This past weekend I had the pleasure of taking Cervical Revolution for the 2nd time. My first go around was the class debut in January of this year. I had also taken the original TMCC course as well a year before that. Based on my cervical-cranio-mandibular ride thus far with its most recent stop in NYC last weekend, I must say that Ron (and Mike Cantrell) have done an excellent job of re-synthesizing this material for clearer comprehension and practical application.
I believe that the concepts covered in Cervical Revolution are an essential piece of the PRI chain. In order to truly integrate the body, one needs to know not only what is occurring below the neck, but at the neck and above as well. The following case study supports the importance of learning how to engage with the cervical-cranio-mandibular system:
A 40 y/o gentleman who is a competitive underwater hockey player presented with R shoulder pain over the past 5 months. His history was unremarkable except that he finished up Invisalign 2-3 years ago but still wore his top appliance at all times during the day and night. He reported the reason behind wearing the retainer was because his teeth would shift without it.
He initially tested positive bilaterally for restricted humeral glenoid internal rotation, abduction (pain on the R), flexion (pain on the R), toe touch, straight leg raise, adduction drop test, cervical lateral flexion, and cervical axial rotation putting him in a pattern of a PEC, B BC, B TMCC. He also was weak and painful with the R "full can" test for rotator cuff strength.
I started out treatment with Standing Supported Wall Squat and Reach and Modified All Four Belly Lift which resulted in about a 50% improvement in his testing. I then had him remove his Invisalign retainer and his testing went to neutral. However, he was unable to reciprocally find his bite. This means he was unable to make contact on one side of his molars without contact on the other side. Regarding his cranio-mandibular positioning, his mandible was centered and his cant seemed fairly even (it may have been being marginally higher on the right). His right temporal bone was observed to be in a little more external rotation/flexion compared to his left. For those that have taken Cervical Revolution, this indicates he may be in a right torsion cranial pattern but it appeared mild. His bite was Class 1 with canine guidance during full laterotrusion and no interferences bilaterally. This means he had good occlusion and range of motion.
Based on these findings, I conjectured that by wearing his Invisalign retainer for so long he essentially locked up his cranium which had a parallel impact on this thorax and pelvis. I then gave him Standing Alternating Cranial Expansion (a Cervical Revolution exercise), taught him how to properly position his tongue to prevent undesirable teeth shifting while encouraging movement in the cranial complex, and instructed him how to practice finding his bite in a reciprocal manner. This will not only get his cranium moving but his neck, thorax, and pelvis as well.
By the end of the treatment, he was able to move his shoulder in the directions that previously were restricted and painful with full range of motion and no pain. Furthermore, he was able to hold his arm in a "full can" test position without pain and improved strength.
The ability to manage this patient is owed to the concepts I learned from Cervical Revolution. Even if one doesn’t directly treat head, neck, and jaw conditions you will gain incredibly powerful tools that apply to not only this region but below it. After all, our bodies are ultimately connected from the foot all the way up through the head and vice versa. If we want to keep evolving our abilities to help our clients and patients, consideration of integrating the cervical-cranio-mandibular system is essential. Furthermore, this complex supports crucial neurological and sensory matter that impacts system wide regulatory function. Getting the head and neck to properly re-position and synchronize with the thorax and pelvis can not only impact how we move but how our entire neurological system functions. I can’t wait to find out how this relates to the auditory system and vice versa at the spring Interdisciplinary Integration Symposium next year!
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