Specialist article: Training
“Initial worsening”Adaptation, not a setback
Since you started training with the FaceFormer, your neck feels tight, the ear noise seems louder or your mouth is full of saliva? Here you can find out why, in our view, this is adaptation and not worsening, how to recognise warning signs and how to dose your training.
Does this sound familiar?
Since you started training, is something new making itself felt?
What applies to you?
Tap whatever applies to you.
If one or more of these points apply to you, you are not alone. Reactions like these are not that rare in the first few weeks and, in our view, show that a long-established pattern is changing.
What lies behind the reactionsHow to adjust your trainingThe key points at a glance
- In our view, the so-called “initial worsening” in FaceFormer training is not a deterioration but adaptation: a pattern of breathing, swallowing and head balance that has been habitual for years is being changed.
- Muscle soreness in the neck and back of the head, a temporarily more noticeable ear noise, more saliva, jaw tension or pressure on the incisors are typical reactions and not a negative sign.
- In that case you reduce, increase gradually and focus on clean execution rather than force. Above all, you keep at it. Some warning signs, on the other hand, should be checked by a doctor promptly.
Video
How pain, snoring and jaw problems are connected to our childhood
Das Video lädt erst nach dem Klick. Dann werden Daten an YouTube (Google) übertragen.
The term
What is meant by “initial worsening”
Anyone searching for “initial worsening” has often just started something new and is wondering whether the first few days are supposed to feel like this.
The term “initial worsening” comes from homeopathy. There it describes the idea that symptoms are supposed to intensify at first after the first dose of a remedy. The word is now used for almost anything that feels unfamiliar at the start of a treatment, including after a new TMD splint or in FaceFormer training. It is clear what is meant. In our view, however, it does not accurately describe what happens in training.
That is why, in training, we do not speak of worsening, but of adaptation. A sequence to which the body has become accustomed over years is being rebuilt. Reactions during this process are not all that rare. In our experience, they are a transition and not damage, because the training does not practise an artificial movement; it leads breathing, swallowing and head balance back into their natural pattern. If you follow this logic, you are not doing anything wrong.
It is not the complaint that grows. The pattern is being rebuilt.A reaction at the start is no proof of effect, but as a rule it is no cause for concern either.
Background
Why the body makes itself felt at first
In our view, the chain of many complaints usually begins early, often in childhood. If a child breathes through the mouth, if the tongue lies low or if the head sinks forward, the body finds a substitute solution, because breathing and swallowing have to continue. This substitute solution, known technically as compensation, becomes more entrenched with every repetition and at some point feels normal.
The habitual pattern
Breathing, swallowing and head balance have been running via a substitute solution for years.
The new stimulus
In training, you practise the natural sequence: lips closed, nasal breathing, the tip of the tongue on the palate behind the upper incisors (tongue reference position), head upright.
The expectation does not match
The nervous system expects the old sequence. The new feedback feels unfamiliar.
Muscles readjust
Muscles that have had little to do for a long time are needed again. You feel this as a pull or pressure.
The new pattern takes hold
The new sequence becomes more familiar, and the reactions usually become weaker.
Behind the third stage lies a basic principle of motor control: the nervous system works with an internal model of the body and calculates in advance what feedback a movement will produce5. If the feedback does not match the prediction, this is noticed. That is why the correct sequence often feels more wrong at first than the habitual one.
Like getting back into running
Anyone who starts running again after years feels it in their calves on the second day. Nobody would say that running has made their legs worse. After a few sessions the soreness is gone, even though you keep running. It is similar when the tongue, lips, floor of the mouth and neck are brought back into their role.
The first weeks
Which reactions can occur
This is the feedback we hear most often in our support.
Muscle soreness in the neck and back of the head
Head balance is part of every exercise and challenges the neck muscles in a new way.
Ear noise temporarily more noticeable
The jaw, neck and pressure equalisation are changing, and tinnitus can react to this.
More saliva
The FaceFormer is a new stimulus for the oral mucosa.
Tension in the jaw
The chewing muscles and the floor of the mouth work together in a new way, especially when too much force is used.
