Oral Posture and Pilates: A Natural Face Lift · forces exerted on the bones of the face. (4)...

Oral Posture and Pilates: A Natural

Face Lift

By Jenna van der Merwe

14th June 2019

BASI Comprehensive Teacher Training Ballito

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Abstract

Overtime the face can change for the better or for the worse. Just like any other part of the

body the face has muscles and bones that dictate its appearance and so just like any other

part of the body training them can result in improvements.

Pilates has the potential to address the underlying biomechanical issues that lead to a

downward sloping face through gut health, corrective breathing techniques and postural

retraining but there is another important component that we can introduce into our sessions.

Resting tongue posture refers to where your tongue likes to relax. The correct position is on

the roof of your mouth whilst awake or even asleep. Through educating the clients and

practitioners about resting tongue posture it is possible to retrain the face and essentially ‘lift’

it.

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Table of Contents

Abstract .................................................................................................................................... 2

Table of Contents ...................................................................................................................... 3

Introduction .............................................................................................................................. 4

The Anatomy of the Face .......................................................................................................... 5

The bones of the face ........................................................................................................... 5

The Muscles of the face ........................................................................................................ 6

The nerves of the face .......................................................................................................... 8

Breathing and the Face ........................................................................................................... 10

What is Good Oral Posture ..................................................................................................... 13

How Can Pilates Help .............................................................................................................. 13

Case Study .............................................................................................................................. 15

Client History ...................................................................................................................... 15

Orthopedic ...................................................................................................................... 15

Personal Postural Findings using Video footage ............................................................. 16

Goals ............................................................................................................................... 16

Pilates Prescription ................................................................................................................. 17

Week 1 ................................................................................................................................ 17

Weeks 2 – 5 ........................................................................................................................ 18

Week 6-9 ............................................................................................................................ 20

Week 10 to 12 .................................................................................................................... 22

Conclusion .............................................................................................................................. 24

Bibliography ............................................................................................................................ 26

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Introduction

‘Beauty is in the eye of the beholder’ however aesthetic beauty is most often a matter of

symmetry, proportions and physics. (1) Studies have shown that some faces are more

appealing and that most people can objectively agree that certain facial features are deemed

attractive. (2) Things like a strong jaw line and high cheek bones are used as a means to

measure beauty. Surgical interventions are on the rise to attain these perfect proportions and

this leads me to the question. Can the face change shape and form and therefore appearance?

The answer is yes! I will attempt to highlight why we propose that the face is able to change

for the better or worse and hopefully give insight into how we as pilates teachers can create

an opportunity for positive change through cuing and program prescription.

The way we move our face, hold our face and the habits we accrue in and around our mouths

will ultimately change our face. This is a significant observation. Especially because we see so

many bad postural habits, so many poor breathing, chewing and swallowing techniques and

a rise in respiratory conditions due to allergies and asthma (3).

Assuming that beauty and facial symmetry is genetic alone would disregard the effect of the

environment. Studies have shown that bony development of the face is directly related to the

forces exerted on the bones of the face. (4) Habits like thumb sucking and mouth breathing

can lead to downward sloping faces. Evidence of facial bony deformation can occur even later

if life when people suffer strokes or nerve palsy.

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So what happens outside of genetics to affect face formation? And how can we use this to

our advantage? Firstly, we need to understand what makes up the face to be able to

understand how, when and why the face changes.

The Anatomy of the Face

The bones of the face

Below is an image of the bones of the face. The zygomatic arch forms the cheek bone with

the mandible forming the jaw bone and the maxilla the roof of the mouth. The formation of

these bones is largely determined by

genetics but can be impacted by the

resting tongue position on the roof of the

mouth. A lack of upward and outward

pressure results in a downward sloping

face, skew teeth and a poor jaw line. The

biggest culprit contributing to these facial

features is mouth breathing. When

chronic mouth breathing occurs due to

allergy or habits there is less pressure on the maxilla which can result in a narrow bony

formation of the roof of the mouth, teeth malalignment and a receding jaw. (5)

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The Muscles of the face

One of the strongest muscles in the human body. Is the

masseter muscle. This large muscle is responsible for

clenching the jaw and therefore chewing. It can become

larger with training and is one of the suggested ways to

improve jaw appearance through hypertrophy. In

addition to the improvement in Jaw line this action can

also lead to bony formation and a strong jaw line (6)

It has been suggested that people are not making full use of the role of the teeth and the jaw

and the age old adage of chew your food properly seems to be fitting. Rushed meal times and

overeating of poor quality foods may be contributing factors to improper digestion and

weakness in the masseter muscles leading to

atrophy and poor jaw development.

