OPEN AND CLOSE

Myofunktional Exercise  Collection

Application:

to enlarge click picture 1

to enlarge click picture 2

This exercise principally is quite simple and contains only the training of a small detail step of the swallow reflex (SWALLOW MECHANISM). In paragraph “Discussion” you may find an explanation about why this exercise as many others can, with the biomechanical mechanisms well understood quite beneficially be applied elsewhere. (Anatomy: Synergism of mandibula adductors (1.6, Area VII. Page 31and levators of the tongue body (1.2, Area II, Page 18)).

Contents:

Detail step within the swallow reflex in the coordination of occluding molars and lifting of the tongue back to the hard palate.

Materials:

If desired, elastic (rubber ringlet) at the start (see  ELASTIC EXERCISES ,”Discussion”) or similar devices.

Procedure:

- Previous exercises: Exercises for an orientation of the tongue tip to the POINT, see also TONGUE-TIP-       ORIENTATION   best also the ,L-M’-POSITION, here especially FROZEN PLOP.

-Starting position: A special posture is not compulsory, the ,L-M’-POSITION is recommended.

- Step-by-step-Description:

-1 Mouth shut, the tongue is, as with FROZEN PLOP , sucked against the palate.

-2 While the tongue stays sucked against the palate the molars are lightly set upon each other. With the 

    rare cases of adductor muscle hypotone the patient puts the fingertips bilaterally against the angle 

    region  of the mandibula to feel the hump of the swelling masseter when occluding. (Picture 1)

   In this position count to ten. By this training mode thy exercise may be stressed as a hold-exercise (see  

    below).

-3a (variation) The mouth opens and the tongue may let go from the palate wit a “pop”. Then back to the

    starting position.

-3 b(variation) While the tongue stays sucked to the palate the mouth is opened wide, this position held  

    while counting to ten. Then back to the starting position (or directly to step 2).

-3c In case of a deviation of the centering of a straight-line movement during opening or shutting:

- the lips stay open while the straight-line centering of the opening movement is monitored in a mirror.

In the initial training phase the hand may guide the chin  2); for checking the motion sequence ‘rotation / prolation’ the exercise may be combined with the exercise “THE PEA”

   Subsequently to relax the BAGGY TONGUE may be positioned in form of   ALTERNATIVE EXERCISE.

- Timing: The duration of one sequence is defined through the counting which may be increased if necessary.  For arranging a series five sequences may be added up either -  as proposed above – in an ALTERNATIVE EXERCISE or in repetitions to 5 sequences.

Characteristics:

a: Myobalance, Reflex control (partial reflex), function kinetic, coordination.
b: additional: Mobility, stretching, tone reducing.

Remarks: In the description above alternatives have been pointed out in case of adductor hypertone (and see below).

Discussion:

As previously described,  patients with a tendency of adductor hypertone may learn swallowing without setting the molars upon each others by supporting the mandibula via the tongue musculature. With the nonadductorhyperactives the here discussed detail step should, indeed, belong to the composition of the swallow reflex. Besides this objective the exercise opens up other possibilities of a therapeutic influencing. With sucking the tongue to the palate the mandibula as well gets oriented in the vertical median axis while on the other hand, caused by the direction of the extrinsic muscle fibres of the tongue it is directed backwards which latter makes the exercise valuable for “gnathologic” patients tending to deviation movements in the opening or closing movement of the jaw. Furthermore, by the step “variation 3b” the adductor muscles will get reduced in tension. Through the muscle tone in the tongue and the sucking to the palate rather the muscles of the oral diaphragm and the suprahyoid region are caused to open up then the adductors to close. Thus the here discussed exercise will cause a very effective tone  release or a reduction in training the mandible.

3c) This variation aims at disorders in the movement pattern of the Mandibular movement like the inverted opening (the prolation preceeding the rotation), or the lateral deviation.

In the course of the complete reflex of swallowing (see SWALLOW MECHANISM)  the here discussed immediately follows after the partial reflex steps of sucking up out of the vestibulum (,ZIP', MOUSE-SQUEAK ), forming the DIMPLE  and  keeping the POINT position. If the swallow reflex is to be trained, the just mentioned exercises should have been worked-out before. Through step 3b the patient will be able to monitor the posture of the tongue and the stretching of the tongue frenum in a hand mirror. Literature, in case of a non-centered occluding suggests  a deficiency (non coordination ) of the pterygoid musculature  (1.6, AreaVII/3,4) . To strengthen it the chin tip is caught between thumb and forefinger while, against the pressure of the fingers, the mouth is to be opened. This activity may be included in the here discussed exercise. It is recommendable, though, to apply for this reason a special exercise as it is given in THE  PEA