Dentist Westborough Watch How Mouthguard Enhance Athletic Performance

My name is Barry Portnoy 

I am a Dentist from Westborough MA

 

THIS PROJECT STARTED WHEN I WAS APPROACHED BY THE AD OF A FH GIRLS HS TEAM THAT WAS GOING TO MAYBE MAKE THEB DISTRICTS BUT WOULD ONLY  GO 1 ROUND DEEP BEFORE LOSING.  He asked me to do mouthguard for 3 players.  Since he also asked me to do his son a div 1 baseball player. His came in with him and I asked him how are the girls doing with the mouthguards. He said the other girls on the team stopped talking to him because "WHY DIDN'T YOU PICK ME" SO I ASKED  MY NEIGHBOR ( Fran got my neighbor Chris the Basketball coaching job at this Hs) So as a favor to Chris he told Fran that it was open to all the girls. 
I did have some restriction if I did it I wanted to get some data outbox it. So I had 

 

I am currently studying how a Mouthguard can be used to Improve an Athlete's Performance 

On-the-Field  On-the-Court  On-the-Ice 

to Enhance GAME TIME EXECUTION 

 

 

The Basic Idea is to Change the Skeletal and Muscular Physiology and their Airway Dynamics to Improve their Performance 

 

As an Athlete you are now in your best shape for game-time execution to succeed.

 

 

Still with that said - Can it be improved upon?

 

Can a Mouthguard make a Difference?

 

A better Cranio-Mandibular-Cervical Vertebral Alignment means more effective muscle recruitment to improve strength, airway dynamics, flexibility, range of motion and balance.   

 

 

 

NOTE: 

There are 5 million dental injuries per year. 13-39% are oral-facial. 

80-90% involve the upper 4 front teeth 

 

Mouthguards Make Sports Safer


Go on Internet look up:

 

 

Reference: Mouthguard Mysteries: Can Wearing One Really Improve Performance; LER (Lower Extemity Review); Nov 2016

 

Reference: Can wearing a mouthguard increase your performance; Becca Borawski Jenke

 

Reference: The Effects Of Mouthguards On The Athletic Ability Of Professional Golfers; Ahran Poe, Ra-Kyung Yoo, Kwantae Noh, Kung-Rock Keon; Dental Traumatology; 2013; Feb; 29(1) 47-51


Reference: Physioligic Effects of Wearing Athletic Mouthpieces While Performing Various Exercises, Military Medicine, Michael F Zuppan, USAFA, BSC (Ret), Dyana L Bullinger, BS, MS, Brenda Buffington EdD, Caroline Koch, BS, Samantha Parker, BS,  Steve Fragleasso, MS,   Taylor Fogg, Shay Rasmussen-Woerner, BS, Volume 183, Issue Suppl_1, March-April 2018, Pages 510-515

 

I have obtained data comparing how playing with a mouthguard device compares to not wearing one 

 

The Basic Idea is to Change the Skeletal and Muscular Physiology and their Airway Dynamics to Improve their Performance 

 

We can only improve an athlete's performance if he/she has dysfunction in his/her Head and Neck and Occlusion that we can see as a result of Body Asymmetry 

 

If that is the case than we can performance enhance the sports athlete 

 

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LET ME NOW INJECT THIS THOUGHT INTO THE CONVERSATION 

 

Can Mouthguards Impact Athletic Performance?

 

It takes months of preparation to prime an athlete for competition. It involves attitude, perserverance, rigorous training, practice time, nutrition and hydration regime, strength and conditioning, physical therapy especially as it relates to posture, balance, the influence of the muscle patterning and kinetematic body movement necessary for your sport. Your head coach and assistant coaches expertise,
understanding what it takes to win and the studying of your opponent's strategies and how they might execute their game plan against you. The role of your certified athletic trainer with respect to preventive services, clinical evaluation of diagnosis, immediate treatment care, rehabilitation, recovery and reconditioning. "It truly takes a village" to get a team ready to compete.
 

You are now in your best shape for game-time execution to succeed.

 

Still with that said - Can it be improved upon?

