3D From CT

[vdm]

@Henrik

Maybe it is a good thing to take messurments off the space between hyoid bone and the C2 Vertebrae ?

The hyoid bone is [the only] free floating bone in the body, suspended only by ligaments and muscles. That means a) its position is likely affected by gravity, and possibly distances between the corns and the spine change between lying supine, prone, and standing upright, b) the muscles can stretch and contract, temporarily (swallowing) or permanently (stiffness, looseness).

As long as there are no solid attachments (e.g. badly calcified ligaments), the hyoid bone has quite a lot of range of motion (again, it’s not attached through any joint - just soft tissue, which is deformable.)

Therefore I’m not fully buying into “hyoid syndrome” and “clicking hyoid” as contradictory to the styloid processes, attached to the skull, the hyoid bone’s position potentially might be changed using soft tissue forming techniques.

Note, additional stiffness might develop between the thyroid cartilage (which also sometimes calcified as the person gets older), and become more like a unified structure moving together, though often retaining a “soft” link between the hyoid bone and the [calcified] thyroid cartilage.

[vdm]

@Henrik

If the Atlas is misalign it could lead to rotary problems off the other vertebrae, and other nasty stuff over time, and the Atlas holds your whole brainstem and cranium wich is avreage 5 kg off massive weight and think about the muscles in your neck wich conects to your biggest muscles, I would like to hear his or her opinion for myself.

Over the time I became a bit sceptical about the mechanism of atlas misalignment being blamed on the “misalignment”. If that was the case, simply hanging upside down would solve this issue as the head stops compressing the cervical vertebrae and pushing them into certain configuration. But that isn’t, at least as far as I know. So likely something else is the main cause why atlas isn’t just letting the dimples and pimples nicely align to each other and just stay there (if you google up for atlas 3D view, skull base 3D view and axis 3D view, those “pimples and dimples” are quite obvious, except for C1-C2 joint which by design is “unstable” joint, otherwise rotating the head would need great strength to overcome downwards force generated by the skull’s weight - think of the car wheels riding on a smooth surface vs the car wheels trying to slowly climb up the curb - it’s a bit of revving to achieve it*)

So I think one of the likely culprits might be the force generated by levator scapulae [was: scalene - sorry, I meant lev.scapulae] muscles, as they attach to C1 [among other vertebrae]. Uneven/imbalanced force would pull the sides differently and thus one side would be pulled more downwards and backwards, the other less, thus causing atlas’s “misalignment”.

On the other hand, at this moment I tend to agree that misaligned atlas might cause hell of problems, and perhaps in some cases (but I’m not sure about this, just a wild speculation) even the stylohyoid ligaments might calcify (through constant irritation/inflammation pathway) as a response, basically giving the neck some “stability” (or more accurately, limiting the range of motion of the atlas).

*Unless you drive an electric car.

P.S. itself, atlas can easily hold those 5kg when in balance. Example is many ethnic groups (I believe mostly in Africa and some Asian countries) carrying quite heavy (but perfectly balanced) loads on their heads for their whole life.

[Henrik]

@vdm

The hyoid bone is [the only] free floating bone in the body, suspended only by ligaments and muscles. That means a) its position is likely affected by gravity, and possibly distances between the corns and the spine change between lying supine, prone, and standing upright, b) the muscles can stretch and contract, temporarily (swallowing) or permanently (stiffness, looseness).

I fully agree on that, as it is a “free” part with no structual contact points, only suspended by soft tissue. That is why i was second guessing misalignment theory off hyoide bone itself, rather the conecting parts like the greater cornua could be dispositioned by as for my case calcified ligaments. And i support my guess by the messurments off distance between C2, as it differs 1,5 mm roughly messured, and by eye balling the position(does not look level from one another).

And i also support that guess by taking in consideration that since the space between C2 and the left greater cornua is 5.0 mm, and the calcfied ligament is 4,5cm in total lenght wich is the most severe side(also with symptoms). If you put these numbers in simple eqaution, you could see that there is a chance that it is a matter off the level between those two greater cornua.

But i do also have in mind that both C2 and C1 could be off aswell, there is probably a way to find that out and dig deep down with messuring everything in that area. But for now i support that it could align itself after surgery.

@vdm

Therefore I’m not fully buying into “hyoid syndrome” and “clicking hyoid” as contradictory to the styloid processes, attached to the skull, the hyoid bone’s position potentially might be changed using soft tissue forming techniques.

Thanks for pointing your belife on that, as i was reading some studies about enlargement off the thyroid gland, makes sense to me.

Love your insights everytime @vdm

[Henrik]

@vdm

So I think one of the likely culprits might be the force generated by levator scapulae [was: scalene - sorry, I meant lev.scapulae] muscles, as they attach to C1 [among other vertebrae]. Uneven/imbalanced force would pull the sides differently and thus one side would be pulled more downwards and backwards, the other less, thus causing atlas’s “misalignment”.

