Nanette attended Daemen College and has been a physical therapist since 1993. She has spent her entire career in both Rochester and Canandaigua specializing in orthopedics and manual therapy. She has established professional relationships with area orthopedic and primary care physicians, oral and maxillofacial specialists creating a teamwork approach to patient care and treatment. Nanette specializes in the treatment of orthopedic, spinal and post surgical conditions with a special interest in the treatment of TMJ disorders.
She is trained in Mulligan, Laslett and McKenzie concepts. She has completed and remains active in achieving numerous continuing education hours to further her knowledge and manual therapy skills. She has worked as a clinical instructor in private practice and outpatient settings and served as adjunct faculty at Nazareth College.
Since 2007, Nanette has had the privilege of learning from and working closely with the area’s best maxillofacial (oral) surgeons, TMJ specialists, dentists and physicians in treating patients with TMD. She has treated patients of all ages, backgrounds and lifestyles including athletes, Broadway performers and Olympic gymnasts. Nanette is committed to providing you with the best care possible as we work together to restore your pain free function and improve your quality of life.
TMJ is the abbreviation we use for the temporomandibular joint or your jaw joint which is located directly in front of your ears. These are the joints that connect your jaw bone, called the mandible, to your head. TMD stands for temporomandibular disorder which very simply and generically describes a dysfunction of your jaw. TMD is a very common condition. Not only will it cause pain in your jaw, but even more debilitating will commonly cause pain in the face, neck, ears, and head. It will cause pain and limits with functions such as biting, chewing, yawning, talking, singing and swallowing. It can affect your tolerance to lying in bed, your speech or comfort with playing an instrument. Common symptoms besides jaw pain also include headaches, muscle spasm, tightness, ear pain, ear congestion and difficulty swallowing, Physical Therapy can help minimize pain and dysfunction caused by TMD, restore normal jaw motion and teach prevention or self care techniques to maintain comfort and function.
Patients with jaw issues will often first seek help from their primary care physicians or dentists. These visits often lead to referrals to ENTs or maxillofacial surgeons. Commonly a panoramic x-ray is performed which provides a panoramic view of your mouth and jaw, including the joints themselves, to determine the health of the mandible and condition of these ball and socket joints. Early interventions by these physicians often include a soft diet, anti-inflammatory or muscle relaxer medications, instruction on the use of heat and sometimes an occlusal appliance such as a night guard. Although these are very important interventions, used alone they are not enough to eliminate the jaw problem and this is where physical therapy can help you.
Your temporomandibular joints (TMJs) are no different from the other joints in your body in that there is a capsule surrounding these joints, ligaments, a disc and muscles that move the joints and your jaw. The TMJ issues can arise from wear and tear, trauma from sports and accidents, muscle spasms, disc issues, effects from your posture, orthodontic treatment, dental issues and very commonly from the stress of our busy lives. The most common jaw problems arise from chronic clenching and or grinding. Conscious awareness of your jaw and self care are key to resolving jaw issues. I will instruct you on exactly that, in addition to utilizing manual techniques and therapies to help you decrease your pain, improve your jaw motion and restore function.
TMD issues are very common. Those who suffer from the pain often have experienced it for many years and have adopted a thought process that nothing can be done to fix it and they just have to live it. This is NOT the case. No matter what the cause, your TMD is a mechanical issue requiring mechanical treatment. Whether your symptoms just began or have been going on for many years, physical therapy can help you and more importantly teach you what to do for yourself.
At your first visit, I will have a conversation with you to obtain your experiences and history with your jaw issues, find out what kind of treatments you have received thus far and review your medical history. I will then perform a thorough evaluation to assess your jaw mechanics, range of motion, and muscular involvement to determine the cause of your jaw pain and functional limits. I can then develop a treatment plan to address these deficits, restore your function, and meet your goals. Treatment interventions may include the use of heat, use of other modalities such as iontophoresis, manual therapy techniques, instruction on self care, home exercise program and a lot of education along the way. Most importantly, I will explain and teach you what you can do to help yourself so that you are empowered and know what to do for maintenance and prevention.