resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
July, 2009, Vol. 09, Issue 07
The Progression of Airway Obstruction, Part 2
By Dale G. Alexander, LMT, MA, PhD and Thomas M. Walsh II, DDS
Note from the author: This article is co-authored by Thomas M. Walsh II, DDS. Dr. Walsh is the principal author of these "Airway" articles; feedback, questions, or observations may be sent to him via .
In our last article "The Progression of Airway Obstruction," we illustrated a normal airway, an abnormal airway and described a number of progressive disorders that may evolve from this abnormal growth during childhood. The clear assertion of this article series is that normal development requires that air be able to flow through a clear and unobstructed airway from the nose through the throat and bronchial tree ending in the lungs.
In this article, we are describing more of the anatomy of normal facial and dental growth and identifying the primary factors that alter this progression. The most obvious sign of airway obstruction is mouth breathing. At first thought mouth breathing seems natural. When we exercise heavily we can breathe better through our mouths. However, nasal breathing is a cornerstone of longevity. Nasal breathing warms, moistens and filters the air that we breathe. Further, the tongue can remain in its proper "home," the roof of the mouth.
As massage therapists, we can train to quickly identify people with airway disorders and make a difference. Stop, look and listen. When you see and hear the signs and symptoms of airway disorders explain what you are learning from this article series to your clients. Many of these people have sleep disorders. Refer the person to their dentist, family physician or, to an otolaryngologist, nutritionist or registered dietitian. Finally, explain to them that medicating a structural problem may not be the only option.
Let's review the gross anatomy of the upper jaw (maxilla) for a moment. The maxilla houses all of the upper teeth, sinuses and the nasal cavity. The roof of the mouth is actually the floor of the nasal cavity. The shape and location of the palate defines the amount of nasal and oral volume. The size of the maxilla determines the total volume of air that can be transported down to the lungs via the nose and throat.
Every time we swallow correctly, the tongue compresses against the palate. This upward and outward force directs the upper jaw to expand in a lateral and anterior direction in a growing individual. The maxilla grows properly in both size and direction because of a normal swallow and tongue pressure. In a normal swallow the lips and muscles of facial expression remain passive. The erupting teeth are guided into a proper position by the outward push of the tongue against the inward pull of the facial muscles.
A normal maxilla exhibits the following anatomical features: a wide broad low flat palate, forward protruding teeth, a wide and tall nasal chamber with plenty of room for both filtration and airspace. Individuals with a broad wide smile most likely have a nicely formed maxilla.
If the nasal airway is obstructed or insufficient a person may convert to abnormal mouth breathing. Mouth breathing during childhood development causes the tongue to leave its normal position in the roof of the mouth and posture lower toward the floor of the mouth. Absent tongue pressure against the palate allows the inward pull of the external facial muscles to direct the teeth inward and the maxilla fails to expand outward and forward properly. Open mouth posture (from mouth breathing) requires facial muscles to pull downward on the lower jaw. Consequently the angle of the lower jaw grows more open and the face elongates. The mouth is growing open while the nasal cavity is failing to develop.
Gradually the orbicularis oris muscles will strain to bring the lips together. This pull of the lip muscles to close the mouth then misguides the upper front teeth, gums and bone downward. This can result in a "gummy smile." Many times the upper front teeth are tipped inward. This traps the lower jaw from growing forward gradually squeezing down on the oral airway. It can drive the lower jaw backward and compress the temporomandibular joints which provokes symptoms such as jaw pain and headaches, clicking jaw joints, dizziness and vertigo, and compression of the superficial temporal artery.
Abnormal function has created the abnormal form of the face. The function of constant breathing through the mouth acts to stifle the proper growth of the face and further reduce the airway. Form follows function and function follows form. The beautiful wide broad robust healthy smile is lost.
What are the forces that create a full and robust upper jaw you ask? Or put another way, how can I get a big wide smile? It all starts at birth. Trust Mother Nature. The process of breastfeeding is a crucial one. The suckling action of the tongue pressing against the palate and then pulling downward to draw in breast milk patterns a strong tongue housed in the maxilla. Infants that are nursed for a long time (1-2 years) will have better facial development as they have stronger and properly trained tongues.
Breast milk contains a gift from mother to child, i.e., antibodies. The immune system of an infant will not develop until age 2 at the earliest. Therefore, these antibodies are necessary to protect the infant while the immune system matures. The mouth and nasal cavity house tonsillar tissue which are a vital directive part of the immune system. How will these tissues form if we alter nature's design by denying breast milk and antibodies? Will they be recruited to enlarge beyond their normal capacity? What if we introduce an abnormal diet and allergens too early?
It is Dr. Walsh's speculation that three variables: lack of breastfeeding, altered diet from indigenous to processed food and environmental allergens combine to stimulate the formation of enlarged tonsils and adenoids. These block the normal flow of air through the nose and upper throat. The result is mouth breathing, low tongue posture and you guessed it, a small maxilla, crowded teeth, a gummy smile and a small nasal chamber.
Nature completes the development of the baby teeth around two years of age. This signals the end of the nursing phase when the toddler should alter the nursing swallow and adapt to solid food. Our ancestors and still, many cultures today, eat nuts, berries, vegetables and fruits that require heavy chewing. Chewing such foods stimulate maxillary growth. These people exhibit full faces and broad smiles.
Thumb sucking and other oral habits will progressively alter the normal development of the maxilla and teeth and can contribute to a narrow high-vaulted palate and an open bite in the front teeth. This occurs again because the tongue is displaced and the outer facial muscles squeeze inward and stifle the growth of the jaws.
We now have a formula to identify clients who present with chronic head and neck problems. Look for individuals that were not breastfed, given junk food especially at an early age and that were introduced to an allergy prone environment. These will be the individuals that typically exhibit a small maxilla, crowded teeth, a small and congested nasal cavity, a reduced airway, forward head posture, lips apart posture, mouth breathing, possibly a gummy smile, and a long lower face. They will usually report pain in the muscles of the head and neck, TMJ (temporomandibular joint) disorders, headaches, sleep apnea, atherosclerosis and arteriosclerosis, acid reflux, anxiety, depression and sleep disorders, obesity and the list goes on.
Is there a better way to deal with this you ask? Prevent these problems in the first place and follow nature's design. We can breastfeed infants, eliminate junk and processed foods from our diet and eat real food. We can catch abnormal growing faces as early as possible and redirect facial growth. We can identify abnormal airways and oral muscle function and retrain it as soon as possible.
Waiting until the permanent teeth come in crowded and then extracting teeth and putting on braces fails to address the underlying problems. Treating TMJ problems and getting a continuous positive airway pressure (CPAP) for sleep apnea and taking medications for high blood pressure, headaches, dizziness, sleep deprivation and allergies fails to address the underlying origins of these progressive disorders. Yes, we need to treat people with ailments but we also need to recognize these problems and eliminate the reasons for these progressions. Nature has provided us with a clear first step to follow through breastfeeding our infants.
As massage therapists, we spend time with people. We care about our clients. Our opportunity is to serve them as part of their early prevention team. When you notice that a client is mouth breathing, do refer them to their dentist or family physician.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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