Condylar Resorption, Posture, and Your Airway
“Shoulders back!”
“Straighten up!”
If you have condylar resorption (CR), it’s likely you’ve heard these reminders before. Poor posture is extremely common in those with CR and is a pretty good example of how CR can have systemic consequences. So, why do people with CR struggle to maintain correct posture? The answer: they’re just trying to breathe!
As condyles breakdown and lose height during the CR disease process, the lower jaw finds itself rotated further and further back into the airway. The only way to compensate for this infringement on airway space is to either A) consciously jut one’s lower jaw forward or B) subconsciously maintain forward head posture.
Doing either of these chronically can result in the development of chronic pain (head, neck, and jaw pain, spinal issues, etc.) and spinal issues, and many CR patients find themselves doing some combination of both. When sleeping, these airway-protecting behaviors cannot easily be engaged and CR patients often snore and experience sleep apnea.
In the image to the right, the devastating impact of trying to maintain correct posture with CR can be appreciated. In the left forward head posture example, the neck is craned into a more forward position, allowing for the airway to be more open, but at the cost of spinal health (CR patients commonly develop military neck/cervical kyphosis) and muscular health (head/neck/jaw tension).
In the right correct posture example, the lower jaw is pressed against the soft tissues of the throat in a way that greatly limits airway space. This position is simply not sustainable for long periods of time, and any situations that result in the lower jaw being pressed against the throat (for example, needing to open your mouth at a dentist’s office) can cause great discomfort and anxiety.
The constant fight for airway maintenance can be quite exhausting, and certainly the associated poor quality sleep does not help. Chronic airway issues can also impede CR patients ability to exercise comfortably. CR patients with concerns about their airway should reach out to a qualified somnologist (sleep doctor) to see what options, such as the use of a CPAP machine, are suggested. For muscular pain, a mixture of physical therapy, massage, and medication can provide relief. If your primary care physician is not comfortable managing your pain, do not feel guilty asking to be referred to a pain management specialist.
For those who ultimately wish to proceed in surgically correcting their joints/jaws, the good news is that airway issues and pain due to bite-associated muscular dysfunction can improve significantly following surgery.
Left: CR patient in pre-surgical braces.
Right: CR patient following TMJ replacement and upper jaw surgery (type 1 3-piece Le Fort)
