Neurokinetic Therapy and TMJD treatments

Hi, everybody. I'm Dr. Sandhya Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most natural way. Hi, everyone. Welcome to today's show at the Holistic Dentistry Show. I'm your host, Dr. Sandhya, and I'm so excited to talk to you today about something very different in physical therapy that probably you haven't heard of. And with me today is Dr. Bryn Akin Young. She's a director of physical or a doctor of physical therapy at Bechtel Physical Therapy. Bryn, welcome to the show.

Thank you for having me.

How did you, you know, as a physical therapist, stumbled upon this neurokinetic therapy that we're going to be talking about today?

So I stumbled onto neurokinetic therapy because I'm just someone who loves to learn. And so in my entire life, I've done a lot of education and a lot of learning. So after going to college and majoring in exercise biology, I decided to become a physical therapist. So I went and I got my clinical doctorate degree in physical therapy down in San Diego. And then after that, so I graduated back in 2018 and started practicing and what I'm sure in your field as well, and our field is physical therapists, after you graduate and you have your degree and you're licensed, you always have this opportunity to do continuing education. So we're always asked every year when we renew our license to do continuing education. So we just keep on learning even after we're out of school. And so I stumbled upon it through a mentor of mine who had taken the whole series. And so this neurokinetic therapy, it was something. It's something so new and so modern that it's not yet taught in physical therapy schools. It's not widely even known about. It's been around for a while, but it's just kind of the word is finally starting to get out on how important it is and how it really is different than any approach traditionally that's been used in the past. So I stumbled across it just, I think, coincidence or fate or whatever, where I just started in the level one course back in 2020. And when I took it, it spoke to me in a way that really answered a lot of my questions. As I had been practicing, there seemed like there was something missing and there was something a better way we could offer physical therapy and healing. And so I started with this in 2020 and went through all three levels of the course, and it's totally changed the way that I practice.

So this technique, neurokinetic therapy, has an approach in creating the brain, not just the body. But when we think about physical therapy, we think muscles or joints or bones. We don't really think mental or the brain. Correct?

Yes. And very good question, because I feel like this is where physical therapy needs to evolve and move forward. Where typically, yes, physical therapists, like I consider myself, I now consider myself an integrative physical therapist or a holistic physical therapist because I'm drawing from so many different areas and fusing them all together. But typically I would be called an orthopedic physical therapist, where I specialize in orthopedics. And I treat the body, I treat the joints, I treat the spine, I treat the musculoskeletal system. And in our field in particular, things get really siloed and really divided where it's like I treat ortho or I treat neuro or I treat pediatrics. And what we used to always joke about is like, well, everybody has a nervous system. Every single patient you see has a brain. Every single patient you see has a spinal cord. And what I tell my patients about neurokinetic therapy is it's a new approach, but it's just applying things that we've known for a long time in theory, but we've never really applied them to an orthopedic population. It's using concepts that have been around for a long time in the neuro rehab world and applying them to someone like you or someone like me who you. You and I have an intact nervous system. We haven't had a stroke, we haven't had a brain injury, we haven't had, you know, all these things that can happen. We are, you know, neurologically normal, as they say, or to neurotypical, and haven't sustained major damage to our, to our brain. But neurokinetic therapy is going upstream of where your pain is. So, so if you come to me and you have pain in your shoulder, pain is just a message saying something is not functioning very well in your shoulder. And so traditional physical therapy would go to your shoulder, maybe do some soft tissue work, maybe do some ice, some ultrasound, some muscular, you know, strengthening range of motion, what have you. So that's kind of the traditional approach. And a lot of people have tried that. And for many patients, that does work. They do get better, they do get out of pain. But there are a lot of patients that kind of, they do physical therapy, they do massage, they do acupuncture. They're kind of going through all of the modalities out there and they're still in pain. And so that to me, I'm all, again, as a person who likes to learn, I'm like, well, why is that? We did all the stuff that they taught us in school and this patient is still in pain. Why is that? And so neurokinetic therapy treats your shoulder pain in the brain, where movement is generated. So we go, it's using. I don't like to get too into the weeds because I don't want to bore anybody to sleep. But what we're doing is we're treating. It's called the motor control cortex in your brain that actually manages your skeleton, so that actually creates movement of your shoulder. And so it's using a very specific protocol that again, people have to go through the certification to learn, and you have to really practice to get good at, but it allows us to correct movement where it is generated. Movement is not generated in your shoulder. Movement is generated in your brain. And it sends this message from your brain down your spinal cord to the nerves that go to your shoulder for me to be able to lift my arm. So that's where this approach is really, really different. And that's what I tell my patients. I promise you, this is like, not you've ever done. And a lot of people, a lot of my patients tell me, you know, they view it as magic. They're like, oh, this is like magic. And I'm like, you can think I'm magic, that's fine. But it's actually based in clinical neuroscience. And so that's what I'm very much like. I'm very much a scientist, I'm very much science based. And I tell them, it's like if you had taken classes in clinical neuroscience or neuromuscular classes like all pts take in school, this would make total sense to you. So that's what I tell them is we're basically, we're basically using neuroscience to treat your brain.