 

If you have a malocclusion resulting in dysfunction related to the Teeth, TMJ and Muscles of Mastication then dysfunctional movement can show up elsewhere in the body to affect full body movement.

 

So could putting a new mouthguard in your mouth be one more "Tool in your Toolbox" to give you an additional edge over your opponent? 
 

 

Our goal is to improve upon what your coaches, athletic trainers and fitness personel have prepared you for your first game.

 

Most games are won or lost in the last 5-10 minutes of the last half, 5-10 minutes of the final period or the last 3 innings of the game.

 

We know the goal is:

 

BE THE BEST  PLAYER YOU CAN BE  

 

WIN A CHAMPIONSHIP 


 

? Include rest data ******mouthguards improve performance XXXXXXXXXXX

 

*****************************STOP HERE

 


 

Where do we start this process and

What is the Rationale

1.  We know what it looks like when your posture is out of wack and you have dysfunction in your neck and occlsion (your "bite")

1a. We know what it looks like when there is no skeletal midline, there is asymmetry, there is larger space as a result of posterior rotation of the left occipital condyle on the superficial facet of C-1 with subsequent anterior rotation of the right condyle

 

1c. We know what it looks like when Atlanto-Axial (C1-C2 is no horizontal)

1d.  We know what a TMCC issue is occurring and how it can diminish an Athlete's performance

1e.   We know what a left side bender looks like

1f.   We know there is only one skeletal midline and it passes through the center of the odontoid process of C2.  AND only then are the ligaments between occiput and C1-C2 will be horizontal and parallel to maxillary plane orbital plane Mandibular plane.  AND only then is the occiput centered over the C-Spine and the muscles and tendons and ligaments are at a PRP AND only then can you obtain Neurtality of the CRANIO-MANDIBULAR-CERVICAL JOINTS @ are the TMJ and the Atlantic-Axial Joint (both C1-C2 both rotate but C1 rotate more AND YOU ALSO NEED SHOULDER GIRDLE NEUTRALITY AND PELVIC GIRDLE HIP NEUTRALITY. 
1g. We know you are constantly hitting your teeth during a game. We know gritting your teeth makes you stronger and able handle stress.

1g.  We know if the atlas rotates to the left via posterior rotation of the cranium then in a trans oral X-ray you will see odontoid process larger space to the left therefore then you have lost your skeletal midline. Skeletal midline must pass through the center of the odontoid process. Neutrality of CRANIO-Mandibular-Cervical joint only if skeletal midline passes through the center of odontoid process of C2.
1h.  We know left condyle rotates to the left posteriorly and right condyle rotates anteriorly as C1-C2 are also rotating resulting in left side bending TMCC (Head and Neck) head tilt to left right shoulder lower than left sphenoid bone also moves with lesser wing of  sphenoid goes anterior and down therefore left side bender

1h.  From ASD Symposium what is it about gritting your teeth at a PRP resulting in better muscle contraction FIND THIS  PHRASE

1i.    Since I am not a neuromuscular dentist and don't have the benefit of thevJ5 K7 T scan at my disposal I have to relieve upon some basic principles eg  

a.  I need to mark the Athlete's midline per dr metha in Boston in 2010 if the midline is off >.5 mm you will have weakness on that side. I need to capture the athletes organic midline

b.  I need to lock in the bite so it can't shift laterally or ant/posterior 

c.  My goal is to approx a Gelb 4/7 position 
d. I need to test athletes with and without for a baseline

e. I need to see if they have FHP

f. I need to see if the mg can correct their FHP

g. I need to see if there skeletal midline is off with and without mg

h. I need to find out about through the questionnaire what there thought are about the mg in particular 2 specific question 

