Wednesday, May 20, 2015

Myofascial Release for the Nasopharynx, and Soft Palate


The Tension Behind Your Face

You have a large muscular knot behind your face. This knot becomes tighter every time you feel stressed. It also becomes tighter when you are in social situations. It makes you wince and grimace and it gets worse every day because it is never touched, massaged or released. Worse yet, the tension accumulated from years of misuse makes the muscles ache, sending pain and panic signals to your brain. Ischemic compression, soft tissue mobilization and myofascial release are very popular remedies now. Here I am advocating that you perform this specifically for your nasopharynx. It is painful at first but it is easier every time and it only takes a few weeks to completely get rid of the pain. Afterwards your face feels amazing, you feel much calmer and have much more social composure.  Here, I will explain how to provide myofascial release for the tonsils, the uvula, the palatopharyngeal sphincter, and the nasopharynx.


 

How to Get the Knot Out

I recommend that you provide compression and self-massage to your nasopharynx. You do this by donning a plastic glove, putting your thumb into your mouth and up into your nasopharyngeal opening in the back of your throat. To find this opening you want to feel the roof of your mouth, traveling away from the teeth and towards the area where the hard roof of the mouth (hard palate) turns soft (soft palate). An inch posterior to this border is the uvula, the hanging fleshy structure and just behind the uvula is the opening of the nasopharynx. The nasopharynx is an invagination that you want to explore and massage using either your left or right thumb. You insert the finger into the mouth, with the fist pointed to the sky, as if you were sucking on your thumb. If you have never done this before the opening will feel tight and painful, and pressing against it will initiate a gag reflex. The best way to get through this is to always perform the soft tissue release while breathing diaphragmatically, preferably to a breath metronome. The discomfort that you feel when stimulating this area is proportionate to the pain signals that this area sends you every day, throughout the day. This was the single tightest and most painful muscle in my body, and it was also the easiest and quickest to rehabilitate. Suck it up, and massage it, you will be glad that you did.

With your thumb inside your nasopharynx you can place strong pressure on many muscles and soft tissues throughout the nasopharynx, and nasal cavity. You want to press against each of the walls and folds of the nasopharynx and even up into the nasopharyngeal ceiling. When you start out, simply insert the thumb past the first knuckle and keep it still. It will be uncomfortable and it will feel sore as if you have an infection. It feels like an itchy, scratchy sore throat. Next try to swallow a few times and feel the nasopharyngeal sphincter tighten and loosen around your thumb. The first few times this is very uncomfortable but it should be painless within a week. Next you want to gently press your thumb into different areas, massaging the soft tissues, stimulating the nerves, reducing tension in the accompanying muscles and brining needed blood to the area. I recommend doing this for five minutes a day, five days a week. Within the first week you will notice that it is less painful, that your face feels calmer all the time, that you breathe better, that mucus clearance is easier, and that your face actually looks more aesthetically pleasing.

The main muscle that you want to rehabilitate is the nasopharyngeal sphincter. The padded side of your thumb (without the finger nail) will come into contact with this anterior muscle. You want to grab it firmly and flex it rhythmically in order to exercise it and gain conscious access to it. Doing this helps you know how to use it and how to relax it. Do this at the most inferior portion (near the opening of the nasopharynx) and the most superior portion (a lip of muscle near the roof of the nasopharynx). For me the superior portion was the most painful and it took a week to remove all of the pain from it.

Why This is Helpful

While reading about orofacial pain disorders I began to think about the tension behind my own nose and eyes. I figured that a strong form of stimulation could increase the circulation to my nasal tissues, alleviate the trauma that they held, and help reduce the tone in my facial musculature. My nose was broken 15 years prior (at age 17) and was numb and painful at times. I really felt like my nasopharynx was a tense rock in the middle of my head, and I hoped that myofacial release could help me better incorporate it into a calm, healthy facial posture.

