Course Notes: Advanced Integration and PRC Reflections

I Passed

I officially became a Jedi this past December after retaking Advanced Integration and going through the Postural Restoration Certified (PRC) testing.

Both were a wonderful experience in terms of learning new concepts and fine-tuning old ones.

Since I have retaken this course, I will not go into huge detail in terms of the material covered (if you want detail, read last year’s AI notes here, here, here, and here).

Instead, I will reflect on a few concepts that really hit home for me (No, i’m not saying what we did at the PRC)!

Enjoy.

 Extension is Evolution

Extension is what allowed our brains to develop because it brought us to two legs.

The big extenders: psoas, paravertebrals, lat, QL, capitis

Extension given us more but comes with a cost. As we continue to extend, we increase system demands. Extension will likely be a necessary adaptation to live in the world we are creating.

I’m scared to see what the future looks like.

Position

Refers to triplanar position of the body. Neutrality is the state of rest and transition zone from one side to the other. We want this most of the day, but can’t expect this to occur all day. We want to establish a rhythm in and out of neutrality in alternating and reciprocal function.

The alternating and reciprocal rhythm has alternate appendages on either side of the body. When the left leg is in front, the right leg should be back.

In right stance, the appendages take the following positions:

  • Legs – right back, left forward
  • Arms – right forward, left back
  • SCMs – Right back, left forward
  • Lateral pterygoids – right forward, left back
  • Extra-ocular muscles – right back, left forward

In left stance, the above positions are reversed.

Oftentimes one or many of these appendicular positions is flipped. This flipping is when you have defensive patterning (LAIC/RBC/RTMCC/PEC).

Position is More than the Body

Position extends beyond body states. Position reflects who you are.

There was a table regarding human asymmetrical concepts present in this year’s manual that listed characteristics of neutral versus PEC individuals.

It blew me away because it very well matched my personal transition; especially comparing how I am now to when I was a young lad. Check this out.

NeutralPEC
Movement/motionRest/locked
LooseningBinding
ArbitratinessOrder
AccidentLaw
Live, create, playWork, formal, rigid
Lead/risk takingFollow
FreedomConstraint

I’ll probably be in jail painting pretty pictures once my wisdom teeth are pulled.

 Septums and Chambers

Septums are partitions in our bodies that separate chambers. For example, the diaphragm is a septum between the thoracic and abdominal chambers. These septums stiffen with flexion and loosen with extension.

We want septums to be tight, as septal tightness allows for chambers to expand, shift, and rotate. When a chamber can’t expand, it shall become loose.

If you want a tight septum you must be able to flex. Flexion is what gives one access to shift and rotate.

The normal respiratory cycle alternates between chamber and exoskeletal dominance. Upon inhalation, the exoskeletal system becomes unstable, but chamber pressure increases. When exhalation occurs, exoskeletal stability increases and chamber pressure decreases.

Thinking about this alternation clinically, one who lives in a constant state of inhalation (i.e. extension) will stay upright via chamber pressure. Stability is passive. On the flipside, one who spends more time exhaling (i.e. flexion) must keep upright stability via active elements

Poop Talk

The rectum is shaped somewhat like a cone to which a pressure gradient for defecation occurs by gravity and peritoneal cavity shape.

Our natural human asymmetry is necessary to mobilize abdominal contents. Our iliums act as pumps for the rectum, shifting contents back and forth with each step we take.

If we only have access to one phase of gait though…things get shitty.

Create with Your Arms

Hands should be free to reach and create, but when we are in a protective pattern, inability to reference the ground through our legs leads us to find reference elsewhere.

In some individuals, the arms can act as a reference center to hold us upright. This occurs most notably when we lack transverse plane activity. If you see these behaviors, think need for transverse plane:

  • When one writes, they push the pen into the table as opposed to gliding it across paper.
  • Nail biting.
  • Hands in pockets (guilty as charged).
  • Fist clenching.

When you have people who cannot create with their arms, being able to feel the ground is one of the best things you can do. Ground push-off is what reduces the reference needs of the arms.

It’s Not Illegal for your Right Ab Wall To Engage

One of the biggest mistakes I made was losing a right zone of apposition (ZOA).

A slight right ZOA is necessary when creating right apical expansion. The LAIC/RBC/RTMCC pattern dictates the ribs on the right are closed down. Airflow ought to be used to open up these ribs.

However, if I lose the ZOA on the right by letting my ribs flare and over-externally rotate, the right ribs will stay compressed. All that will be stretched is the right ab wall.