Fascinating. It makes total sense. You're going to the root cause really of the pain. The root of the pain. Can you talk like you've had probably patients that have gone through physical therapy and they didn't get results? Does this technique, neurokinetic therapy, help you improve your results?

Absolutely. Absolutely. So as when I was practicing before neurokinetic therapy, I would get many patients better, but there would Be many where I feel like I would hit a dead end, and I'd be like, I feel like I've done everything I can do for you. And it would always puzzle me, like, well, some patients are getting better, some patients aren't. And that frustration of, like, I got into the field to help people and wanting to, like, get all of my patients better, and not everyone's going to get better, but thinking, like, they're just. I had this feeling in my gut of, like, we can do better than this. There's, you know, there's more out there. And I think, again, I'm not sure if this is the case in your field, but in physical therapy, a lot of what's taught in schools has to be vetted by research. So it takes about 10 years to vet something and get it into the curriculum in school. So by the time you get out, you are a little outdated, and you do actually need to update your practice as quickly as you possibly can. And that's where I felt, you know, I again, love learning new things. And so when I grabbed onto this, it was like, why didn't we learn this in school? Like, this is something that needs to be taught. And so I'm actually part of, like, the clinical research that's going on so we can put all this research behind it so that it can be taught in physical therapy schools. But like you just said, it makes logical, intuitive sense. So that's what. When I find. When I explain it to my patients, they get it. It's like, you can. And that's the cool thing is you can feel it. Like, you can feel as we're doing these treatments, when I tell people I feel like an electrician, where we're, like, turning the lights back on. Like, if there's. Your brain is a supercomputer and it's trying to send a message somewhere, and the message is not getting through. It's like, well, why is this light switch not turning on? Why are the lights out in this room? And so when we get that light switch back on and there's a connection, the brain can now connect with that part of the body. The patient is like, whoa, like, now I feel totally different, and I feel totally better. And so it's been more of my practice with my patients that's affirmed how valuable this. This tool is. And again, some of the results. I was chatting with you a little bit earlier. Some of the results that I've achieved with my patients with conditions I previously never would have expected improvement with. So I've now Been able to help people with really complex, seemingly unsolvable problems that have improved dramatically. And so I've had patients. Like, one of my patients, he's in his 40s.

And.

And this poor guy, he said he's been in pain since he had a football injury in his 20s when his shoulder dislocated. And we've been able to actually get him. He's almost 100% pain free. After 20 years in pain, he's almost 100% pain free. And the other day he had tears in his eyes because he says, bryn, you know, people always look at me like, you know, you're a complex case. I can't figure you out. And just he goes, I get this kind of like deer in the headlights. Like, I don't know what to do with you because you're so complex. And he just had thought for 20 years, like, I am incurable. And, like, I just have to live like this. I just have to live in chronic pain. I can't do my daily activities. Like, he couldn't even vacuum his carpet. And he's 40. And in my mind, I look at, My heart goes out to those people because I'm like, you haven't gotten the good, like, good help that you need. And there is a way out of all of this. And so that's what the first step with my patients is like, re. Instilling hope. Because I feel that a lot of people become very hopeless. Like, oh, I'm just. I'm just a mess. I hear that all the time. I'm just a mess. My doctor told me I'm a mess. My, oh, my spine is just a mess. Oh, my TMJ is just. It's wrecked. I just. It's been like this for 30 years. Blah, blah, blah, blah, blah. And so I hear this all the time. And then I get patients who, after 20 years in pain, are starting to feel better. And they look at me and they're like, is this real? Like, can I believe this? And again, I explained to them, we're doing. We're going upstream of where everyone else has been treating you. So most of the modalities are downstream, where I love that expression, where it's like pulling people out of a river. And it's like we're just pulling them out, pulling them out, pulling them out. And I was like, well, let's go upstream and let's see why they're getting pushed in, because if we could stop them up there, then we wouldn't have to do all this work of pulling them out of the river. And so I tell people that of like, this technique goes to the source of where you're having dysfunctional movement to correct it there so that then you can go do whatever you want. You can do Pilates, you can do. You can work out with your trainer, you can go hiking, you can do. I don't care what you do after that, but you need to be able to function. And the other thing that I really specialize in is surgeries. So surgeries and injuries are what create a lot of this dysfunction in the body. And so that's why I see a lot of folks with, again, like, kind of a laundry list of surgeries. And I tell them, like, every single surgery going back your entire life needs to be treated and corrected. And so that's another area where neurokinetic therapy treats those kinds of things very differently.

