,TAP-TAP’-EXERCISE

Myofunktional Exercise  Collect ion

Application:

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This exercise is especially suitable for controlling the eutonic, basic or rest tone (stand-by tone) for all temporo-madibular joint exercises. As a stand-alone exercise it may be used to mediate the feeling of non-tensed-up adductors. With a suitable receptivity it may also serve as a means for self controlling in connection with dysfunctions like hypertone or hypermotility of the mandible (in this context see annotations to the training mode in “Discussion”). It is moreover suitable for the assessment of the tone control by the patient as a DIAGNOSTIC EXERCISE (see there).

In a special way of manipulation it is used for a repositioning of the dislocated joint (see “Discussion”).

Contents:

Manipulated tension (and posture) control for the mandible.

Materials:

Procedure:

- Previous exercises: Optionally the PAUSE-POSITION or at least the ,DRAWER-IN’-EXERCISE should be mastered.

-Starting position: See pre-exercise

- Step-by-step-description:

-1 The patient takes place on a stool or training ball.

     a.  heteromaipulated procedure:

-2 The therapist is positioned behind the patient, his head leaning against the therapist, and grasps the jaw with both hands as holding a platter.

-3 The patient is asked to loosen up the mandible.

-4 Now the therapist seeks to tilt up the mandible sensitively and without any force on the patients side (or on either sides) and , thus, to ‘tap’ the dental arches together. No muscle actions should be perceptible in the jaw. This will mostly be accomplished only after several tries. For diagnostic reasons the more or less high manageability or a failure are noted.

In its therapeutic handling the ‘Tap’ is carried out over some time, it is recommendable to practice the movement none rhythmically and asynchronic to avoid a covered collaboration of the muscles. The general idea of this exercise is to completely relax, to “unharness” the muscles. 

-Timing: A training sequence is given trough the carry-out over a defined period of time. Recommendable is a span of one minute.

b. Self manipulated performing:

-2 not inevitably but as to make practicing easier the patient sets the elbow of one arm on the desk top before him bents it upward and tips the dorsum of the hand under his chin.

-3 This hand, now, will substitute the guiding hands of the therapist. The patient remembers the feeling sensed before to “let loose” the mandible as practiced under a. . His hand, then, chucks the mandible slightly upwards.

-4 all further steps as under a. .

Characteristics:

Manipulation, relaxation, motility, under b. motivation for a self control.

Remarks:

The exercise requires a high degree of concentration fro all candidates and a high empathy.

Discussion:

The exercise is basically designed to mediate the patient with the help of the guiding hand of the therapist the feeling of a not seized-up adductor musculature. This mode has been described under a. .Under b. the practicing routine is described in which the patient can test the containing of the eutonicity on his own or practice it.

Furthermore the therapist might conduct the procedure equally in a position sitting in front of the patient. Here, now, thumb and forefinger grasp the chin tip; the guidance will be somewhat unsafe.

In the case of a rostral displacement of the condyli the measure may be used for a joint reposition. In this case the same procedure is executed, the manipulation, though, is carried out with more vigour and emphasis on the retral direction of the mandible. If under this condition the musculature is acting to strongly against the manipulation (protective reflex / spasm) the reposition may be induced with the help of two tongue spatula: On each side one spatula is positioned upright between the last molars, the end projecting to the sides. Both spatula, then, are rotated in the long axis in a direction to shift the mandible retrally forcing the joints into their terminal position.

Instructions:

The muscles lifting up the jaw will learn to relax.

Sit down comfortably. Get seated on a chair by a table. Now set one elbow on the desk and the chin on the back of the hand. This works when you lift your head just a bit and turn the hand upside down, the back of it now showing up.

The back of the hand settles under the chin, the head no more resting on the hand but, merely, hovering freely above it.

The mouth, now, takes up the ,M’-POSITION. Normally it now should be relaxed and loose, the jaw hanging. And our exercise is made to proof it or to attain it.

The hand jolts up a bit giving the chin a little knock.

If the jaw was relaxed it will make a soft ‘click’ from the teeth tapping smoothly against each other and the jaw immediately sinking down again.

If it did not work properly the muscles just were not loosened. Then practicing starts.

A short nudge from below the chin, again and again, till it works. Do not jerk in a regular manner, try to startle the jaw.

Do not push the chin forward!

Drawer in!