Our practitioners have been at the forefront of identifying and collaborating to restore function for babies and others with tongue tie for several years. We network with practitioners throughout New England to optimize care. We typically see babies for 4-6 treatments, ideally 1-2 prior to frenectomy and 3-4 as the tissue is healing and remodeling. We are thoughtful about what it takes for bodies to heal and recommend strategies to support good nutrition and emotional support in addition to the manual therapy and rehabilitative exercises needed to ensure the efficacy of the procedure.
How can manual therapy help?
Touch facilitates change in the body on many levels. Touch can be soothing and calming, and therefore, very healing. That’s why parents massage their babies and why it is particularly effective when parents do massages and exercises daily. Parental touch is reassuring and frequent interaction between parents and baby builds trust and improves baby’s development.
Specific manual therapy techniques and knowledge of the babies’ anatomy can facilitate even more change. Gentle palpation of muscles and soft tissue called fascia can tell us if a muscle is being overused or is underdeveloped. Gentle palpation of a joint can reveal if it’s moving too much or too little. The level of training of the person palpating will reveal more and more information about the state of the body and manual therapy can help facilitate changes that can improve baby’s ability to accomplish important activities like breathing, eating, moving their head, neck, arms, and legs so that they can fully experience the world around them and continue to develop their motor (movement via muscles) and cognitive (thinking) skills.
A comprehensive biomechanical and neurologic exam may reveal the reason for the infant’s challenges with breastfeeding and provide a resolution.
In the case of tethered oral tissues:
- Manual therapy can improve the flexibility and range of motion of the tethered tissues (lips, tongue, cheeks) in preparation for the surgical or laser release of the tethered tissues
- Help to maintain flexibility in the mouth, neck and body as the tongue and lips heal
- Normalize and integrate full functionality after the procedure
What are biomechanics?
Biomechanics are the way our joints move, dictated by the health of the ligaments, muscles, and bones that comprise the joint. Our joints should have healthy, full range of movement, and good stability. Can you move your arm in a full circle? Does it pop, click, or hurt when you try? A full, painless circle is great biomechanics; anything else is dysfunction. If a baby’s temporomandibular joint (TMJ) is not able to move properly or is unstable when it does (because of how the head was handled during the birth process, perhaps) then their mouth may not be able to open as wide as it needs to when they want to eat. It may even be uncomfortable or painful for them or you might feel or hear a click when they try. This is one biomechanical reason that an infant may have difficulty nursing or feeding by bottle.
What is neurology?
Neurology is how the brain communicates with the body. If the brain is injured (as in a person who has had a stroke) and cannot communicate well with the body, you may see difficulty with speech or using a limb effectively. There are many serious issues that can interfere with the brain telling the body what to do, but there are also several less serious, easily treatable situations where biomechanics may affect how the brain interprets what is needed and that can interfere with how the brain communicates with the body. For example, if the mouth can’t open widely to feed, the brain will try something else, like asking the baby to tip backwards from the waist hoping to make more space and then the muscles that allow baby to tip backwards will eventually become stronger than the muscles that should open the mouth. Subsequently, the muscles that should be opening the jaw lie dormant, waiting for the brain to task them. If the biomechanics of the TMJ are corrected and the brain senses the mouth can open, it will once again communicate with the appropriate muscles and they will begin to be restored to good function and activation.