So, speaking of surgeries, I mean, is it because a surgery part causes scarring? Is that part of the problem?

Amazing question. And so that's where. And this gets into the. A little bit of the nitty gritty of what neurokinetic therapy is. So I'm going to try to keep it simple. But I explain to people is there's this media attention right now around fascia. Have you heard about. I'm sure you've heard about fascia.

Absolutely. So, so important, even for clenching. And we're going to talk about that in a bit. Tmj, clenching, everything. Yes. It has memory.

Yeah. Yes. Oh, my gosh. Did you just say fascia has memory?

Yes.

Amazing. Oh, my God. I'm so glad I don't have to explain that to you. So that's what I tell people. Like, in your body, your body has a memory of everything that's ever happened to you, whether you consciously remember it or not. So that's where, again, we're going to get a little bit out here now. But I view the body as the extension of the mind and even more so the body as an extension of the subconscious mind. So even when you were a kid or when you were under anesthesia for your surgery, your body always knew what was happening to you. And so this, I say muscle memory because people have heard that term before. I'm like, it's kind of like muscle memory, where your body has this memory of any trauma that has ever happened to you, physical, emotional, spiritual, what have you. And so I've, with my practice, have gone into, let's heal that area that was never really properly healed, and that goes into the treatment of the fascia. And so if people don't know what fascia is, so we've got our skin on the outside, you can see that we have skin underneath the skin. There are layers of tissue, kind of like an onion. And so we've got skin, we've got connective tissue, we've got fascia, we've got kind of layers and layers and layers until we get down to actually the muscle itself. And so all of these layers of tissue are extremely important in how we're actually functioning. And so again, when I was in graduate school, fascia was kind of like, oh, fascia. We just like kind of get rid of it so we can get to the good stuff. Like we were doing anatomy, dissection and like, let's look at the muscles. Like we care about the muscles and we care about the joints. And it's like, well, that's great. But now we're realizing the importance of fascia. And that fascia, which for simplicity is just this connective tissue right under your skin. So if you touch your hand right now or you touch your shoulder, your skin is sending information to your brain that something is happening there. And so that communication is through your fascia. And so we look at this fascia as actually kind of the king or the queen here, where the muscle is actually kind of the lowly pawn, the lowly guy just doing whatever the brain and the fascia are telling it to do. And so instead of kind of a bottom up approach, neurokinetic therapy takes a top down approach where we're going to go up to where the supercomputer is, where the, where everything's happening, instead of just trying to be like, what in your shoulder is going wrong here? And so this fascia is this kind of electrical communication network where the brain sends its message to whatever part of the body it's trying to move. And so that is where, again, it's very different than traditional therapy because we're looking more at improving, restoring or creating connection between your mind and your body, between your brain and your body, which typically gets disrupted with injury or surgery. And surgery. Your question about scar tissue. Circling back to your question about scar tissue, I will treat like I had a patient who I treated a surgery from when she was five months old and I was treating her in her 60s and she hadn't even mentioned it because she was like, why would I mention a surgery from when I was five months old? And so what I explained to people is any surgery you've ever had, whether it was orthopedic, whether it Was a general surgery, whether it was a cosmetic surgery, whether it was a C section, a hysterectomy, what have you. Anytime the doctor had to cut through your skin, they create a disruption in that communication network in your fascia. And so what I explained to people is that part, if someone has a C section. I had a patient today who, she had a c section in 83. And so since 1983, her abs have been offline since 1983.

Wow. Because of that disconnect in the fascia.

