Tongue 'n Cheek!

A fit man in his 30’s walked into our centre, frustrated by persistent shoulder and neck pain after his workouts. A dedicated weightlifter since his teens, his form was solid, but the right trapezius pain never seemed to go away.?

He is from Kashmir, working in Bangalore.? Growing up in Kashmir his parents had forbidden him from playing outside the house compound due to the terror operations, subsequently they shifted him from their house to his uncle's house which was in a much safer area.? There too he was kept away from other kids for safety and security.? This impacted many aspects of his life including executing fundamental movement skills such as throwing, falling, kicking etc.? These extraordinary circumstances would later on have an impact on the boy's basic function of respiration, swallowing and movement skills.

“Any push and hand lift above the head movement triggers it, especially on the right side,” he explained.?

This pain had been constant for over two years, and despite trying myofascial release, exercise rehab and medications; nothing seemed to offer long-term relief or resolution..

He also mentioned two protruding lumbar discs (L4/5) that hadn’t caused nerve impingement or radiating pain, but left his lower back feeling stiff.

Upon examination, we found pain in the superior-posterior capsule of his right shoulder joint during end-range extension—even without weight. Stabilising his acromioclavicular (AC) joint gave him range of motion and reduced the pain. His external rotation in abduction strained the superior-posterior labrum, further contributing to the discomfort.

As part of a broader systemic assessment, we checked his vestibular system and found his bite was uneven, with his TMJ misaligned. Our orthodontic specialist confirmed two findings: 1) His TMJ wasn’t sitting correctly in its socket, and 2) He had a tongue-thrusting habit, likely due to open-mouth breathing or/& early childhood stress.

His rehabilitation is now underway. We’re focusing on correcting his TMJ alignment and lengthening his tongue, which will lower the hyoid bone (the small bone you feel when you swallow). This will improve his breathing, swallowing and encourage closed-mouth sleeping. Paired with shoulder stabilisation exercises, we’re already seeing improvements in his range of motion and reduced pain during shoulder movements especially in end range.

Surprisingly, working on his jaw and tongue has led to a few unexpected wins. He used to bite his tongue frequently—now that’s nearly resolved. His speech has also sharpened, with clearer pronunciation—no more confusing “S” sounds with “Z”! His breathing has improved as well, and we’re continuing to lengthen the tongue while inhibiting the temporalis muscle during activities like lifting.??

Another change we have seen is his gait and pelvic position has also improved which as a consequence has eased his back stiffness.

We are progressing well and as he says, we will resolve it.? I couldn’t be more proud of the progress he has made, the mind set he brings, the curiosity to learn and his very effervescent approach to life.? It is such a pleasure to be part of his recovery.?