Pressure on the incisors
At night, the negative pressure draws the FaceFormer’s membrane against the row of teeth.
Intermittent dizziness
The sense of balance first has to process new signals from the neck.
How long have you been training?
Not every complaint during this time comes from the training; an infection or poor sleep can also make itself felt. Pay attention to whether a reaction occurs shortly after practising and eases with fewer repetitions. You can find more answers about the initial period in the frequently asked questions.
Neck and jaw
Muscle soreness in the neck, back of the head and jaw
In every exercise, you balance your head upright over your spine, even though in everyday life it tends to drift forward. The small muscles between the back of the head and the upper cervical spine then work differently from usual. A pull in the neck or at the back of the head is therefore not unusual in the first few weeks.
If you pull your chin back forcefully or tilt your head back, the neck muscles tense up unnecessarily. Upright does not mean rigid. More on head balance in the article on neck pain.
after targeted overloading of the chewing muscles, fatigue and muscle pain were increased in a laboratory experiment with 21 women3
after that, all measured values in the same study were back at baseline level3
Muscle soreness mainly occurs when an activity is new or is resumed after a break2. The experiment from Amsterdam also shows it in the chewing muscles. There, the muscles were deliberately overloaded; the training is much gentler. The direction is the same: the reaction comes, and as a rule it goes again.
If your jaw feels tense, this is often due to too much force. The FaceFormer is held by the lips, not the teeth, and at first you do not need to press the lip wedge together completely. You bite down with your molars only briefly before swallowing. More on this under Understanding TMD.
Ear and balance
When the ear noise becomes more noticeable
Many people train because of tinnitus and are alarmed when the noise seems louder at first. The brain processes hearing together with signals from the jaw, face and neck. If tension and posture in this area or the pressure equalisation in the ear change, this can affect the ear noise, in both directions.
with tinnitus deliberately tensed muscles of the head, neck and limbs in a study from São Paulo4
were able to change their ear noise in this way; head and neck muscles had a stronger effect than arms and legs4
healthy people without tinnitus triggered an ear noise with the same contractions4
If your tinnitus becomes more noticeable at first, in our view this is, as a rule, a sign of the changeover. Reduce the load and keep training cleanly. More in the article Tinnitus: causes, jaw, neck.
It is similar with dizziness: the sense of balance processes information from the inner ear, the eyes and the sensors in the neck muscles. When the head realigns, a slight feeling of dizziness can occur at times. In that case, leave out night-time use for a few days and train for shorter periods during the day. More under Dizziness and Ménière’s disease.
If an ear noise comes on suddenly together with poorer hearing, if it pulses in time with your heartbeat or if everything spins violently, this is not adaptation. In that case, have it checked by a doctor promptly. With sudden hearing loss, the first two weeks count.
Mouth and teeth
Saliva, swallowing and pressure on the teeth
A lot of saliva is common at the start, especially in former mouth breathers. The FaceFormer is a new stimulus for the oral mucosa, and the salivary glands react to it. This is practice material: collect the saliva on your tongue and swallow it down with the exercise. If that is difficult at first, swallow only on every second repetition. More on the sequence under Swallowing and swallowing disorders.
After the night with the FaceFormer, many people feel pressure on their upper incisors. Due to the negative pressure in the closed mouth, the membrane rests against the row of teeth, and protruding teeth feel this more strongly. The pressure shows that forces are acting on the row of teeth. If the lips and tongue work in the physiological pattern again, the forces to which the teeth are exposed every day change. This can create the conditions under which a tooth position changes; a particular result cannot be promised.
If it is too uncomfortable, leave out the night for a while, keep training during the day and then gradually work your way back. At night you wear the softer ZERO. More under Night-time use.
If the inside of your lip is irritated, spread a thin layer of lip balm, Vaseline or a little cooking oil on the mouth shield before inserting it. If a spot is sore, pause until it has healed again.
