EastWest Healings Totem Pole Approach

Every day we speak to clients from all over the world who suffer from a variety of ailments including unresolved orthopedic injury, neurological injury and overall ill health. Though many of these clients are working people, we also work with elite athletes whose livelihood depends on their ability to develop and maintain exquisite balance skills.

In order for a client to acquire new balance skills, it is important to ensure optimal function of all the control centers in the body that affect balance. Some of the control centers affecting balance are not as obvious as others. Based on clinical experience, the Survival Totem Pole is a representation of the order of developmental reflexes expressing their dominance over the motor system with regard to a hierarchical influence, based on survival of the organism. In other words, the further up the Survival Totem Pole you go, the more important that particular reflex is to survival.

RESPIRATION

Respiration and all its related reflexes, reign supreme on the survival totem pole. If you stop breathing, you have about three minutes before your brain begins to die! Therefore, it is pretty safe to say that anything disrupting respiration will quickly cause postural alterations to facilitate improved ventilation, since breathing takes precedence over posture , posture may be altered to facilitate breathing.

One of the most common responses to obstructed respiration is forward head posture (below). In fact, the nervous system is so sensitive to respiratory obstruction that most people will begin developing forward head posture within as little as five minutes of acquiring a nasal airway obstruction. Such obstructed respiration could be caused by a number of factors including food allergy, growth and developmental disorders or structural aberrations such as a deviated septum from a broken nose.

MASTICATION: TMJ

Next in line on the Survival Totem Pole is the highly position-sensitive masticatory system. Between chewing our food, swallowing and other oro-functional activities associated with daily living, we may open and close our mouth as many as 4,000 times a day. If for any reason the teeth don’t fit perfectly in what is called centric occlusion, we default to a compensatory masticatory mechanism called the hit-and-slide mechanism. In order to guide the teeth into occlusion,the hit-and-slide mechanism results in a guiding of the teeth along the facets, which at a rate of ~4,000 times a day, could quickly wear your teeth out. Simply put, if you didn’t have teeth 10,000 years ago, you died! There are numerous reasons for a hit-and-slide mechanism including: growth and development disorders, malnutrition, trauma, forward head posture, dental disorders such as a cracked or rotten tooth or structural dysfunction such as subluxation of the upper cervical spine.

Because mastication is vital to survival, the body has developed an elaborate array of reflexes generated from the periodontal ligament and temporomandibular joint mechanoreceptors. These reflexes are used to influence subtle and gross motor responses of mastication to help adequately position the craniomandibular complex, such that hit-and-slide occlusal corrections are minimized in attempt to save the teeth. A simple example to demonstrate just how powerful these reflexes can be is to think of the last time you had a small sesame seed or piece of beef stuck in your teeth – you probably wore your tongue out trying to free it from your teeth!

VISION

The eyes are the chief exteroceptive organs. Your eyes function with two main systems to aid movement control, both of which are important to balance. Developmentally, if we lost our vision, there was a good chance we would not have survived very long. However, respiration and mastication are even more important to our survival, hence the eyes are ranked third on the Survival Totem Pole.

When it comes to balance, consider the following with regard to the function and impact of the eyes on balance:

The focal system is specialized for object identification. It is mainly concerned with objects in the central field of vision and serves to answer the question “What is it?” This recognition occurs so you will know how to respond to the challenge. For example, the way your body reacts to balancing on a bicycle and a balance beam are different, and therefore require different responses; the bicycle will create a much greater need for an integrated tilting response, while moving across a balance beam will primarily require a righting response. It is your focal visionthat provides the visual image that triggers the cognitive response to the balance challenge.


The ambient system is specialized for movement control and involves the entire visual field, central and peripheral. The ambient system functions to detect motion and position of elements in the environment, and provides information about your own movements in relation to them. Thus, the ambient system provides answers to the questions “Where is it?” and “Where am I relative to it?” This is vital information with regard to maintaining your balance!