So it's like they turned the lights out on her abs in 1983. And so a lot of my patients are like, bryn, that was in 1983. My son is, however, years old. We're fine. It's fine. And so what I tell people is your system is designed to compensate, and it compensated beautifully for 40 years. And those compensations are what people end up needing treatment for down the road, that they then say, well, my back has been hurting for 20 years now. And it's like, well, it was actually that C section that took away your abs in 1983 that caused your low back to compress and your lower back muscles supposed to get really tight, that now you have all this back pain 20 years later. But it takes a while for those compensations to kind of, I say, like, run out of road. Like, they start out working very well. You function. And so that's where people. You know, I'm trying to get this understanding out there of what injury and surgery does to your system, because typically, I would want to see someone six weeks after their surgery and address that scar. And we have to bring whatever that scar is over. It's going to affect what's right underneath. And so if you've had a shoulder surgery and now you can't lift your arm, it's like, we have to treat that scar. And because it's an injury to the fascia is part of the proprioceptive system. It just allows your body to know where it is in space and how it's moving. And so we have to treat that scar to bring that whatever it was back online after the surgery, because or else you're going to be functioning without key parts of your body.

Very interesting. But it makes total logical sense, as you said. So, you know, I'm sure there's a lot of dentists out there like me. I have neck issues because of working with patients. I have to constantly work on my upper strength. And is neurokinetic therapy good as a therapy, let's say, for dentists and hygienists or for anybody that's working a lot, like, hunched over.

Absolutely, absolutely. And this is where one of my patients. I've known him for a long time as a dentist, and he's a really tall guy and he's. And he has a lot of back pain, and he's like, Bren. The position that I'm in every day is just really not great for my body. I'm sitting there, I'm leaning over my work, I've got my head turned to the side. And so I find a lot of dentists and hygienists that I know end up with neck pain, upper back pain, lower back pain, sometimes pain in their hands and their arms, like numbness or nerve pain going into their arms just because of the sustained posture that you're in all day, every day. So part of my job is looking at you, Dr. Sanda, and how are you using your body every single day? And what stresses are your. What demands and stresses are on your body every single day and wanting to maintain your health, your wellness, and your longevity despite those stresses that are going into your skeleton every single day? And so I look at it. I used to practice up in Silicon Valley before I moved to la. And so we were treating people who are on computers, like 13 hours a day. And we used to call it. We called it tech neck because it's the technology world. Like, they're just. Their necks from being on computers all day are just totally wrecked. And so I look at this neurokinetic therapy as a way to maintain your wellness, not just to treat injury, but to kind of do more of a maintenance, where some. And I actually make the comparison to dentists, where I tell my patients, I'm like, you go see your dentist for a cleaning. You go see them twice a year for a cleaning. They get to check things out. They get to say, okay, let's keep it. Let's keep you going, or let's make a game plan to intervene and do something. I envision my patients seeing me in that way and, like, come see me for a movement wellness exam so we can catch injuries before they snowball into, like, a massive problem. And so we can keep your system functioning well. Because I find that our current medical system is very reactive instead of proactive. And so I find that, especially in our world, I'll see people after they've been in pain for decades, and it's like. Or years or months. And so I would love to shift to more of a model of prevention of pain. Come See me before you're in horrible pain so we can keep your system happy and functioning well. Because again, pain is just a message. Pain is just your body saying, hey, something's not working very well here. And it's kind of a call to action. Like, could you please take some action and maybe do something differently? And so for you, when you're in for dentists and hygienists who are repetitively in this posture all day, every day, sometimes you can't change that. Like, you can make it as ergonomic as you possibly can, but typically you need, like a little bit of TLC for your body to counter that repetitive stress. And that's what I look at as any profession. What kind of repetitive stresses are you forced to deal with? And how is your body handling those repetitive stresses? And can, like I say with my computer, people who are on computers for eight hours a day, let's give you an anti computer routine so that you can do it in the beginning of the day, in the middle of the day, try to just break up this monotony that's really harming your skeleton. Because computers, cell phones, all the devices we have, are really harmful to our musculoskeletal system because we did not evolve to be sitting in a chair looking at a computer. Like, our skeleton is just not designed for that.

Yeah, I'm glad you're mentioning that because most people think about computers, oh, it's just the eyes, you know, it's the blue light. But we don't think about the impact that it actually has on our skeletal system. And, you know, my husband actually spends eight to 10 hours on a computer every day. So, yes, he's gonna definitely need to come to you. But.

