SPEAKER_05 0:02

Did that go? Oh, I think we're live. We are live. Hello, everybody. Welcome to another episode of Beauty of Breathing. I have the honor of having one of my favorite people in the world here with us today. And having saying that, uh, to everybody who was speaking to today, oh my gosh, I'm interviewing one of my favorite people, Mike Kinswell. How are you doing?

SPEAKER_00 0:26

We broadened your list of people. I'm doing fine. I'm doing well. I'm happy as a clam.

SPEAKER_05 0:31

It is such an honor to have you over here. A little bit of a different discussion than uh Aerie Circle TNL. We go a little bit deeper, more for professionals here. Uh, we have a big

Welcome, Guest, Feet And Airway

SPEAKER_05 0:44

range of uh professionals and the general public. So it's a more laid-back conversation. Everybody who's listening to this live, if you guys don't know, I do record the Beauty of Breathing uh podcast episodes live on Instagram. So you can run over to my own moves and be a part of this live. So you can ask questions. Make sure to message, I'll be checking them out. Uh so let me go ahead and present our speaker today. Presenting Mike Contrao. He's a physical therapist and co-founder of the Applied Integration Academy, AIA, where he pioneered an interdisciplinary approach combining physical therapy, dentistry, myofunctional therapy, and human performance. With over 35 years of experience, he has educated healthcare professionals worldwide and consulting with elite athletes from organizations including the NBA, NFL, MLB, FIFA, FIFA, and US Navy SEAL. So you can't tell which one's my favorite. Mike is also an author and educator, uh, passionate about biomechanics, airway health, and human movement. Today's topic is what do feet have to do with airway? Connecting the dots. Welcome to the air circle, or not air circle, but the beauty of breathing stage.

SPEAKER_00 1:57

Hi, yeah. It's a lot of dots to connect. It is. So the airway thing. I thought it'd be a fun topic, and we I like it.

SPEAKER_05 2:07

Your work connects physical therapy, dentistry, malfunctional therapy, and performance in a way many people have never considered. How did you begin seeing disconnections?

SPEAKER_00 2:17

It was probably in 2008, nine at that time frame. I was uh exposed to this sort of material. And um, and I had patients who I shocker, I couldn't fix some people. Go figure. And um, you know, as you struggle with these these patients that you can't corral in and and claim the success, you begin to realize that well, well, first you analyze where you're weak, you know, where where do I lack? And what I realized was sort of above the collarbones, I knew nothing. And um, and that was very problematic. And it's I think a lot of PTs are this way. And and and and below the chin, dentists know nothing. And I I think uh the myofunctional therapist sort of owns this anterior neck that I refer to as the mandibular diaphragm. And um, and in AIA, we sort of call it that, and because it is a functioning pump that has, you know, that has a septum that that works like the pelvic and rib cage diaphragms, if we want to name those three and obsess on them, which we will here momentarily. So for me, realizing I had too many patients that I didn't know a thing about or how to fix, I realized that I better um sharpen my sword, and I began to do that. And that has led me into nerd world looking at research articles and realizing that people are putting out wonderful information, but we don't act on it. Or I don't know, there's a delay between what's put out there before we ever do anything with it. And um, and we don't look in the right journals. And so, you know, I'm over here looking in physical therapy journals from 1989 when I was cheating off of Benjamin Franklin's paper in school. I realized that I better, you know, get up to speed and learn more because back then I didn't read research articles. Who does? I mean, I don't care about that stuff. But after a while, I began to realize I'd better, and as you do, I also realized that out of my own journals, get out of physical therapy journals. They're the last place you want to learn about physical therapy. And likewise, if I'm a dentist, let me get out of dental journals. And so I started realizing there's a whole world of physical therapy in the world of dental journals, and vice versa for dentists in the world of physical therapy. And then, and myofunctional therapists are the umbrella that sort of covers both of us because there's such a strong connection between this silly little thing we call a tongue and what it does for dentistry and for PT. So it's sort of the bridge that connects these two professions. And I joke all the time that PTs and movement, not just PTs, kairos and massage therapists, everybody, and uh personal trainers, we're all down here in this body and we reach up through the throat to shake hands with dentists who are reaching down through the mouth. And um, and I think the person who's got their hands on top of our hands, holding our hands while we shake hands, is the myofunctional therapist. And I think that dentists don't realize the power they have, myos don't realize the power they have, and PTs don't realize the power they have. And you realize that when you read other people's stuff. So you look on somebody's shoulder and peek into their world, and you see a wealth of articles and information that explain why the stupid stuff you do works, and you didn't know you were doing it, and so it makes a difference. So the journal articles kind of led me down a pathway that led us to forming with my partner James and Alice Lamar Dennis,

Why Healthcare Misses The Connections

SPEAKER_00 6:00

to forming this academy. And um, because the academy itself, by having an academy, it sort of what is it? The you know, the old saying is if you really don't want to learn something, try to teach it. So it forces you to learn more, and so it it there's there's this pressure. I know you experience that yourself. There's a certain amount of external pressure from questions that you're asked, and you're like, I don't know the answer to that. And so you have to go and you seek. And as you seek, you find out the answer, but you also find out 10 more questions. Sorry for the long-winded response. You asked me.

