My oldest son had to get braces for the 2nd time last week. He was born with a mild cleft in his lip that while visible, did not require surgery. However, it created some problems with his gum line and teeth.
He essentially has 3 front teeth because the cleft line went through his tooth bed and caused the tooth just left of his front tooth to split into 2 teeth. When his baby teeth came in he had 11 teeth on the top and 10 on the bottom. That same tooth was split into 2 adult teeth but it had time to grow together in the gum line so it came through as one big tooth.
That adult tooth it is actually several millimeters bigger than either of his front teeth. It came in through the roof of his mouth, backwards and out of place (1st braces). It is misshapen and abnormal causing problems with his bite and is already wearing his bottom teeth down. We don’t know if the structure of this tooth is sound because it is deformed and therefore we don’t know how it is going to respond to a lot of change. The life of this tooth will most likely be short and it will deteriorate faster than his other teeth, setting the teeth up around it for faster decay.
Dr Hillam, the orthodontist, and I have had a lot of discussion about what to do with this tooth and through talking about the future of this tooth I have learned a lot about tooth movement and the science behind tooth movement. Believe it or not, what the orthodontist is doing with teeth is the same thing I do with muscles and that is why I wanted to tell you about this experience. It is a great object lesson!
Mother! For the Love of …… Quit Talking!
As my son was getting braces, wishing I would quit talking I am sure, the orthodontist and I were have a great discussion about tooth movement and physics. I had no idea how much science was behind tooth movement and how profound it was. He was eager to talk to a parent that could understand his passion for physics just as I am always eager to talk to a massage therapist about physics!
When Dr Hillam graduated from school, he went to work for his dad who was also an orthodontist. At that time in school, they were teaching more aggressive ways to work with teeth and trying to change things faster to help eliminate the time someone had to spend in braces. He was taught to use a 6-gauge wire in the braces to force more pressure into the teeth and really get them to shift.
His dad however did not practice the same progress methodology. The older Dr Hillam maintained that the greatest and most profound change came from slow consistent force applied to the teeth over time. He said that all you needed was a 2-gauge wire and time. The younger Dr Hillam observed that study after study about tooth movement and health of the tooth during and after movement validated that his dad was right.
Physics and Forcing Teeth to Move
Orthodontics is all about force and applied force. It is about understanding physics and how you apply force to create a change in certain ways. You are not pushing teeth around in the mouth, you are pulling teeth in certain directions. Because of that, a wire and bracket in one area may be creating the change in another area. It is not all about direct effect – its cause and effect.
- We do the same thing with PPS techniques, always approaching the body from the stance of cause and effect ppsseminars.com
You have to know how each tooth is working off of each other and how to place the brackets and wires to create the movement you want – and to make sure you do not create undesired movement. It is also biologically about breaking down bone while moving a tooth and forcing bone to recreate and hold teeth in a different place.
Gentle pressure from a tooth forced against the bone will cause it to deteriorate. But the orthodontist tries to minimalize the deterioration and does not want it to happen faster than bone can regrow behind the tooth to fill in the gap between the bone and tooth.
The pressure of the tooth against bone will force the bone to break down, creating space behind or around the tooth where bone fills in again. An orthodontist is literally shifting teeth by deteriorating and recreating the bone that holds it in a certain position at a controlled rate.
Dr Hillam explained to me that if you try to force a tooth to move to fast you create a force that tilts the tooth where the front of the tooth moves forward faster than the tooth can break down in the bone. This causes the back of the tooth bed to put pressure into the bone and the bone breaks down behind the tooth (instead of in the front where it needs to). The bottom of the tooth then starts to point forward instead of move forward and deterioration occurs in the wrong place. When this happens, he said that you now have 2 problems to fix instead of one, costing more time and money as well as unnecessary pain and possibly tooth death.
Massage Therapists Have a “Wire Gauge”: It Is called Pressure and Depth
You wouldn’t think that massage has much to do with physics as orthodontics. But what you need to realize is that massage is just an “applied force” of varying degrees to the body. Think about the pressure difference between a Swedish stroke or Deep Tissue stroke. Do each of those “pressures” create a different response in the body? You bet they do and because of that massage is most definitely in the realm of force and physics.