I. I no this is not a scientific based lecture or talk but it might have some relevance wrt an insight that you have as yet to hear right from the athletes mouth

j. At time this done I didn't understand about FHP rounded shoulders but I do now so here is a section on my athletes with and without mg wrt their FHP and body Asymmetry plus how by Improving their FHP we are making the athlete stronger more flexible better airway better balance eve though no foot mat in video she is no stronger than before I am releasing her body strength by Improving her vertebral alignment and muscle recruitment because if you can align the bones better and we know that muscles attach to bones therefore if the bones are aligned better than the muscles lengths will be more ideal in relationship to their irigins and insertion then they can contract more efficiently resulting in improved strength flexibility  balance airway

k. Muscles function mechanically more efficiently from their full resting length

l.  John Haughty There is a significant positive correlation between the biting force and grip strength and muscle recruitment between biting force and chin ups reference in German SEE REFERENCES ON JOHNS SLIDE IN MY PHONE
m. The concept is you have postural imbalance instability postural FHP is related to a weaker less flexible athlete due to the bite or occlusion as in all are comparisons it is only the mouthguard that is the only variable 

n. The goal is to optimize the stomatognathic system or the muscles - joints- teeth - airway 

o. Muscles will go into spasm if they are not at their resting length position 

p. Two joints are the key Dr Rag photo

      AO and AA Joints

       1) Atlanto-Occipital Joint. OA  C1 (Atlas) helps in rotating the head 

       2) Atlanto-Axial Joint C2 (Axis) helps tipping the head see photo dr rag

the odontoid process from C2 fits into the depression on C1 around which it rotates

        C1-C2 - Occlusal plane see photo dr rag

The occlusal plane is a horizontal line running back to dissect between C1  - C2. See photo

Gushy says Also remember the pivitol rotation of the occipital condyle heads is between C1 C2  

q. Goal: Better Function as a result of creating a better postural chain of bones and the how the muscles will now attach at a better resting length

r. Think bones muscles joints bite posture airway

s. If the head weighs 10 lbs and it is centered in the center spine the muscles are in their most relaxed position.  However for every inch forward the head movevanteriorly it adds and additional 10 lbs of weight the posterior muscles have to deal with, 3 inches 30 lbs. etc.

Basically the more forward the head posture the more weight of force on your neck to keep it upright. Your neck isn't designed to handle this weight resulting in stiffness. Muscles become imbalanced due to prolonged weight of the head in a more FHP position. It is also associated with rounded shoulders.  It is a vicious cycle of causing changes in muscle length but not functioning at a their normal resting length.
t. The peak flow rate observed with forward head posture were significantly lower than with normal 
head posture. The upper thorax showed a greater forward shift and the lower thorax showed a greater forward and inward shift with the forward head posture than with the neutral head posture. No significant difference in upper thoracic mobility was observed during respiration between the forward head posture and the neutral head posture. However, mobility of the lower thorax during respiration was significantly reduced with the forward head posture. [Conclusion] The forward head posture causes expansion of the upper thorax and contraction of the lower thorax, and these morphological changes cause decreased respiratory function. 

 

preference Physiopedia READ

Effect of Forward Head Posture on Thoracic Shape and Respiratory Function 

read above data

does FHP diminish athletic performance google. Read people also ask READ FIRST GREAT PHRASES


see FHP AND WHAT IT DOES and does it matter

goog points FHP= anterior head carriage. It is an adaptation of musclesvaind joints of head And neck. 

THE 42 lb head just ok

 

 

THE INFLUENCE OF ATHLETE POSTURE ON ATHLETIC PERFORMANCE 

KEYVARTICLE READ

 

POSTURE FOR PERFORMANCE GOOD POINTS READ

 

FHP WHAT IS IT HEALTH FIRST SPINE AND AND WELLNESS READ ON FIRST PARAGRAPH GOOD

 

TMD FACIAL PAIN AND FORWARD HEAD POSTURE 

GREAT PHASES

 

 

 

u. GOAL IS TO SHOW THAT BY ALTERING FHP ITVCAN IMPROVEVATHLETIC PERFORMANCE PHYSICALLY AND SUBJECTIVELY VIA QUESTIONNAIRE ******************

v.

w.

x.

y.
z.

