Micaela Weinberg Physiotherapy

How is the pelvic floor and TMJ connected?

The body works in mysterious ways I always tell my patients, until recently! It has always fascinated me how the body is so intertwined and interconnected and how it works to make us all live our lives the best way we can!


There has been a lot of new research done in the field of pelvic health and the most fascinating link has been found. The link between the TMJ and the pelvic floor. Pelvic floor and TMJ dysfunction is often referred to as comorbidities, meaning they often occur at the same time. Let’s find out why…


The pelvic floor and TMJ anatomy are similar in their complexity with both having many muscles and layers of fascia contributing to its anatomical structure. They are both similar in that movement of one side of the TMJ and pelvis affects the other side and cannot be isolated individually. The pelvic floor is a hammock shaped group of muscles that support the bladder, uterus and rectum in women and the bladder and rectum in men.


The first link I want to talk about is the embryological link so this connection is formed before you are even born. This connection begins in the embryo at day 15. Two depressions form of which one goes on to form the mouth (oropharyngeal membrane) and the other goes on to form the openings of the urinary, reproductive and digestive tracts (cloacal membrane). As the embryo develops, the spine grows between them and they stay connected. Here are side by side comparisons of structures in the pelvis and in the mouth and look how similar they are!



Weird right?


Fascia plays a big role in our body yet it is not really taught in grade 8 biology so here is a pretty simple explanation. You know that hard, white piece of sinew you find when eating a steak? Fascia is like that! It’s the glue in our bodies and connects and supports all blood vessels, muscles, nerves and organs in the body. There is a fascial line that can be traced from the jaw to the pelvis. So if there is tension on one part there may be in the other. When I’ve seen a patient with a very tight pelvic floor and I’ve loosened their jaw they can feel it in their pelvis.


What I’ve noticed with my patients who have jaw issues together with pelvic problems is a tightness in the dura mater of the spine. This sounds very complicated but actually it just has to do with how the spinal fluid moves when one end for example the top (TMJ) is pulling on the bottom (pelvic floor/pelvis). Many of you who have come to us have heard of the dura mater that gets affected by whiplash injuries.


Start bringing awareness to when you are holding your pelvic floor in for the toilet how you clench your teeth.


This brings us to our last link which is stress. The jaw and the pelvic floor are areas where we store a lot of emotions. During stressful times, the hypothalamic-adrenal (HPA) axis creates a series of events in where the hormone cortisol is released from the adrenal cortex in our brain. This triggers our body’s fight or flight response (sympathetic nervous system), and this constant state of being in “survival mode” causes constant contractions of certain muscles. So what do we do when we are stressed? We tighten our bum and our jaw, so we are tightening our TMJ and our pelvic floor!.


I know, this is a lot of information to take in! But to bring it back to the basics, if you have issues in your TMJ and your pelvic floor now you know how they are connected. Understanding the connection between the two helps me as a physiotherapist with a special interest in the TMJ and pelvic floor to treat my patients in the best, holistic way!

Yours truly in pelvic floor and TMJ,