SPEAKER_05 6:37

Yeah, please.

SPEAKER_00 6:39

That's how I got into it.

SPEAKER_05 6:41

We are here to listen to you. But why do you think healthcare has traditionally separated the body into systems instead of viewing it as a one integrated structure?

SPEAKER_00 6:53

I think two words diagnosis codes. So, you know, insurance companies drive um reimbursement for a lot of healthcare. And if the um if the insurance company is going to reimburse, they need a code, they need a diagnosis. What's wrong with this guy's shoulder? Well, he has a rotator cuff impingement. Okay, 726.1, whatever it is. And then you send in that diagnosis code, and then the insurance company reimburses. Well, the problem is what insurance companies have done is they've said, well, for the poor doctor, the doctor says, Well, my patient walks in and her neck hurts, her back hurts, her hip hurts, and her foot hurts. And the doc says, sorry, my insurance company only lets me treat one or two diagnosis codes at a time. So you'll have to come back for a different visit for me to treat your shoulder while I'm treating your neck. And and so it it gets into this insurance-driven care. And there's there's problems there. And um, and so you you're you're restricted. So I can't, as if I'm a doctor, I can only look at one diagnosis code at a time. If I'm a dentist, I don't dare talk about somebody's back. If I'm a physical therapist, I can't talk about their teeth. If I'm a Mayo, I can't talk about anything but their tongue. So we're all stuck in a silo because of licensure and insurance companies. So it's what we see is in normal fee-for-service practice, it tends to drive us into a position where we can actually look at this human that walked in. L V Panke said it best. He said, I never saw a tooth walk in the clinic by itself. And it's true. And so Mike Cantrell says all the time, I've never had a patient come in yet without a head. So I better know how to look at it. And it's part of a body, so I better know how to examine it. I may not, I'm not breaking out a drill and working on a tooth. I will dang sure discuss this patient's oral posture and behavior, and I think that's well within our purview to do that. So let's look at the whole body for once, please.

SPEAKER_05 8:58

I love it. And the key of working together, it's okay if you don't understand, but reaching out to another profession, to another professional. You know, if you're a PT, reach out to a dentist. If you're a dentist, reach out to a PT and a malfunctional therapist.

SPEAKER_00 9:11

Um we please, I'm just begging for that. I don't see a problem with that, and nobody should. It's like, I want to be able to phone a friend. Yeah. And say, hey, I've got a patient and I need help.

SPEAKER_05 9:24

And by the way, if anybody listening is interested in starting their own study club, Aery Circle does help you do that. So reach out to me and we'll get you guys together. We just opened two chapters in North Carolina. We're opening a chapter in Florida. Uh, we're opening a chapter in Las Vegas right now. Uh, so many people that want to get it's this interdisciplinary team where you get to see because we do great things online. I try to get the community to to grow as much as I can online, but the magic really happens in that local level. Um right.

SPEAKER_00 10:00

I I know this is true for us. You know, we we're sort of I live in Georgia, I work in Houston, Texas, and um, my partner James lives in Utah. He works in Houston, Texas. And and consequently, we have a ton of patients who will come into Houston, Texas. And I'm like, why are you coming to see us? I would love it if you could just be seen, as you said, locally at your own place. And that's what AIA is trying to do is create pockets of places that understand this material to the depth and degree that we should. And that's our mission to get people trained up, speaking the same language, and provide the Rosetta Stone to translate that language into something that people can work with. I don't want someone, I'm I'm somebody might say, Well, golly, wow, you've got patients coming from all over. And I'm ashamed when I hear that because I'm I'm I want to hang my head and apologize and go, no, I'm sorry. Uh we're trying to fix it so they don't have to come. Nobody should fly 4,000 miles to be treated, but they're doing that, and it's wrong. What should happen is they should be treated locally. But until we can get the word out through your study clubs, through the efforts that we do with courses and this kind of thing, you know, we could have the best course in the world, but if two people show up to take the class, it's useless, right? Who cares? Who cares? So doing things like these podcasts to get your information out, my information out, helps us get it where we don't have to see these patients from all over BFE coming to see me. It's dumb. If somebody thinks that I'm the sharpest tool in the shed, they're dead wrong. We need people who are pretty sharp.

SPEAKER_04 11:38

Yeah, I I know the first time I ever heard you speak, I'm like, I'm gonna go see him. He's in Georgia. I mean, it wasn't Savannah at the time, right?

SPEAKER_00 11:45

And it's like, man, don't come see me. Go go go see somebody that knows what they're doing. Find somebody that actually has some good a good handle on all this material and and is comfortable with it that lives near you. And that that's our goal. That's what we're trying to do. That's what you're trying to do with your study clubs as well.

SPEAKER_05 12:02

So now with AIA,

Building Interdisciplinary Teams Locally

SPEAKER_05 12:05

do you guys have a directory of professionals who have taken your courses?