The Ear (Audition and Vestibular Function)

The fourth spot on the Survival Totem Pole is held by the ear and the vestibular system. Ten thousand years ago, if you couldn’t hear out of one or both ears, you had a chance of survival but not nearly as great a chance as someone who had a well functioning audition and vestibular system.

The auditory portion of your ear consists of the outer auricle and the tympanic membrane (ear drum), which serves as the barrier between your outer and middle ear. The ear detects exteroceptive sound that is often useful to function and performance. Clinically, the client with deafness in one ear will have similar postural adaptation as the person with unilateral visual loss. He will rotate his body and/or head to position his most functional sense organ for optimal function of the organism. As described above, such aberrations of posture will ultimately reduce an individual's capacity to balance or learn balance skills.

The vestibular system senses motion and speed of movement of the head in all three planes of motion and is highly integrated with the cervical and ocular systems. The reflexes elicited by the vestibular organ principally serve two mechanisms:

• Maintenance of the equilibrium of the body (including postural responses)
• Keeping an eye on the surroundings independently of movements of the head and body (visual motor control)

UPPER CERVICAL FUNCTION
The upper cervical spine maintains an intimate relationship with the cranium, the masticatory apparatus, the eyes, the vestibular system and the CNS. This is because every nerve that leaves the foramen magnum passes through the atlas. The upper cervical spine is also intimate with the vestibular system and visual system in producing the majority of the body’s righting, equilibrium and tonic neck reflexes.

VISCERAL RELATIONSHIPS
The average person in the gym or physical therapy clinic today presents with musculoskeletal disorders, sub-optimal nutrition and frequently has functional deficiencies within their organ systems. Some of them are in physical therapy programs for injuries such as sprained ankles, hurt backs and fractures of the arms, legs or hip – all of which can be related to poor balance.
While it is certainly logical to think, “if you have poor balance, you need to do balance exercises,” such thinking only displays superficial logic. The human body is a highly integrated, holistic, cybernetic system – a system of systems. If we were simply just a collection of muscles and joints, or some form of sophisticated robot, balance exercises for poor balance approach might just work. But we are not merely a system of muscles and joints, and balance skills development in the absence of unwanted and unnecessary biomechanical stress can only come in concert with balance in the body at the segmental level, both structurally and neurologically.

EMOTIONS
Emotions can be incredibly healing or incredibly destructive to the body. For example, take a look at the posture of someone who is clinically depressed. People who harbor too much anger, grief, pain or any other negative emotion are far more susceptible to illness and disease than those who do not have such emotions.

PELVIC INFLUENCE ON EQUILIBRIUM
The pelvis is essential to postural stability of those structures above and below it. To appreciate the effect of pelvic disposition on craniocervical structures, imagine the body as a skyscraper with a pelvis for a foundation. Similar to a skyscraper with many segmental levels and a roof at its apex, the body has many segmental levels with the cranium at its apex. The removal of an eight of an inch from the anterior aspect of a skyscraper's foundation may not be as threatening to those on the first floor as it is to a window washer on floor 24, in the human body an anterior pelvic tilt of an eight of an inch may produce a substantial postural response 24 segments up at C0-C1. That region has great influence on our ability to balance and be balanced!

THE SLAVE JOINTS (Upper and Lower Extremities)
We are now at the bottom of the Survival Totem Pole, in the region of the slave joints. The slave joints consist of the hip, knee, ankle, foot, shoulder/arm complex and all the spinal joints between C3/4 and L/5-S1. The pubic symphysis and sacroiliac joints can be considered as intimate with the sacrococcygeal system because the pelvic girdle is a functionally closed chain. The reason these joints are called slave joints is because among those skilled at assessment of all the regions superior on the Survival Totem Pole, the slave joints merely serve as buffers willing to be sacrificed by the body in the name of supporting all structures and systems higher up on the totem pole.