resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
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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