Issue link: https://www.massageandbodyworkdigital.com/i/149404
Myofascial techniques Once you're in position with your forefinger, use the fingertips of your outer hand to press the masseter against the inside finger. Gently roll this finger to feel for tissue restrictions within the masseter itself. When you find a denser area, wait for it to soften. Your client can clench and unclench to aid this process. Work along the masseter's length and width, paying special attention to the muscle's attachments: superiorly, up under the zygomatic arch (be gentle, as a branch of the trigeminal nerve exits the skull here), and inferiorly, on the lateral mandible. Gently press into these attachments and wait for the overall reduction in muscle tone that signals a Golgi tendon organ-induced shift in resting tone. Repeat on the other side. Since the masseter's angle gives it a small amount of lateral pull, this technique will be indicated when you see the jaw pull to one side upon opening (work the masseter and temporalis on the same side as the jaw pulls toward, and recheck. For more, see the previously mentioned July/August 2009 Massage & Bodywork article). Mandibular Fascia Release Although it can be helpful to focus on one side of the jaw at a time, as in the Masseter Technique above, functionally, the jaw's two sides always work together. Finish and balance your work with the masseter by addressing both sides simultaneously. The Mandibular Fascia Release Technique (from AdvancedTrainings.com lead instructor Larry Koliha) is a great option. Begin by using the palms and thenar eminences of both hands (Image 7) to feel into just the outer layers of skin and superficial fascia over the masseters and jaw (Images 8 and 9). Use a gentle downward (caudal or inferior) pressure to sense and release any restrictions or side-to-side differences, but just in the outer layers of tissue. Don't use cream or lotion (at least not yet), as you'll need a bit of friction to feel these superficial layers—with a lubricant, you may be working the muscles themselves, but you'll be sliding over the outer layers, which are a big part of the jaw's structural makeup. Once the outermost layers feel released and even side-to-side, repeat this technique, but engage a slightly deeper tissue layer each time. With practice and sensitivity, you can often feel into each of these layers in turn: 1. he skin and subdermal layers T (which have varying amount of adipose cells within them). 2. he parotid fascia (a continuation of T the chest and neck fascia associated with the platysma muscle, which contains its own muscle fibers parallel to the platysma's [Image 8]). 3. osteriorly, the parotid glands P and ducts that the parotid fascia surrounds (gentle pressure here is usually well tolerated). 4. he masseter muscles, which T themselves have two or three layers (depending on which anatomy text you consult), with the outer layer usually the most textured and tendinous, and the inner layer the softest and most muscular. 5. eep and anterior to the D masseters, the deeper mucosal layers of the mouth cavity. 6. nd finally, the teeth, gums, and A bones of the upper and lower jaw. Once you've slowly worked down to the level you want, you'll be passively depressing (opening) the jaw with your slow, sliding movement. If you feel your client resist this opening, slow down, come back out a layer, ask for breath, and wait for the masseters to let go. Of course, masseter issues do not exist in isolation. The jaw, being very mobile and suspended primarily by soft tissue, is particularly vulnerable to imbalance and strain elsewhere in the body. For example, jaw tension is one response to the instability of a whiplash injury to the neck, as the masseter, temporalis, and other jaw muscles attempt to brace and stabilize the injured area. As always, be sure to address wholebody patterns, since issues such as hip pain,5 pelvic angle, pelvis muscle tension,6 posture,7 and spinal curves have all been shown to correlate with jaw function. A whole-body approach will yield more sustainable results and more satisfying outcomes. Notes 1. J. G. Travell et al., Myofascial Pain and Dysfunction (Baltimore: Lippincott Williams & Wilkins, 1999), 330. 2. P. J. Adnet et al., "In Vitro Human Masseter Muscle Hypersensitivity: A Possible Explanation for Increase in Masseter Tone," Journal of Applied Physiology 80, no. 5 (1996): 1,547–53. 3. Mayo Foundation for Medical Education and Research, "Bruxism/Teeth Grinding," accessed August 2013, www.mayoclinic.com/health/ bruxism/DS00337/DSECTION=causes. 4. R. Schleip, "Fascial Plasticity—A New Neurobiological Explanation, Part I," Journal of Bodywork and Movement Therapies 7, no. 1 (2003): 14. 5. M. J. Fischer et al., "Influence of the Temporomandibular Joint on Range of Motion of the Hip Joint in Patients With Complex Regional Pain Syndrome," Journal of Manipulative and Physiological Therapeutics 32, no. 5 (2009): 364–71. 6. C. Lippold et al., "Relationship Between Thoracic, Lordotic, and Pelvic Inclination and Craniofacial Morphology in Adults," Angle Orthodontist 76, no. 5 (2006): 779–85. 7. A. Cuccia and C. Caradonna, "The Relationship Between the Stomatognathic System and Body Posture," Clinics 64, no. 1 (2009): 61–6. Til Luchau is a member of the AdvancedTrainings.com faculty, which offers distance learning and in-person seminars throughout the United States and abroad. He is a Certified Advanced Rolfer and the originator of the Advanced Myofascial Techniques approach. Contact him via info@advanced-trainings.com and Advanced-Trainings.com's Facebook page. www.abmp.com. See what benefits await you. 117