This topic will be important for whoever suffer from postural problems such as back pain, TMJ, hyper lordosis, thoracic kyphosis, scoliasis, 'pink panther syndrome' and much more. Could it be that specific joint or muscle which is causing the problem? Or is it something else? Would visiting orthopaedic surgeon help fix the problem? Can you improve if not eliminate the condition without involving surgery? Let's get into the fundamentals of our biomechanics and analyse in details some of our postures and muscles association.
In this post, I will mainly discuss about facial muscles in the face. As some of you would have known, good posture is a good habit that contributes to the wellbeing of the individual. The structure and function of the body provide the potential for attaining and maintaining good posture. Conversely, bad posture is a bad habit and, unfortunately, is all too common. Postural faults have their origin in the misuse of the capacities provided by the body, not in the structure and function of the normal body. If faulty posture were merely an aesthetic problem, the concerns about it might be limited to those regarding appearance. However, postural faults that persist can give rise to discomfort, pain, or disability. The range of effects, from discomfort to incapacitating disability, is often related to the severity and persistence of the faults.
Discussion of the importance of good posture springs from a recognition of the prevalence of postural problems, associated painful conditions and wasted human resources. This text attempts to define the concepts of good posture, to analyze postural faults, to present treatments, and to discuss some of the developmental factors and environmental influences that affect posture. The objective is to help decrease the incidence of postural faults resulting in painful conditions. Cultural patterns of modern civilization add to the stresses on the basic structures of the human body by imposing increasingly specialized activities. It is necessary to provide compensatory influences to achieve optimum function under our mode of life.
The high incidence of postural faults in adults is related to this tendency toward a highly specialized or repetitive pattern of activity. Correction of the existing conditions depends on understanding the underlying influences and implementing a program of positive and preventive educational measures. Both require an understanding of the mechanics of the body and its response to the stresses and strains imposed on it. Inherent in the concept of good body mechanics are the inseparable qualities of alignment and muscle balance. Examination and treatment procedures are directed toward restoration and preservation of good body mechanics in posture and movement. Therapeutic exercises to strengthen weak muscles and to stretch tight muscles are the chief means by which muscle balance is restored. Good body mechanics requires that range of joint motion be adequate but not excessive. Normal flexibility is an attribute; excessive flexibility is not. A basic principle regarding joint movements can be summarized as follows: the more flexibility, the less stability; the more stability, the less flexibility. A problem arises, however, because skilled performance in a variety of sport, dance, and acrobatic activities requires excessive flexibility and muscle length.
Posture is usually defined as the relative arrangement of the parts of the body. Good posture is that state of muscular and skeletal balance which protects die supporting structures of the body against injury or progressive deformity, irrespective of the attitude (erect, lying, squatting, or stooping) in which these structures are working or resting. Under such conditions the muscles will function most efficiently and the optimum positions are afforded for the thoracic and abdominal organs. Poor posture is a faulty relationship of the various parts of the body which produces increased strain on the supporting structures and in which there is less efficient balance of the body over its base of support.
Painful conditions associated with faulty body mechanics are so common that most adults have some firsthand knowledge of these problems. Painful low backs have been the most frequent complaints, although cases of neck, shoulder, and arm pain have become increasingly prevalent. With the current emphasis on running, foot and knee problems are common. When discussing pain in relation to postural faults, questions are often asked about why many cases of faulty posture exist without symptoms of pain, and why seemingly mild postural defects give rise to symptoms of mechanical and muscular strain. The answer to both depends on the constancy of the fault. A posture may appear to be very faulty, yet the individual may be flexible and the position of the body may change readily. Alternatively, a posture may appear to be good, but stiffness or muscle tightness may so limit mobility that the position of the body cannot change readily. The lack of mobility, which is not apparent as an alignment fault but which is detected in tests for flexibility and muscle length, may be the more significant factor. Basic to an understanding of pain in relation to faulty posture is the concept that the cumulative effects of constant or repeated small stresses over a long period
of time can give rise to the same kind of difficulties that occur with a sudden, severe stress.
Important differences exist between treatment of an acutely painful condition and that of a chronic one. A given procedure may be recognized and accepted as therapeutic if it is applied at the proper time. Applied at
the wrong time, this same procedure may be ineffective or even harmful. Just like an injured neck, shoulder, or ankle, an injured back may need support. Nature's way of providing protection is by "protective muscle spasm," or "muscle guarding," in which the back muscles hold the back rigid to prevent painful movements. Muscles can become secondarily involved, however, when they are overburdened by the work of protecting the back. Use of an appropriate support to immobilize the back temporarily relieves the muscles of this function and permits healing of the underlying injury. When a support is applied, protective muscle spasm tends to subside rapidly, and pain diminishes.
Evaluating and treating postural problems requires an understanding of the basic principles relating to alignment, joints and muscles:
• Faulty alignment results in undue stress and strain on bones, joints, ligaments and muscles.
• Joint positions indicate which muscles appear to be elongated and which appear to be shortened.
• A relationship exists between alignment and muscle test findings if posture is habitual.
• Muscle shortness holds the origin and insertion of the muscle closer together.
• Adaptive shortening can develop in muscles that remain in a shortened condition.
• Muscle weakness allows separation of the origin and insertion of the muscle.
• Stretch weakness can occur in one-joint muscles that remain in an elongated condition.
Now, let's look at muscles located in the face. Facial muscles are called the muscles of expression. The facial nerve, through its many branches, innervates most of the facial muscles. Numerous muscles may act together to create movement (e.g., as in a grimace), or movement may occur in a single area (e.g., as in raising an eyebrow). Loss of function of the facial muscles interferes with the ability to communicate feelings through facial expressions and with the ability to speak clearly. A smile, a frown, a look of surprise expressions such as these are created by the actions of muscles that insert directly into the skin. Because of the unique insertions of facial muscles, tests of these muscles differ from other manual muscle tests that require test position and fixation for the subject and pressure or resistance by the examiner. Instead, the subject is asked to imitate facial expressions while looking at photographs of a person performing the test movements or while watching the examiner perform them.
Let's talk abit about TMJ. Movements of the temporomandibular joint (TMJ) include depression of the mandible (e.g opening the mouth), protrusion of the mandible (e.g movement in a forward direction) retrusion of the mandible (e.g movement in a posterior direction) and lateral motion of the mandible (e.g side-to-side movements). Retrusion is very limited compared to protrusion. There are two primary movements of the TMJ, which includes rotation about a mediolateral axis and translation along the anteroposterior and superoinferior axes.
1. Rotation occurs first, and then translation, as the mandibular condyle moves anteriorly and inferiorly on
the temporal bone. Closing of the mouth is initiated with posterior translation of the mandible to the maximal opening. The combined translatory and rotatory movements that occur during opening of the mouth are reversed for closing to the resting position.
2. In normal jaw opening and closing, the movements of each TMJ are synchronous so that the jaw does not deviate toward either side. Asymmetrical lateral shift involves sliding the mandible to one side.
3. Disorders of the TMJ can lead to headache, facial pain and limitations of jaw opening. The muscles
usually involved in such disorders are the pterygoids, masseters and temporalis.
4. Conservative physical therapy treatment may be sufficient to relieve pain. Various dental devices may be used to help realign or exercise these muscles.
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| Cranial nerves and deep facial muscles |
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| Cranial nerves & deep superficial facial and neck muscles |
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