Can bones of the roof of the mouth be a location to release persistent arm and shoulder tightness after breast cancer?
Before last week, I would have said: “no way! How could treating the bones at the roof of the mouth affect muscles and joints outside of the mouth?”
But now I think yes - definitely worth a try, especially after a serious fall or head injury, either before or after a breast cancer diagnosis. Breast surgery and radiotherapy are known to cause shoulder tightness with a lot of people. Bad neck posture and neck and head bony changes also negatively affects shoulder movement.
A lack of movement or flex within the bones of the roof of the mouth reflects bigger problems; tightness in the skull and upper neck and then via several mechanisms (dural sheath, bio-mechanical, nerves to muscles) leads to impairments to the quality of electrical messages to the rest of the body. And what we'll see immediately is - movement restrictions at some joints.
Why the turn around?
Last week I was introduced to the Vomer Technique by Biofield Flow instructor and physical therapist, Melanie Weller (MW). The vomer is a vertical bone that sits between and behind the right and left hard palate at the roof of the mouth, sits at the base of the nasal cavity and joins three other major bones of the skull.
Because of how the body is all connected, you can press into the hard palate bones (the orange bones in front of the yellow bone) and this should move the vomer ( yellow bone), then you should feel the pressure transmit into movement at the bones of the skull and the upper neck bones.
But what can happen after a fall or an injury to the head is this system of movement between bones gets jammed and the outcome is compression to the nerves that exit along the whole spine. Melanie delighted in teaching us to check movement at the hip, kneesand even as far away as the big toe, to evidence the impact of vomer release.
Can the Vomer Technique be useful for people with movement restrictions after breast cancer?
This is the question that is always on my mind when I’m learning new skills. Currently, there’s no research reporting this technique being used for breast cancer survivors as a rehabilitation approach. But that usually doesn't stop me from appraising new treatment methods.
This appraisal starts with evaluating the treatment approaches. I need to find the method that sits safely within my scope of practice as an Occupational Therapist- which is a gentle soft-tissue release and definitely not the quick bone mobilization method used by Chiropractors.
Learning a new treatment technique for breast cancer survivors starts with me, friends and family.
I knew straight away that this new MW Vomer Treatment method and approach to whole body release could have legs for me personally and for my clients who experience long-standing pain after breast cancer. So I immediately tried this technique out on myself for a couple of days, of which I was happy with the immediate results I experienced at my long-standing neck and pelvis movement restrictions.
Then I turned to my trusted group of family and friends, whom I regularly call on when a new technique needs to be learned: my partner, my mum and a couple of my best friends and nearby clients. In each of these learning opportunities, I was able to get a better feel for what upper palate flexibility is and then what it feels like when it isn’t.
During my early training phase, each person I worked on had a tight upper palate: some had a wonky palate, where the right side and the left side felt a different shape, some had tightness and tenderness on one side only and one person not only had a raised ridge in the centre of their hard palate, but I could feel a large uneven bony “knob” right at the back- just before the soft palate. But when the palate was tight there is no upward movement of the palate, when gentle pressure was applied.
Each person could also recall a really serious fall where their neck and head issues stayed way too long. Melanie’s experience is that people who have had a concussion or a head injury are quite likely to have a rigid, non-flexible palate and then go on to develop secondary joint movement restrictions somewhere else in their body.
I am really thankful for the universe and the trusting supporters of my new skill-testing, because in just a few days I was able to get a good handle on using simple joint testing methods, testing and treating tightness at the vomer and upper palate, and then retesting movement to see what changes occurred. Retesting changes in the movement of arms and shoulders offered me an insight AGAIN into the amazing workings of the human body. Gaining more range of movement and easier and faster movement at the arms and shoulder is really helpful for many tasks over the day.
With no reported pain or problems with having my finger in someone else's mouth, I felt ready to try this with some of my clients with breast cancer-related movement impairments.
Trying new rehab treatments with breast cancer survivors
I am especially thankful for my clients who have been keen to examine new treatments over the years. I have amazing people in my networks, who hope that there will be new treatments for them and more so, they express a keen desire to help me find new treatments that can help others in the same boat as them.
I went into this trial with eyes and mind wide open but with the knowledge that the Vomer technique certainly could not unlock large amounts of scar and adhesions. And what I have found so far, is that having a technique that can relax and release tightness within muscles across the whole body can be a great start, so I can then focus more time on releasing the underlying surgical scars and adhesions and radiation fibrosis.
Melanie Weller has found from her work with people with chronic pain and movement restrictions, that her vomer release takes 1-2 sessions. This is because the tightness in the skull bones developed after the injury and not at the injury. This could be the case for breast cancer survivors, but I am already wondering whether radiation to the neck region may be a risk factor to tightness reforming at the skull and upper neck. The answer to this and new questions will be investigated over time.
So after appraisal and more practice, the (MW) Vomer Technique is now on the list of treatments to offer to my clients who have persistent shoulder problems after breast cancer, especially if they remember having had big falls or head injuries.
Makes you want to check your hard palate and vomer now, right?
If you clean your hands well and then place your thumb into your mouth- like you are going to suck your thumb- feel the ridge leading to the smooth rounded shape beyond your thumb. The hard palate is left and right of ridge and sits behind the maxilla bone which supports the upper teeth.
Using about 5gms of pressure gently press into the roof of the mouth- does it flex upward? Can you feel this flex with your other fingers gently resting on the top skull suture (join) - where your soft bit was when you were a baby?
Reach too far back with your finger and you can cause a gag response at the soft palate which is further back.
If you are a Brisbane local and experience persistent joint movement restrictions and remember having had a head or neck injury, make a booking with Denise to have your joint movement assessed, your vomer treated and your movement reassessed.
Is there more that can happen after a Vomer release?
The Vagus nerve can not function well if there is tightness within the vomer and it's connecting bones. Vagus nerve dysfunction is a whole other blog.
Thanks to Sam Webster for his Youtube skull bones video and image.