And we like, yeah, go ahead a.

Little bit towards, you know, TMJ and physical therapy, because, you know, when I went to dental school, physical therapy was not mentioned as a way of treating and helping patients with tmj. I want to talk to you about that because I know as dentists we can refer to physical therapy, but we just don't know if you can help our patients with tmj, besides for relaxing the muscles. So how does neurokinetic therapy maybe offer. Offer a different solution when it comes to tmj?

Yeah, excellent. And so this is where I find a lot of professions who maybe haven't had physical therapy themselves or had it like a really long time ago sometimes aren't even aware of what we do. And so a lot of doctors, when they refer to us and their patients, go back and are like, oh, you know, I had a great experience. You know, doctors sometimes aren't really tuned in with like, what exactly is physical therapy? Like, what are we doing? Because like you said, it's not covered in dental school, it's not covered in medical school. That's where a lot of times some doctors will kind of defer to us and be like, look, I didn't take these musculoskeletal courses, like, let your PT drive this. Where they kind of are admitting, like, hey, this is not my wheelhouse here. Because it's just different educational curriculums that we're all getting when we're in graduate school or professional school. And so in school, when I, before I took neurokinetic therapy, we do a whole training on tmj. And so it's great because you get kind of the basic anatomy, biomechanics, pathophysiology, all this kind of information about TMJ dysfunction. And so I was always interested in that because I've had. I've had some friends who've struggled with tmj. I know lots of people who are like, I clench at night. I have to wear a mouth guard. So it just, it's been something that has always been interesting to me and something that, again, with my traditional knowledge, I was treating. But then with this neurokinetic therapy course, it really changed the way I even assessed and treated tmj. And this is where the last time I was at the dentist, I was asking her if she refers her TMJ patients for physical therapy. And she's like, well, I refer them to this other, you know, this. I think he's an orthodontist where they're going to get fitted for a custom mouth guard or they're going to do bracing or what, or, you know, I've heard a lot of things they'll do, like Botox injections into the jaw muscles to try to relax the them. And so what I talk to my patients about with neuroconnect therapy is like, yes, your jaw muscles are tight. Well, why are they tight? Like, I'm always asking why. It's not just that they're tight. Let's fix it. What I say is, when there's tension being held somewhere, there's always a reason for that tension. One of my favorite mentors, he always says, nothing comes from nothing. Like, there's always a reason, reason why there's tension being held there. And again, we have to go upstream and we have to remove the reason that there is tension there. And so that's where I go for more of this holistic approach and holistic in regards to body, mind, spirit. So there's a lot of reasons, including trauma, why someone might be clenching their jaw. And so we have or stress, severe stress. And so in the physical therapy world, we do a lot of like stress reduction techniques, mindfulness, breath work, diaphragm work to work on stress reduction and getting someone out of that like fight or flight stress state and getting them more into like a relaxed nervous system state where they can relax and they can heal. So that's one reason why someone could be clenching their jaws. But then as far as the physical side of things, there's lots and lots and lots of reasons why someone might have tmj. So I look at TMJ is this kind of diagnosis that's just thrown on jaw pain. And so it's kind of one of those catch all diagnoses where I think it is a broad umbrella and someone just comes in and they're like, I have tmj. And I'm like, yeah, I do too. I have two of them. So the fact that it's like, oh, it's this, like I have this pain. And again, it's, it's very debilitating. So it'll be, you know, people can't chew their food, they, they can't open their jaw, they can't, they get locked jaw, they get grinding, they get clenching at night, they get headaches, they get neck pain. So it's very debilitating not to make light of it. It's a very debilitating condition. And so as far as looking at it holistically, we ask, why is the jaw dysfunctional? And that again, can be for reasons that are far away from the jaw. And this goes into this looking at everything as interconnected. So I don't look at anything as separate from the top of your head to the tips of your toes. It's all one closed system. And so a lot of patients that are getting jaw clenching, the jaws are very strong, powerful muscles. That's how we chew. So it's like we are able to produce this large amount of force with these jaw muscles. They're very small muscles, but they can generate a lot of force. Force. Like if you think about biting into an apple or biting into a carrot, they're very strong muscles. And so the brain reads that as a great backup for weakness somewhere else in the skeleton. So I will see a lot of times someone with really weak abdominal muscles and they're in their Pilates class. And they're doing whatever they're doing in Pilates, which. Pilates is great, but you need a core that works, that is on, that is online. And so they'll be in that Pilates class, and they'll be clenching their jaw the entire time they're being asked to strengthen their abdominals. So that's a very common compensation. I see stress, and then we see neck problems, creating jaw problems. So we see a lot of upper cervical dysfunction. Someone who's been in a car accident, has had whiplash, has tension headaches. The neck and the jaw are right next door. So typically, you'll see a lot of jaw problems in relation to neck pain or neck problems. And then the one that. This really is something I've only ever looked at since taking neurokinetic therapy, is the connection between the jaw. So our lower jaw, our mandible, how it relates to our pelvis and what's going on in our pelvis. And this has to do. It has to do with. And this is where the physical therapists should all be able to understand this is. It has to do with anatomy and biomechanics. And it's looking at the skeleton. When your skeleton is in motion from the ground up, what is it doing? And so we look at, like I look at with TMJ problems, a lot of times we'll have a lateral jaw shift, which is creating malocclusion. So a lot of, I think people in your world are treating malocclusion like the teeth are not coming together, the bite is not symmetrical. And so if someone right now, if I had my jaw shifted this way, I'm shifted over here. My teeth are not going to meet together. But I always ask, well, we're not going to fix that unless we know why the jaw is shifted to the side. And so what I treat a lot is weakness, typically, actually. So a lot of people with TMJ will also have low back pain. So there's this big connection between weakness in your low back, typically on one side, that will create this jaw shift to compensate. So someone walking around will literally. And this is all subconscious, because people are like, well, why would I do that? And so this is all subconscious. This is not in your conscious perception. Your jaw will shift to make up for that weakness in your pelvis or your low back or whatever, something with what your hips are doing, people who sit a lot. And then one side of the jaw will be compressed and painful, and one side will actually be decompressed. And so neither will function very well or the way it's supposed to. So that's where I see people with all these problems that are actually need to be fixed in their low back to correct their jaw shift.

