Why does my jaw click? An experienced Hands-On approach to TMJ clicking with Russell Mottram
We sat down with Russell Mottram, an experienced Chiropractor, Published Author & Lecturer to chat about the clicking TMJ / jaw. Russell splits his time between Chiropractic Balance in Hampton and Parade Chiropractic in Ocean Grove, blending traditional chiropractic, myofascial therapy, dry needling and craniopathy. As a published author and national lecturer on craniofacial pain, he has spent decades helping practitioners and patients navigate the complex world of the jaw.
In this summary article of our chat we discuss a hands-on, conservative care approach to the clicking jaw, why mechanics matter and ultimately how it may be more complex that single joint dysfunction.
The anatomy of the jaw click: what’s actually happening?
Most people assume a clicking jaw is “broken”. In reality, the jaw joint is a marvel of engineering—it is a "hinge and glide" system with a small disc that makes the movement frictionless.
"A displaced disc in your jaw joint is what causes most clicks and pops... Inside your jaw joint where the mandible sits, there's a socket... And on top of that, there's a little disc or meniscus, which is a hard smooth cartilaginous structure. It's the job of that disc in the glide phase to stay in a secure position... However, for a variety of reasons, that disc can either be damaged or the ligaments that hold it in place can become stretched or loose." — Russell Mottram
When those stabilising ligaments get loose, the disc slips out of place. As you open your mouth, the jaw snaps back into alignment with the disc. That pop isn't the joint collapsing—it’s the jaw and disc re-establishing their relationship.
The manual therapy toolkit for the clicking TMJ
How do manual therapists approach the clicking jaw? Rather than purely chasing a "cure" for a silent structural pop, hands-on care focuses on restoring ideal mechanics, releasing muscle tension, and stabilising movement patterns.
1. Targeting the lateral pterygoid muscle
This small, powerful muscle plays a massive role in jaw mechanics. When tight, it can physically pull the disc out of position.
"The lateral pterygoid... when it's functioning well, actually stabilizes the disc on top of the condyle. In fact, one cause of the disc possibly being pulled into an abnormal position is tension and tightness in that muscle. And if we can release that muscle, often we find that the disc may reposition itself." — Russell Mottram
Through targeted myofascial release techniques and dry needling, manual practitioners work directly on these internal and external jaw muscles to reduce abnormal pull on the joint.
2. Joint mobilisation & adjustments
Manual therapy utilizes precise manipulation and mobilisation to restore normal tracking in the jaw joint, encouraging smoother hinge-glide mechanics.
3. Stabilisation exercises
If the joint is hyper mobile or the ligaments are lax, manual therapy shifts toward motor control and exercise prescription. Specific stabilisation exercises train the patient's deep jaw rotators and flexors to keep the condyle centred during movement.
Beyond the joint: stress, clenching and "Teeth, Tongue, Breathing"
Manual therapy can have quite a global approach. A massive component of managing TMJ issues is helping patients realise what they are doing with their jaw during the day.
Subconscious clenching—often driven by daily stress or "fight or flight" nervous system tone—keeps the jaw muscles in a state of permanent low-grade spasm. Russell advocates for a simple, accessible cognitive check-in called Teeth, Tongue, and Breathing:
Teeth: Are your top and bottom teeth touching right now? (They shouldn't be! Keep a few millimetres of space, even with your lips closed).
Tongue: Rest the tip of your tongue gently on the roof of your mouth, just behind your front teeth.
Breathing: Shift to calm, steady nasal breathing.
The Shift: From Bad Teeth to Sensitive Nervous Systems
Over Russell’s 40 years in practice, the understanding of TMJ pain has evolved dramatically. Decades ago, practitioners blamed bad bite mechanics (dental occlusion) and spent years grinding down teeth. Today, the focus has shifted toward central sensitisation—how the central nervous system processes pain signals.
"There are people out there with terrible bites who have never had a day's jaw problem in their life, and there are people out there with perfect bites who suffer jaw problems all the time... Temporal mandibular disorders along with a lot of other disorders... are now being thought of as having a component of what we call central sensitization in the nervous system." — Russell Mottram
When a patient suffers from chronic, intractable TMJ pain without clear structural damage, the jaw joint itself isn't necessarily broken—the nervous system's alarm system is set too high. In these cases, effective care requires a holistic network: working alongside dentists (for specialised intraoral appliances), GPs, psychologists, and ear, nose and throat (ENT) specialists.
In summary
A clicking jaw is simply a mechanical imbalance, not a life sentence. Through conservative manual therapy—combining hands-on tissue work, joint mobilisation, targeted stabilisation, and stress/nervous system awareness—most people can restore fluid, painless movement without aggressive procedures.