Awesome that you would take muscles into this, as i have also been taking this in consideration the past days. For my case, if i stand upright in a “at ease” position you would notice if you would be looking at me from behind, you would notice that my left side from Trapezius and Latissiumus dorsi is “dragging” my whole side very much down to the left looks a bit like a “kink” in my back, it does also look like i have extra fat and skin at the abdomen part off my body on the left side.

So my conclution to this, there is a great possibilty that there is something going on with both the whole spine and the muscles at my left side. And since muscles is great tissue that contracts and stretches as you say it creates force and a force against gravity.

Why do i conclude with this? Because apart from pain in the neck,Scapula and jaw, i do have mostly or only my lower and mid back pain on the left side, and as my left stylohiod ligament is the mostly calcfied it seems that everything that is going on is most likely to be a combination off things happening at the left side off my body

So it would be quite interesting to get a CT scan off my whole spine.

Speaking off extra fat, we have both discussed muscle in conection with C1 misalignment. @vdm do you have any insights that may take overweight and extra fat as a considaration off misalignment in the vertabrae or the whole spine itself ?

@vdm again, your insights, keep 'em coming

[vdm]

Not sure about the fat tissue… It’s lighter than muscle, and doesn’t create explicit tension, so the force is only as high as generated by gravity, which is relatively nothing compared to the power muscles.

In your case, I’d check your pectoralis muscles too. Pec minor on the left side might pull your scapula firmly down towards the ribcage too causing mild thoracic outlet syndrome, which itself possibly mat cause some back pain in addition to the neck pain. Though true TOS is often associated with arm pain

[Henrik]

@vdm Thanks for suggesting having a look at my pecs, they have being trough some rough handling the past 6 years or so

[vdm]

You might be surprised by HOW BADLY tight and shortened they can become over a few years of repetitive strain and holding for long time in one position

[Henrik]

@vdm

Not sure about the fat tissue… It’s lighter than muscle, and doesn’t create explicit tension, so the force is only as high as generated by gravity, which is relatively nothing compared to the power muscles.

The reason i ask is that it could in my opinion affect the densety off the bones, i have read that more fat means more mass off bones, could be wrong though but as for my case, i have struggled for some time with some extra couple off pounds off fat.

And i have been loosing weight the past 4 years, and gained some again 1,5 year ago and then started loosing weight again the past half year.

And i can tell you that the pain i felt in my neck is more subtile now that i have lost the weight.

Fat can also surround organs and blood vessels

[Henrik]

@vdm

You might be surprised by HOW BADLY tight and shortened they can become over a few years of repetitive strain and holding for long time in one position

Yeah i belive you !

What can be done to this issue ? Like for the TOS ?

[vdm]

@Henrik

What can be done to this issue ? Like for the TOS ?

Yes, in general, the best might be to use the full TOS protocol. But briefly, stretching and professional massage therapy. A simple test is, locate your pec minors with fingers through the armpit (not sure if you are good at palpating muscles, but a good massage therapist or physiotherapist would help with this). If they are painful to press against ribcage, feel like a rope - yep, you have a problem. Also, if freely hanging from a bar (as if preparing for pull ups/chinups) causes pain in the armpits - pecs (both minor/major) might be the cause (though this can also be affected by stiff latissimus dorsi).

[vdm]

@Henrik

Fat can also surround organs and blood vessels

That’s actually a good observation, makes sense. Then perhaps it also contributes to various restrictions, esp. around the veins.

I’m not sure if you’d been willing to watch/interested in, but YouTube has quite a lot of videos with real human cadavers being dissected (autopsies). They show what the real body composition is, so it might be worth looking into the fat composition and typical distribution.

As for weight loss, it depends… If you lost muscle mass of stiff muscles, that also (most likely) means those stiff muscles became less aggressively pulling, as they got weaker.

But I agree, losing weight is often seen as one of the effective ways to improve variety of painful conditions. And likely, it’s not only because of the sheer loss of mass, but also because of improved vascular function as you noted.

[Henrik]

@vdm

I’m not sure if you’d been willing to watch/interested in, but YouTube has quite a lot of videos with real human cadavers being dissected (autopsies). They show what the real body composition is, so it might be worth looking into the fat composition and typical distribution.

I have actually watched alot off brain autopsis lately, so much that they pop up at reels and shorts on variouse social media, but it is interesting stuff !

This made me think off when i went to farmers school(high school) when we disected a whole horse, that was awesome. Specially when we studied their stumach, and they are huge !

@vdm

As for weight loss, it depends… If you lost muscle mass of stiff muscles, that also (most likely) means those stiff muscles became less aggressively pulling, as they got weaker.