Wow. So basically, I mean, I've actually worked with a chiropractor for a long time. At any time, we do any kind of night guard. I always believe in balancing the smell and then balancing everything before we introduce that nightguard. But unfortunately, it's not a norm in dentistry. The only thing we're taught in dental school, oh, somebody clenches and grind, just give them a bite plate. But what I find is, like, if you get this night guard that and you're not imbalanced, you're going to clench even more.

And that's what even the chiropractor that you're working with, that's amazing. And even this neurokinetic therapy is open to multiple disciplines. It's not just for physical therapists. So even chiropractors can take this course where it just focuses, folds into what you already do. So if you're a Cairo, if you're a pt, if you're an acupuncturist, if you're an osteopathic doctor, you can fold this into what you already do for your patients. And so I explained to a lot of chiropractors, you're doing some kind of manipulation to restore whatever you're trying to restore. But then as soon as that patient gets up and walks out your door, their system is going right back to what it. What the brain has been running when they walked in here. So I explained to people, you know, your brain is running your body on autopilot all day long. And when it automates, it's like a bug in a software. It's like when our phone doesn't work and they're like, okay, we're gonna, like, roll out a new software update and fix those bugs. Same thing with our brain. It's like neurokinetic therapy is like doing like, a reboot and like a software update for your brain so that it can run the machine better and without pain. And so, yeah, like you said with those mouth guards and bite plates, I had a patient who her grinding was so bad that she had bit through her mouth guards. She had a bite plate, and she was clenching so hard she was splintering her teeth on this bite plate. And she was one who. She had had a lot of trauma. And so that's where I address it, where I'm like, we need to address in the emotional and spiritual and mental Health realm, what's going on, or the physical body will not know that it's safe, and it will not know that it needs to stop clenching your jaw. So that can be a big part of that as well. Where I view this, like, multidisciplinary approach that I think you really are a master of is really important because I tell them, I'm like, I can release your masseter, I can teach you how to diaphragmatically breathe, I can get your neck moving well. But if you're not dealing with some of this emotional and spiritual stuff, the jaws are just trying to protect you. They're just creating like, I'm going to protect her. She's in danger. And again, what I explained to people is it doesn't matter how long ago any of the injuries or trauma was your. This memory that you said in the fascia, the body remembers it as if it was yesterday. So I have people who tell me, like, well, that was when I was a kid. I'm so old now. I'm fine. That's what I always get. I'm fine. And I was like, you could logically and intellectually know you're fine, but your body doesn't know you're fine. And so that's what. There's all these wonderful modalities now that are trying to get to those root causes in those realms as well. So that's what. For dentists who have patients with tmj, Malocclusion, clenching, what ha. All the neck pain, headaches, or just pain, like the pain, the clicking that people get, the locking that people get, or if during a treatment, your patient can't open their jaw because it's too painful, they're getting pain. With your treatment that you're trying to do, it's like, I tell them, send them them over to me so I can help them, and then they can come back to you and they will be able to hold their jaw open for an hour or however long you need to do your treatment. Because, again, we have to get some of these underlying causes of why someone's TMJ is painful.