Context
Homeopathy, splint, training: not the same thing
In homeopathy, many regard “initial worsening” as a sign that a remedy is working. A systematic review of 24 placebo-controlled trials compared how often aggravations occurred with the remedy and with placebo1.
were attributed to the homeopathic remedies1
occurred with placebo, i.e. without any remedy at all1
The authors found no clear evidence that homeopathic “initial worsening” exists as a phenomenon in its own right. So a reaction at the start proves nothing, in training either. There, however, it has an explainable place: muscles, sensors and mucous membranes working differently from what they are used to.
After getting a new occlusal splint for craniomandibular dysfunction (TMD), some people also report a difficult initial period, because the splint imposes a new position on the lower jaw from the outside. The point of contact is then the dental practice that fitted it. You do not wear the splint and the FaceFormer in your mouth at the same time, and you do not stop wearing a prescribed splint on your own initiative.
Remedy or aid
- A remedy or a splint works as long as it is being used
- Position or state is imposed from the outside
- The body remains largely passive
Active training
- You practise the sequence yourself until it runs without thinking
- Control readjusts from within
- You adjust the dose to your body’s feedback
Aids can provide relief, but they do not do the relearning for you. A pattern is stored in the brain and cannot be inserted from the outside. In our understanding, there is therefore no other way of changing a disturbed pattern of breathing, swallowing and head balance than training it.
Limits
When it is not adaptation
Adaptation reactions are usually moderate, are linked to the training and ease off with fewer repetitions. The following signs do not fit this picture and should be medically assessed promptly:
Suddenly hearing worse
Hearing in one ear suddenly decreases, with or without ear noise.
Pulsating ear noise
The noise throbs in time with your heartbeat.
Severe rotational vertigo
Everything spins strongly, accompanied by nausea or unsteadiness when walking.
Neurological signs
Numbness in the face, paralysis, visual or speech disturbances.
Pain radiating into the arm
The neck pain radiates into your arm or hand, with tingling or numbness.
Jaw locked
Suddenly you can barely open or close your mouth, with severe pain.
If you have acute inflammation in the mouth or throat, a blocked nose or recent surgery in the mouth, pause. If symptoms persist unchanged for weeks despite a reduced dose, have your technique checked by a practice. Do not stop prescribed medication or treatments on your own initiative.
Adjusting the training
Reduce, build up, stick with it
The same applies to any training: the dose is what matters. A stimulus in the right range encourages adaptation, too much at once overloads. So don’t stop, adjust the amount instead. A few clean repetitions will get you further than many done with force.
Sports medicine recommends the same for muscle soreness: reduce the load for a day or two and introduce new exercises gradually over one to two weeks2.
If clear reactions appear, take a step back and rebuild your training the way our support team has recommended for years:
- From today
Only the basic exercise
Three times a day, 8 repetitions of the basic exercise with the FaceFormer ZERO. Leave out the pull exercise and the night for now.
- Every day
One more repetition
Increase by one repetition each day until you reach 20. That takes just under two weeks.
- At 20
Add the pull exercise and the night
Now add the pull exercise, again starting with 8 repetitions and adding one a day up to 20. From now on you also wear the ZERO at night.
- After
The full programme
Three times a day, 20 basic and 20 pull exercises each, plus the night. After a few weeks you train during the day with the firmer ONE.
- Over months
The pattern runs by itself
The exercise manual allows six to twelve months until the new sequences run without thinking.
The work is done by the lips and tongue, not the jaw and neck. Head upright, shoulders relaxed, calm nasal breathing, the tip of the tongue at its reference point; more on this under Tongue resting posture.
If your neck, chin or chewing muscles tense up noticeably, it is too much. To check, place two fingers on the side of your chewing muscle.
Adjust rather than stop
A reaction is a pointer to the dose. Fewer repetitions keep the learning process going.
Bridging bad days
If you are not feeling well on a given day, just practise the tongue reference position and nasal breathing without the device. That counts too.
Build up after calm days
Only increase again once two to three days in a row have gone smoothly.
Keeping at it
A pattern built up over many years does not change in days. More under Process and duration.
You will find all the modules on the exercise pages. If you are not making progress on your own or would like support, a practice can check your technique.
Questions
Frequently asked
Is there an initial worsening with FaceFormer training?