Yeah, and i think that it also goes the other way around if you keep adding and loosing alot off fat without the prefered consitensy it could break down muscle tissue and weaken your bones

@vdm

But I agree, losing weight is often seen as one of the effective ways to improve variety of painful conditions. And likely, it’s not only because of the sheer loss of mass, but also because of improved vascular function as you noted.

Totally agree, there is a reason why cardio vasculare workout is so effective both for weightloss but also gaining muscle mass, and also build your immune system. Moderate cardio has helped me trough this journey off ES.

But some would disagree i suppose, rather stedy state workout, Mike Mentzer would totally disagree

@vdm

That’s actually a good observation, makes sense. Then perhaps it also contributes to various restrictions, esp. around the veins.

Well the studies shows that the first loss off weight is the surrounding fat cells and tissue around your organs, and that is the most easy fat to loose. Belly fat on the other hand is harder because off the sheir mass and compactness. And belly fat is the “reserve” storage.

[Henrik]

My pecs seems a little tense under my arms, right behind “the cage”. Sometimes the tension goes through out my arm as im thinking off now

yess i belive i gotta chek em out after surgery, probably going to be referd to a physican right away as i go straight into rehab plan after surgery.

[vdm]

Under that large pec major there is the much smaller pec minor which is often the culprit of TOS.

Check it too.

[Henrik]

Apriciate you !!

When i went to my physican when undergoing diagnosis, she mentioned that my lats, lev.scalupla and trapezius was awfully “sour”.

Prehaps it is like what you say that lat.dorsi could cause some domino affect. It is going to be something to catch up to after surgery thats for sure!

[vdm]

There is a chance those stiff and tender muscles (coincidentally/“coincidentally”) occur in very stressed people, that’s maybe why a lot of Eagle’s diagnoses first come as “stress/anxiety/depression”. And I have mixed feelings about it. I do agree that some cases might be result of the stiff muscles and not “true” Eagle’s syndromes, so as in the recent post was mentioned, even highly praised doctors like Mr Axon call it “hit and miss” if you don’t have very specific pain-related symptoms Can anybody help me to confirm if my CT shows elongated styloids? - #74 by Warrick

[Henrik]

@vdm

stress/anxiety/depression”. And I have mixed feelings about it. I do agree that some cases might be result of the stiff muscles and not “true” Eagle’s syndromes

Sorry, could you elaborate that a little more. I might have misunderstood you a little.

Is it that you don’t buy into the diagnostic part off muscle sorness and stiffness can be an affect off anxiety ?

[vdm]

I mean, some people are convinced that they have Eagle’s syndrome because they have elongated styloid processes/calcified SH ligaments.

But also we know that many people with long styloids are asymptomatic.

So there is a good chance some people with long styloid processes and certain symptoms aren’t suffering from Eagles syndrome and don’t need to be operated, but rather need to work on their muscle to remove the tension in the neck/shoulders and the styloid processes will stop causing the issues.

That’s my opinion, but I am not sure for how many people it may apply to. Maybe only 1% of all symptomatic cases. Maybe 20%. Maybe 50% or 80%…

[Henrik]

Thanks for elaborating this a bit further !
Good point !

The chances are very low maybe 2/10 cases could be solved as you say by working on muscle tension, but this is my observation i wanted to add, and i think that states the obviouse that with ES it is defintly worth looking into other aproaches than surgery.

Apart from that, i do see why it is very hard to diagnose ES with certainty and why some doctors disagree even though that they have getting clear proof from elongated styloids with CT scan, but rather diagnose or try to look in to nerves and muscles.

But i disagree with doctors that take the easy way out and slam the papers into the table " Diagnosis: anxiety, depression" because off the symptoms off tension,headaches etc.

So why do i have a statement off disagreement and agreement on this topic?

Well as i said, some doctors clearly have a good view and wants what is best for you and have second thoughts about symptomatic picture, even if in that moment you disagree, because i have experienced this and im very greatfull for that!

Short story:

Before i was diagnosed with ES,
my recent personal doctor, did see my pain symptomatic picture as some form off nerve tension, and as a result off nerve tension i would probably develope tension in my muscles and hence anxiety and headaches. You are proably guessing wich diagnosis he was on to as you are reading this.

If im not wrong, you are thinking about trigeminal neuralgia, and that is correct !

After 5-6 years that is the only doctor who have had a clear view off what kind off pain it was and that was also the first doctor who did not rule out anxiety or external otitis as an easy way out. And by that, the ball started rolling.

[Isaiah_40_31]

It’s a huge blessing & benefit when your primary doctor is willing to come alongside you & help rather than pass your symptoms off as more psychological. I’m glad you have a doctor like that in your life, @Henrik.