And today I am doing part two of a two part lecture on treating TMJ with motor points, scalp acupuncture, and submuscular needling.
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Hi, my name is Michelle Gellis. I’m an acupuncture physician and I teach cosmetic and facial acupuncture classes internationally. And today I am doing part two of a two part lecture on treating TMJ with motor points, scalp acupuncture, and submuscular needling. So if you can go to the first slide,
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I previously was a former, I’m a former faculty member and clinic supervisor at the University, Maryland University of Integrative Health. I was there for almost 20 years and I’m currently on the doctoral faculty at Yoson University. I’ve writtenly written. I’ve recently written a book on treating the face.
It is a comprehensive guide, covering everything from the five element treatment of the face to cosmetic acupuncture, treating neuromuscular facial conditions, facial cupping, gua sha, microneedling, red light therapy, and many other. So you might want to check that out. So last time I spoke about TMJ and its etiology, its symptoms, treatments.
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As far as some Western medicine theory and TCM theory, and today I am going to go over a multifaceted approach to treating TMJ because it is a very common condition that we will see in our patients. The underlying theory in my treatment protocol is that neuromuscular facial conditions such as Bell’s palsy, TMJ, myasthenia gravis, and others can best be treated using a multifaceted approach.
So today we are going to talk about three of those. Scalp acupuncture, Facial motor points and submuscular needling. Scalp acupuncture is actually a fairly modern technique in our medicine. It’s only been around since the 1950s and really became popular in the 1970s. And we use our needles to stimulate different areas of the scalp, which stimulate different areas of the brain, which control different parts of our body.
And it is not based on acupuncture points. It is based on neuroanatomy and it makes it Very beneficial for treating the face because frequently when people have certain conditions that are very painful, it’s hard to do localized treatment. But by treating the scalp, we can affect. the face. So there’s three main areas that we would look at when thinking about treating, using scalp acupuncture to treat the face.
And that would be the motor area, the sensory area, and the foot motor sensory area. And depending on the condition, whether it’s more motor function or sensory meaning pain or neuropathy, you would choose the particular area. So again, it’s based on neuroanatomy. Basically, on the homunculus.
So looking at this, the face takes up a really large section of the brain area. So this is motor and this is sensory. And you are going to be needling horizontally through this loose connective tissue. So we have the scalp, the clo, the skin rather, the close connective tissue, the aponeurosis. And then we have the loose connective tissue, which is where we would be.
needling. So the landmarks that we’re going to be looking for are the glabella and the occipital protuberance. So we need to measure the scalp and we usually do that with two hands. And so you would look at the glabella and the occipital protuberance, and then you would draw an imaginary line between the two, and when you find the midpoint, you go back 0.
5 centimeters, and that is going to give you your your vertical line this way, and When you’re deciding on your horizontal line, you want to start at the midpoint of the eyebrow. So you are going from the midpoint of the eyebrow to the occipital protuberance. That is going to be you’re starting here 0.
5 centimeters back and you go right to the hairline when you measure from the midpoint of the eyebrow to the occipital protuberance. So this is the motor area and the bottom two fifths. So we have five fifths. The top one fifth is your lower extremities. So we’re not concerned about that middle two fifth, the upper extremities.
And so that would be the hands and the arms, and then the face and the head would be the right here, this section right here. That is the bottom two steps.
Another technique that we can use is submuscular needling. Submuscular needling is a technique that we use when we need to or want to relax an atrophied muscle or overly tense muscle and it is really beneficial for long term paralysis or if someone has a lot of tension in an area and there are several muscles on the face and head that we can use submuscular needling for, but TMJ, the ones that we’re going to focus on are the temporalis and the masseter.
So here you can see the temporalis and the masseter. And what you would do is you would take. half inch acupuncture needles and you would thread them around the edge of the temporalis and underneath or through, if you can’t get underneath the masseteer. And by doing this, it brings blood and qi flow to this area.
So here’s another close up of what that might look like. It doesn’t really matter what direction the needles are going. As long as you stay right on the edge of the muscle and the easiest way to find the border is you bite down and where you have your patient bite down and you can feel the front of the edge.
of the temporalis, and then you are just going to, once you find the front edge, then you can follow it around on the temporal fossa, and this will go all the way back behind the ear, and you would just thread the needles all around horizontally along the edge of the muscle. And it looks something like this.
And then for the masseter, the easiest way to find it is ask your patient to bite down and it will pop out. And then you are going to place needles right underneath from the origin to the insertion. Right underneath the muscle and some people the muscles very thick and you might be going right through the muscle and it looks like this
some additional ancillary treatments that you could add in are to use some points to help relax your patient like Shen Men, you can also In the auricular area there’s a TMJ point that you can use and lower jaw, so you would look those up on an auricular acupuncture chart and for if they’re having sensory issues like pain, you would do both sides for scalp acupuncture.
And if it’s just one side, if it’s motor issues, you would just do one side and then cupping and Gua Sha can also be very beneficial. and submuscular needling of the massetere, temporalis and there’s also some auricular muscles that you can see right here in this picture. These are the auricular muscles.
You could also needle under those and in some individuals that is very beneficial. Why does it keep doing this
and also the motor points for the masseteer and the temporalis. So the facial motor points, the motor point for the temporalis is just anterior to gallbladder a. Okay. And it is on the temporalis muscle and you would just go anterior to that and you can needle that and stimulate it a little bit. And then there are two motor points for the masseter and one is stomach six is a motor point.
And then just below stomach seven, in line with the earlobe, there is another motor point. And you could needle both of those on the affected side or on both sides and stimulate those. And all of these used in combination can really be very beneficial to helping to relax the face, relax the jaw, relax your patient.
If they have TMJI cover this in great detail in my classes and there is my website, facial acupuncture classes.com. And you can also follow me on Facebook, Instagram, TikTok. I have I have a Facebook group with over 8,000 acupuncturists in it. There’s always a lot of conversation going on and I. Teach classes internationally so you can check out my schedule.
Thank you so much.