           

 

 

 

 

2.  If you stand in front of the athlete, he/she is a good candidate for this project if you will notice at least 2 of the following:

For a Right Handed Dominant Athlete

        1. Head is Not Centered over Spine

                Head is Tilted to the Left and Forward 

        2. Has a Rounding of Shoulders 

        3. Right Shoulder is Lower than Left

        4. Right Hip is Higher than Left Hip

        5. Right Knee is Higher than Left Knee

         6. Her Rib Cage is Not Symmetrical  (This decreases lung capacity and negatively affects Stamina. A decreased lung capacity also decrease oxygen to the brain. This decreases an athltete's ability to concentration and focus under stress.)

 

 

          7. This Body Asymmetry, Vertebral Mal-Aligment                                                  Hinders Athletic Performance     

          8.  FHP or Forward Head Posture

                                            we believe is Problematic

                a. The Head arrives before the Rest of the Body                  b.  For every inch your head moves forward it                            gains 10lbs in weight and can add up to 30 lbs in weight as far as the muscles

                         in your upper back (SCM Trapezius

Latissimus Dorsi} and

                         neck are concerned, because they have to work that much harder to keep the head (chin) from dropping into your chest.  This also forces the suboccipital muscles (they raise the chin, are located below the occipital bone and insert on C1 and C2, the two straight rectus muscles rectus capitis posterior, rectus capitus posterior minior and the two oblique muscles obliquus capitas superior, obliquus capitas inferior) to remain in constant contraction.

                 c. FHP can pull the entire spine out of alignment and may result in the loss of 30% of lung capacity

 

 

           9.  Is there any Dental Midline Shifts

                 Dr Metha from the a Gelb Craniofacial Pain Center at Tufts was ask by the NE Medical Center Dept of Neurology to make splints at different VDO to see if they could improve cervical muscle strength.

                   Results: 2 mm 4 mm 6 mm 8 mm They found too little VDO and too  much VDO didn't work. They found in the 4 mm range improved  their cervical muscle function.

                    Other conclusions of their other studies and not related to sports indicated

                        1. Capturing the organic midline was critical

                               if you were off by .5 mm it wouldn't work
                         2.  Therefore you need to lock the bite in so

                                that it doesn't move laterally or ant/ post 
                         3.  I founded by trial and error that if  I

                                  included the anterior teeth at least the  

                                   canines that it was easier to get my

                                    kinesiology baseline

                         4.  I found that the more strength and conditioning the athletes eg 5-6 days per week that I noticed a commonality whereby these athletes constantly gritting their teeth resulted in grinding the shit, wear faceting flat the buccal cusps of first molars and bicuspids      
                          5.  If midline shift to left I notice the indigitation of the teeth marks are deeper on the left (probably due to the retruded condyle > on left than right).  I've found that I've been evening off the depth of the teeth marks. I prefer that the mouthguards are more balanced in appearance.

6.  They can not chew on the mouthguards because if they disturb the VDO then it is like krypton it's

7.   It is age dependent and as long as there is G&D of the jaw the Athlete needs a new mouthguard every year usually til 18 yo. At 18 yo when jaw fully grown then you only Ned 1 last mouthguard equilibrated

 

                                     

 

          10. Is there any TMJ Dysfunction

          11.  A Great Athlete Compensates for this by Adaptive Mechanisms which Kicks in and without Knowing to Compensate the Neck starts coming Forward. Again, we are back to the FHP Forward Head Posture Issues

          12. WE TEST INITIALLY TO SEE IF WE CAN CHANGE "THE BITE" OF THE ATHLETE in .25 mm INCREMENTS TO SEE IF SHE WILL RESPOND POSTIVELY TO ONE OF OUR DOWELS.  THIS WILL TELL US IF WE CAN CHANGE HIS/HER  SKELETAL PHYSIOLOGY  

MUSCLE PHYSIOLOGY AND  AIRWAY DYNAMICS TO UTILIZE HIS/HER BODY ENERGY MORE EFFICIENTLY.  THIS IS LIKE A "WOOOH" FACTOR. YOU ARE DEFINITELY NOT STRONGER THAN YOU WERE JUST 10 SECONDS AGO. WE ARE JUST TRYING TO NAKE YOU MORE ENVIRONMENTALLY SOUND. 

