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Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
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Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
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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