MTY 2: Creating 3D Health: Oral Cavity to Pelvic Floor Wellness through Trauma-Informed Psychology & Physiology

Course overview

The body has not one, but three diaphragms. The concept of 3D health describes the functioning of three vital diaphragms that influence whole body health through their neural, mechanical, and myofascial connections. These diaphragms include the oral cavity (cervico-thoracic or laryngeal) diaphragm, the respiratory diaphragm, and the pelvic diaphragm/floor. The neural mechanism is provided by the wandering 10th cranial nerve, the vagus nerve. As the largest nerve in the autonomic nervous system, the vagus extends from the brain to the colon. Vagal afferents comprise at least 80% of vagus activity, and dictate everything from heart, lung, and digestive function to our physiological health and psychological wellbeing. Self-regulation and stress management are also functions under vagus control which are of particular interest, given that over 50% of the population reports experiencing at least one significant trauma in their lives. Research tells us these trauma statistics increase the risk of a person developing PTSD, and since perceived stress is also a risk factor in noncommunicable disease (NCD) and pain genesis, we now know that stress management is a vital part of clinical practice. Strong vagal tone is associated with healthy stress management, a high emotional IQ, resilience and well formed coping mechanisms, while poor vagal tone has been linked with chronic inflammation, poor digestive health, immunity, and emotional resilience, and is associated with a higher risk of cardiovascular disease, type 2 diabetes, depression, and some forms of cancer. Learning how to work with the three diaphragms as a whole is supported by osteopathic theory, which says the diaphragms are involved in controlling fluid pressure and movement of the entire body and also by biomechanical theory, neuroscience, and neuroendocrinology. A review of the diaphragms includes: The Cervical-Thoracic Diaphragm (laryngeal and oral diaphragms) is responsible for neurological optimization of stress response, swallowing, and communication, which controls vagal tone for cardiorespiratory functioning and the respiratory and pelvic diaphragm functioning. The Respiratory Diaphragm is a connecting point between cephalad and caudad diaphragms, and is the main muscle influencing pulmonary function. None of the diaphragms work in isolation, therefore, each exacts an influence on vagal tone and function. The Pelvic Diaphragm is the terminal end of the tri-diaphragmatic (3D) system, and can bear the brunt of trauma and impairment with dysfunction in the superiorly-located diaphragms. The pelvic diaphragm contains the muscles of the pelvic floor, which in turn impacts pressurization of the entire 3D system. This course will teach you immediately applicable techniques for improving patient outcomes and satisfaction, including how to: 1) Impact vagal tone, 2) Use trauma-informed clinical reasoning & intervention, 3) Employ positive psychology to affect self-regulatory mechanisms, 4) Scaffold yogic breath, postures and meditation, 5) Evaluate the three diaphragms multi-system effects on the mind-body complex from the oral cavity to the pelvic floor using the orofacial examination and biopsychosocial vector analysis, 6) Understand epigenetic impact on rehabilitation outcomes, and 7) Use appropriate documentation to support reimbursement.