Conclusion: exhale and keep the ribs down and in on both sides. Then upon inhalation, a stretching sensation should be felt in the right intercostals. You won’t take in much air.

It is Illiegal to Overflex

We don’t want turtle humps, as this would be the same as creating excessive kyphosis in standing.

Instead, what we want is appropriate kyphosis via posterior mediastinum expansion. Get a ZOA, keep the ZOA, then inhale.

Mirrors are Cool

We learned some neat tricks you can do with a mirror. The mirror takes away visual reference by disassociating what is being seen from what is being felt.

This strategy is especially useful for people who can’t find and feel muscles on one side but can on another. Check out the video below to see an example.

Vision

Public service announcement: When getting your eye exam, ask your optometrist to make sure that you are not overcorrected and that your eyes work together or are balanced. These changes alone will make visual information coming into your brain less threatening for the system.

Foot Fun 

I came with a new appreciation of the subtalar joint. It’s a triplanar ball and socket-like torque absorber that creates pronation and supination.

This rotational force is not always occurring by the leg muscles however. In the closed chain, the opposite hip swinging forward creates supination in the foot. The effect is like a ratchet (twister is the pelvis, stationary end is the lower extremity).

This rotational component is one possible reason why many orthotic therapies can fail. A foot orthotic must be able to return the entire lower extremity to the center of the frontal plane (i.e. neutral).

Contrary to the haterz, orthotics will not weaken the foot. What they are made to do is change proprioceptive inputs that can have an effect on motor learning. Orthotics can allow one to find and feel muscles they may have not felt before.

It’s a different sensory experience, just like anything you wear is.

Even though PRI likes its orthotics, you may not always need shoes. Sometimes you can gain greater proprioceptive feedback to sense the floor barefoot. It’s going to be person dependent.

The verdict? Wear many different shoes and go shoeless occasionally. Give your dogs variable sensory inputs.

Infamous Ron Quotes

  • “If you’ve got rhythm you’ve got a diaphragm.”
  • “You should be moving so sinuses can drain snot.”
  • “If your gut is moving the bowels in your lungs are moving.”
  • “You have a center of your body…And I’m going to do this a lot…But it’s not the center of your body.”
  • “You have to handle the big G in some way.”
  • “What is this guy nuts? I am nuts.”
  • “Do something to become alive.”
  • “Wear different shoes everyday and you’ll probably poop.”
  • “If you cannot exhale you are probably dead.”
  • “Is your septum tight? Mine is.”
  • “If you don’t own yourself you can’t be kind.”
  • “I gave you these tests just so you would wake up.”
  • “It’s cool to be twisted.”
  • “If you suck at twister you can’t uncoil.”
  • “I like to break the law once in a while.”
  • “If you are going to do PRI, underbreathe.”
  • “Pain distorts where you are at.”
  • “Gosh, all my patients are snakes.”
  • “Quadratusitis. It preceded ebola.”
  • “The more references you have the less obese you will be.”
  • “Curvatures run the show.”
  • “Really? We’re going to fight to move a joint through a range?”
  • “Leave the body alone unless you really have to do something.”
  • “Can you imagine me in black spandex? Or a penguin?”

Lori-isms

  • “I have her in good shoes. She knows I have an attitude.”
  • “That old bald guy this morning…”
  • “Oh she’s shaking like a leaf.”

Cantrellisms

  • “I’m not afraid to say I don’t know.”
  • “These type A patients, and I don’t mean Hong Kong Taipei.”
  • “Neutrality is nothing. You need to be able to work with it.”
  • “It’s not illegal for your right ab wall to engage.”
  • “No! I’m sorry, just trying to find the floor on the left side.”

Great James Quotes

  • “You want to know why? Cuz Ron happens.”
  • “Extension is not bad if you can manage air and chains.”
  • “You can train everything but you don’t want to overtrain discord.”
  • “If you can’t trunk rotate you can’t ZOA incorporate.”

 

 

  1. Hey Zac,
    That was a great summary of AI for 2014. Congrats of receiving the PRC… I hope to test for it this year. It was a pleasure to finally meet you in person at the course. I’m the guy that Ron treated at the TMCC course in NJ last year.

    I see penguins and snakes everywhere!

    Best regards,
    Manny Kim, DPT

    1. Hey Manny,

      It was great seeing you again at AI and I absolutely remember you. Thank you so much for the kind words. I hope you got as much out of the course as I did. Stay alternating and reciprocal and keep treating those snakes and penguins 🙂

      Hope to see you at another course soon,

      Zac