The poll, TMJ and teeth triangle
The poll, the TMJ and the teeth influence each other in a big way, so it's important to always address all three when addressing one of them.
The TMJ is connected to the rest of the body via the superficial fascial lines, which means dysfunction here can impact the entire body.
This week I would like to talk a little but about three important areas in the horse's body that have a huge impact on movement and overall wellbeing – the poll, the teeth and the TMJ (temporomandibular or jaw joint). These three have a big impact on one another, so it's important to always address all of them.
The balance of the teeth will directly affect the biomechanics of the TMJ, which will in turn influence the function of the poll. But it goes the other way around too. Tightness in the poll can transfer to the TMJ, effecting its biomechanics. The altered biomechanis of the joint can then cause uneven dental wear. Obviously, dysfunction in these areas will cause pain, but it will have broader ranging effects as well. TMJ issues in humans can cause chronic headaches, so it is quite likley that it happens in horses as well. Tightness in the TMJ and poll area might cause the horse to tilt his head, which can impair his sense of balance. If we look at the body from a fascial point of view, both the dorsal and ventral superficial lines end up at the TMJ. Tension here can cause issues down the entire line, all the way to the hind end. Very often horses with TMJ pain have serious tightness around the SI area and a limited range of motion in the hind legs. A seemingly small issue can cause tightness in the entire body.
Unevenly developed chewing muscles can be an indicator of poll-TMJ-teeth issues.
Some symptoms of TMJ-poll-teeth issues include uneven development of the chewing musculature, overdevelopment of the poll and an offset lower jaw. The horse might be very sensitive around the head and might be ear shy. He might be carrying his head tilted or can have issues taking up contact when ridden. In the long run, he might start to lose his neck musculature and have trouble engaging his thoracic sling. If you notice any of these symptoms, it's important to address all three areas. First, I would recommend having the dentist out to sort out any imbalances in the teeth. The dentist visit should be followed up with a visit from the manual therapist to address TMJ and poll tightness and any other dysfunction in the body that might have occured due to compensation.
An offset jaw needs to be addressed by both the dentist and manual therapist.
As with everything, prevention is better than cure, so here are some tips on how to take good care of the poll-TMJ-teeth triangle. Regular dentistry check-ups are a must. A rule of thumb is once a year, but this can vary from horse to horse, so consult your dentist on how often you need to make an appointment for your horse. Avoid any headgear whose buckles or straps go directly across the TMJ. A buckle in the wrong place can do a lot of damage and cause a lot of pain, but it's something that's easy to avoid. If you are unsure, get a profesional out to help you with halter and bridle fit. Avoid things that put too much pressure on the poll, like yanking on the lead rope while leading, too much rein pressure or prolonged use of lunging aids (any use of lunging aids is extremely tricky, but let's not get into that). If you are feeding your horse from hay nets, get his poll and neck area checked regularly, to make sure he is not developing tension patterns in this area. With proper care, most poll-TMJ-teeth issues can be avoided, but we need to make sure to always keep an eye on this sensitive area.