SPEAKER_00 12:09

We are currently creating that directory. We just changed up our website, and I'm so uh the web, the the the web server we use needs to be better. And so, you know, people cry out all the time about the problems they're having with you know logging on and doing certain things, and it's the nuts and bolts that I despise, you know, that I'm not good at oh my god, you're you're way better than I am. I mean, you know, it I can't even put out content on Instagram, you know. I suck, and I wish I were better, you know, but I'm always I don't know. I'm I'm listening.

SPEAKER_05 12:46

We're all good at our own things, it's okay, but and whatever we're not good at, we're partner with, right? We find people to help us. Yes, yes, right out there. Um, but I am going to add to our Aerie Circle Directory an option for them to write on there that they have taken your training. So if you're searching on the directory, you can search uh AIA and it's gonna pull up everybody who has added that to their bios. Thanks.

SPEAKER_00 13:15

Yeah, at least you're doing it. Somebody will think we'd be smart enough to do that, but you know, we're taking forever.

SPEAKER_05 13:21

It's gonna work. We we, I mean, we all of us have audiences and we have different audiences. Yeah, and it doesn't matter if one person is doing this, we need everybody to be doing this.

SPEAKER_00 13:32

Um, because the more the more we talk, the more we talk, yeah. They can say, I know her.

SPEAKER_05 13:40

And what is what is the point of us doing this is to serve people to get people the right help. Uh, and most of these patients don't even know that there's there's something that can be done, they don't even know they have a problem many times.

SPEAKER_00 13:53

I know you're getting these, I know you get text messages and DMs all the time on Instagram, etc. I know I I do, and nobody even knows who I am. But if if I'm getting them, I know you're getting them, and I know all of our peeps are getting that that we associate with, and these are people that need help. Uh and just recently I did a a silly little post on Instagram about teeth, you know, extraction and this kind of thing. And I had so many uh like dentists who were just upset at me, and I was like, whatever. I mean, yeah, you can be mad, don't shoot the messenger, you know. I'm like, this is just the way it is, pal. You know, it blows. I mean, it's old school, so I don't know. I don't know how I got on that.

SPEAKER_05 14:38

The more you grow, the more you shake, you know, that traditional thinking, the more people are gonna come after you. I just have gotten used to I love it.

SPEAKER_00 14:48

Just spell my name right when you yell at me because I want to make sure that people people understand this material, and I'm I have totally lost any concern or fear about that stuff. And I'm like, we got to get this out there, you know. If I if I went on and did a post and said that, for example, um, a pronated foot, like going back to our title, a pronated foot can lead to external rotation of a temporal bump on the same side.

Research That Upsets The Status Quo

SPEAKER_05 15:20

Crazy. How would you say something like that?

SPEAKER_00 15:23

Exactly. But I can look, uh, well, oh look, right here on this in this bibliography, right there, Rothbard vertical facial dimensions are linked to abnormal foot position.

SPEAKER_05 15:36

That's insane.

SPEAKER_00 15:37

So don't blame me, I'm just talking about it. Rothbard did the research, and so he's out and he did that. Wait a minute, wait for it. 2008. Wow, and therefore yelling at us 2008, and we're talking about it in 2026. And if I post about that, some of these same people are gonna. If I didn't mention him and I just said, Hey, you know, blah blah blah, they're gonna have a cow, they'll literally deliver a baby child cow and go, are you out of your mind? You need to go fly off a bridge someplace. And I say, dude, I'm just quoting the research. Exactly. I'm sorry if you didn't bother to read, but we did, and it's all right here. That's like calvarial bone motion. Well, if that temporal bone's gonna externally rotate, it doesn't mean that these skull bones move. Well, duh, but the minute you say that, a whole host of dentists will have another cow. And you're like, are we really still here? This is like Stone Ages material. This was this research was done in the 70s. I mean, like, real in the hell in the 40s, in the 1940s, they already suspected it. And then when you explain to them that NASA is obsessed with cranial bone motion, they're like, Wait a minute, NASA? You're like, Yeah, you know, the National Aeronautics and Space Administration, those guys, they're obsessed with cranial bone motion. They've done research articles on it, and they say, not does the cranial bone group move, but when it does, how much? Because we need to know when we send somebody up in outer space. Thank you. I mean, hell, the bag of potato chips when you go in the airplane expand. Exactly. Put your bottle of water in the airplane at 30,000 feet and watch what happens. You fly a lot, I fly a lot, I live on a damn airplane. You want to get mail to me, just put a sticker on the back of the seat. I'm sure I'll read it because I'm on a damn plane so much. And the thing is, if you open that bottle, you're gonna get wet half the time. Yeah. Well, you think our skulls don't? And so if my skull bones move, couldn't we direct movement? Who's the main director? Uh, your tongue. I mean, so if this tongue directs palatal excursion, but nobody looks at palates, even the dentists. When you say that palate is asymmetric, they're like, it is. That'll give me my question. Two-thirds of the time, it is, and this is not a slight on dentists, it's a slight on the education. Do you think they taught me that in PT school? Hell no. I literally asked about um, could back pain be related to diaphragm function? You know what I got? Absolutely not. And and still to this day. So, you know, the relationships are there, and we're gonna chat in this podcast a little bit about it. I'll connect those dots here and it'll be kind of fun. But if we if we if we address the connection, we could say, well, is it a top-down driven problem or is it a bottom-up driven problem? Now, what AIA does is it teaches people how to figure out which it is. Are you frozen? I think you're frozen. I see you frozen. Can you hear me? I'm going to send a text.