I am convinced that soft tissues in this area can become traumatized due to stress, cold, physical injury, sickness, or undue tension and then remain excessively tonic (tense) so that: 1) circulation decreases and inflammation increases, 2) the muscles atrophy and undergo “adaptive muscle shortening,” 3) the neurons in the area relay pain messages to the brain, and 4) this causes the muscles to become excessively tense further exacerbating the psychological stress. I am also convinced that reduced circulation diminishes the immunological response rendering these tissues more susceptible to upper respiratory tract infection. I believe that firm pressure, applied to these soft tissues (that are rarely, if ever, stimulated), reverses these four degenerative processes.

The stimulation and physical compression of the tissues helps to reduce past trauma, and in my opinion is much like massaging a sprained ankle. Massage and isometric stretching is really the only way to return the ankle to its premorbid state. Of course it is painful to massage, but compressing the muscles is the best way to reduce their tone. The fact that the muscles and soft tissues deep in our nasal cavity are never stimulated allows them to “remember” past trauma. They become a “somatic anchor” deep within the face for pain. Each time you do this the treatment becomes less painful. One of the reasons we hold tension here is because we are afraid to breathe through our nose and mouth at the same time in front of other people. We are afraid that we will look “too” calm to others. Once the area is no longer painful, this look becomes authentic and breathing using both the nose and mouth simultaneously becomes preferable.


I believe that this technique has the potential to help anyone, but may produce the best results for people that focus concertedly on remaining calm before, during and afterwards. Influencing how your brain interprets intense forms of stimulation is incredibly important to how your body copes with them. The way that you breathe surrounding an injury helps the body to appraise the injury and determine how best to deal with it. I recommend making calm a priority after the procedure and attempting to breathe diaphragmatically, employing deep breathing exercises. I would recommend doing this at home, before sleep or a rest. I do it a few times a week and it is the last thing I do before I go to bed.

After applying pressure to these areas you become aware of muscles and tissues behind your face that you never noticed before. The first time I laid down for several hours with my eyes closed in order to focus on the accompanying sensations. You feel these muscles tighten and release after the procedure. While this happened I tried my best to memorize what it felt like for these areas to release and I tried to keep them relaxed. Simply turning your attention to these sensations builds somatotopic and musculotopic maps in the cortex which help you sense and control these areas. I believe that after using the technique people want to build these cortical maps so that they can notice when these areas become tight later. As I did this I used other facial muscles, flaring and constricting my nostrils, in an attempt to link these new cortical maps to existing ones. It would be interesting to follow the efferent nerve pathways from these areas up into the brain. Pain signals originating in the nasal cavity are probably sent to subcortical threat/stress areas such as the amygdala, and end up in cortical ones such as the anterior cingulate cortex, and the insula.

After the procedure I went on a long walk and I noticed that my face felt surprisingly calm. As I passed people on the street I was worried that perhaps I would appear “too” calm. I realized that I should embrace the calmness and try to take full advantage of my current state and really focus on allowing my face to remain placid. I focused on breathing deeply and evenly, with eyes wide while looking upwards. I figured that if I practiced this over the course of a few days it would look natural. It really did. I no longer have a perpetual pained and fearful expression on my face and I no longer look like someone who had their nose broken violently. It does have a cosmetic or aesthetic component and definitely helped me to develop a more relaxed countenance.

Try probing your nose with q-tips. Again, at first this was very uncomfortable but became much less painful with time. I didn’t press very far but would make circles with the q-tips just past my nostrils while breathing deeply. Afterwards you want to think about how to build this relaxed nasopharyngeal posture into your normal day-to-day facial posture.

