Thursday, April 27, 2017

One Exercise that helps Sleep Problems


What does Tongue to the spot mean? Why do I need to do that? Who is it for? Why will it help me sleep better?

What does Tongue to the Spot mean? Touch the anterior portion of the alveolar ridge (right behind the upper central teeth) using a cotton swab, tiny dental band, life saver or a tongue depressor. and hold the tongue on the "spot" 5-10 times for several seconds at a time. Repeat the holding procedure several times a day in order to insure awareness for the tongue tip's in the correct resting position. This also strengthens the tongue in this position.

Why do I need to do that to sleep better?  This exercise helps awareness of proper placement of the tongue tip when at rest and when initiating the swallow pattern. This is the natural resting position of the tongue to allow air to pass through the nose, allowing good, nose breathing sleep. Also reducing mouth breathing, sleep apnea and snoring.

Who is it for? Anyone that mouth breaths, snores, has sleep apnea, "buck" teeth from tongue thrust, lisp, TMJ etc. young and old, you are never too old to strengthen your tongue and sleep better!

Wednesday, November 2, 2016


What is an Orofacial Myofunctional Disorder?

Orofacial Myofunctional Disorders (OMDs) are disorders of the muscles and functions of the face and mouth. OMDs may affect, directly and/or indirectly, breastfeeding, facial skeletal growth and development, chewing, swallowing, speech, occlusion, temporomandibular joint movement, oral hygiene, stability of orthodontic treatment, facial esthetics, and more. Most OMDs originate with insufficient habitual nasal breathing or with oral breathing.

The subsequent adaptation of the muscles and the orofacial functions to a disordered breathing pattern creates many OMDs. Orofacial Myofunctional Disorders may impact treatments by orthodontists, dentists, dental hygienists, speech-language pathologists, and other professionals working in the orofacial area.

Some Orofacial Myofunctional Disorders (OMDs) can be, but are not limited to;

    •    Tongue Thrust
    •    Jaw Pain
    •    Cross Bite
    •    Nail Biting
    •    Short Upper Lip
    •    Sleep Apnea
    •    TMJ/TMJD
    •    Thumb/finger/tongue sucking

Correct swallowing depends on a proper relationship between muscles of the face, mouth and throat. The act of swallowing is one function that depends on the body’s vital balance. To swallow properly, muscles and nerves in the tongue, cheeks and throat must work together in harmony. When a person swallows normally, the tip of the tongue presses firmly against the roof of the mouth or hard palate, located slightly behind the front teeth. The tongue acts in concert with all the other muscles involved in swallowing. The hard palate, meanwhile, absorbs the force created by the tongue.

Dental Problems related to an OMD

When a person swallows incorrectly, the tip and/or sides of the tongue press against or spread between the teeth.
This is commonly called a tongue thrust. Constant pressure from resting or incorrectly thrusting the tongue away
 from the hard palate may push teeth out of place. That pressure may later prevent teeth from erupting (breaking through
 the gum). An OMD may lead to an abnormal bite – the improper alignment between the upper and lower teeth known
as malocclusion. This problem may lead to difficulties in biting, chewing, swallowing, and digesting of food.

Tongue thrust is the act of pushing the tongue against or between the teeth when swallowing.

The constant pressure of the tongue against or between the teeth will not allow the teeth to bite together. This is 
as an open bite.

An improper alignment or malocclusion between the upper and lower teeth can lead to difficulties in biting and 
chewing food.

Orofacial Myofunctional Therapy (OMT) eliminates many of the causes of swallowing 

abnormalities and improper rest posture of the tongue.

Orofacial myofunctional therapy is painless and the exercises are relatively simple. When certain muscles of the face 

are activated and functioning properly, other muscles will follow suit until proper coordination of the tongue and facial

 muscles is attained. For success in this therapy, consistent exercise every day is necessary until the patient has corrected 

their improper muscle pattern. It also takes commitment by the patient, family – and time. Treatment usually consists 

of a regular program of exercises over a 6 – 12 month period, although treatment length may vary. 

