How The Trigeminal Nerve Could Supercharge Your Practice
For this week’s episode of the Unreal Results podcast, I’m throwing it back to episode 28, The Power of the Trigeminal Nerve. This is legitimately one of my favorite episodes, which yes, I know I say that a lot, but what I talk about in this clip can be tremendously helpful for your practice if you don’t know this information. In this episode, I talk about how the trigeminal nerve is more than just a sensory nerve to portions of the face and innervates the masseter, but also its role in the parasympathetic nervous system. I break down the anatomy of the trigeminal nerve and relate that to cranial and spinal nerves, headaches, and nervous system tension throughout the body. I truly believe that this information could truly improve the outcomes that you get with your patients.
Resources Mentioned In This Episode
Episode 28: The Power Of The Trigeminal Nerve
Episode 41: 3 Powerful Nerves
Episode 38: Accessing the Parasympathetic Nervous System without Focusing on the Breath
Episode 29: What You Are Missing With Hamstring Strains
Related Treatment: Regen Session - Reset Your Nervous System
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Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole body approach to care, however it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com
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Anna Hartman: Hey there, and welcome. I'm Anna Hartman, and this is Unreal Results, a podcast where I help you get better outcomes and gain the confidence that you can help anyone, even the most complex cases. Join me as I teach about the influence of the visceral organs and the nervous system on movement, pain, and injuries, all while shifting the paradigm of what whole body assessment and treatment really looks like.
I'm glad you're here. Let's dive in.
Hello, hello, and welcome to another episode of the Unreal Results podcast. So, uh, just a reminder that the podcast for the summertime, so about a month and a half between the beginning of July and the middle of August 2024, We're going to be doing some, um, reruns, but not whole episodes, just clips of some of my favorite things that I've covered in the last 66 episodes.
I'm going to be focusing on more of the episodes that haven't got as many downloads as others. Um, just thinking that, you know, Not sure why you missed it, whether it was timing of the year, or the title, or whatever. Um, want to make sure you get the information, and then also I know that when you, when it comes to learning stuff, whenever you can hear it repeated again, it's going to have a better opportunity to sort of be absorbed and stick.
And then also, um, my experience and a lot of the mentorship alumni. Experience is when you re listen, re watch material, go back to it in a, you know, in another year, in another time, sometimes you hear and catch different things because often what we pick up in a class or what we pick up in a lecture is what we need to hear in that moment.
And you are a completely different person now than you used to be, um, a completely different practitioner, especially if you. been listening for a while and implementing some of these practical tips of utilizing a more true whole body approach, uh, that considers the viscera and the nervous system in your, uh, assessment and treatment plan.
So, um, Maybe it is exactly what you've already heard, but you're going to hear it in a different way and pick up different gems and different information from it. So I hope you enjoy it. I'm curating this specifically for you. And, uh, thanks for being here. Enjoy this episode.
Hey there, this clip from episode, uh, from season one, episode 28 called the power of their trigeminal nerve. It's one of my favorite episodes. I feel like I say that every time I have a lot of favorite episodes, but the power of the trigeminal episode is so good because it's so practical and understanding the trigeminal nerve and how it relates to.
The cranium and all of the different visceral containers and the autonomic nervous system can be such a helpful tool in your toolbox to understand how a whole organism approach works, but then also to be able to provide some really simple strategies that change people's mobility and pain and just overall
movement tremendously. So enjoy this episode, the power of the trigeminal nerve, this clip from that full episode.
So, you know, there's a lot of emphasis in the world right now, or the world, the industry, um, on the vagus nerve. Like everybody's all about how to treat or affect the vagus nerve, um, which I'm not mad about. The vagus nerve is also a very large cranial nerve and has a very powerful effect. However, the vagus nerve is, um, The majority of the bulk of the nerves is, are in the, um, trunk, going to the viscera.
And, um, and the trigeminal nerve, the bulk of it is all around the face and the head. And so, in terms of how we can leverage providing more information to the nerves, I think the trigeminal nerve is actually... A lot more accessible for us as manual therapists and even when you're taking care of yourself or teaching people how to take care of themselves.
So this is why I feel like the trigeminal nerve is such an important nerve to know about, learn about, et cetera. So the trigeminal nerve is cranial nerve number five. Like I said, it's really large. It is one of the largest cranial nerves and it The, the bulk of it, the majority of the nerve, if you even look at like the trunk of the nerve, it's huge.
It's like very thick trunk and the majority of those fibers are all sensory fibers. There is a portion of the trigeminal nerve that has a motor function and that motor function happens to be a very important. motor function as well, going to the strongest muscle in our body, which is our masseter, so our jaw muscle.
So the trigeminal nerve motor function is the closing of our jaw, so eating, which is fundamentally a very important function of our body, as well as obviously talking, because moving our jaw helps to create our words, creates our sound, right, in conjunction with other, um, muscles and nerves functioning.