Housed within the muscles under the jaw is the

hyoid bone. When there is an imbalance in the

muscles that lift or depress the hyoid because of

poor posture the appearance of the space under the

jaw can be affected. The suprahyoid group acts to

lift the hyoid and the infrahyoid group pulls it down. People who have the appearance of a

long sloping jaw line may in fact have an imbalance in these muscles.

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When a client has upper crossed syndrome the thoracic

spine is stiff and kyphotic which forces the head forward

and produces a c7 prominence. This is because the cervical

vertebra assumes the shape of the thoracic spine and is

projected anteriorly. There is therefore a loss of the

natural lordosis of the cervical spine. In order to correct

their eye line the client will need to hyper extend the first

2 vertebra and leads to adaptive shortening of the

suboccipital muscles which may cause tension headaches.

This new posture then stretches the Suprahyoid muscles which pull on the

temporomandibular joint and result in pain and poor oral posture.

The tongue is also a muscular organ in the mouth anchored to the hyoid bone. If

hyperextension of the cervical vertebra occurs with a forward head carriage the hyoid will

drop, the tongue will fill the space under the jaw and the jaw line will appear shallow.

In order to train the muscles in the floor of the mouth to tighten, the tongue must find an

appropriate rest position on the roof of the mouth. (07) This is the role of the suprahyoid

muscles and the palatoglossus. This action and upward pressure should continue to tighten

and tone the muscles that support the neck and face like a natural face lift and also act to

improve the bone shape of the face.

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The nerves of the face

There are 12 cranial nerves. These nerves act as either sensory or motor

nerves to interpret sight, smell, taste or control movement. These

nerves connect the brain to different parts of the head, neck and trunk.

Of the 12 nerves that control the head, 5 have an effect on the muscles

of the jaw and the act of swallowing. The trigeminal nerve, facial nerve,

vagus nerve, accessory nerve and hypoglossal nerve. Of these nerves

the most intriguing in the vagus nerve which directly affects resting

tongue posture and coincidentally is also called the wandering nerve as

it is the longest cranial nerve with branches that affect the heart, the

diaphragm and the gut.

It is this property of the valgus nerve which connects the brain to the

gut and visa versa. The vagus nerve is key to the body’s Autonomic

Nervous System. This is the behind the scenes system with involuntary

changes within the body such as digestion and heart rate. The vagus

nerve acts to calm the body down for a state of rest and digest and is

labelled the parasympathetic nervous system. Its functional opposite therefore, is the

sympathetic nervous system which, readies the body for fight or flight. This adrenaline

pumping response is something we see a lot of in todays civilised, go getter society. It is

therefore so important that we honour our rest and digest pathways. When someone has

dysfunction in the valgus nerve we might find any of the following problems. Poor digestion,

imbalance in the microbiome, allergies and respiratory conditions, autoimmune diseases,

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poor swallowing technique, poor diaphragmatic breathing, elevated heart rate, constipation,

bloating and chronic pain.

Interestingly the gut is referred to an the enteric nervous system which can act independently

of the Autonomic nervous system. (08) It is therefore considered to be the second brain

producing more serotonin and dopamine then the brain. The vagus nerve is at the center for

research into treatments for Anxiety, Alzheimer’s, Parkinsons, Autoimmune diseases with a

major emphasis on nerve stimulation treatments.

In this case study I aim to treat vagal tone to heal the gut, improve breathing and activate the

muscles in the face and jaw line. I propose that through BASI pilates principles of awareness,

balance, breath, concentration, centering, control, efficiency, flow, precision and harmony

we can improve parasympathetic nervous stimulation and posture which will have a direct

affect on the neural pathways of the vagus nerve and the muscles that support the face.

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The vagus nerve can be stimulated through the following exercises. Deep diaphragmatic

breathing, singing or humming, holding your breath or the Valsalva manoeuvre. These

principles can be simulated and incorporated into the original matwork and apparatus

exercises.

