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Bluegrass Doctors of

Physical Therapy, PLLC



Cranial Compliance and its Role In Chronic Pain

Posted on September 18, 2021 at 3:25 PM

Cranial Compliance and its Role In Chronic Pain

Since I began my journey into the world of healthcare I was taught very early on that the cranial bones were made of multple synarthrotic (fibrous immoveable) joints that fuse in early adulthood. New evidence is now emerging stating that there may be more movement in the cranial bones than originally thought. These joints are not highly moveable like, our shoulder or wrist, however there has been some postulations that the cranial joints can move up to 5mm in a healthy adult. We call this movement "compliance". This is to differentiate this type of movement from other joints of the body. We have been noticing that if we lack cranial compliance then we can see outward changes in head and neck pain. Lack of cranial compliance can be brought on by head trauma, repeated sinus, and ear infections, repeated bouts of deep scuba diving, going to high altitude excessively, as well as genetic faults. The lack of compliance results in the skulls inability to adapt to changes in the neurocranium (the top part of our head) as well as the visceral cranial (from the nose down to the chin). There are many nerves that run through holes in the skull bones that cause various functions in our head and neck as well as in our trunk. We are also starting to see a correlation between people who have craniofacial dysfunction and gut dysfunction. This is (as for now) believed to be due to vagus nerve disruptions, possibly from a mechanical interface deficit at the Jugular foramen (hole) which is formed in front of the petrosal bone and temporal bone/ occipital bone interface. If these two bones ( we differentiate the petrosa and temporal bones in the clinic) as well as the occipital bones do not have enough movement they can influence faulty vagus nerve activity which can lead to gut dysfunction. This area of study is still emerging and is very exciting as cranial techniques can help alleivate not only head and neck pain but possibly gut pain as well.  

Sore throat caused by my shoulder?

Posted on February 3, 2019 at 2:10 PM

Yep, you read that right. Can you have a sore throat that is caused by your SHOULDER? Well, we arent talking about a sore throat in the classical sense but a muscle that runs from your neck to your shoulder. Yep, there is one! This muscle can have referral to the anterior throat when the restriction/trigger point is at the insertion of the shoulder. Yep, that muscle is called OMOHYOID. Heres a picture below: 

Predictors of TMJ and Facial Pain

Posted on January 4, 2019 at 10:00 AM

Have you ever wanted a quick way to see if you may be at risk or more likley to develop TMJ pain and or facial pain? 

There is a simple way to check you own facial lines. All you need is a mirror!

Take a lookat your self in a relaxed position in a mirror. Where do your eyes sit? Do they sit level with one another? Or is one slight lower or higher than the other? Where do the corners of your eyes sit? Upward or downward.

Now, Look at your ears. Sepcially ear lobes. If you have detached lobes this is a bit easier to do but will still work for those who has lobes attaches to their head. Does one of your ears appear slightly lower of higher than the other? Take note of this.

Lasty look at your mouth. Where are the corners lying? is one lower than the other? are the equal? Is one lip curled up or flattened out?

If you noticed that one side you have an eye, ear and corner of the mouth that all are lower or higher OR if your eye and ears are lower but the corner of the mouth on the same side is higher, it would be an indicator that, if you are having pain, it would be from that side, or you may be likely to experience pain on that side in the future. Try it out!  

TMJ and Daily Life

Posted on November 9, 2018 at 3:50 AM

Don’t let TMJ (temporomandibular joint) dysfunction hijack your life. When it comes to managing chronic pain, small steps can make a big difference.

Sometimes Less is More


If you’ve had temporomandibular disorder (TMD) for any length of time, you are probably willing to try almost anything that promises a better quality of life. Keep in mind that an episode of worsening TMJ pain is often caused by inflammation around the joint itself. Sometimes, a few simple changes are all it takes to reduce the inflammation and stop the pain for a while.


Have you Tried and Failed?

We’ve all seen TMD handouts telling patients to eat soft foods, to use ice packs, and to avoid extreme jaw movements. These are well-intentioned ideas, but do they make sense in your daily life? Do you keep an ice pack in the office? Are you willing to subsist on a nursing home diet? Can anyone really avoid yawning?

TMJ Pain Relief for the Real World

Five Easy Ways to Relieve TMJ Pain Right Now:

1. Give up the gum habit.

Some people with TMJ dysfunction believe their symptoms might actually improve if they chew gum; after all, if jaw muscles get tight and sore, they should be exercised, right? Wrong. Unless you have taken a vow of silence and never eat solid food, your jaw muscles are getting enough of a work out already. If you absolutely must chew gum, be sure to chew for no more than three minutes before tossing it.

2. Try a quick and easy DIY massage.

Gently massaging the masseter—the powerful muscle that opens and closes your jaw--can relieve jaw tension and muscle pain. You may find it simpler to employ a set of therapy balls to do this massage. (Click here for a video tutorial.) This gentle technique is easy to learn and reduces muscle tension. It can improve chronic pain from conditions like TMD.


3. Fight pain with acupressure/Trigger point pressure.

Acupressure is a great way to help relieve TMD pain. Acupressure uses the same body points as acupuncture to activate the healing process. While acupuncture activates these points more strongly, you can try acupressure on your own. There are a host of online resources for finding acupuncture points. You may be surprised to discover that some of your most effective points for TMJ relief are nowhere near your jaw.


4. Relax your jaw.

Are you clenching right now? Whenever you notice tightness or pain, try to lower your jaw very slightly until your teeth stop touching. This is easily done with your mouth closed, so no one will notice. If your tongue is pressing upward on the roof of your mouth, this is the time to let it drop back down. The goal is to keep your teeth from touching, and to keep your jaw relaxed, for most of the day. With practice, you may be able to drastically reduce TMJ pain caused by clenching.

5. Check your posture. 

Is your head on straight? If you’re not sure, have someone take a picture of you from the side while you sit or stand as upright as possible. If your ear is not in line with your shoulder, you may suffer from forward head posture. Along with the spinal misalignment mentioned here, forward head posture can contribute to TMJ pain. To help correct your posture, try this simple exercise: lie down on the floor—or stand tight against a wall--and tuck your chin to your chest as if you are trying to make a double chin. Repeat. This exercise strengthens the muscles in your neck and can help relieve TMD pain.