 

          13.  THIS IS AN IMPORTANT POINT:

                a. I CAN NOT I REPEAT I CAN NOT MAKE YOU ANY STRONGER THAN YOU ACTUALLY ARE BECAUSE OF ALL YOUR GAME TIME PREPARATION WRT STRENGTH AND CONDITIONING AND PRACTICE THAN YOU ACTUALLY ARE
                b. ALL I AM DOING IS FINDING A FIXED JAW POSITION SO THAT THE BODY STRENGTH YOU ALREADY HAVE CAN BE DISTRIBUTED TO YOUR CORE MUSCLES MORE EFFICIENTLY. as a RESULT OF VERTEBRAL RE-ALIGNMENT for BETTER MUSCLE RECRUITMENT TO ALLOW YOU TO BE MECHANICALLY MORE EFFICIENT AND HAVE MORE STAMINA AND ENDURANCE DURING THE LAST 10 MINUTES OF THE GAMES WHEN MOST GAMES ARE WON AND LOST

 

 

 

HOW DOES THIS MOUTHGUARD  PROJECT HYPOTHOSIS WORK:

 

IF AN ATHLETE HAS

CRANIO-MANDIBULAR-CERVICAL 

(HEAD-NECK-C SPINE)

(OCCIPUT-C1-C2)

ISSUES  (AS A RESULT OF WHEN THE BITE IS INHIBITING THE MANAGEMENT OF THE HEAD & NECK POSITION)

 

 

BY USING A MOUTHGUARD TO MANAGE OCCIPUT TO CERVICAL VERTEBRAL POSITION CAN WE ALTER SKELETAL AND MUSCULAR PHYSIOLOGY AND AIRWAY DYNAMICS TO GIVE THE ATHLETE 

 


BETTER VERTEBRAL ALIGNMENT

BETTER MUSCLE RECRUITMENT
BETTER OXYGEN / CARBON DIOXIDE

                      EXCHANGE


AND AS A RESULT OF THAT

CAN WE IMPROVE THE ATHLETES 

 

      STRENGTH

      FLEXIBILITY 

      BALANCE
      
RANGE OF MOTION

      STAMINA AND ENDURANCE 

DURING GAME TIME EXECUTION 



We use a combination of a MORA TMJ Appliance Theory and a PRI MOOO MANDIBULAR OCCIPITAL OCCLUSAL ORTHODIC Splint Appliance Neutral Theory Positioning Incorprated into a Type III Mouthpiece taking into consideration:

Your Age: It works best we find if you are at least 16 1/2 years old

Dental Occlusion

TMJ

Body Asymmetry - Head,Shoulder, Hip &Pelvis Position

Vertebral Alignment - Postural Chain, OA and AA Space

Muscle Recruitment - Muscles Attach To Bones

Cranio-Mandibular-Cervical Relationship as it relates to Posterior Rotation of the Cranium and Forward Head Posture

 

Basically what are we talking about here and what does this all mean?

     1. It is all about finding a "FIXED JAW POSITION which is basically a PHYSIOLOGICAL REST POSITION (When all the muscles of the head and neck are in their most relaxed state at rest): to Create a Skeletal Midline that is common for the Cranium, the Maxilla, the Cranio-Cervical Vertebral Joints Occiput-Atlas C1- Axis C2 and the Mandible that allows them to all be horizontal

      2. The Atlas C1 relating to Occiput and relating to Axis C2. Functioning in between the two Structures the Cranial C2 Position is dependent on a Skeletal Midline that crosses the center of the Maxilla, crosses the center of the Odontoid Process, Crosses the Spinous Process of C2 that is at the center of the body of C2 and crosses the center of the Mandible that gives us just one Skeletal Midline that passed through the Maxilla, the center of the body of C2 and the center of the Odontoid Process, that causes the Tranverse Occlussal Plane of the Mandible to become Horizontal. 