Breathing and the Face

Breathing is something we do daily on average 16 times a minute. Something we have done

all our lives. Modern day living has made this automatic process difficult to get right and we

are seeing an epidemic of breathing related issues such as sleep apnoea and asthma. The

diaphragm is the primary breathing muscle alongside the scalenes and intercostal muscles.

They are responsible for changing the pressure inside the ribcage and encouraging the lungs

to fill with air. The accessory breathing muscles of the pectoralis major and minor, the

sternocleidomastoid, serratus posterior (inferior and superior) and the latissimus dorsi help

with this volume change. With the increase in desk work and poor posture, forward head

carriage and increased stress, we have noticed a steady decline in quality posture. This places

extra stress on the thoracic spine and

therefore the organs. As the body bends into

flexion the diaphragm cannot expand easily

against the slumped posture. Stress levels

lead to apical breathing patterns where we

see people breathing with their shoulders

and only into the first third of their rib cage.

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This reduces the tidal volume of air entering the lungs and possibly gasping or mouth

breathing ensues. Permanent slumped posture leads to a forward head carriage.

As you can see by the images above the upper crossed syndrome not only has an effect on

the muscles of the trunk but also of the face. In order to correct this habitual posture we now

need to address the major imbalance in the skeletal system while simultaneously addressing

systemic issues as well. This prolonged posture affects the airway and can lead to chronic

strain on the body. The image below shows an obstructed airway from a retruded jaw.

In additional to the postural demands of a modern society we have increased health issues.

Chronic sinus problems, allergies and pollutants have caused many a bad breathing habit.

Nasal breathing is the norm in infants but we see children with chronic ear infections and

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asthma adopt a mouth breathing posture and the effects of this on the growth of the bones

in the face are profound.

Above is an image of a 10 year old boy who at age 10 shows good alignment and body

formation but by age 17 has a significant downward sloping face. It tuns out that he received

a pet hamster in his early teens and the chronic allergy led him to adopt a mouth breathing

posture and significantly affected the outcome of his appearance.

These changes in facial features are quick in children but one can hypothesise that bony and

muscular changes are possible in adults too. Within your lifetime you can affect your own

facial form as sutures in the face have not solidified until 75 years old. It is therefore possible

to create an upswing in facial features in all ages.

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What is Good Oral Posture

Good resting oral posture is with your teeth lightly touching and with the tongue on the roof

of your mouth. This position is said to be the most optimal position for airway flow and muscle

tension. It is said to result in both a better bony formation and muscle development.

One study has gone as far as to say that when the tongue is on the roof of your mouth isolated

knee extension strength using state of the art testing reveals as much as 30% improvements

in results. (9) So not only will this position improve appearance but also performance. It is

therefore possible and surely advisable to cue clients to assume proper oral posture in all

pilates movements.

How Can Pilates Help

Joseph Pilates developed this method of exercise with the following 6 principles: centering,

concentration, control, precision, breath, and flow. Breathing and purposeful movement with

a mindful intension must be taught throughout the sessions. This makes for an incredible

opportunity to cue oral posture. Not only can we prescribe exercises to work directly on the

face we can improve the entire system to help achieve better alignment with the BASI Block

system.

A number of exercises in the repertoire are intentionally designed to massage the stomach.

Gut motility and massage (also referred to as visceral manipulation) is achieved through

flexion in the trunk in abdominal exercises, through mechanical compression in exercises such

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as stomach massage on the reformer when the knees compress into the tummy. Rest position

on the mat and even work done prone on the barrels mechanically compresses the stomach,

massages the organs and loosens the bowels. This helps with gut motility and therefore gut

health and will impact the body’s ability to maintain a healthy biome and therefore fight off

allergies.

Pilates is well known for the benefits of breathing. Using the lateral breathing focuses on the

diaphragm to draw in the breath. This benefit of diaphragmatic breathing helps to reduce

tension in accessory breathing muscles which allows a more natural neck and head position

as well as movement in the respiratory diaphragm in the body. Movement and flexibility in

the diaphragm is vital for lymphatic movement. (10) The diaphragm is also a key component

in vagal tone. Using the principles of centering, awareness and harmony we can achieve

feelings of presentism, reduced sympatheic activity and increased vagal tone.

