Issue link: https://www.massageandbodyworkdigital.com/i/70065
JOIN TIL LUCHAU AND THE ADVANCE-TRAININGS.COM FACULTY, WITH SPECIAL GUEST ART RIGGS, IN COSTA RICA, FEBRUARY 26–MARCH 5, 2011, FOR AN ADVANCED MYOFASCIAL RETREAT. CALL 877-499-8811 OR VISIT WWW.ADVANCED-TRAININGS.COM FOR MORE INFORMATION. In the embryo, development of the maxilla and palatine bones closes the plate. A cleft palate results when this closure is incomplete. Image from Gray's Anatomy of the Human Body, 1918. Conversely, a pronounced palatine raphe (an anterior/posterior ridge along the palate's intermaxillary and interpalatine midline sutures) may be a result of cranial crowding or narrowing of the palate. Image courtesy of Primal Pictures. Used with permission. only is the hard palate the "keystone" of the cranium's interlocking bony structure, compression of the palate by braces or orthodontics seems to have at least an anecdotal relationship with migraines and comingled headaches.2 When working the palate, all customary considerations about intraoral work apply, of course. Be sure to explain the purpose for working inside the mouth to your client and get explicit permission before you do so. Practice sanitary procedures with glove disposal and hand washing, ask about latex sensitivity, and be familiar with any local or state scope-of-practice stipulations (some states require specifi c training or endorsement to be qualifi ed to work within the mouth, and a small minority prohibit it outright). To work the palate, use your gloved index fi nger inside the mouth, together with the thumb of the other hand outside, feeling the maxilla and palate between your two hands (Images 1 and 2). Use fi rm, static pressure to feel the shape and mobility or fi xity of the bones that make up the palate. Don't slide around with your inner fi nger; instead, press, feel for a response, wait, and then release and move to the next spot. Feel for unusual bony resilience (soft or hard areas, not to be mistaken for the nodules of the small glands on the posterior palate). Check in with your client (verbally and nonverbally) for feedback about any places that change the quality of the head pain. If your client is having a headache, there will usually be areas where pressure will relieve or change the pain. Wait in these places with steady pressure, encouraging your client to relax, breathe, and release. Although it can take several minutes in each spot, you can often diminish the headache's intensity and sometimes relieve it completely by being patient and methodical here—painstaking might be the right word. We aren't trying to release the soft tissue or myofascia on the palate; we're waiting for a change in bony mobility. Although subtle, this tangible yielding of bony resilience indicates suture release and an increase of osseous adaptability. Although your touch is receptive, this isn't the light touch of craniosacral work. Although skilled craniosacral work can be extraordinarily helpful for migraines, in this technique we use fi rm, tangible pressure and wait for a small, yet perceptible, yielding. The pacing of your pressure is slow and steady. Imagine pushing a boat away from a dock: at fi rst, there is no movement, but as you lean and wait, the boat yields and begins to drift. At the risk of mixing metaphors, another way to describe what we're feeling for might be the tactile "give" of a nearly ripe avocado. A pronounced palatine raphe (an anterior/posterior ridge along the palate's midline sutures, Image 4) can sometimes be a result of cranial crowding or narrowing of the palate. Using gentle but fi rm outward pressure, encourage widening and lateral release of the roof of the mouth. A cleft palpate could be thought of as the opposite—a palate with too much decompression. In fetal development (Image 3), the bones of a cleft palate never met and closed along the centerline. Anecdotally, some people whose cleft palates have been repaired surgically report an increase in migraines, almost as if the closing of the palate was accomplished too tightly. Why does mobilizing the bones of the palate so often reduce migraine pain? Perhaps it is through an effect connect with your colleagues on massageprofessionals.com 111