I have discussed the atlas role in the generation of upper cross syndrome and forward head posture.
However one factor should also be considered that plays an incredibly important role in the aetiology of these postural faults.
Mouth breathing is very common and usually develops in infants. Its development is often caused by thumb sucking or the use of dummies (sixty eight percent of parents give dummies to their babies before 6 weeks of age
The normal physiological rest position of the tongue is on the roof of the mouth.
This not only ensures a good anchorage or origin of attachment for the deep flexor muscles of the neck but the upward forces from the tongue ensure good formation/development of the maxilla or roof of the mouth.
When the tongue is in this position it is also impossible to breathe through the mouth.
Thumb sucking and dummies disturb this function of the tongue and as a result the tongue will no longer rest on the roof of the mouth at rest.
This will encourage mouth breathing.
Well what has this got to do with forward head posture and upper cross syndrome?
Well in an effort to get air through the mouth the head moves forward from the vertical gravitational axis to open the airway.
Overtime the forward head posture results in other biomechanical compensations such as upper cross syndrome to accommodate this deviation from the vertical gravitational axis.
I must add that there are other causes of mouth breathing such as allergies, nasal congestive disorders and diseased tonsils and adenoids.
However these are often temporary and may not alter the natural tongue resting position for the long term unless they are very chronic.
Unresolved allergies to foods like milk and wheat in children may cause future problems.
Unfortunately mouth breathing has tragic consequences which may appear unrelated.
When the tongue rests on the floor of the mouth in children the face will grow long and narrow which causes overcrowding of the front teeth.
The lower third of the face grows down and backwards which causes recession of the jaw which will cause back teeth overcrowding and result in wisdom tooth impaction.
This reduces tongue and airway space. As the head moves forwards in its attempt to create more airway space biomechanically this is the catalyst for the evolution of a number of conditions.
Tempero-mandibular dysfunction can occur as these joints are thrown off there axis compromising there optimal function.
The angle of the Eustachian tube is altered disturbing its function which may be responsible for many of the ENT problems in children.
Mouth breathing is the main cause of snoring and sleep apnoea. 65% of people that have strokes have associated sleep apnoea.
Mouth breathers are much more likely to grind or clench their teeth at night as this mechanism causes the jaw to move forward and open the airway.
Mouth breathers breath rate and volume is double that of nasal breathers. Mouth breathers over-breathe and blow off excessive carbon dioxide.
From a bio-chemistry perspective in a nut shell this creates acidity in the body. The effects of an over acidic environment in the body are well documented.
What can be done?
It is important that manual therapists ascertain if the patient is a mouth breather otherwise postural correction with atlasprofilax and treatments aimed at correcting muscular imbalance will be limited.
Once recognised it is possible to correct this faulty motor engram.
Orofacial myofunctional therapists specialise in correcting this condition – see the International Association of Orofacial Myology
A good starting point with patients as Professor Mike Mew, Founder of the London School of Facial Orthotropics says is ‘ keep your lips sealed and your tongue on the roof of your mouth’.
Over the last few centuries the western diet has become softer and softer.
The implications of this regarding forward head posture and poor posture are largely conjecture.
However for sure the muscles of mastication are being underutilised and weakened causing facial dystrophy and orofacial bone growth retardation.
This fact has been highlighted by a study published in the European Journal of Orthodontics, Vol 12 Issue 2. Titled the effects of attritive diet on craniofacial morphology the study compared Finnish skulls from the 15th/16th century with present day Finns.
The results indicated that a soft diet effects mandibular growth.
In conclusion if someone mouth breathes forward head posture and upper cross syndrome are an inevitable outcome as biomechanically the body will adapt to enable itself to receive air to survive.
To correct forward head posture and upper cross syndrome atlas correction with atlasprofilax is the first step.
Then to ascertain if the patient mouth breathes.
If this is the case the next step is to address this problem. Following this the faulty motor engrams which have developed need to be addressed which will be discussed in the next blog – Upper Cross syndrome 4.