SPEAKER_03 20:14

Oh, I feel better. I was worried it was me.

SPEAKER_05 20:16

No, I think it's my computer just froze completely. I'm okay. It's mad at me. Sorry about that. I was just thinking of like, oh no, but I don't even think it was the internet. I literally think my computer just like the software.

SPEAKER_03 20:33

Yeah.

SPEAKER_05 20:33

I am done, Renata. I need some time. And I'm skipping. Am I skipping right now? It looks like I'm delayed.

SPEAKER_00 20:39

Yep, because right now you're frozen again. Your your your image is frozen. I hear your voice. Say something. Okay, I'm here.

SPEAKER_05 22:01

We're gonna have to edit that out. I'm so sorry. I don't know what happened. Can hear you, Mike. You're looking with C you. Hi, Mike. Good. Thank you guys for letting us know you guys could hear. My computer was completely I don't know what what happened to it. Are we still recording?

SPEAKER_00 22:17

All right. Well, you look normal now.

SPEAKER_05 22:21

All right, let's go, Mike. So we were talking about where oh my gosh, my thing.

SPEAKER_00 22:26

Oh god, I was on a tear. You know, I it was probably good that that happened. It probably just shut me up a little bit.

SPEAKER_05 22:31

Okay, I have a question. What happens upstream when the feet are unstable or dysfunctional?

SPEAKER_00 22:40

Okay. So first and foremost, what we need to understand is that this concept called grounding, grounding itself, you know, there are kind of two worlds of grounding. You know, one is the ooh, you know, I'm in touch with Mother Earth, man, and you know, the kind of granola grounding. And um, but I'm not speaking to that. I'm speaking to grounding that can occur. Let me just read a definition. I'm gonna read this verbatim. Grounding is defined as having the ability to deliver forceful pressure down into the surface upon

Grounding, Tongue, Three Diaphragms

SPEAKER_00 23:20

which the body is standing, and correctly sense the ground reaction force delivered up from that surface into the foot and or into the body. Sensing the ground reaction force helps the body gain aligned compression, keep that aligned compression, and use it for functional tasks like body transfer and hemispheric escape. Now, that just sounds like a bunch of mumbo jumbo. But what it really means is can you load on one side and compress like a spring to then escape? That's all it is. Can you sense it? Can you feel the ground? Now, without that sense, bad things happen. But how do you achieve that sense, right? That feeling occurs through diaphragm management. That means mandibular diaphragm, right half or left half, rib cage diaphragm, right or left, pelvic diaphragm, right or left. If you align all three on one side, you will achieve compression, which allows you to feel the ground. Well, at the same time, mandibular diaphragm comes with something unique, a tongue and a maxilla that it engages with. So that means there's maxillary grounding, which also has another definition. Now, all of that, maxillary grounding, by the way, comes first in the womb. Before you ever touch the ground with your feet or your knees or your butt or anything. Tongue-to-palate grounding occurs first in utero. So we already begin a grounding process before we're ever born. Don't shoot the messenger. I'm just quoting the research. And so, but you know, it's nice. Okay, somebody does some research projects on this, but but if we don't read it or if we don't know, if we don't listen and don't apply it, what good does it do to do it? Somebody had a question and they studied the question and they found answers. Now let's use those answers. So this now, to the world, to the credit of many pediatric dentists and myofunctional therapists, they are. The culprits who aren't would be the movement people like me. We tend to not. Well, it's up there. I don't need to mess with that. And so we better mess with it. We better understand it because it affects downstream the movement that's happening below. So, you know, if that child has good tongue-to-palate grounding, they tend to do better in development and mid-facial growth and yada yada and neck function, etc. Well, back to your original question, like what what uh how do we I can't remember how to question your phrase?

SPEAKER_05 26:07

The feet upstream when the feet are unstable or dysfunctional.