At the beginning, reactions can occur, such as muscle soreness in the neck, a more noticeable ear noise, more saliva or pressure on the teeth. We do not speak of worsening, but of adaptation: a pattern that has been habitual for years is being changed. In our experience, this is a transition and not damage, because the training leads breathing, swallowing and head balance back into their natural pattern. If you follow this logic, you are not doing anything wrong.
How long does the adaptation at the start last?
Muscle soreness usually subsides after a few days. In our experience, the reactions become noticeably weaker in many people within the first two to three weeks, especially with a slow increase. The pull exercise or night-time use can temporarily trigger something again.
Should I stop training if it gets worse?
No, reduce the repetitions instead of stopping completely: only the basic exercise with 8 repetitions, one more each day up to 20, and only then add the pull exercise and night-time use. It is different with warning signs such as sudden hearing loss or severe rotational vertigo: have these checked by a doctor promptly.
My tinnitus has been louder since I started training. Is that normal?
That can happen at the start. The brain processes hearing together with signals from the jaw and neck, and that is exactly where the training brings about a change. Reduce the load and keep training cleanly. If the noise comes on suddenly with poorer hearing, if it pulses with your heartbeat or if everything spins violently, have it checked by a doctor promptly.
I have felt dizzy since starting the training. Should I carry on?
A slight, intermittent feeling of dizziness can occur during the changeover because head balance is realigning. Train for shorter periods, and if you already wear the FaceFormer at night, leave out night-time use for a few days. Severe rotational vertigo or neurological deficits are not adaptation and should be checked by a doctor promptly.
Why does the FaceFormer press on my incisors at night?
Due to the negative pressure in the closed mouth, the membrane rests against the row of teeth. Protruding teeth feel this more strongly; this is common at the beginning. The pressure shows that forces are acting on the row of teeth. If the lips and tongue work in the physiological pattern again, these forces change, and this can create the conditions under which a tooth position changes. A particular result cannot be promised. If it is too uncomfortable for you, leave out the night for a while, continue training during the day and then gradually work your way back.
Is there an initial worsening with a splint for craniomandibular dysfunction (TMD)?
Some people also report a difficult initial period after getting a new occlusal splint, because the splint gives the lower jaw a new position. In that case, your point of contact is the dental practice that fitted it. You do not wear the splint and the FaceFormer in your mouth at the same time, and you do not stop using a prescribed splint on your own initiative.
More articles from the knowledge section
Where to go next
Sources
- Grabia S, Ernst E (2003). Homeopathic aggravations: a systematic review of randomised, placebo-controlled clinical trials. Homeopathy 92(2):92-98. PMID 12725251. Source
- Cheung K, Hume P, Maxwell L (2003). Delayed onset muscle soreness: treatment strategies and performance factors. Sports Medicine 33(2):145-164. PMID 12617692. Source
- Yoshida E, Lobbezoo F, Fueki K, Naeije M (2012). Effects of delayed-onset muscle soreness on masticatory function. European Journal of Oral Sciences 120(6):526-530. PMID 23167469. Source
- Sanchez TG, Guerra GC, Lorenzi MC, Brandão AL, Bento RF (2002). The influence of voluntary muscle contractions upon the onset and modulation of tinnitus. Audiology and Neuro-Otology 7(6):370-375. PMID 12401968. Source
- Wolpert DM, Ghahramani Z, Jordan MI (1995). An internal model for sensorimotor integration. Science 269(5232):1880-1882. PMID 7569931. Source
Get started
Ready for the training?
The free FaceFormer app guides you through the basic exercises, counts along and reminds you of your sessions. If you wish, a practice from the practitioner directory can support you.
FaceFormer ZERO + ONE
Both material hardnesses for getting started, day and night. The set for adults.
FaceFormer ZERO
The softer FaceFormer for getting started, for children and for the night.
FaceFormer ZERO Children’s Set
ZERO with hygiene box, plush bag and success book with stamp.
FaceFormer training aims to restore the physiological setting of the basic functions of breathing, swallowing and head balance, with lip closure and the tongue reference position, thereby creating the conditions under which symptoms can improve. It does not replace a medical assessment. You can find practitioners near you in the practitioner directory.