10 comments:

  1. I'm just a Yogini, sharing my experience:

    Re: Getting the Knot out

    I find that the use of a plastic glove is inhibiting, so just to be a rebel I continued this exercise without it. Once I got to the hanging fleshy section I didn’t feel any pain, I felt a repetitive pressure and gentle release. Very similar to a deep yawn; my eyes would lightly water, and my ears would, for a lack of better words, “pop”! Mind you, I haven’t done this exercise before, so I was expecting a bit more discomfort. As soon as I started pranayama (with my thumb in position) I began to salivate. The pressure would become less intense, but I would get a little light headed (a similar kind of euphoria I would experience if I was high on an Indica).
    While moving my thumb around against walls of the nasopharyngeal I definitely feel an itching sensation. I wouldn't describe it like a sore throat, as I do usually experience intense pain associated with the sore throats I get. Again, no pain while doing this exercise. Swallowing was a challenge for me. It was almost as if my mind didn’t trust my body for putting it in this position. It took a while (like 3 whole minutes of pranayama), but I finally relaxed enough to swallow and really feel my thumb be kissed by the nasopharyngeal sphincter. However, after the third swallow my gag reflex would kick in and I’d pull my thumb out and start over.
    Attempting to grab the nasopharyngeal sphincter with my thumb (in which I was simply using more force in pushing that area while bending my thumb knuckle was extremely painful, mainly because my nail (though on the south end) extended past my finger and when I bend my knuckle deeper it would (basically) feel like a sharp and piercing stabbing sensation. I’m too vain (or practical) to cut my nails (I got a manicure last week); they will however, break in a week or two and I will try again then.

    Re: why this is helpful
    I find that I don’t fear appearing too calm to others, as I do hearing others say to me, “what’s wrong”, when my face is calm. Don’t they know, to hold the face in a smile or frown takes more energy and causes more tension? So of course to combat the “what’s wrong?”, I systematically smile and (usually) kindly respond with, “Nothing, why?”. I often get a response like, “you just looked, I don’t know, quiet.” To which I respond with “I’m wonderful, thank you” or honestly tell them what I’m feeling in that moment; which they usually don’t really what the answer to. I then almost automatically take a several deep diaphragmatic breaths, to get back to a state in which I am most comfortable…peace.

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  2. Such a great description. Thank you for sharing. Glad that others will be able to read about your experience. My eyes water and my ears pop too. "Nothing, why" - I like that. Interesting to hear about your inclusion of pranayama breathing as well.

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  3. I found it very difficult simply to get to the edge of the soft palate. I cannot get further and place my thumb into the nasopharyngial space, it just doesn't go through. Is it because the soft palate is too tensed? Do you have any suggestions? Thanks!

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  4. Hi. I am curious to know exactly where was your pain before. I have had a chronic muscular pain on both sides of my soft palate that no doctor can explain. It's driven me close to insane.

    I am wondering if this kind of release can work. I don't have much more to loose.
    But where you having pain in the soft palate too or somewhere else?

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    1. This can help you. This and things like it. One thing to do right off the bat, is to make sure you're drinking enough water. I too have some chronic tightness in the soft palette, and when I get dehydrated I can get cramps in those muscles. Particularly when eating. Soft AND hard palette, believe it or not. (There's even some work to do on the hard palette, crazy I know. It works almost like a spine to your whole palette region, but that's a bit advanced and you have to be careful (there and everywhere)).

      You can fix this though, if you haven't already. (and provided those same (useless) doctors have ruled out anything obvious, medically).

      Let me know if I can help.

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  5. Ding ding ding!! Bravo. Once in a blue moon I'll google related terms to see if anyone's caught onto this yet. And you're the first! :) Only, it can be taken much, much further.

    Long story short, I've been doing this going on ten years. But deeper. More thorough. There are all sorts of goodies in there once you train them to let you in.

    First off, I'll echo what someone else mentioned. Ditch the rubber glove. This is what you'll need:
    Nails clipped down to nothing.
    A cloth to wipe up your slobber (eww but whatever).
    Your thumb, middle and index fingers moistened with your own saliva.
    That's it.

    You're going to need to gain the trust of those internal muscles (especially if you're going deeper), and the gloves will get in the way of that. It's also easier to gain a more intimate feel/knowledge skin-on-skin. (as Def Leppard probably put it).

