TMJ & Vestibular Specialist
Sarah Kennedy BHSc PT MCSP HPC CCTT
Sarah completed her BHSc in Physiotherapy from Auckland University of Technology in 2005. She is a Board Certified Cervical (neck) and Temporomandibular (jaw) Therapist via the American Academy of Orofacial Pain and has completed Advanced training in Vestibular Rehabilitation. Where as many physiotherapists would only encounter TMJ and vestibular conditions very occasionally, and perhaps have very preliminary training in these areas, Sarah has focused the bulk of her clinical experience on TMJ and Vestibular conditions in private practice and has worked with audiologists, ENTs, dentists and orofacial pain specialists. In addition to specific TMJ and vestibular exercises, Sarah incorporates Orthopaedic Manual Therapy and Stecco Fascial Manipulation into patient care.
Temporomandibular Dysfunction (TMD)
“The temporomandibular joint (TMJ) is located just in front of the ear on either side of the face and attaches the lower jaw to the rest of the skull. Temporomandibular Dysfunction (TMD) is a blanket term which covers any number of problems affecting the normal function of the jaw. Symptoms may include jaw pain, neck pain, clicking or noises in the jaw, difficulty opening the jaw, headaches, ear discomfort, ringing in the ears, a sensation of ears being blocked, altered facial sensation, fascial sensitivity, dizziness or fatigue. Symptoms may be exacerbated when talking or chewing. The TMJs may become inflamed and the muscles of chewing may become over-active and tight.
Individuals with TMD may notice these symptoms develop gradually, over time, or they may be related to a particular incident such as a car accident, a jaw dislocation or following significant oral surgery. Many TMD conditions can resolve completely, where as others may persist and require a plan for long-term management.
Physiotherapy can play an important role in diagnosing and managing TMD conditions. Treatment often includes education on how to care for your jaw, jaw exercises, soft tissue techniques, mobilization of the jaw, ultrasound, application of ice or heat, and relaxation techniques. Soft tissue therapy can often be helpful when ongoing soft tissue techniques are needed for pain relief. Other areas with musculoskeletal problems, such as the neck or shoulder, may also need to be addressed.
You do not require a referral to seek TMD treatment from a physiotherapist, however, physiotherapy may be recommended by your doctor, dentist, or oral medicine specialist. Your physiotherapist can communicate and work with these healthcare providers to optimize your treatment.”
Vestibular Rehabilitation for balance, vertigo and dizziness
“Our ability to remain balanced when upright and to stabilize our eye movements is largely determined by the function of our vestibular system. This system is comprised of the vestibular apparatus in the inner ear and the parts of the brain that process balance information.
When there is a problem in the vestibular system an individual may experience some of the following symptoms: a sensation that the room is spinning, a feeling of moving when at rest, nausea, dizziness, motion sensitivity, light sensitivity, noise sensitivity, blurry vision, double vision, imbalance, and hearing changes.
Many conditions which cause dizziness can be improved with physiotherapy. You may have already been diagnosed with a vestibular problem that is appropriate for physiotherapy intervention. These include, but are not limited to, Benign Paroxysmal Positional Vertigo (BPPV), vestibular neuritis, labyrinthitis, inner ear infection, Ménière’s disease, or post-traumatic vertigo (following a head injury or car accident).
A vestibular assessment will involve filling out a questionnaire, discussing the history of your condition in detail, and a series of head positioning tests, vision tests and balance tests specific to your condition. Treatment may involve manual techniques performed by the therapist as well as balance, vision and coordination exercises. Testing my provoke some of your symptoms and it is recommended that you do not plan to drive yourself home after your first visit.
If you are unsure if you could benefit from a vestibular assessment please contact Physiotherapy London to speak with a therapist before booking an assessment. Some conditions involving dizziness cannot be improved with physiotherapy. These include dizziness from cardiovascular disease, vertebral artery insufficiency, medication induced dizziness, postural hypotension, auditory and visual system dysfunction. Our therapist may recommend that you see your physician prior to booking your appointment.”