Several muscles are involved in expiration. Forced expiration occurs in pilates at the end of

each breath with an emphasis on abdominal recruitment. Research has shown that forced

expiration produces a Valsalva manoeuvre and draws the hyoid bone upward. (11) The act of

forced expiration is predominantly caused by the abdominals. (12) By recruiting these

muscles to expel all the air out of the ribcage we can affect oral posture and also stimulate

the vagus nerve.

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Not only is breathing able to stimulate the nerve that helps with oral posture but the action

of taking the breath to its maximum on inhalation and exhalation helps to draw the

suprahyoid up and so too the tongue.(13)

By cuing clients to hold the correct resting tongue position in sessions and out of sessions we

can assist with facial posture and appearance.

Case Study

I decided to do my case study on myself. I have been battling with my oral posture for several

years. I noticed changes in my profile in photos and felt that I had less space inside my mouth.

I have never experienced pain in my mouth or face but felt a fullness of my tongue which I

had never noticed before. It was not until I started working on my case study that I learnt the

significance of my tongue and my history. This case study has been invaluable to me and I am

so grateful to have learnt so much through the process.

Client History

Orthopaedic

I am a 35 year old female with rounded shoulders and forward head posture, a c7 prominence

and down sloping face. In 1998 I had braces on the top jaw for a period of 6 months after

which I wore a plate for a short period. I did not complete treatment and had a gap in my

teeth for which I received a bridge in 2010. In 2019 I had 4 wisdom teeth extracted and the

canine tooth that was imbedded in my palate was surgically removed. I do have a history of

back pain and I had a C section in 2015.

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The decline in posture and the drop in facial profile was slow and steady over a 10 year period.

I do have complaints of chronic abdominal pain and inflammation and environmental allergies

which began in 2002 at the age of 19. I do experience bloating and constipation.

Personal Postural Findings using Video footage

Right hip hike and right shoulder lower. Pelvis has anticlockwise rotation and a trendelenberg

gait on the right. Functional C curve scoliosis to the righthand side. Tight cervical lateral

flexors and locked short suboccipitals. Tight scalene muscles bilaterally. Week deep neck

flexors and thoracic spine extensors. Tight pectorals and upper rectus abdominis but weak

and tight psoas with weak hip extension.

Goals My aim is to improve the appearance of my face and my kyphotic posture, to improve

diaphragmatic breathing, facial posture and oral alignment. I would like to aid with digestion

and reduce my chronic pain and bloating.

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Pilates Prescription

Week 1

BASI BLOCK SYSTEM

EXERCISE PRESCRIPTION THEORY AND SPECIFIC SUGGESTIONS OR CUES

Warm Up Roll Down

Self Auditing process to check in and center the mind. Essential when trying to work on vagal tone. The stomach massage helps with gut motility. I would cue sternal depression as apposed to cervical flexion to emphasize exhale and also work the deep neck flexors.

Foundation

Pelvic Curl Focus on sternal depression and reduced rib cage flare. I noticed excessive chin tuck with the curl up and had to adjust with extension in the cervical spine.

Spine twist Again the chin tuck was present with elevated sternum. Neutral was hard to hold. I placed a physio ball under feet.

Chest Lift Emphasis on neutral pelvis and reduced neck flexion. Used the isometric extension of the neck to avoid sternocleidomastoid involvement and also encourage the teeth to meet on the inhale.

Chest lift w rot

Abdominals

Teaser prep I could watch myself in the mirror and focus on jaw posture throughout the movement. The reversed breathing meant forced expiration in the mirror and long drawn in inhale during the hardest part of the movement.

Double leg stretch

Neck pull Lovely stretch into the cervical extensors as I did pull gently on the head to stretch the whole spine.

Spinal Articulation

Rolling Like a Ball

Introduces the concept of fluidity in movement while still working on abdominal control. The massage on the spine

Spine Stretch Deep neck flexion here at the end range with general spine extensions keeps the alignment and chin position correct.

Roll over Cervical and thoracic spine stretch as well as abdominal control.

Bridging

Front Support

Shoulder girdle strength is vital for face and neck rehab. Scapular setting and alignment of the cervical vertebra with length and strength can and must be achieved.