         3. In other words the Skeletal Midline allows:

               a. the Maxilla to be Horizontal

               b. the Atlas C1 to be Horizontal

               c. the Axis   C2 to be Horizontal

               d. the Mandible to have a Horizontal Plane of Occlusion

               e.  Therefore they are all Parallel to each other

               f.   Resulting in:

                                 1. Better Vertebral Alignment

                                 2. Better Muscle Recruitment

                                 3. Improves Airway Space

               g. This is sometimes refered to as the

              Cranial Vertebral Ticentric Relation Concept at Rest

                                                         or

Tricentric Relation Craniovertebral Craniomandibular and Centric Occlusion at Rest

 

Loss of Horizontal and Transverse Occlusal Plane and Progression of altered Synovial TMJ Function, Disc Pathology and Joint Degeneration of Cranio Vertebral Origen.

Relation between craniovertebral joints and cephalalgias. Trigeminocervical nucleus.

10:30 – 11:00 COFFEE BREAK

11:00 – 12:30

Concept of Congruency of STMJ and Craniovertebral Centric Ralation.
Importance of physiological curvatures of the spine in the maintenance of head posture in space and in relation to the rest of the body.

12:30 – 14:00 LUNCH HOUR

14:00 – 15:30

Influence of head and neck dynamics in mandibular function and dental occlusal contacts.

 

 

FINALLY:   SEE THESE VIDEOS 

   a. REMEMBER THE MOUTHGUARD IS THE ONLY    
         VARIABLE IN EACH EXERCISE 

   b. THE MOUTHGUARD IS WHAT IS EFFECTING THE 

         ANATOMY & PHYSIOLOGY 

     

 

 

How important is Skeletal Alignment as it affects the Muscle Physiology of an athlete to help her perform better?

How Important is Flexibiltiy to an Athlete?

How Important is BETTER Vertebral Alignment to an Athlete?

 

WATCH BELOW and SEE WHY it can be important.

 

A Mouthguard Is the Only Variable In Changing Her Skeletal and Muscle Physiology!

 

 

 

 

 

How Important Is Strength To An Athlete?

Is A Stronger Athlete Better Than A Weaker Athlete? 
Is A Stronger Softball Player Better Than A Weaker Softball Player?

How Important is BETTER Vertebral Alignment to an Athlete?

 

 

 

 

How Important Is Flexibility To An Athlete?
Is It Better To Be More Flexible Or More Rigid?
Is a more flexible range of motion Softball player BETTER one less flexible more rigid?
How Important is BETTER Alignment is for an Athlete?



 

How Important is Breathing To An Athlete?

We Will Control Your Airway Space Opening Through Our Mouthguard So That We Can Help You Breathe Easier Thorughout The Game. So When You Need To DIg Deeper During The Last 10 Minutes When Most Games Are Won Or Lost You Will Have An Advantage

How Important is BETTER Vertebral Alignment for an Athlete?

 


 

 

With respect to this Mouthguard project: 

 

To Give Athlete A Competitive Edge

 

Playing At Your Optimal "FIXED JAW POSITION"

 

Goals:  "With Mouth Device As Only Variable"

 

1.  Can we Visually Alter the Athlete's FHP and Postural 

          Chain for Better Vertebral Alignment and 

           Muscle Recruitment

 

2.  Can we Make a Player Stronger Functionally and More Mechanically Efficient

3.  Can we Improve Athletes 

          Body Symmetry - Vertebral Alignment

          Grip Mechanics - Stronger  Muscle Recruitment

          Stance Mechanics - Balance Foot to Ground Platform 

          Swing Mechanics - Flexibilty 

          Hand-Eye-Ball-Puck Coordination - Posture

          Hit Ball-Puck Harder - Strength

          Hit Ball-Puck Farther - Strength

          Run-Skate Faster - Body Symmetry 

          Vertical Leaping Ability - Muscle Recruitment 

          Increase Pitch Velocity - Range of Motion

4.   Does the Athlete Want To Wear a Mouthpiece in High School Sports Not Requiring One?

5.   Are Mouthpieces Devices Results - Placebo or Real?   

6.   Does Athlete has any Positive or Negative comments 

                  about wearing the Mouthpiece Device?
7.    Do you feel your Performance Improved by 1-2-3-5% or Hindered your Performance 

 

Thanks for listening

Dr Portnoy

 

Call: 508-366-1700