening exercise: Due to the nature of this muscle, strengthening exercises are not necessary.

Stretch exercise: Temporalis

Masseter and trigger points

Masseter pain pattern