Something I've noticed more and more with training/treating is some seriously poor jaw positioning in clients. Whether it's just resting posture or the middle of a big lift, people go thru some weird jaw movements: flaring it wide open, biting down hard and grinding, protracting the jaw forward, or just being slack-jawed. Besides weirding people out, it indicates that we are lacking a strategy for maintaining a stable, centered jaw position over the upper cervical spine which is critical for movement integrity, neural output, and resolving neck or jaw pain including headaches. Essentially, the system is looking for stability and finding it in dysfunctional positions.
We know that head position can actually influence pelvic tilt such that a forward head or looking up during a lift promotes an anterior pelvic tilt and an overextended lumbar spine - which is why we should NOT cue athletes to "look up" during squats or deadlifts. I previously wrote that mouth breathing can destabilize the cervical spine and certainly it affects jaw position. Developmentally, motor control is learned from proximal to distal and from head to toe (i.e., we learn to move the jaw before the lips and tongue; control the head before the arms). The ability to keep the head in midline is a prime example of developmental progress. So by accessing a developmental or primitive pattern and setting the jaw (including the tongue) into a stable position, we can better access the nervous system and promote adaptation and improve output.
So what is the stable position of the jaw?
The mandible attaches to the temporal bone like a boat to a dock - it's floating around in there rather than anchored like the hip, for example. What this means is it's a joint that requires loads of stability and motor control for optimal function.
Ultimately, the jaw is not optimally stabilized if we do not have full cervical range in all planes while maintaining the lips sealed, jaw slightly open, and the tongue at the roof of the mouth. Having that tongue position really optimizes and integrates the whole system.
Check out the video below for a few ideas on improving upper cervical spine mobility and jaw positioning. These are also clutch for tension-type headaches.
Not having the basics of jaw positioning (including the tongue) just won't cut it and will lead to alterations in the nervous system, spinal control, and power generation.
This is the first in a multi-part series on breathing and performance. I think we can all agree that mouth breathing is not ideal. It ruins your date and makes you dread sitting next to a mouth breather on an airplane. But aesthetics aside, it significantly compromises the ability to maintain a packed neck position which, we discussed in the last post on jaw pain, alters the control of the head and neck.
Here's the deal: with chronic mouth breathing (present in >50% (!) of the population in some studies), the body naturally adopts a forward head posture as a compensation to maintain an open airway. This causes a tilt of the rib cage (overextension fault - we've established in previous posts that is a major no-go) to keep the chest upright. What we've seen clinically and in the research, is that once the stacked posture of rib cage over pelvis is lost, the diaphragm is at a mechanical disadvantage (becomes less efficient) and its synergy with the abdominals is lost - they both shut down.
In order to maintain aerobic capacity with decreased diaphragm activity, we adopt a mouth-open upper chest/neck breathing pattern that is both ineffective and costly. This faulty pattern will rob you of performance and exercise capacity because you're increasing the work of the accessory muscles in your neck and upper chest which is metabolically very costly. With heavy breathing during training, we further challenge this system which is often exacerbated by the cue to "look up" during squats, deadlifts, etc. reinforcing this faulty mouth-breathing pattern.
Furthermore, the more you breathe (gulp) with the chest and neck, these muscles (SCM, scalenes, pecs) become quite stiff increasing the forward pull and shear on the cervical vertebrae - especially the scalenes as they attach directly onto the spine. It's pretty common to see this neck breathing pattern in those with cervical radiculopathy (impinged nerve roots) and TMJd. Weird that they often have a forward head posture too, right? (hint - it's not weird at all) The 1st rib can get chronically elevated as well, limiting overhead shoulder position. The overall result is a destabilizing effect and faulty mechanics in the entire upper quarter.
Here's the fix: Remember having tantrums as a kid and your mother would tell you to "breathe in thru the nose, out thru the mouth"? Mother was helping you out because by inhaling thru the nose you automatically adopt a more upright, packed neck position.
In the past few weeks I have seen numerous athletes with jaw pain or TMJd (temporomandibular joint dysfunction- Google it for more general knowledge). In all cases, they had chronic forward head positioning particularly exacerbated with heavy exertion. We see this often with athletes, the head juts forward (aka chicken neck) when concentration is diverted towards completing the movement (particularly with overhead movements and lifts such as the overhead squat, snatch, pull-ups, throwing). This forward head protrusion is also clearly a postural fault seen in daily life, particularly those deskbound at work. There is some research to support head-neck posturing and jaw dysfunction. And most importantly, forward head/ugly posture decreases your attractiveness (but you probably already knew that, Quasimodo).
Anatomically, a forward head changes the line of pull of several muscles (the infrahyoids) running from the mandible (lower jaw bone) to the sternum and even the scapula. This new alignment causes an altered pull on the jaw jamming up the delicate, sensitive disk within the TMJ. So if we're adding poor control of the head (forward head posture is an open, unstable position) to an altered and weak jaw alignment, the result is an ugly - literally - and painful TMJ. The real problem is that coaches and athletes are NOT paying nearly enough attention to head position and it's impact on the jaw. Especially when athletes are biting down hard, adding huge compressive loads to a poor jaw position in an effort to close the circuit and gain stability.
Here's the fix:
As with prior posts on prioritizing spinal position, proper head and jaw position is crucial to avoid injury and stabilize movements.
Thoughts? What are some cues you use to fix the dreaded chicken neck position?