Object lesson time! Let’s tie this all together. So my questions for you are:
- Is the treatment you provide with your hands and the force you apply to the body a 2-gauge wire or the 6-gauge wire?
- Are you using force to create the opportunity for change or force a change in tissues to occur?
It can be a powerful realization for each of us to understand that massage has the ability, with time and consistency, to help things change in a positive healing way in the body or to break them down and make things weaker. This has nothing to do with intention – we all have good intentions for those we serve and work on. What I am talking about is the real, physical outcome that occurs from the force you apply with massage.
In my 24 years of being a massage therapist, I realize more every day that the body heals best with a consistent force applied over time that does not create extreme conditions in the body.
- Massage creates the greatest, long-term, positive change when your pressure and force is the same as the applied force of a 2-gauge wire.
As massage therapists we use inflammation to help heal tissue. Through our manually applied force, we can create the opportunity for the body to heal itself or we can create so much inflammation that all it does is try to keep up with damage control. One scenario heals; the other depletes.
The trick is to know when and how much pressure creates both of those scenarios.
Master Yoda Said to “Use the Force Wisely”
For applied force to be a healing force, you have to understand what different “gauges” of force do. You can allow yourself to be taught as to what different pressures do for different results.; your clients and their bodies can be your greatest teacher.
So how do you know what the correct pressure will be for healing? There are 2 basic answers and both involve using a 10-point scale to learn how this works:
- If you go above an “8” pressure level, your force can (and most times will) tear tissue.
- This shifts healing from assisting a positive change to having to healing what was done to the tissue.
- Controlled change (remember 2-gauge wire) stays within a 4-point decrease in pain in each session. Less than 4 isn’t enough change, more than 4 many times creates inflammation.
- While we feel better in the short term, many times we are being set up for injury in the long term. This has to do with continually being in acute to chronic stages of inflammation from too much consistently applied force. The body stays busy healing trying to heal from the force and not changing.
Some people like really, really deep “force” and it works for their body. But most people, if you observe carefully, don’t actually heal from what they complain about with too much force. They are sore, achy for days, feel better for a week or two (there it is) and then go back to somewhat of the same pain cycle after the session. That moment of relief in the middle of that cycle is what they keep coming back and enduring the force for.
- I have observed, in myself, with some depths or levels of force that a therapist can straighten my spine completely but it can leave me feeling exhausted and depleted for weeks. Being set up for injury is not always in muscle tissue, but can be immune, endocrine, or possibly nervous system related as well.
Over time this force can weaken an area, sometimes in the same area you are trying to heal, setting the person up for injury later on down the road. No different than the tooth that is indeed moving, but is also deteriorating at the same time.
For pain management massage, positive change for the long term should be the goal of all force and pressure used on the body. Focusing on just the short term change (the feeling of relief) may not always be in the best interest of those we apply our force to.
As you head into your next massage sessions, I invite you to try these tools:
- Ask your client to tell you when your pressure reaches an 8 and hold your force there.
Let your client teach you what your pressure and force is to them. Ask frequently to know if you are staying at an 8. Listen to what they say. Trust that you are making a positive change even if your hands feel like there is “more to do”. Combine this with the next question.
- Ask your client for a beginning and ending pain level and see if you can create a 4-point decrease in pain required for a healing change.
If you created a 4-point change in pain, continue to repeat what you did and build upon that for the next sessions. It is rewarding to observe a client going from a 7 to 3, and in the next session from a 6 to 2, and then in the next session a 5 – 1. Clients love to see and feel this response in their bodies, too.
- This is how healing change works. If you don’t ask for pain levels (and write them down in charting notes), many times you won’t see it and your client won’t see it either!
- You can learn more about charting and change in Massage Your Market: Defining Client Expectations
Pay attention to the clients that start at a number and stay at the same number after the massage. If a client comes in at a “6” and leaves at a “6” but “feels better” the force applied created change but not healing change. The proof you need is in the number.
- You might need more force or less force. Only the client can show/tell you what they need by what force decreases their pain level. Pay attention to what does and write it down.
- This is an example of the healing energy created through force/massage being shifting into the requirement of having to heal the force that was over-applied (too much inflammation).
Try these things and see what happens with your clients. They are great teaching tools for you to know if what you are doing is creating the healing change in the body that you are intending it to be.
Have a great week and “May the force be with you!”