SPEAKER_00 26:12

So if I have, for example, a is it does it go the way up or does it go way down? Well, that's where we left off before we had our system failure a minute ago. Yeah, we that's what we train a movement person or a dentist or bio to understand is it a top-down or a bottom up? And in some instances top-down, gotta have a dentist. If it's by have a guy, what if it's both? Gotta have both. So, this is what the trick is for a student of this material to learn it as well as possible so they don't waste a lot of patient time barking at the wrong tree. Let's figure out what the right problem is as soon as possible to begin the treatment as quick as possible that's accurate. And if we can do that, it's a big win. This is what we're training for. This is what you and I do. We're trying to figure out as rapidly as possible which is it? Is it in here? Is it is it my eyes? Is it my mouth? Is it my neck? Is it my feet? Is it all of the above? And the quicker we can come to those conclusions and get those questions answered, the better off the patient is because they get better quicker. But let's say it's from the bottom up. Well, if let's connect a dot. Let's do it now. Here are two feet a left foot, a right foot. I'm going to take my left foot and pronate it. The minute I roll my left foot in, my femur turns in and my pelvis goes forward on that side. This is Rothbar. If my pelvis is forward on the left side, my pelvic diaphragm now is on slack. Uh-oh. That means my rib cage will rise on that side and my diaphragm will flatten, my rib cage diaphragm. That immediately means my neck is going to increase activity and draw my tongue down on that side. Huh. Well, that means it's not a question of airway,

Bottom-Up Chain From Foot To Tongue

SPEAKER_00 28:16

it's a dysfunctional air flow because of a tongue, right side, left side, that's now scoliotic. I have a scoliosis in my tongue, and I had not seen anywhere people mentioning scholar tongues until AIA started talking about it a few years ago. And I'm starting to hear the term more, and I love it.

SPEAKER_05 28:37

You're the first one I heard say that.

SPEAKER_00 28:39

Say that again.

SPEAKER_05 28:40

You were the first one I ever heard say this.

SPEAKER_00 28:43

Well, I don't think this whole scoliotic tongue business. But you know, the minute you have too many people open their mouth and you see that, we need to pay attention to it. They're doing something weird, or that this one's even weirder. So I would call it a complex scoliosis. So when you have this scoliotic tongue, there has to be a reason. But more importantly, the minute you deal with the rib cage, now the tongue is no longer scoliotic. Wait a minute. Now I can get tongue to palate suction on both sides in eight seconds flat. That matters to me. And what makes it stay? Fix the damn foot. Because that foot caused the femur to rotate and tip the pelvis forward. So if I supinate the foot and get the femur to turn out, the pelvis can pull back. Now the root cage can drop and the neck gets long. Now the tongue is free to rise. Class dismiss. So if we can think like that, whoa, it it suddenly, you know, I wouldn't know a myo functional therapist exercise from a man on the moon. I don't do that. What I do know is that if the Mayo puts the patient in certain positions to allow rib cage to descend and free the neck, the tongue's going up better. And then now the Mayo is free to train that patient more easily in if the patient's in a certain position, that's outlined in some of the stuff that we teach, which is why we're writing this myo course right now. So I'm not interested in telling the myofunctional therapist how to do exercises, they know that we need to understand this though, because so many times we see that.

SPEAKER_05 30:23

And then the questions the parents are like, okay, if the tongue is asymmetrical, is that because the palate is asymmetrical? Is there something else affecting that? Does that mean that whenever I expand, it's going to be asymmetrical expansion?

SPEAKER_00 30:35

Can you talk a little bit about expanding people with you're you're teasing me now? Okay, so let me just say this that an asymmetrical palette, let's say this is a right side, here's a left side, and let's call it internally rotated on the right side and externally rotated on the left side. Now, pallets, according to a researcher, I think his last name is Crow. He said that pallets move one millimeter six times a minute. Wow. Well, that gets interesting. A total excursion of one millimeter six times a minute. Well, that's imperceptible. One millimeter. They had to measure that using ultrasound stuff and all that. Now, the interesting thing about that movement is it's brought to you by a tongue. But what if my tongue is asymmetric? Is that what caused the palate to be asymmetric? No. What I would tell you is the palate wasn't asymmetric and caused a scoliotic tongue. A scoliotic tongue caused a palate to be asymmetric from two different directions. One from what I described a minute ago. Two is the skull bone movements that that is created by the asymmetric position of the entire body. Now, you and I were at Panny up in New York, and you saw that little talk I did there. And when that neck bends one way, there's an asymmetric pressure of the atlas against the occiput, which creates a cranial strain that internally rotates one or the other side of the palate. That has nothing to do with the tongue. Wow. That's just body position. So body

Asymmetry, Expansion, Body Position

SPEAKER_00 32:10

position can create an asymmetric palate, but body position creates an asymmetric tongue, which enhances the asymmetric palate and makes it worse.

SPEAKER_01 32:18

Oh my gosh.