But jaw movement is tied to very, two important things, um, associated with our safety and survival. And then the sensory function, which is the bulk of the trigeminal nerve. is sensory to the face, to the scalp, or head, as well as sensory to the meninges of the cranium. So the structures within the cranium that sort of hold the brain in place and house the venous structures of the brain.
So the dura sinuses are within these meninges that are innervated by The trigeminal nerve. So the trigeminal nerve, its power lies in its relationship to the autonomic nervous system to safety and survival. So from a parasympathetic nervous system, it is one of a few cranial nerves that have a parasympathetic ganglia.
That's where its power lies.
Just like the vagus nerve, right? We started off talking about how people are focused on the vagus nerve. Part of the reason people are so focused on the vagus nerve is this power of tapping into the parasympathetic nervous system, and we care about that, right? Because the parasympathetic nervous system is actually the dominant part of the nervous system for our autonomic nervous system function in terms of the parasympathetic kind of our Baseline is our sympathetic response.
That's sort of our older brain our order older operating system Totally wilder wired for survival and our parasympathetic Creates like adds a break to the system. That's what Drops our heart rate down drops our respiratory rate down and allows us into this state of safety in the state of safety We are That's where we eat.
We digest food We're you know feel like we can have a relationship with other humans So this is an important part of our parasympathetic nervous system and in this state When there is this good balance between the two and this resiliency within the autonomic nervous system and this robustness of our parasympathetic nervous system.
This is the state of which regeneration, recovery, healing, the self healing capabilities of the organism get expressed. And so being able to tap into this parasympathetic nervous system piece is really powerful, just from a self healing standpoint and from a decreasing pain, uh, standpoint as well. So the trigeminal nerve, um, Ganglion.
Right, so the, the, basically, the nerve root comes from the brainstem, like the rest of the cranial nerves, and then it, it branches out to this, like, thick ganglion. And the trigeminal nerve ganglion, the, the area that it rests, it sort of lives in, right in the, um, Suture or sort of the junction of the cranium, the cranial base, between the temporal bone, the sphenoid bone, the parietal bone, and the occipital bone, or the frontal bone, excuse me.
And in this area, especially in like the petrous part of the temporal bone, so the spongy sort of, there's this area, this is very, close to where the vestibular system lives within this part of the temporal bone too, that is where the trigeminal nerve ganglia is. And from that ganglia, I like to sort of tell my athletes that ganglia is, or when I'm teaching other professionals, the ganglia is like the supercomputer powerhouse of the cell where all the information comes back into.
It's almost like a little mini brain that sort of then transfers where other information goes within the nervous system. So, the, um, from there, from that trigeminal nerve ganglia, back in that, if you, if you took a, if you drew a line between the junction of those bones, which is an anatomical location right behind your temple called the pterion, which is, starts with a P, like pterodactyl, pterion.
It's H shaped, the suture lines. That tarion right there is sort of like where the trigeminal ganglia is if I did a line across there and then, you know, um, just off of midline. would be that spot. Almost right behind my orbit of my eye. And, um, that location is where then the three main branches of the trigeminal nerve come out.
So, the trigeminal nerve, like I said, is so big, each branch has its own name. So, um, you'll often see the, like, acronym, like, cranial, like, CN, cranial nerve. Five, which is... trigeminal nerve, granule nerve 5, which is Roman numeral V, and then a subscript 1, 2, or 3. And that's denoting the branches of the trigeminal nerve, the ophthalmic branch, the maxillary branch, and the mandibular branch.
So each of those three branches go to a different part of the face or a different part of the meninges within the cranium, right? And the cool thing about This meningeal piece, too, that I didn't mention, but is important, and I've probably talked about it in other podcasts, is By innervating the meninges, the sensory part of the meninges, you're also influencing the intracranial pressure a ton.
So, the ability to regulate or change intracranial pressure, even, either for the... Better or for the worse, right? Too much pressure or not enough pressure, um, can be influenced by the sensory components of the trigeminal nerve and the meninges are the base of the cranium. But then also, there is a main meninges that goes down the center of the cranium as well, and that separates the parts of the cerebrum.
And then there's another little part that separates the hemispheres of the cerebellum too. So, um. Another cool thing is the trigeminal nerve, anastomose. So joins has a recurrency with this cervical plexus nerves. So the cervical plexus coming from your neck are peripheral nerves and the, the upper cervical plexus nerves, the greater nerve of Arnold, the lesser nerve of Arnold, they innervate the back of your scalp and they actually sort of come up the back of your, uh, head and anastomose with branches of the ophthalmic
nerve, providing sensation to the whole scalp. And so there is a relationship here too, between the trigeminal nerve and the cervical plexus. And then that means the cervical plexus and the brachial plexus and the phrenic nerve, right? So trigeminal nerve can influence a lot. Diaphragm, um, functions, sensory information from the phrenic nerve, brachial plexus.