Modified back support

Doing back support with bent knees helped the glute and leg muscles to work in anticipation of back support which helps visualise the end goal in the next exercise. The flexibility of the shoulders will affect neck position and therefore face position. This exercise is tough for me as I always have my head up instead of back.

Back support Trying to do it fully Lateral Flexion & Rotation

Side lifts

With the moderate scoliosis these are needed to address right and left imbalances.

Side bend

With the curvature of my spine this is a lovely stretch and controlled strengthening exercise. The addition of neck rotation helps to stretch the lateral musculature without compressing anything. It’s a lengthening and twist action.

Side kick kneeling TBC bridge

Weak glute medius on the right. This exercise helps strengthen in weight bearing. The flexion and extension at the hip also challenges the psoas and glute maximus to work in an agonist and antagonist way with a lovely stretch

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in both directions. The leg also needs the hip abductors to engage to maintain height. Head position is greatly influenced here by the momentum of the heavy limbs and it was good for isometric neck extension in front of the mirror.

Back Extension

Basic Back Extension Focus here was on spine length and not height. The distraction of the cervical vertebra help make space under the jaw and the adduction of the arms opened the chest and helped stretch the scalenes and upper trapezius,

swimming

Percussive breaths and rhythmical movement on the tummy help move the lymphatics. This lengthly breath will aid in full expiration and working the slings of the posterior chain help bring the neck back into appropriate alignment.

Rocking prep

Stretching the hip flexors and opening the upper rectus abdominus will help with my overall posture but being on my stomach has a wonderful massaging effect on the organs. Rocking prep into rocking helps to do visceral mobilization and this brings stomach and gut relief. It is through this process that I also hope to free the diaphragm and assist lateral breathing.

Cat stretch Simple and so important to be able to control segmentally the curves of the spine. Both isolate and integrate. This exercise for me is the perfect auditing process for the health of my spine.

Cool Down Rest Position

Deep restorative breaths helped me to re center and bring a calmness back into breathing which was full and diaphragmatic. The rest position ensures that the intercostals get a lovely stretch with each breath and that the sternum is depressed. Avoiding apical breathing. I often feel breathless after swimming so bad habits can creep in especially with the chest opening rocking exercise.

Roll Down Checking in again and feeling the changes

Weeks 2 – 5

BASI BLOCK SYSTEM


Warm Up Roll Down

Self auditing process to check in and center the mind. Essential when trying to work on vagal tone. The stomach massage helps with gut motility. I would cue sternal depression as apposed to cervical flexion to emphasize exhale and also work the deep neck flexors.

Foundation

Pelvic Curl Focus on sternal depression and reduced rib cage flare. Neck position. Spine twist Check for neutral and sternum depression. Chest Lift Focus inhale and isometric neck extension. Emphasis on oral neural Chest Lift w rot Pelvis neural with even rotation in flexion. Watch neck and face posture.

Foot work Reformer

The reformer footwork allowed me to focus energy on a neutral pelvis and sternum. The spring tension helped with exhalation and inhalation rhythm.

Abdominals Chair

Standing pike

This fundamental abdominal exercise in the abdominal block brings in scapular stabilization. This is key to setting the tone for the rest of the session bringing focus is into what the shoulder blades are doing. The deep breath abdominal connection in the exercise is perfect to massage the stomach and work on vagal tone.

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Cat stretch kneeling This exercise brings in flexion and extension with an acute awareness of head position in space.

Sitting pike

Again attention went to scapular stability and also the pelvic floor. Through thoughtful breath the abdominals received a deep activation and the large latissimus dorsi group is also strengthened. The long c curve helps with deep sternal depression and so the deep neck flexors have to work to maintain the length throughout.

Hip work

Reformer Hip series Frog Neutral pelvis with hip disassociation was difficult. My adductors are very

tight and I compensate. It appears there is a rotation in my pelvis as well as the hip hike a possible innominate rotation. The straps help to highlight the differences in the two sides. Springs will be even better.

Down Circles Up circles Openings

Spinal articulation NONE

Stretches

Pole series

Shoulder stretch Keeping the head from chin poke here is tough. My shoulders battled to externally rotate.

Shoulder stretch 2 The right side was stiffer then the left. Pec minor is tight but this felt so good. Side stretch This was surprisingly difficult for me. I tend to flex forward out of the stretch. Spine twist Ladder barrel

Shoulder stretch 1 Good active stretch. I focused on levator scapular stretch as I did protract the scapular in standing.