Yeah, I'm glad that you describe how can a dentist work with you, because I highly recommend. You know, I think the dental profession in general needs to learn to work, work with a physical therapist like you to help get our patients better and not just put a band aid on things or, you know, most people don't like to wear their night guards anyway. And you could probably get them to a point where they don't have to.

So and that's what I tell people. It's like, let's protect your teeth while we're fixing this. But that's the other cool thing about neurokinetic therapy, is that you can get change really quickly. Like, I can get change in one session, and then the patient just starts building on that. And as soon as they reprogram, as soon, I always say, we're doing brain reprogramming. And as soon as your brain reprograms, which it is perfectly capable of doing, that's the whole concept of neuroplasticity, where your brain can always adapt, can always change, can always build new pathways. As soon as you get there, you won't need to do this stuff anymore. You actually. Because some people are like, oh, I just have to do my exercises forever. I'm like, no, you just have to do your exercises. So you stop clenching your jaw, and then you're fine. And then you could stop wearing your night guard. So that's where, again, I love what you're saying of, like, working together, having our professions work together, because I think it's hard to deal with things in isolation when it's not in your scope. Like, I tell people, like, I'm not going to fill your cavities. You have to go see your dentist for that. Like, you know, it's like, we all do kind of our own area, But I think that a lot of disciplines. Who wouldn't think to refer to us. This is why I'm trying to get the information out there, so we can help your patients do better in what you're trying to do. And I tell people as well, because neurokinetic therapy is so new, it's not available everywhere you go. So I'm one of the owners here at Bechtel Physical Therapy in Sherman Oaks. And so our whole staff are in, Our whole staff certified in this technique, so that when you come here that you always have this option available, no matter who you see here. Because I can only treat so many people. I only have so many hours in the day. But I'm part of the movement to teach this to other physical therapists. So at our clinic, we host classes twice a year where we're teaching this to other physical therapists. And so I tell people, if you go to physical therapy and it doesn't work, don't give up on physical therapy. Keep looking until you find someone who can help you, and then come try neurokinetic therapy. Because it's very different than traditional physical therapy.

Yeah. So we're going to put some links down in the show notes for anybody who's interested in learning more and learning about your center. I mean, I've been to Bechdel Physical Therapy myself with a shoulder problem, which luckily I no longer have. Or if somebody's interested in neurokinetic classes, I will put the link in the show notes. One last topic I want to talk about, and it was very surprising to me that you actually treat this like mouth breathing. How, you know, because most people right now maybe are just mouth taping. And mouth breathing is a problem. Obviously it changes the microbiome. I see people with gingivitis because of mouth breathing. And really breathing through the nose has a lot of health benefits. So how do you help people with mouth breathing?