SPEAKER_00 32:19

Here's the kicker. Wait for this. Now, let's do a palatal expansion. Let's say this asymmetric palate is also narrow. Now let's let's expand it. Now, what we know is when you expand it, it's going to expand on the side that's weakest. Well, that would be the externally rotated side. So now you have a wider but still asymmetric palate. So a patient might report some improved ability to breathe, and I'm happy for them. In fact, palatal expansion activities and surgical devices, et cetera, surgeries and devices have been very beneficial. I want to make sure I'm coming out front and saying that because suddenly somebody will say, Well, Mike hates palatal expansion. What I love is palatal expansion in the right place. That's like saying Mike hates umbrellas. No, I love umbrellas when it's raining. But you know, it's fine. I don't need an umbrella. So I like palatal expansion on the right patient, and plenty of patients will have their palate expand, asymmetric though it may be, they're happy. What do I care? I'm happy for them. But many times what you see is a dramatic enhanced asymmetry. What stopped this side from expanding? Because this side was internally rotated like this compared to the other, because there's an entire body behind this internally rotated palate. Who's over here keeping it from moving? A sphenoid bone. Why is that sphenoid bone pterygoid plate in the way? Because the entire sphenoid bone is down on that side and forward, which is pushing the palate in. Why is that sphenoid down and forward? Because the occiput is turned in the wrong direction. Why? Because of the neck. Why? Because of the body. Why? Because of the load. Why? Because I can't feel the ground. Change it, change it while they're getting palatal expansion, and you will see immediate symmetric palatal expansion. I don't even think it. I freaking know it. Why? Because the research already tells us that. Just go read the articles. But that's what we're doing. We're just reading the articles. We're saying, dude, if you're doing palatal expansion, link up with somebody who knows how to correct body position at the same time. And A, the palatal expansion goes faster. And B, it becomes more symmetric and less dramatically asymmetric. Well, how do you know when you're doing the body stuff right? Testing. It's not hard, it's not mumbo jumbo, let me push down on your arm. It is literally testing performance with objective data and measurements. Because if it's not objective, I'm not buying it.

SPEAKER_05 35:10

So, what would you usually recommend in terms of a patient who's coming to you and they are too narrow, they do need expansion, they're completely dysfunctional. And by the way, let me do a side note here. Think about the dysfunctional patient. Everything is crooked, out of place, and they go to a dentist and they get a feeling or they get a crown and they get something else. Those are patients that are gonna have pain. They're gonna have more issues. I can only imagine. But how about a patient comes to you and they do have this narrow, uh narrow palate, they do need more skeletal extension, more help? Um, how should they think about this? Should I go to the physical therapist first and get this treatment done? Uh, how long does it take usually? When do I uh go to the dentist and start the process? Can I do both of them together?

SPEAKER_00 36:01

So, first, if it's not extremely complex, treatment doesn't take very long at all. I also noticed that in younger patients, it's really fast. Oh, broken down folks like me, it takes a little longer, but it still can work just fine. As far as when do you do it, do I, you know, do it, which comes first, the chicken or the egg? Do I see the dentist? And, you know, what I would think would be a normal progression is somebody might go see a dentist and you know, they may determine that they've got an airway dysfunction. Okay, fine. And they say, you know, one of the things we might suggest is is palatal expansion. Now I'm I'm I'm blessed, and let me tell you why, because a number of the palatal expansion folks out there might say, okay, go see these guys and um and let them work on you a little bit because after they work on you, we may discover that you don't really need that palatal expansion or that tongue release or whatever. So we can start a little bit of work, and suddenly if the patient's reporting, you know, I I kind of feel okay. Okay, then don't have the palatal expansion. Great. But the next patient says, This is definitely improving, or better yet, the patient says, I mean, I I think I'm a little better. You know, that's just them being nice. So they say, Well, I think I'm a little better. And you go, Okay, maybe you are. Your tests look great. So since you're not saying, Wow, do I feel great? You're a good candidate for that palatal expansion. So go have it done because your scores tell me that you will do well with that expansion. So now it'll happen faster and more symmetric. Your test scores look good. It's saying your body is ready to receive the expansion, just like braces. Somebody wants to get braces. Hmm, let me do a little bit of work with you because now your body is ready to receive those braces. And lo and behold, instead of two years, it was six months. Wow, it's just easier. Bodies get in the way of teeth movement, and teeth get in the way of body movement all the time. Wow. So if we could get the two to shake hands, everybody's happy. It just may it's just common sense. You don't need an education for that.

SPEAKER_05 38:20

So for those people who have already gone through the process and they're just listening to this now, do they have hope? Can they still here's the last thing I want?

SPEAKER_00 38:29

I don't want somebody to go, oh my god, uh uh, I had palatal expansion. Am I doomed? Hell no. You had palatal expansion. So what? Let's work on you. If you're having problems, they may say, I feel fine, great. You don't need me. You need me like a fish needs a bicycle. But if you are having difficulty, like I had my palatal expansion, but I still feel like I have the same problems I had before. That's super common. Well, if you still have those problems, then let's work on it. It's not that tough. And there are plenty of AIA people out there and an email to us or checking out your your um your your uh what you said you were gonna put up, you know, about some people who whoever's taking it. But that, you know, if if you just get someone who understands this body movement, and there are plenty of them, they can look at you and and teach you how to teach your body how to move. And suddenly, now you got a huge airway already because you've had this expansion. Well, suddenly now you know how to use the airway. I had a patient who had expansion double jaw surgery twice, twice, and was still having problems. I can't breathe. Well, it was like he bought a brand new Ferrari, but he didn't have the keys. So it's like, look, you gotta, I mean, the airway is monstrously big, it's as big as a number 10 can, but he doesn't know how to use it because his tongue is in the way. Well, he needs Mayo, he had Mayo, but Mayo can't work if a rib cage is elevated. This is him, except he had a big forward head because he was trying to find air, and so the neck always chases the face. So if you build a face forward, the neck's coming forward, and so all we did with him was teach him how to breathe. You just don't know how to breathe, which seems silly. What do you do? You inhale, you exhale, but he couldn't do that.