Cosmetic Problems related to an OMD

Often the most obvious symptom of incorrect oral posture involves the muscles of the face. A dull, sluggish
appearance and full, weak lips develop when muscles aren’t operating normally. Constantly parted lips (with or without 
mouth breathing) also signal this disorder. A person swallowing incorrectly will often purse and tighten the muscles of 
the cheeks, chin and lips – a symptom known as a facial grimace. This can give the chin a knobby appearance because
these muscles are being overused.

The face can have a dull sluggish appearance when the muscles are not in proper balance. 

An incorrect swallow will purse and tighten the muscles of the cheeks, chin, and lips, causing a facial grimace. 

Mouth breathing or constantly open lips is a cause and/or signal of tongue thrust and low tongue rest posture.

Multi-Disciplinary Approach

A properly trained myofunctional therapist is one member of the team that will successfully treat an OMD such as
Robert Murdocco PT
Other allied professionals such as dentists, orthodontists, and osteopaths can ensure that the patient’s needs are
addressed and handled appropriately.
We feel that the patient needs to be looked at from a variety of approaches in order to be successful in treatment.

Speech Problems that may develop from an OMD

A person with abnormal oral muscle patterns may suffer a lisp or have difficulty in articulating sounds.
If muscles in the tongue and lips are incorrectly postured, this can prevent a person from forming sounds of normal speech.
Improper oral muscle function may additionally lead to TMJ dysfunction, headaches, stomach distress (from
swallowing air), airway obstruction, and other health challenges.

Sleep Disordered Breathing and Mild to Moderate OSA

Recent research has shown that myofunctional therapy may reduce the symptoms of sleep disordered breathing
(such as snoring),
and ameliorate mild to moderate OSA (obstructive sleep apnea).
When functioning and used properly, the muscles of the tongue, throat, and face, can reduce obstruction to the airway.

Positive Impact: With myofunctional therapy, a patient can regain the joy of eating, speaking, breathing, and even sleeping more soundly. Cosmetic improvements can help restore confidence and self-esteem. We believe that everyone deserves to be educated about myofuncitonal disorders and treated if they suffer from OMDs. We endeavor to increase awareness of OMT amongst the medical, dental, and academic communities to support the acceptance and progress of this profession world-wide.


Sunday, March 29, 2015

TMD/ TMJ Temporomandibular Joint Dysfunction and Physical Therapy with Robert Murdocco PT

TMD/ TMJ Temporomandibular Dysfunction

What is Temporomandibular joint Dysfunction?

The temporomandibular joint (TMJ) guides jaw movement. Problems with the TMJ are known as temporomandibular joint disorder or dysfunction (TMD). TMDis very common; more than 10 million people in the United States have it. For most people the TMJ problem is a temporary annoyance and resolves without treatment. For some, however, the pain is ongoing and treatment is needed. The underlying causes for TMJ pain are often difficult to pinpoint in the early stages. Contributing factors include bruxism (grinding teeth), stress and problems with alignment of the teeth. 

How can I tell if I have TMD? What are the symptoms?

Jaw pain
Jaw fatigue
Difficulty opening your mouth to eat ortalk
Ringing in your ears
Headaches & Migraines
Popping sounds in your jaw
Neck pain
Locking jaw

How did I get TMD?

Bad posture habits. One of the reasons TMD/TMJ is so common is because many of us spend a great deal of time sitting at a desk, and using our cell phones where we often hold our head too far forward. But there are many other kinds of bad posture. Sitting in the car for along commute, working at a checkout station, cradling a telephone receiver against the same shoulder for long periods of time, always carrying your child on the same hip—all can place the head in an awkward position and cause jaw problems. The "forward head position" puts a strain on the muscles,disk, and ligaments of the TMJ. The jaw is forced to "rest" in an opened position, and the chewing muscles become overused. In Physical Therapy  with Robert Murdocco, not only the jaw alignment is addressed, but posture corrections are made. Other symptoms of overstretched cervical muscles, forward head posture can include headaches, neck pain, poor neck rotation, difficulty opening the mouth, popping sounds in the jaw.

