Immediate Effects of Combining Local Techniques in the Craniomandibular Area and Hamstring Muscle Stretching in Subjects with Temporomandibular Disorders: A Randomized Controlled Study.

Treatment protocol in the experimental group Three techniques were performed in the following order. (a) Neuromuscular technique of the masseter muscles. With the subject lying supine, the therapist sat at the head of the table and rotated the subject’s head. One therapist’s hand was placed on the zygomatic arch to fix the superior edge of the muscle, while the thumb of the other hand performed longitudinal myofascial strokes, of about 5-8 centimeters length (each of four to six seconds of duration). Tissue restrictions were respected during the gentle slide movement and no pain was provoked during the technique (b)Passive stretching of the hamstring muscles. With the subject supine, the therapist performed a hip flexion keeping knee extension until the edge of flexibility of the posterior muscle chain, with no pain or discomfort. When this position was achieved, the therapist underwent a dorsal flexion of the ankle and kept the position for forty seconds. The stretching technique was performed in both lower limbs, avoiding any possible body compensation during the stretching. c) The suboccipital muscle inhibition technique. With the participant lying supine, the therapist placed both hands under the head of the subject as a hammock. While contacting the inferior edge of the occipital bone, the therapist exerted a constant and painless pressure in cranial and ventral direction until suboccipital soft tissue was relaxed. The technique was performed for four minutes approximately. The whole treatment protocol lasted about 10 minutes and involve a single treatment session