Shoulder stretch 2 In preparation for the shoulder stretch on the Cadillac Full body integration F/I

NONE

Arm work

Arm supine series on Reformer

Stable base for the scapular but open chain. The neck was rested and we could cue tongue throughout.

Extension Adduction Up circles Down Circles Triceps

Full body integration A/M

NONE

Leg work Reformer Single leg Skating I need glute med work in standing for the trendelenberg gait


NONE

Lateral flexion and rotation

Mermaid I am so tight in my lateral flexors and the internal hip rotation is wonderful. I particularly need the isometric neck lateral flexor work through a change in posture to reiterate the facial posture.

Side over Box Added isometric neck extension to the mermaid awareness of head placement.

Back extension Chair

Swan basic on chair Tongue posture and Deep inhale and exhale. Had to think about the deep neck flexors to stop the cervical extensors compensating for my rigid

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thoracic spine. Stomach compression through weight bearing on the chair to help with tight psoas and bloating

Swan on floor Larger range and more stability required. Had to work hard not to chin poke at the end of breath to get my head down. Created a slight Valsalva in the terminal exhale.

Rest position Deep breaths and an intercostal stretch

Week 6-9

BASI BLOCK SYSTEM


Warm Up Roll Down


Foundation

Roll up Much improved head carriage on the roll up but incidentally more difficult to keep pelvic lumbar stability. Possibly because of changes in the trunk.

Spine twist Much less pec minor shortening for stability so the shoulders stayed down more

Double leg stretch Focused on deep neck flexion and tongue with dramatic breathing Single leg stretch As above Crisscross Isometric neck extension with more height in the chest lift.

Foot work

Cadillac

Parallel heel Stomach massage in this position will help with the gut and the added emphasis on maintaining neutral pelvis will stretch into the back for my lordosis.

Parallel toes Ankle work also aids in the pelvic floor and neck connection V position toes Adductor strength can help with tightness Open V Heels Stretch and strengthen Open V toes Ankle stability Calf raises Ankle strength and hamstrings Prances Breath work and the diaphragm for vagus nerve and lymphatics. Single leg Heel Pelvis position Single leg toes Pelvis position and ankle

Hip opener Adductor stretch is also needed to open up the pelvic floor so that the diaphragm can work properly.

Abdominals

Cadillac warm up series

Roll up with roll up bar Assisted roll up because of the tightness in the warm up and trying to recruit deeper

Mini roll-ups Scapular control and deep neck flexion focus. Tongue position and space between the sternum and the throat emphasized.

Mini Roll-ups oblique

External rotation of the makes more protraction and space on the shoulder girdle. Had to work hard not to get c7 prominence and chin poke. Had to think about depressing the sternum into the rhomboids and protract more.

Roll up Top Loaded Lovely shoulder stretch and head position challenge.

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Hip work

Cadillac Basic leg springs

Very different from the reformer as the instability between the two sides was very evident. Stability in the pelvis was difficult as is timing of the 2 legs. I will have to continue with fundamental hip exercises for some time.

Frog

Neutral head position meant I could soften the neck and maintain. Great deep neck flexion and scapular stability moments here.

Down Circles Up Circles Walking Bicycles

Spinal articulation Tower prep

Cervical neck extensor stretch. Had to work hard not to let the movement come from c7 and rather had to do deep neck flexion and feel the stretch into the mid back and upper c spine.

Stretches

Ladder barrel Shoulder stretch 1 Again I did the shoulders but added the Cadillac shoulder stretch to loosen

the capsule. Shoulder stretch 2 Cadillac Shoulder stretch Very difficult and reminded me of the pole series limitations but I need

this to be able to do the back support without a chin poke. Reformer Kneeling lunge Hip flexor and hamstring stretch with a nice upright position to correct

the hips and fix the neck posture. Also weight bearing on the arms so bringing scap stability into the picture and even breath. So much to this exercise and a great way to make things more functional.

Full body integration F/I

Up stretch 1 Scapular stability and stretch and preparation for the other up stretches which I need

Down stretch This reverse c curve will help with my kyphosis and try return flexibility to my thoracic spine so that my cervical can remain in lordosis and not flatten as much.