Chronic jaw clenching at night ("bruxism"). Many people clench their jaws at night while they sleep, usually because of stress. This puts a strain on the TMJ because of the constant strain on the joint and surrounding muscles. Many people have no symptoms for years. Symptoms include pain and fatigue of the jaw, difficulty chewing, clicking in the joint, teeth that are ground down.. etc. Robert Murdocco will use special techniques to massage and stretch the jaw muscles and ligaments. Myofunctional Therapy can also help relax the jaw muscles and align the tongue.

Problems with teeth alignment("malocclusion"). If your teeth come together in an unusual way, greater stress is placed on your TMJ. Robert will work alongside Neuromuscular Dentists and Dentists to help correct the neck and jaw alignment. The Dentist will complete the dental side i.e. fixing the misaligned teeth or "malocclusion".  Robert will complete the neck and jaw alignment. The collaboration with the Dentist is important so the long term outcomes are the best for the patient. The patients primary goal is to have no pain and be able to open/close the mouth properly.

Fracture and/ or Trauma. Ina traumatic accident involving the face or head, a fracture to the lower jawmay result, and even when the fracture is fully healed, TMJ stiffness and pain may remain. Sometimes the trauma was from years prior, even as a child with no symptoms after the event. However, over time the changes caused by the trauma (i.e. compression of the spine etc) begin to manifest. Other symptoms include neck pain, headaches, difficulty eating and opening/closing the mouth. 

Surgery.Following surgery to the face and jaw, there may be a loss in mobility and function of the TMJ.  Trismus ("lockjaw"). This condition—where jaw muscles spasm and the jaw cannot be fully opened—can be both a cause and a symptom of TMD. Other causes of trismus include trauma to the jaw. This requires Robert to massage and stretch the muscle spasm, relaxing the jaw.

Tongue Tie, Tongue thrust and Tongue misalignment. Having tongue ties and misalignment's can lead to chewing and resting position changes. Over time these changes can cause the jaw and neck to also change, causing TMJ, jaw pain, headaches etc..Robert uses combinations of Craniofacial, craniomandiular and myofunctional therapy on these cases. 

Asthma, chronic nasal congestion, sleep apnea and other illnesses. Conditions such as Asthma and chronic nasal congestion from allergies cause mouth breathing at night. Mouth breathing at night causes the head and neck to move back to allow the jaw to stay open. This constant position causes misalignment of the jaw and neck. It can require Dental  (Orthodontics) and Physical Therapy to correct. Robert uses a combination of craniocervical and myofunctional therapy in these cases. 

Facial atrophy and lip changes. Muscles of the face can atrophy and change, lip closure and fullness can change causing jaw pain. Robert uses myofunctional therapy to strengthen the muscles of the face and change the lip position. Movie stars in Hollywood now use myofunctional therapy in order to improve their facial features. 

How can Physical Therapy relieve my pain?

Robert Murdocco PT will review your medical history, and discuss any previous surgery, fractures, or other injuries to your head, neck, or jaw, review x-rays, MRI's etc.
Conduct a physical examination of your jaw and cervical spine/ neck.
He will evaluate your posture and how your cervical spine—your neck—moves. Then he will examine the TMJ to find out how well it can open and whether there are any abnormalities in jaw motion. 
Each case is individualized based on Medical History and Physical Assessment, no two cases are the same.  

Why use Robert Murdocco RPT, CFC? 

Robert Murdocco RPT, CFC is a Certified Specialist through the University of St. Augustine, he has over 20 years of experience as a Physical Therapist. He has dedicated educating himself specifically in craniomandibular, craniofacial, craniocervical, and myofunctional therapy. He has attended numerous conferences, lectures, workshops, min-residencies and study clubs throughout the country with world leaders in Dentistry, Physical Therapy, Medicine, Speech Therapy and Myofunctional Therapy. He incorporates all the techniques he has learned to provide the individualized treatment that each case requires.