I have a referral into the clinic for a 60 year old female with continuing right facial pain after having a dental cleaning. It has become more frequent and intense over the past month. Everything dentally has been cleared and she has been cleared by the ENT. My immediate thought is Trigeminal Neuralgia but this has not been formally diagnosed. Other than the things we have been shown through the Postural Respiration course are the other things I should look for or use for someone like this?
A pivotal treatment consideration for this patient is her ability to rotate her C3-C7 cervical spine to the left. If it rotates well to the right and is limited to the left then your spinal position is strongly oriented right and requires that her cranium counter rotate to visualize the frontal plane via right TMCC activity.
You will need to get her into left AF IR and secure her left hip with both frontal and transverse plane musculature. And after you secure her left hip, her right glute max will be needed in the transverse plane to redirect her pelvic and spinal orientation to the left. Her left ZOA and left IO’s and TA’s will be a key to anchoring the spine left prior to thoracic-scapular and scapular-thoracic right low trap work. This would be my first course of action to get her neck to rotate to the left. If she is very overactive in her right anterior neck, she may have developed into Superior T4 Syndrome, but the spinal orientation issues are still going to need to be addressed. Manual BC treatments are likely in this case.
If you can neutralize her neck with the Myokinematic Restoration and Postural Respiration principles described above, she would probably do well with some cranial stability afforded by the lateral pterygoids. Teach her to “cluck” and to blow a balloon and other related activities with her tongue on the roof of her mouth. In fact, it would be good if she could move her jaw both ways with her tongue elevated to the roof of her mouth (jaw to the right will likely be the challenge) while she shifts and rotates her body in gait-like fashion.