Stomach massage series

Round back, flat back and reaching

Mechanical abdominal massage and deep neck flexion in round back and then the challenge increased as we got straighter and then unassisted with the reaching.

Arm work Cadillac

Sitting side prep Scapular control

Sitting side

This was too difficult to do well. But definitely needed for all other weight bearing or open chain exercises. I should do more hug a tree and protraction work with springs instead.

Chair Shrugs In preparation for Back support and balance control back. The upright

posture helped to align the spine and think about neck and jaw position. Tricep press sit Tricep prone Closed chain in front of mirror


NONE

Leg work

Chair

Backward step down Ankle work in weight bearing and now functional glute medius work on the weight bearing limb with knee tracking. Arms in front to protract scapular. Mirror to check posture and facial expression.

Hamstring curl Concentric and eccentric control.

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Chair Side stretch Adding on from the reformer. An easier exercise but without the foot

strap I have to actively anchor my own foot so I round it harder because it was easier. More about control and less about strength. It made me hyper aware of not leaning forward.

Side kneeling I tried these although we hadn’t learnt them yet as I could tell I needed more lateral work. Keeping the knee down was difficult but maintaining head position was much easier then previous weeks.

Back extension

Reformer

Pulling straps 1 and 2 Great shoulder depressor and back extensor. Working the lats helps to depress my shoulders and stretch my scalenes.

Breast stroke Movement in the shoulders will hopefully free my scapular I was careful not to over extend the cervical spine and over stretch the suprahyoid muscles. It was difficult to control with so much happening.


Week 10 to 12

BASI BLOCK SYSTEM


Warm Up Roll Down


Warm up series on the cadilac

Roll up with roll up bar

Having done this exercise the weeks before in the abdominal block I chose to do it. I was also considering the Avalon warm up because I like the extension to neutral to flexion component but ultimately think I need to wait for better neck stability.

Mini roll ups Mini roll up oblique

Roll up top loaded

Foot work chair

Parallel heels

Upright and face focus. Breath, tongue and sternum. Added variations in the arms.

Parallel toes V position toes Wide heels Wide toes Calf raises Single leg toes Single leg heels Abdominals Reformer Short Box series

Round back Upright and face focused.

Flat Back

Tilt Hands behind the head for position and like my lateral flexion blocks before I struggle with range but much improved awareness.

Twist Stay on my axis here. Learning to turn the body and not the neck or flex the spine.

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Round about Tough on oral posture at the reclined angle but a good opportunity to learn.

Climb a tree

Had to work hard not to hyper extend c spine and then also not to chin poke on the climb up the leg but enjoyed the challenge and also the little stomach massage on the 3 knee to chest pulls at the top in extension. A really good exercise to show case improvement in cervical spine control.

Hip work

Reformer Hip work series 2 Down circles

Dynamic adductor control and an opportunity to cue breathing and focus on length in the c spine and a scalene stretch on the shoulder pads.

Up circles Extended frog Extended frog reverse

Spinal articulation

Short spine Rolling along the spine and massaging the tummy helps with gut inflammation. This also stretches the cervical spine and prepares me for the next exercise.

Long spine

Control on the shoulder girdle with the legs in the air all the while affecting spinal articulation was necessary and I achieved it. I feel more confident with the curves in the spine and my ability to control them in space.

Stretches Full lunge on the reformer

Pole series Moving back to the pole series to see the improvements and it felt great.

Full body integration F/I

Up Stretch 1 Scapular control, neck alignment and trying not to become kyphotic. These are difficult but necessary Up stretch 2

Long Stretch

Arm work

Cadillac Shoulder adduction Double arm

Lats and lower traps with focus on sternal depression and a slight jaw jut.

Sitting side prep I stuck this one out and it improved

Sitting side


Side reach

This full body movement stretches into the chest and shoulder adductors and the neck alignment was very difficult for me. It just always looked funny until I realised how tight my Sternocleido mastoid was and I actively added stretches for the scalenes and SCM. This helped as did a little jaw thrust. It was as if I was retracting the jaw under effort instead of the neck.

Sitting back I added this exercise because of the shoulder stretch

Leg work

Chair

Hip Opener Because I did foot work on the chair I chose not to do quadriceps and hip extensor glutes in the leg work block and did adductor stretching and external rotation exercises.