So I'm so glad you mentioned that. And just you mentioned, like, the oral microbiome, like how important that is to prevent, to preventing cavities and keeping your mouth healthy. And again, we're living so long now. We need to be healthy for a very long time. And so we need the tools to be able to support our skeleton and its longevity and its function. And so the mouth breathing is something that, again, it seems so simple, right? Like, everyone knows how to breathe, but what really happens is when we're born, we know how to breathe. When we're babies, we know how to breathe. If you watch baby, a baby, newborn baby breathe, they're breathing just the way we were intended to breathe. As we move from infancy to now, wherever you are now, we forget that we move away from that. And there's various reasons why that happens. But it's funny because I work on breathing so much with my patients, and it's something that we're doing all the time, like you and I right now. I don't even have to think about it. We're breathing. But I see a lot of times these kind of faulty breathing mechanics that again, just go into the anatomy of breathing. How do you breathe? How does one breathe? Nasal breathing, mouth breathing, neck breathing, diaphragmatic breathing, belly breathing, as you've probably heard it, like in yoga and those kinds of things. And so I find a lot of people, people with what I call paradoxical breathing, where they're not really using their diaphragm and they're not really. They're not breathing correctly. They're breathing, but they're not breathing like a baby would breathe. And so we work on treating that and fixing it, because that breathing dysfunction wreaks havoc through the whole system, not just the mouth, like everything the whole system doesn't work well when we're talking about the gut, the diaphragm is a gut pump. And so the diaphragm not functioning in the way it's supposed to will affect the health of the entire organism. And so that's something that I'll have a patient come in and we'll evaluate how they're breathing. And if they're breathing incorrectly, then we go about re educating that system of how to breathe using neurokinetic therapy. So we use, it's basically myofascial release and neuromuscular re education, which are fancy words. And so I encourage people to come in and to see how that works so that they can experience it for themselves. Because it's a little bit hard to explain how it's done, but we're basically helping that person learn how to breathe correctly so that they're not. And again, this is where if they can't nasal breathe because of like a deviated septum, it's like they typically have to have something like that fixed. But if they're not nasal breathing because they're just not getting enough air, it's like a dog panting. They'll get more air through their mouth than through their nose because they're not getting enough oxygen because of what's going on in their rib cage. So that's what I work with people on, how to breathe, which again, seems so simple, but, yeah, it's really critical to the function of the whole system.

Yeah, absolutely. And I think we also have somebody on our staff who constantly breathes through his mouth, not because he had something wrong with his nose, it's just, I think, easier. And the brain, as you said, I think it just gets used to breathing through the mouth because it is an easier pathway. You get in more air. So you forget. I think people just forget how it is to breathe through your nose.

And it becomes a habit. It becomes a habit. And so because of that habit, you know, then they're mouth breathing at night. And so then they're having, you know, all these problems that then you end up dealing with sleep apnea, snoring, like, it just. The list goes on and on and on.

So how long does it take you typically to teach somebody how to breathe?

Well, again, again, it'll start in one session. So it'll start in session one. And then for neuroplasticity and re education of the nervous system, it does take repetition, and that's different for everybody. Some people's nervous systems pick up change really fast. And some people take A little bit longer. But again, I let people know, like, you're instantly going to be seeing improvement. And then the more and more and more we go, the faster your brain will reprogram. So it doesn't take as long as traditional therapies when they're like, oh, it's going to take like two, three months before you're feeling better. It's like, no, you're going to put probably feel better today. And then each session we do, you're going to continue to feel better and better. And that's where I've had patients who have told me they've done everything, and then they come in and they try neurokinetic therapy, and they're like, oh, yeah, so I feel better. And I'm like, yeah, you should feel better. You shouldn't have to live in all this chronic pain and dysfunction. So that's what I'm passionate about, is helping people not live in chronic pain and dysfunction. And then people just get told, oh, you're old. And I'm like, oh, I hate that one. Like, it's. No, it's not about how old we are. It's about how functional we are. Or I get people who are like, oh, I'm just incurable. And I'm like, no, that's. I also don't accept that. So, yeah, so I get a lot of people who are told various reasons why they are still in pain, and I challenge those beliefs because I'm like, well, that was just what someone told you because they couldn't help you get better.

Dr. Brin, this is amazing information. Thank you so much for sharing any. Any last words of wisdom that you want to share with us that I.

Haven'T asked you words of wisdom. Just what I always like to tell my patients is that movement is medicine. So we were designed to move. So the more you can find yourself in movement and in motion, the better for your health. That being said, with COVID people were being very still for three years and then went out and tried to start moving again and were hurting themselves. And so if you're hurting while you're moving, then come see us so we can help you move. Well, because that's what I view as the key to health and wellness and longevity. So we like people to know that we're a resource in the community for your wellness.

I love it. And, you know, you're so generous. You're giving people a 10% discount on their first session. For anybody who lives in LA or in San Fernando Valley, you're located basically just at Venturanza Polva down Sherman Oaks next to the Galleria Bechtel pt.com I'm going to put all this in the show notes and thank you so much for joining us on today's episode about physical therapy and it's really the miracle that it could do for our body.

Thank you so much Dr. Sanda. Thanks for having me.

Thank you everyone for listening. And if you'd like to comment on today's episode, you can go to our YouTube channel and leave us comments or any other topics that you'd like to listen to. Until next time, stay healthy. Thank you so much for joining me this week. Please make sure you check out the show notes for any link mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram rsanda. This is Dr. Sandha and remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.