    The other thing not mentioned, and to me it was the motivating force and is easily the greatest gain from these techniques, even beyond the stress relief, is the benefit to the speaking/singing voice. An mis/undiagnosed major voice disorder/structural issue took my voice from me for many years. After an adjustment (long story) it was regained, but I was left with major tension throughout my nasopharynx, face and throat. It was through sheer desperation that I eventually stuck my finger in as far as I had to, to find the source of the bruised, tense, gripping feeling deep inside my head. From there it was a learning process.

    I fully restored my voice to almost effortless perfect pitch, from very deep to high falsetto without need of additional exercise or even warm-ups. The richness that can be restored to, or gained by, a voice using these techniques cannot be overstated. Range as well.

    Without getting into it the whole of it, there is one giant element I will share with everybody. It takes time, but eventually you'll want to use your index finger and thumb, to go up PAST the uvula (index further deepest) to be able to squeeze the entire soft palette between your thumb and index finger, including the uvula. Yoweee it will hurt. And it'll take some training and time... but oh my goodness. As some of you may know, any time you can get around to both/all sides of a muscle and squeeze it... you can do a tremendous amount of good. Again, baby steps.

    But there's more to be done to get the full benefits.

    Dr. Reser, if you'd be interested in hearing more of the details, in an effort to further your studies and spread the word on this, I'd be glad to share with you what I've discovered over my many years of experimentation.

    My few attempts to enlighten a person or two on this have fallen on deaf ears. One myofascial guy I was seeing was really intrigued and interested and had a patient who would benefit, but I'm not even sure he passed what I told him along, and certainly didn't come back to me for any more info. I'd love for more people to know about this, but I don't exactly have the credentials to advance the cause.

    People who've never sung a day in their life, or think they're tone deaf, may in fact be able to sing like little angels. Naturally. Intuitively. By simply softening up all of these tense, overworked, never-ever-thought-about-let-alone-paid-attention-to muscles. In addition to the stress relief described in the article.

    And bravo, as well, for the descriptions of the pain processes in dealing with these areas. Very accurate.

    So Dr. Reser, let me know if you'd like to be in touch. Glad to see someone in your position addressing this.

    Thanks.

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    1. Thanks so much for your contribution. It didn't even occur to me that this could be used to rehab the voice as well. I found your description very helpful, and thank you for posting about your insights and techniques.

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  6. I'll add a couple more things...

    Fascinated by your article regarding tension in the lower eye lid. (http://www.observedimpulse.com/2012/10/ideal-eye-posture-relaxing-lower-eyelid.html) A revelatory way to look at it.

    Similarly, related to the intraoral, many people are aware of tension in the jaw. But I've come to realize the importance of what I call the "top jaw"; the muscles/tissues/etc holding the palette from above. It's a similar experiential epiphany, and helps in letting go of some of that internal unconscious "holding", and allows an awareness that helps in getting a good stretch of these neglected areas.

    And along the same lines, and again in particular to voice function, I've come to think of the soft palette as almost a "second tongue". As odd as that sounds. But once it's softened (and mine needs near CONstant attention), and once you can hear and feel its implications for voice, you really begin to understand how the two of them work together (or can) to produce and shape sound. It's almost a new instrument, with the amount of subtlety that can be gained.

    The way you described the lower eye lid and its tensions made me think you'd understand these aspects of this subject.

    Again, thanks.

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    1. Great Article!

      Christopher, I am a singer who has been enduring pain in my soft palate for the last two years. I would very much like to continue the discussion from your post about massaging all of these hidden muscles. Would you please email me at kevinchinn1992@gmail.com or respond with a way in which I can contact you. Thank you so much, I look forward to hearing from you.

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    2. Hello! I, too, am a musician. A rather young one who has been experiencing inhibition due to soft palate tensions for quite some time. The grooming of these elusive muscles is an intriguing topic and discussing this with you, I intuit, is the right solution to this matter. Would you please contact me at samhester28@gmail.com? Or provide some means of communication? Thanks very much, looking forward to hearing from you!

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