Frog front This exercises was also my nemesis before in the lectures when I did the demo so to be able to open up the hips and finally do it properly without looking awful was a great achievement.


Cadillac

Side lift I did a concentric strengthening exercise here as I had previously wanted to stretch more then strengthen. I felt I had the length.

Back Extension

Prone 1 In preparation for the prone 2

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Prone 2 Huge shoulder stretch here and hanging head potential. I made sure to

think of oral posture and slow breathing with deep end of breath moments.


Conclusion

Through the use of postural correction, oral posture and resting tongue awareness and with

an emphasis on the full body BASI block system exercises it is possible to improve the

appearance of the face. With muscular changes within the muscles of the neck and head the

face appears slimmer and more aligned. If implemented earlier in life this kind of program

prescription can and should have a significant effect on face formation. This will mean fewer

orthodontic and surgical interventions.

Above is an image of my face over a 3 month period. The initial image is of my face completely

relaxed. The second picture shows the face with corrective oral posture 1 week into the

program. The 3rd image is at the 2 month mark and the final image is at the 12 week mark in

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the program. Notice how over time the tongue position’s effectiveness to lift the hyoid

improved and as did the muscle bulk of the masseter in the final picture.

Although the digestive system improvements are mild I am encouraged by the improved

comfort levels and am eager to continue with this program.

In conclusion, I would encourage instructors to consider this concept with their clients and

possibly add tongue position cues from time to time. I would also recommend asking clients

about other environmental factors when trying to work on postural issues and refer out

where necessary to address systemic problems affecting nasal breathing and tongue position.

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Bibliography

1) Grammer, K.; Thornhill, R. (October 1994). "Human (Homo sapiens) facial

attractiveness and sexual selection: the role of symmetry and averageness". Journal

of Comparative Psychology. 108 (3): 233–42. doi:10.1037/0735-7036.108.3.233.

Retrieved 4 May2019.

2) Jones, B. C., Little, A. C., Tiddeman, B. P., Burt, D. M., & Perrett, D. I. (2001). Facial

symmetry and judgements of apparent health Support for a “‘ good genes ’”

explanation of the attractiveness – symmetry relationship, 22, 417–429.

3) Chaves TC, de Andrade e Silva TS, Monteiro SA, Watanabe PC, Oliveira AS, Grossi DB.

Craniocervical posture and hyoid bone position in children with mild and moderate

asthma and mouth breathing. Int J Pediatr Otorhinolaryngol. 2010;74(9):1021-7.

4) Primozic J, Farcnik F, Perinetti G, Richmond S, Ovsenik M. The association of tongue

posture with the dentoalveolar maxillary and mandibular morphology in class III

malocclusion: A controlled study. Eur J Orthod 2013;35:388-93.

5) Chen, Jan-Hung, et al. “Boning up on Wolff’s Law: mechanical regulation of the cells

that make and maintain bone.” Journal of biomechanics 43.1 (2010): 108-118.

6) Burr, David B., et al. “Bone remodeling in response to in vivo fatigue

microdamage.” Journal of biomechanics 18.3 (1985): 189-200.

7) Carlson CR(1), Sherman JJ, Studts JL, Bertrand “The effects of tongue position on

mandibular muscle activity.” J Orofac Pain. 1997 Fall;11(4):291-7.

8) Furness JB, Costa M (1987) The enteric nervous system. (Churchill Livingstone,

Edinburgh).Google Scholar

27

9) di Vico R, Ardigò LP, Salernitano G, Chamari K, Padulo J. The acute effect of the tongue

position in the mouth on knee isokinetic test performance: a highly surprising pilot

study. Muscles Ligaments Tendons J. 2014;3:318–23.

10) Moore JE, Bertram CD (2018) Lymphatic system flows. Annu Rev Fluid Mech 50:459–

482

11) Zach MS. The physiology of forced expiration. Paediatr Respir Rev 2000;1:36–39.

12) Mansfield P, Neumann D , Kinesiology of Mastication and Ventilation. Essentials of

Kinesiology for the Physical Therapist Assistant (Third Edition), 2019

13) Melissa Wheeler et al. The Pediatric Airway. A Practice of Anesthesia for Infants and

Children (Fourth Edition), 2009

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