TMJ and the Pelvic Floor Connection

Written By Angelique Montano-Bresolin

Molly Drazin, PT, DPT

Pelvic Floor and TMJ Physiotherapist

When you think about the jaw and the pelvis, you probably picture them at opposite ends of the body — and you’d be right. The jaw sits in the head, while the pelvis is located at the base of the spine. So how could these two areas possibly be connected, and why does it matter if you’re dealing with jaw or pelvic floor concerns? Exploring the body as an integrated system — especially the connection between the jaw and the pelvic floor — can make a meaningful difference in treatment and recovery.

Key Points

  • TMJ dysfunction is very common, and individualized physiotherapy treatment can provide relief of symptoms and improve daily jaw function.

  • The jaw and pelvic floor are connected in multiple ways—anatomically, posturally, and behaviorally through stress response.

  • It is important to consider the TMJ in cases of pelvic floor dysfunction, and vice versa, as addressing these shared connections can improve treatment outcomes in both regions.

What is TMJ Dysfunction?

The temporomandibular joint (TMJ) is a connection between the mandible (jawbone) and temporal bone (part of your skull). You use this joint for all mouth functions - like talking, eating and yawning. Temporomandibular dysfunction (TMD) also referred to as TMJ dysfunction can occur when there is an issue with this joint or the face muscles that help control its movements. TMD is incredibly common, affecting an estimated 10–30% of the general population. Despite its high prevalence, many people experience only mild symptoms and never seek medical care.

Common TMD symptoms include:

  • Jaw pain, stiffness or tightness

  • TMJ Clicking, popping, clunking sensations

  • Restricted mouth opening

  • Difficulty with jaw movements (e.g. eating or speaking)

  • Headaches

What Causes TMJ Dysfunction?

Despite ongoing research, the etiology of TMD remains somewhat controversial across medical disciplines. While the exact cause of TMD cannot be determined with certainty, evidence suggests it is associated with several risk factors.

Common TMD risk factors include:

  • Habitual jaw clenching: bruxism, nail biting, excessive gum chewing

  • Hypermobility: in the jaw and elsewhere in the body

  • Psychological factors: depression, anxiety, stress

  • Sex differences: TMD is more commonly reported in females than males

  • Poor posture

The Jaw-Pelvis Connection

The body is made up of many interconnected systems, including the skeletal, muscular, and nervous systems. Although the jaw and pelvis sit at opposite ends of the spine, they are linked through these systems in several ways. We’ll explore this connection through anatomy, posture, and the nervous system’s response to stress.

1. Anatomical Connection

The pelvis and the jaw are both a part of the “Deep Front Line” as described in fascial anatomy. Fascia is a continuous network of connective tissue that wraps around all body structures - including muscle and bone. Because of this anatomical connection, tension in the jaw can result in symptoms in the pelvic floor muscles, and vice versa. In the clinic, this commonly presents during pelvic floor release work—when the jaw suddenly tenses or clenches without the person even realizing it.

2. Postural Deviations

We’ve all heard the advice to “sit up straight,” but long hours at a desk or poorly set-up work-from-home spaces often lead to poor posture. This can cause muscle imbalances at either end of the spine – the jaw at the top and the pelvis at the base – and creates a chain reaction throughout the rest of the body as it works to keep you upright. These postural deviations can contribute to tension, pain, and difficulty coordinating movement. Because of this close relationship, postural education is an essential part of physiotherapy treatment for both jaw and pelvic health concerns.

3. Habitual Stress response

Mental and emotional stress often gets stored in the body. Two common areas where this shows up are through unconscious clenching in the jaw and the pelvic floor muscles. When we repeatedly tense these muscles in response to stress, the brain begins to link our mental and emotional state with physical tension, creating a habitual pattern. Retraining the body to break these harmful patterns while focusing on restorative movement is key for treating each of these areas.

What Does the Research Say?

Emerging research continues to support the connection between the jaw and pelvic floor muscles. A 2024 randomized controlled trial found that a 15-minute soft tissue therapy session on the TMJ significantly lowered resting activity in the pelvic floor muscles and improved the ability to relax these muscles. This research supports what is commonly seen in clinical practice – releasing in one area helps the other relax as well. This powerful link highlights how interconnected our bodies are, and why addressing both areas can lead to more effective, lasting results.

What to Expect for Treatment?

Your first visit will begin with a discussion of your symptoms, functional concerns, and goals for physiotherapy. Based on your primary concern, the assessment will focus on the TMJ and/or the pelvic floor. This may include palpation of the face and jaw muscles, or assessment of the pelvic floor through an external and/or internal exam. It may also involve observing jaw or pelvic floor movement, as well as evaluating posture and breathing patterns. All exam components will be explained beforehand and performed only with your informed consent and comfort in mind.

Based on the findings, your physiotherapist will develop an individualized treatment plan and review it with you before beginning.

Treatment techniques may include:

  • Manual soft tissue release work

  • Therapeutic exercises to strengthen or relax jaw and pelvic floor muscles

  • Neuromuscular rehabilitation to retrain movement patterns

  • Education on posture and ergonomics

  • Breathing and mindfulness techniques

  • Learning to relax both the jaw and pelvic floor

Conclusion

If you are struggling with persistent jaw or pelvic floor pain and dysfunction, skilled physiotherapy can help. Through a combination of hands-on techniques, education and simple exercises, physiotherapy can help you improve body awareness, restore movement and function, and support your overall well-being. The more we tune in to these links and see the body as an integrated system, the more we can move and live with greater ease and comfort.

Interested in learning more? Book a free 15-minute consult with TMJ and pelvic floor physiotherapist Molly Drazin at Proactive Pelvic Health.

References

Sulowska-Daszyk, I., Gamrot, S., & Handzlik-Waszkiewicz, P. (2024). A Single Session of Temporomandibular Joint Soft Tissue Therapy and Its Effect on Pelvic Floor Muscles Activity in Women-A Randomized Controlled Trial. Journal of clinical medicine, 13(23), 7037. https://doi.org/10.3390/jcm13237037

Angelique Montano-Bresolin
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