SPEAKER_05 40:20

By the way, I am gonna share one. I'm gonna share my stories on uh my amoobs right after this. One of my most insane posture changes on a patient I have ever seen, just with myofunctional therapy. Can you see this? Isn't that beautiful?

SPEAKER_00 40:46

And that's just with myofunctional therapy. So here's the question was it a top-down or a bottom up? Well, duh, it was a top-down. That's not done, she has a lot of work to do, but yeah, but uh you know, she's already driven a thousand miles, she's entered the new town, and she is ready to find

Hope After Expansion And Surgery

SPEAKER_00 41:05

a house to live in. She looks great. So when you see that sort of thing, and you know at that point that tongue was stopping everything, it she might as well have been walking on one leg, right?

SPEAKER_05 41:21

It's crazy, it's crazy how much we can help our patients, but by working together, what happens mechanically though, when someone becomes a chronic mouth breather? Tell me now what happens from top down.

SPEAKER_00 41:35

Well, then let's let's say step one. If I'm a chronic mouth breather, it means my tongue is not up. And remember what I said about palatal movement. So, palatal movement is keeping skull bones unlocked. And when skull bones are unlocked, midfacial development can happen because palatal movement is brought to you by a tongue that is capable of movement with a concept that we've created called stomatic flow. This is a big deal. In the world of vision, there's something called optic flow. I can tell I'm moving because I see things going past me. Well, stomatic flow is basically I know my palate is having excursion because my tongue is creating the excursion. Load on the right, load on the left. That creates the palatal movement. Great. That stomatic flow is what develops the midface, but the mid face can't develop if the bones are locked. In other words, there is no stomatic flow. So a free moving mandible and a free moving maxilla, courtesy of a properly positioned tongue and a patent airway, is what develops the midface. Because we always say, well, you you have to nasal breathe to develop a midface. Really? How? That's a fair question. How? Well, well, you well, you just do because the tongue makes the pre-maxilla move forward, right? That's great. How? It's always how or why, and so the tongue alternating sides creates palatal alternation, which unlocks the skull bones, which allows the maxilla and the vomar and all the rest, the zygomas to move and fill out a face. So without that, the patient is not going to have a patent airway. So they now got to do compensation. And the first thing, I am sure gonna do one thing as a person who has these problems. I'm certainly not going to die because I like life, so I'll find a way to breathe. I'll just open my mouth now. And well, why how come I started out that way? How come I didn't start out like my brother or my sister? Well, something happened in utero. My tum to telling did not occur in utero very well. That's interesting, right? So this began before I was born. Maybe I got up early and Instead of having development of my molars, I stood too soon as a baby. And so now it's walking at eight months, and my mom and dad are bragging about it when it really wasn't big at all. Because if I don't crawl, I don't have asymmetric or symmetrical alternating movement, which creates stomatic flow. And that's what creates the um the molars to descend and ascend sooner to emerge to erupt. And when the molars erupt, I stand up. Molars erupt, I stand up. That's the rule. So that should happen, you know, what is it, 12, 13 months, something like that? Not eight. And so that limitation in midfacial development brought to you by a mouth breathe, probably brought to you by something that happened in utero, which was lack of maxillary grounding or tongue-to-palate grounding. All of that then is what limits the motion. But what creates the motion, I think, is more fun. And a tongue that is able to have stomatic flow to create the alternating palate to unlock the skull bones. That's what keeps the neck at a normal curve and keeps the airway open. I hope I answered your question.

SPEAKER_05 45:13

You did. Um, you mentioned about these being locked.

SPEAKER_00 45:17

Yeah.

SPEAKER_05 45:18

Uh are they the same thing as cranial strains?

SPEAKER_00 45:21

That is a cranial strain. So all we did was we we say they're locked, but really they lock in certain ways that we do. Sorry. Hosh dog. So if I bend my elbow, my elbow is bent. This is an elbow strain. What's the name of this strain? Bent elbow. It's technical name. Bent elbow. Well, cranial strains are different because I got a lot of bones and it's an orb. So how do you name temporal bone out on one side and in on the other? How do you name that? Well, the osteopaths began a naming

