George Kerscher Medical Case Study

by George Kerscher

Last updated: January 27, 2019

Case Study: TMJ, Jaw, Ear, Neck and Shoulder Pain, Muscular Skeletal


I am writing this case study about my personal experience. I hope this information will be helpful to others who have pain and struggle to resolve these issues. I will start by saying that this has a happy ending.

In September 2013 I traveled to Beijing on a business trip. I am blind and left my guide dog Kroner home for this short trip and used my white cane. I had a little vision in the lower right quadrant of my right eye. , which is important to understand the events of this case study. I unconsciously held my head to the left to use that little bit of vision. I did this for decades. Because I did not have my guide dog with me, I suspect I held my head to the left more than usual on this trip.

The Onset

While in Beijing I had severe pain an inch and a half in front of my right ear. I had some pain killers with me and took them in the evening to get enough relief to sleep. During the day, It continued to hurt and I found that my speech was affected; it was hard to pronounce words. I also had jaw pain while chewing. On the flight back home to Missoula Montana, I was having problems equalizing the air pressure. It seemed to me that my ear canal was full and the Eustachian Tube was blocked.

I first went to Now Care and saw a doctor who did not find any problems with my ear or jaw, essentially she did not discover anything. I went to my dentist, Dr. Scott at Ponderosa Dental and we found that two fillings on the right side needed work. We fixed these, but this did not resolve the pain. I went to an ENT specialist who did not find any blockage with the Eustachian Tube. Because of the ear pain and because I have some hearing loss in my right ear, he wondered if I might have an audio car soma tumor. With insurance being a consideration, we thought we would wait on getting an MRI.

The above process took many months without relief. With the jaw pain and trouble chewing, Dr Scott looked at the possibility of needing root canal work. After review, I had two root canals on teeth on the right side of my jaw. This did help some of the pain, but I was wearing a tooth Gard most of the time. My teeth even hurt when I walked; the concussion of my heel hitting the ground sent shock waves through my jaw. There was malocclusion, and we started to work on equilibration. I ended up with a total of five crowns over a two and half year period. By now it was 2016. Visit Ponderosa Dental at:


I went to my chiropractor, Dr. Marquardt just for some low back pain. While there I told him about my TMJ and teeth problem. He said that he could do a TMJ adjustment. He could tell that the TMJ joint was in a strange position and he made the adjustment. I felt better immediately. A week later, I came back for another TMJ adjustment and the joint moved measurably . He suggested that I see Lauren a Physical Therapist at Big Sky PT, who specialized in TMJ. Visit Dr Marquort at:

I started visits with Lauren at Big Sky PT, and she found that the muscles of the jaw, face, and neck were spasming and had shortened. We started to work on techniques to get the muscles to relax. We worked on this for many months. At one point, I mentioned that I had a raised point on my right chest. She looked at this and noted that in addition my collar bone was raised about an inch. The muscles of the neck connect at that rib (number 2) where the raised area was.

Finally, a Clear Idea of What Was Going On

Lauren and I figured out that because of my horrible posture walking with my head to the left using that little spot of vision for several decades, caused the muscles of my neck and right shoulder to shorten and spasm. We started to work on these muscles. The collar bone, over time, moved back into place. The raised area on my right number 2 rib reduced significantly, but did not go away completely. I was feeling pretty good at this point, with no pain while walking or problems speaking. I decided to take some time off from PT. Visit Big Sky PT at:

The Shoulder

In the Spring of 2018, I had to do a lot of work with my son clearing logs at our cabin. My shoulder started to hurt, and I checked in with Big Sky PT, where Dawn specialized in shoulder issues. My right shoulder would move forward when I relaxed. Here too, we determined that the posture and muscular and skeletal issues impacted my shoulder. The muscles not only pulled on my ear, TMJ, and jaw, but also the shoulder. The second rib was stilled pulled up and the muscles were pulling the shoulder forward. We worked on mobilization of the rib and elongating the muscles of the neck and back.


Today, I am feeling really, really good. Not all of the issues are resolved, but I feel great. I have some more work to do with getting the muscles to relax, and because of the posture problems there are some bone spurs in my shoulder. We need to sort this out, but overall, I am in good shape.

I would like to thank all the docs who had a hand in this, but especially I want to thank Lauren and Dawn at Big Sky PT in Missoula for all of their hard work.

If readers of this case study have questions for me, you can email me at: