About the Masseter

Because your client grinds her jaw, it may be interesting to detail
here some specifics about the Masseter. It is possible that the neck
(SCM) is not quite involved in the chain reaction I detailed earlier.

A test of the Masseter is known as the 3-Knuckle Test, placing the
client's Index+Middle+Ring knuckles (one on top of each other, little
finger outside the mouth on top of the others, thumb outside the
mouth) in order to give the Jaw and Masseter a strectch should on a
normal Masseter:
1- be possible
2- not reproduce the symptoms
Also, it may be a good stretch for the muscle as part of a treatment,
if not too invasive. I will simply emphasize that in order to be
effective, a stretch has to be maintained for 90 seconds to 2
minutes. Effective tissue manipulation combined to the stretch may
allow to reduce that time a little, but 90 seconds is a good
guideline.
Also this stretch has the advantage of not needing counterforce to
maintain the head. Other stretches that focuss on using the client's
fingers to hook into the lower jaw need a counterforce to keep the
rest of the head + neck to follow. In that case one may either use
the practitioner's arm for the counterforce (on the forhead, client
is laying down on his/her back), or the client's own other arm, which
must be then secured against say a sink or table (performed while
sitting). Typically, the client's active hand on the lawer jaw should
first pull the mandible forward, and then down.
Other ways to maintain the jaw open and slightly stretched while
working with the Masseter may include cutting out a piece of PVC pipe
that may be inserted in the client's mouth. On end of the cut-out
piece may be slanted to allow to adjust the amount of stretch
depending on where the client bites on the pipe (range of length: 2.5
cm to 5.5cm from the shortest possible length to the widest).

Personally, I do prefer the less invasive and more dynamic approach
of movement coaching while working, possible in SI #7. In this case
movements may be opening the jaw slowly, then slowly relaxing, (while
working with the Maseter fibers all along). Masseter fibers can be
accessed from outside to an extent, but the deep head of the Masseter
is the one involved in Tinitus, (ringing in the ear). It seems that
inside may be a good place to access these deeper fibers.
Specifically, the Trigger Points directly involved with the ringing
in the ear are in the portion of the deeper layer of the Masseter
that is higher up and deeper inside the mouth, very close to the
mandible bone, and close to its upper attachment.

Associated dysfunctions include Occlusal dysharmony, which,
interestingly can be quite well addressed with Structural Integration
#7 and the work with the mouth.

Please note that I am not suggesting to perform a #7 without the rest
of the work. I am simply pointing out that this would be a time
where, these specific Trigger Points can be precisely addressed, and
significant positive changes in the ringing in the ear may happen. I
am convinced that there is always a good chance that a lot more is
involved, and that is why I personally like that Structural
Intregation is non-symptomatic and truly holistic in essence. I do
apreciate the fact that at times, there is also room for very precise
focus as well. When research is done in advance, it becomes possible
to be quite specific at times, in a manner that does not interrupt
the flow of the SI recipe, in a manner that doesn't get us stuck in
specific areas and sub-processes for too long. I am still convinced
that without the rest of the work, the body-mind would be little
prepared to such specific focus, and perhaps a good 10-series blindly
performed have a better chance of success than isolated specific
interventions, as researched, documented, and skilled as they may be,
even with these specific symptoms.

The same reference listed earlier mentions that often other muscles
get involved (which suggests to me to not remain focussed on the
Masseter only).
Related muscular dysfunctions:
- Synergists: contralateral (oposite side) temporalis and medial
pterygoid
- Masseter may develop 'satellite' TPs due to increased motor
activity in the sternal head of the homolateral (same side) SCM (what
I developped in the previous posting)
- Antagonists: in time diagastric and inferior division of the
lateral Pterygoid tend to develop active TPs because of the increased
demand placed on them as antagonists to the taut Masseter fibers.

(references from the TP manual, Travell and Simons, which I highly
recommend)

Good luck

Sincerely,

Reda EL ANDALOUSSI
http://www.idaprolf.org



--- In Structure_Integrator@y..., "redaelandaloussi"
<redaelandaloussi@y...> wrote:
> Marie,
>
>
> I - Alopecia
>
> I am affraid I am not knowledgeable as it relates to Alopecia. I
have
> heard that depending on the type, there may be efficient
treatments.
> Internet search results:
> - http://search.dmoz.org/cgi-bin/search?search=Alopecia+
> (for various categories that have links to resources about Alopecia)
> -
>
http://dmoz.org/Health/Conditions_and_Diseases/Skin_Disorders/Hair_Los
> s/Alopecia_Areata/
> (for the specific categorie - make sure you copy the entire link,
> from http://dmoz.org/... to .../Alopecia_Areata/ )
>
>
> II - Meniere's Disease - Tinitus
>
> I am however much more familiar with the ringing in the ear
> (Meniere's Disease - Tinitus), because I have experienced a mild
> version (and keep experiencing it at times), and also because it is
a
> type of condition that is a textbook-like illustration of an
> overwhelming ignorance of most health care providers about the
> subject of Myofascial disorder. It is another of those cases better
> explained by the trigger point litterature than anything else.
> Some keywords here are: ringing in the ear, TMJ and jaw grinding.
> Your client is right to suspect a close relationship.
>
> As a matter of fact Tinitus (the ringing in the ear, Meniere's
> Disease) is a direct symptom of the Masseter muscle on the same
side,
> which closes the jaw. In your client's case, it may be most of what
> there is to it: the grinding pattern exhausts the Masseter muscle,
> which then begins to show its classical Trigger symptom: ringing in
> the ear.
>
> However, things are not always that straight forward, once again
with
> Trigger Points. For instance sleeping while grinding one's teeth
has
> obviously more to it than just muscles doing something they
> shouldn't. Overall tension in the upper body + head + neck, and
> perhaps psychological tension and old traumas may be responsible of
> the jaw grinding pattern, which exhausts the Masseter muscle to its
> active Trigger threshold of making the ear ring.
>
> More specifically, a very classical helper is a chain reaction of
> trigger patterns which starts with muscles of the neck. It just so
> happens that a number of muscles of the neck may actually have
> trigger symptoms around the masseter area. What happens then is
that
> even if the trigger points are 'latent' in the Masseter (the
Trigger
> points are there but they may be not intense enough to actually
> create the ringing in the ear, or the ringing is below the
awareness
> threshold), then the added intensity of the pain in the Masseter
area
> triggered by muscles in the neck may bring the Masseter's trigger
> symptoms to an 'active' state, where the client may hear the
ringing.
> That is more specifically my case, and when that happens, it takes
me
> about 1 to 2 minutes usually to relax and stretch my neck enough
that
> the ringing goes away (someone without a bodyworker's awareness and
> personal self maintainance toolbox may not quite know how to do
> that). But then again, I do not believe I grind my teeth, as your
> client does; in your client's case, the Masseter may be involved in
a
> more 'isolated' manner, without much help from muscles in the neck.
> Such helpers in the neck may be, on the same side, and according to
> the litterature:
> - The sternal division of the SCM (SternoCleidoMastoid)
> (the one involved in my case, and with which I had some success
with
> others)
> - Upper Trapezius
> - Cervical Paraspinal muscles
> (I can't confirm these last two)
>
> The litterature mentions that if such problems in the neck are
> present (SCM), then other problems are usually associated, such as
> with the Scalenes (which I have detailed in a previous posting as
> being usually associated with defficient breathing), and
torticolis.
>
> Some poor habbits associated with SCM involvement, and some
> corrective steps:
> - reading with one's head turned one way for long periods of time.
We
> should be facing forward instead of holding a book to our side.
> The bed lamp may need to be moved to be directly above the head,
> instead of on one side.
> - lifting one's head up when roling to the side (we should roll our
> head to the side instead of lifting it up to the side).
> - it may be appropriate to roll out of a prone position (starting
> laying on the stomac), when getting out of bed (to avoid stress on
> the muscles in the front of the neck.
> - It may be indicated to use pillows to make sure the head doesn't
> roll out of alignment while sleeping.
> - Typical postural adjustment: making sure the head is aligned, and
> not leaning forward. Lumbar involvement may need to be addressed
> (this is our familiar territory as Structural Integrators, really)
> - the telephone hand set should be held in one hand instead of
> between the ear and shoulder, changing hands (not the ear), and
> replacing the phone with a head set if telephone is a repetitive
task.
> - swimming the crawl stroke may be hazardous
> - head rolling exercises should be avoided, as they may overstretch
> the muscles. Also activities that require prolonged neck extension
in
> overhead work should be avoided, as they may overload the checkrein
> function of the SCM.
> ...
>
> I thought you may find this previous list interesting, in order to
> attempt to identify and offer alternatives to movement, behavior,
and
> posture patterns that may be making the SCM and neck work too hard
> and contribute to awakening the Trigger points in the Masseter
mucle,
> which is extremely likely to be the most direct muscular
involvement.
>
> Like I said, Tinitus (Meniere's Disease - ringing in the ear), is a
> textbook example of how Trigger Points can not only trigger weird
> symptoms, fairly consistently accross a population, with possible
> variations however, and with possible chain reactions (SCM). It is
> also unfortunately a classical example of people's ignorance of
> musclular dysfunction, particularily among health professionals,
who
> send patients out with yet another label, but not much hope, as
their
> ignorance is passed on to the patients.
>
> I highly recommend the reference extensively used in this posting:
> - Myofascial Pain and Dysfunction Syndrome, The Trigger Point
Manual
> (Travell and Simons, Williams & Wilkins)
> The 2 volumes allow to investigate numerous phemnomenons in the
body
> that are similarily fascinating to discover, especially from a
> bodyworker's and a Structural Integrator's perspective.
>
> Good luck.
>
> Reda EL ANDALOUSSI
> http://www.idaprolf.org
>
>
>
> --- In Structure_Integrator@y..., tartarean@a... wrote:
> > Hello All,
> >
> > I have a new client with constant ringing in the left ear which
was
> diagnosed
> > as Meniere's Disease, alopecia and plus she's a jaw grinder at
> night (TMJ). I
> > am curious as to what experience anyone has with any or all of
the
> > conditions. She is experiencing high stress and grief in her life
> since
> > January. Some of the conditions preceded this. I find it
> interesting that all
> > three of these things are going on with her and my gut tells me
> that they are
> > connected. She says her doctors have told her otherwise, but
she's
> also felt
> > a possible connection. How would you proceed with this treatment?
> Any
> > comments will be greatly appreciated.
> >
> > Stay Well,
> >
> > Marie Swan Black
> > Acorn Body Care®
> > Portland, OR
> > "down to Earth luxury"
> > www.acornbodycare.com