Have you ever wondered if your incontinence could be related to your TMJ pain?

Have you ever considered that your teeth grinding may be connected to your snoring and need to wake in the middle of the night to use the restroom?

How the pelvic floor and jaw are connected for sleep apnea, breathing and bladder and bowel support.

You may be thinking, “HOW?! How does my pelvic floor relate to my jaw?” and I’m here to tell ya that it may be more connected than you think.

The physical connections

🌸EMBRYOLOGICAL CONNECTION: Around day 15 of embryo development we have what’s called the gastrulation phase. During this time two depressions form next to each other. One goes on to create the opening of the mouth while the other forms the opening of the urethra (where you pee), anus and reproductive organs.

🌸FASCIAL CONNECTION: Fascia is the connective tissue that holds bones, muscles, organs, blood vessels and the rest of the body parts in place. The fascia can hold tension in one area and can cause tension in another area. The good news is that just as tension can transfer throughout the system, so can relaxation!

🌸MIRROR CONNECTION: Have you ever looked at both the anatomical structure of both the uterus and the larynx or the vocal chords and pelvic floor? How about the cervix and vaginal canal? There is a beautiful drawing by Luisa Alexdre that show how they resemble each other.

🌸VAGUS NERVE: Oh gosh, I love this connection. The vagus nerve is a long nerve that is connected to the back of the tongue, the vocal cords and the uterus! This nerve is frequently used to tap into the brain to help the brain and body calm down as the vagus nerve is aprt of the parasympathetic nervous system which helps us feel safe and connected.

🌸CANISTER SYSTEM: Every single time we inhale our abdomens fill with air (increased intra-abdominal pressure). We want this pressure to be well-managed…like a pop can. When the pop can is full and stable, the pressure is well managed and it is hard to bend, break or damage the can. Our body is the can with our throats being the top of the can and the pelvic floor being the bottom, our abdomen and low back are the sides of the can. These areas all work together to create a stable canister.

🌸RESEARCH: Yeah, I’m a nerd so I’m including research here. There are a couple of really awesome studies that reflect how the jaw and pelvic floor are connected. There is one study that highlighted that tempormandibular joing dysfunction (TMJ pain) can restrict hip range of motion and by working on one, it can improve the other (Fischer 2009). Another study showed that obstructive sleep apnea is associated with overactive bladder and urge incontinence (Helene 2009).

Feeling the Physical connection

🌺While paying attention to your pelvic floor, stick your thumb in your mouth right behind your front top two teeth. Suck really hard on your thumb while paying attention to your pelvic floor. You may notice that your pelvic floor naturally lifts away from the chair as you do this.

🌺If you read Ina May Gaskin’s pregnancy books you probably remember her emphasizing relaxing the jaw to relax the pelvic floor. Ina May coined the term “sphincter law” to refer to relaxing the jaw to relax the butt/pelvic floor in labor. That is just as important throughout our daily living as clenching the jaw tightens and lifts the pelvic floor just as relaxing the jaw helps the pelvic floor relax.

🌺Sing. Hum. Moan or Groan. Take deep low sighs. Those low tones naturally relax the pelvic floor. Sometimes if a client is having a hard time with having a bowel movement, I will have them sit on the toilet and practice these while trying to poop. If they are really having a hard time making this connection, they can brush their teeth with an electric toothbrush while on the toilet because it is hard to tighten the jaw and the vibration from the toothbrush can help relax the muscles.

The Emotional Connection of jaw and pelvic floor

🌸STRESSORS: There are two common things I hear from a lot of my Type A mamas, “I hold stress in jaw or upper back” and “I leak more when I’m stressed”. The physical connection leads to these changes but they are also areas where we “hold stress” or tension when anxious. It’s pretty common to grind your teeth or tighten your pelvic floor when we are stressed. There was a really neat study that showed when people were shown a threatening video there was increased tension/muscle activation in the upper trap (shoulder/neck) and pelvic floor. (Van der Velde et al. 2000 & 2001).

🌸TRADITIONAL CHINESE MEDICINE: In acupuncture, the gallbladder meridian (where energy flows) runs along the jaw and through the pelvis. The gallbladder is in charge of decision-making and it’s partner, the liver, is connected to anger (and stress). If you notice that you frequently wake at 3am (when the liver is in charge) to use the restroom or you are constantly clenching your jaw, it may be time to check-in with your emotions and release them rather than hide from them.

What can i do to support the jaw and pelvis connection?

🌺Deep 360 degree breathing! Fun fact, the intestines can move almost one inch near the kidneys. So if you find yourself constipated (which is linked to incontinence), deep breathing can give your intestines a massage and help them move more freely.

🌺Airway-focused dentist and myofunctional therapist: These professionals focus on how the tongue and mouth are working from a wholistic approach. I have been nothing but amazed at how they can work with people to ease TMJ pain, grinding/clenching and snoring (when caused by the tongue and mouth). Dentists can help with the root cause while myofunctional therapists can re-train the tongue to work more optimally.

🌺Guided imagery or progressive relaxation: Simple visualizations, meditations and relaxation of the jaw and pelvic floor can help the other relax.

🌺Yoga or movement practices: There are poses that relax the pelvic floor and jaw like happy baby, deep squats, elevated pigeon, cat-cow pose. Just check in to make sure your tongue is resting on the roof of your mouth and you aren’t clenching your jaw at this time!

🌺Awareness: Like most journeys, this takes time, practice and giving yourself a little grace. Even daily reminders add up and can help you calm the jaw and pelvic floor.

References

Van der Velde, J., & Everaerd, W. (2001). The relationship between involuntary pelvic floor muscle activity, muscle awareness and experienced threat in women with and without vaginismus. Behaviour Research and Therapy, 39(4), 395–408. doi:10.1016/s0005-7967(00)00007-3

Van der Velde, J., Laan, E., & Everaerd, W. (2000). Vaginismus, a component of a general defensive reaction. An investigation of pelvic floor muscle activity during exposure to emotion inducing film excerpts in women with and without vaginismus. Submitted

Fischer MJ, Riedlinger K, Gutenbrunner C, Bernateck M. Influence of the temporomandibular joint on range of motion of the hip joint in patients with complex regional pain syndrome. J Manipulative Physiol Ther. 2009 Jun;32(5):364-71. doi: 10.1016/j.jmpt.2009.04.003. PMID: 19539119

emmer, Helene et al. “Obstructive sleep apnea syndrome is associated with overactive bladder and urgency incontinence in men.” Sleep vol. 32,2 (2009): 271-5. doi:10.1093/sleep/32.2.271