Influence, that kind of thing, right? So, um, the other thing about this relationship. Oh, this anastomosis, the trigeminal nerve also has an anastomosis with the, um, vagus nerve and, or branches of the vagus nerve as well as the facial nerve. The facial nerve and the vagus, and the trigeminal nerve are, live right by each other.
And actually when you, when, when I do a nerve glide for these, um, They're actually very similar looking nerve blades, and they have to do with that area where it sort of comes out of the, um, cranium right behind or, uh, the, uh, TMJ. That's sort of like a main area where the big branches sort of fan out here.
So from a sensory standpoint, the ophthalmic nerve branch, the upper part, does sensory to the sort of upper. part, I said scalp for front of the forehead here, uh, over the eyes and the nose, and then the max, maxillary goes sort of temple and outer part of the eye underneath the nose, above the face, so like the maxilla bone, and the mandibular does below that.
So sensory to these areas are all three branches of the nerve. The motor branch that goes to the masseter So you can feel that when you clench your jaw. That is a branch off the mandibular branch. The, uh, TMJ, the actual joint of the jaw, is also innervated by one of the branches of the trigeminal nerve.
So people with TMJ can often have issues there as well. So, um, Another interesting relationship of all the cranial nerves, but again, like when we look at the cranial nerves, we look at how big this trigeminal nerve is, and we start to realize that, like, this is a big player in this role, is that the cranial nerves actually counteract the downward pull of the spinal cord.
And the peripheral nerves, especially as the spine is going into flexion or the legs are going into flexion. So this means that a good way, a helpful way to sometimes influence people's sciatica or nerve pain down the back of their legs or periphery, even in the arms, the peripheral nerve pain or nerve issues.
can sometimes be helpful by doing cranial nerve stuff, specifically the trigeminal nerve. And so this becomes a really powerful, um, treatment for those sorts of things. Um,
thinking about some of the relationships I want to share before we sort of talk about, like, treatment strategies. trigeminal ganglia...
was, is actually right next to the carotid artery, and so the trigeminal nerve has a great influence on the carotid artery and the blood flow, not just, well I already talked about how it relates to the venous drainage or venous flow from the cranium, but also the arterial flow into the cranium, because of this relationship
to the carotid artery. And so, again, this can be a huge player in intracranial pressures, and just general health of the brain, or brain fog. Um, I always think about my athletes in this context, of like, they're having little micro traumas to their brain with all the starting and stopping and then if you add in any impact, you know, with football players or the soccer players, rugby, like all the people that are like hitting each other on a regular basis, right?
Each change in direction or stop is like a whiplash to the brain and the brain moves and there's little micro traumas to The brain itself to the meninges to, you know, so there's a little extra like inflammation in the brain. And studies have found that when the lymphatic in your brain, your glymph, it's called your glymph, your lymphatics in the brain are not able to drain that very well.
We're at. more risk to having neurodegenerative problems. This perhaps is sort of maybe the scenario of causing like CTE and Parkinson's in people with traumatic brain injury. Because we see that in people who didn't really have huge traumatic brain injuries. But again, these little micro traumas. But perhaps it's because the venous system is not able to flow
and drain very well as well as the blood flow to the brain is not able to get there very well. And the trigeminal nerve is a nerve that can powerfully influence this relationship of fluid flow, blood flow, lymphatic flow to and from the brain. And so it's so important. And then the other thing that you might think of when I talk about intracranial pressure is headaches, right?
Because we've all felt that before, this vice grip sort of pounding headache. Sometimes they come up from the back, or sometimes they kind of radiate from the temple and the eyes, right? That should Trigger something in your head thinking interesting. Those are the paths of some of the sensory nerves, right?
and so the trigeminal nerve can actually be a big player in headaches and in Migraines and vice versa can also be a helper in those scenarios So it's like what and and this is what's cool about when you realize just how smart the body is because people will do things that naturally to relieve their pain,
like intuitively or naturally, and you look and you're like, oh yeah, that's stimulating the trigeminal nerve, so it makes sense. So what do some people do when they start to feel like they have a headache? They rub their temple, right? That's that area, that suture line, right where the trigeminal nerve ganglion is, plus rubbing the skin, that is stimulating the sensory component of the trigeminal nerve.
They pull their hair or, or like. You know, massage their scalp or just play with their hair, which is pulling on the scalp. They yawn, they sometimes like will massage their ears. They'll sometimes like tap. All these things that people do naturally when they start to feel a headache come on and it's like makes sense, right?
Because stimulating this sensory nerve can influence the intracranial pressures.