Mouth Breathing, Growth, Cranial Strains

SPEAKER_00 46:00

process and they named it after the sphenoid. If it's down on one side and doesn't change, well, if it's down on my right, it's a right side bend. If it's down on the left, it's a left side bend. Okay, that's fine. I get it. Now that's relative to my occiput. So if this is my occiput and this is my sphenoid, if they're both down on the right, right sidebend. If they're both down on the left, left sidebend. But if it's down on the right and this way on the occiput, that'd be a left torsion. So I've got a right sidebend, left torsion. Or I could have a left sidebend, right torsion. Or I could have a left sidebend, left torsion. Whoa. Weird, right? Now if I look at me from the top, like I look down like this, and you're looking at me from the top, here's my occiput and here's my sphenoid. They also do this. But what if they do that? Uh-oh, that's a problem. This is a shear. So they should rotate in opposite directions. But if they do this, that's a shear and it creates stress where they meet. So left shear, right shear, superior shear, inferior shear, all named after the sphenoid, the one in front. So if we name the the named cranial strains, left sidebend, right side bend, left torsion, right torsion, superior, inferior shear, left shear, right shear, and then the final guy, compression. Jam my face in. So things like impacts and all that create the shears and compressions and all of that. Body position typically creates the side bends and the torsions. Well, what if I've got a body position and I was in two car wrecks and I was kicked by a horse? Hmm. All of the above. Am I a complex patient? Oh, yeah. So now it takes a lot more nurturing for us to unlock skull bones, free up the mandible, free up the maxilla, get the neck to move, stop neck breathing, which pulls your tongue down, get the rib cage down, create system flexion, teach this person how to rotate, teach them how to ground. All of those things start to happen. And suddenly this complex patient wasn't so bad after all.

SPEAKER_05 48:29

My gosh, Mike, I can seriously listen to you all day long.

SPEAKER_00 48:34

Unfortunately, I would never shut up. And eventually begging me to stop. Like, I'm throwing in the towel. Where's my towel?

SPEAKER_05 48:43

What is the one thing? Oh, I actually had a quick question. Uh, Grace asked, if molars erupt or stand up, is walking appropriate anytime after that?

SPEAKER_00 48:53

Yes, absolutely. Once your molars erupt, it's time for the kid to get up. Usually what's happening is they're starting to cruise on furniture at that point, anyway. As the molars are beginning eruption, they're hanging onto the couch and they're starting to explore, letting go with one hand and trying to do some stunt, you know, like kids do. I have three, so you know how they roll. But yeah, so um, yes.

SPEAKER_05 49:15

I am going to post this on um Maya moves right away for everybody who wants to rewatch the live. However, I lost connection in the middle of this presentation, so I'm not really sure what is actually recording because it's showing me a black screen right now. Um listening.

SPEAKER_00 49:33

If worse comes to worse, we can always do this again.

SPEAKER_05 49:36

Oh my goodness, you know, I would love to have you here again.

SPEAKER_00 49:40

That would be easy, it's fun. I like chatting with you anyway. This would just be fun for me.

SPEAKER_05 49:45

So, what is the one thing you wish every healthcare provider understood about the body?

SPEAKER_00 49:52

The massive impact it has on teeth and tongues. I want every healthcare provider to know that this body directly impacts tooth organization and tongues. All teeth are are kids on a school bus. And those teeth, those kids, we don't have to worry about where they're sitting. What we need to worry about is is the school bus on the road or is it going off a cliff? Now, if it's going off a cliff, all the kids on the school bus are going to be screaming and freaking out and running around everywhere. And the bus driver's never gonna get them to sit down. But if we turn the bus back on the road, all the kids will go sit down where they belong. They'll sit with their friends, they'll chat, and they'll ride to school.

unknown 50:44

I love it.

SPEAKER_00 50:46

This is the bus. These teeth are just little passengers on the bus.

SPEAKER_05 50:51

I love it. Where can people learn more about your work and the applied integration academy?

SPEAKER_00 50:57

Well, if they just go online, applied integrationacademy.com. That's a good place to start. They can go to the Instagram page if they want at AIA. I think, yeah, Applied Integration Academy. So, you know, we're we're easily findable. What I would I would love for movement people and dentists to show up as teams at our coursework. Because the quicker we build more teams and get them officially trained, the happier my life would be, because then I wouldn't have to see patients from Slovenia. And that just shouldn't be. So there you go.

SPEAKER_05 51:36

I agree. Let's get together, work together, connect all these other professionals so we can better serve our patients. Look how much we're missing still to this day. How much more I love them all. Right? And the more we learn, the more we realize how much we still have to learn for these patients.

SPEAKER_00 51:53

But um, yeah, don't it's getting desperate for me. I feel like I know nothing. And it's like the more I learn, the more I realize what I don't know. And I don't know, diddly squat. You can sit and write all the dang dum books you want, but it doesn't mean a damn thing. It's just well, here's what I know so far. Okay, so what? There's still that patient out there I can't fix. Exactly.

SPEAKER_05 52:16

Oh my goodness, Mike, thank you so much for hanging out with us today, guys. If you're not following us on your favorite podcast platform, please run over there, look up the beauty of breathing. And um, this episode should be out next Tuesday. Thank you so much, Mike.

SPEAKER_00 52:31

I love chatting with you. I love you. You're a great person.

SPEAKER_05 52:34

Say, Money too. Everybody have a wonderful day. Bye. Thank you.

SPEAKER_00 52:40

Thank you.