Avin Patel

The Stomatognathic System

This complicated name simply refers to the mouth (stoma-) and the jaws (-gnath). Osteopaths look at the stomatognathic system with particular interest in its relationship with the rest of the body. It might come as a surprise that the two have much bearing on one another, but it can be a relevant consideration when getting to the bottom of your problem. It can be especially significant with neck and shoulder pain, or some headaches.

The Stomatognathic System

How Posture Affects The Jaw

The image above shows the demands placed on the jaw muscles by slouching.

  1. The front of the neck is stretched to keep the head up
  2. This would pull the mouth open, but…
  3. A reflex tightens the muscles around the jaw to keep the mouth closed

These muscles that tighten up are the same that might be tight if you clench or grind your teeth. While the muscles on the front of the neck are stretched, those on the back are working hard. The muscles right at the top of the neck, at the base of the skull, contract to raise the head. They are only small, so can be overworked quickly. It is often these that are involved with cervicogenic headaches. Treating these muscles might provide symptomatic relief, but will not solve the problem if the slouching remains.

Causes of Slouching

Often, when we examine someone who struggles to sit up straight, we find two things. Firstly, the muscles on the front of the shoulders and chest are tight and shortened. Secondly, the muscles of the upper back that work against those tight ones are weakened. In the simplest terms, the plan here is to relax and stretch the muscles of the front, and then strengthen the upper back muscles. When we look at an individual, we might find that there are additional areas to work on in terms of mobility. If you’ve been stuck in a hunched over position, the base of the neck will have had to overwork to compensate for lost movement. There might also be stiffness in the joints around the shoulder, such as those at either end of the collar bone.

We look at these findings as part of the larger picture, aiming to identify and manage each one to allow the whole body to move more efficiently. In managing these symptoms, you may find that other minor problems resolve themselves too, such as tension that was affecting your breathing.

Osteopathy and the Stomatognathic Complex

Your osteopath will evaluate the problem as a piece of the whole body puzzle. A detailed case history at the start of your first appointment will help us to get a better understanding of the factors at play. Sometimes correcting a slouched posture is as simple as improving the balance of muscles as mentioned above. If the problems originate from the stomatognathic system, and especially the alignment of teeth, we may want to work alongside your dentist to solve the problem in its entirety.

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Delays to Joint Replacements

Waiting lists for joint replacements are at an all time high, and the 18 week target for hip and knee replacements has been scrapped. If you are already waiting for a replacement to an arthritic joint, we may be able to help with function and comfort in the meantime. Osteopaths are qualified to help with arthritis, and the earlier you start treatment, the more we can do.

Joint replacements

Early Stages of Osteoarthritis

Osteoarthritis is a condition of the cartilage within a joint. Cartilage has a poor blood supply, so relies on movement to keep nutrients flowing into the joint where it can absorb them. It exchanges nutrients for waste, and movement again helps to flush this away. If movement is limited, the nutrient input is reduced, and waste products are stuck close to the cartilage for longer than ideal. These changes to the local environment play a role in reducing the health of the cartilage, from which point a vicious cycle can develop.

Even without you consciously realising, if the cartilage in a joint becomes roughened, the body might respond by adapting movement. This can be particularly evident in the hip. As movement is now sub-optimal, the fluids in the joint are not flushed through as much as they should be. There may also be areas of cartilage that are no longer compressed and decompressed, so the tissue relies purely on diffusion to exchange those products.

Avoiding Joint Replacements: Managing Arthritis

If spotted early, your osteopath can start to improve movement again. Muscles will be tight to try and protect the joint, which only reduces movement further. By working on those muscles and encouraging joint movement directly, we aim to restore some lost movement and improve cartilage health. Osteoarthritis responds really well to exercise too, so you can expect to have an exercise plan throughout your time with us.

Relief While Waiting for Joint Replacements

In some cases, a joint replacement is the only real solution. But with long waiting times, it can be difficult to make it to the surgery date. Even when cartilage is significantly reduced within the joint, what is left can still respond to treatment. We can also help to relax muscles that are trying to protect the area and potentially causing more pain than they solve. Finally, if other areas are overworking to compensate for the joint pain, there may be things we can do to reduce the burden on them.

If your joint pain leads you to walking with a stick or a frame, we may be able to offer advice for using them in a more efficient way.


Just like you would expect physical therapy after your surgery to improve your joint function, we can help to get your body ready for surgery. If your joint pain affects the way the rest of your body moves, we can work to improve the function of those areas that are adapting. This means that when you do get walking on your new joint, there’s one less thing to iron out.

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