I am inquiring about a patient of mine that you have seen. I believe I understand your reasoning for keeping her symmetrical below her neck and then adding left pterygoid activity. Although, you can still see the left rib flare and she still came in with decreased right HG IR. I instructed her in the Rest Position handout occasionally throughout the day to breathe. I gave her a clothespin and had her gently bite down a few times. This restored her and helped her see what left pterygoid activity does. Is it okay for her to continue with the clothespin? Would it be okay to have her orthodontist build up the left side of her resting splint 1-2mm? I am also wondering about the sequencing of your exercises (jaw exercises first vs. lower extremity exercises). How did you decide that she was ready for a symmetrical program below the neck since I am still seeing some asymmetry? Was it just because her left glute med/hamstring and right glute max are stronger now?
The clothespin is keeping her autonomically alive, if you will, on the left side, occasionally she could do this. I probably wouldn’t build up her left side of her splint yet. I really believe she is in a body on head neuromotor pattern and needs better guidance from her OA and AA joints, cranium, vestibular and neck area. She did well here with her updated HEP. Please keep her vision parallel with the floor…in other words, don’t encourage her to look down so much with single leg work, holding her baby, getting in and out of a chair, etc. Yes, she is sufficiently strong at her glutes, but still needs more left hip shift or COG vestibular balance on the left. Therefore, I hit the adductors as a group hard on the left.
