Rib Flares, Posterior Thorax, and FMS – Movement Debrief Episode 52

Movement Debrief Episode 52 is in the books. Below is a copy of the video for your viewing pleasure, and audio if you can’t stand looking at me. Here is the set list: What is a rib flare? How can rib flares be improved? What is the posterior mediastinum? What is moving when we seek posterior thorax expansion? What tests and interventions can be used in regards to posterior thorax expansion? How far have we come from the FMS/SFMA? What have we learned from the FMS/SFMA? What should we be addressing now instead of the FMS/SFMA? If you want to watch these live, add me on Facebook or Instagram.They air every Wednesday at 7pm CST. Enjoy! and the audio version…                  Here were the links I mentioned: Sign-up for the Human Matrix in Seattle, WA on September 15-16th here Sign up for the Human Matrix in Kansas City, KS on October 27-28th here   Sign-up for the Human Matrix in Portland, OR on November 10-11 here Here is a move for a narrow infrasternal angle a wide infrasternal angle An asymmetrical infrasternal angle Mechanics of the respiratory muscles Here is the posterior thorax expansion activity I like courtesy of Lucy Hendricks. Here’s a signup for my newsletter to get nearly 3 hours and 50 pages of content, a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies:

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Breathing During Exercise, Femoral Anteversion, and Assessment Priorities – Movement Debrief Episode 49

Movement Debrief Episode 49 is in the books. Below is a copy of the video for your viewing pleasure, and audio if you can’t stand looking at me. Here is the set list: When should you breathe during exercise? Are there times in which breath holding is warranted? What is femoral anteversion? Is there a way to test for femoral anteversion? What treatment considerations must one make for femoral anteversion? In what testing order do I chase variability? If you want to watch these live, add me on Facebook or Instagram.They air every Wednesday at 7pm CST. Enjoy! and the audio version…                    Here were the links I mentioned: Sign-up for the Human Matrix in Seattle September 15-16th here   Sign-up for the Human Matrix in Portland, OR November 10-11 here Breathing During Weight Training – Lyle McDonald Concurrent Criterion-Related Validity and Reliability of a Clinical Test to Measure Femoral Anteversion Determination and Significance of Femoral Neck Anteversion FAI Investigation of Association Between Hip Morphology and Prevalence of Osteoarthritis Infrasternal Angle Overhead vs Quadruped Narrow Infrasternal Angle Training Modifications Using the Infrasternal Angle – Lucy Hendricks Restoring Shoulder Motion Shoulder External Rotation Hip Adduction and Abduction Explaining Hip Range of Motion Here’s a signup for my newsletter to get nearly 3 hours and 50 pages of content, a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies: Breathing During Exercise https://zaccupples.com/2018/05/24/movementdebrief49/#Assessment_Priorities Femoral Anteversion Assessment Priorities

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Self-Testing, Postural Evaluation, and Shoulder Impingement – Movement Debrief Episode 41

Movement Debrief Episode 41 is in the books. Below is a copy of the video for your viewing pleasure, and audio if you can’t stand looking at me. Here is the set list: Can you self diagnose why a muscle feels tight? What are some good self tests to assess variability can you appear “flexed” in one area but actually be extended? Can we make accurate assessments regarding posture? Why does impingement occur? How does shoulder testing relate to the infrasternal angle? What each of the shoulder tests I look at are attempting to assess? If you want to watch these live, add me on Facebook or Instagram.They air every Wednesday at 8joc:30pm CST. Enjoy! and the audio version…                    Here were the links I mentioned: Manual Muscle Testing Debrief Here is the toe touch to squat Infrasternal Angle Overhead vs. Quadruped And the active midstance test Posterior Tilt Pelvic Tilts and Lordosis Check out the Apley’s Scratch Test (don’t mind the adhesions portion) If you want to see trunk rotation, check out Respiration Revisited Illmatic by Nas Usain Bolt Debrief Here is the diamond bear exercise Here is the sidelying pec twist Here is the cable hang courtesy of Lucy Hendricks Bill Hartman   Here’s a signup for my newsletter to get nearly 3 hours and 50 pages of content, a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies: Self-Testing Postural Evaluation Shoulder Impingement

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December Links and Review

Every week, my newsletter subscribers get links to some of the goodies that I’ve come across on the internets. Here were the goodies that my peeps got their learn on in December If you want to get a copy of my weekend learning goodies every Friday, fill out the form below.  That way you can brag to all your friends about the cool things you’ve learned over the weekend. Biggest Lesson of the Month I’ve been thinking a lot about generalism and specialism. Becoming a generalist involves implementing things with an individual that intend to have systemic effects, whereas the specialist implements things that intend to have a specific effect. Think about encouraging your clients to sleep effectively, eat more vegetables, and move effectively. Implementing these three strategies will lead to system-wide effects first and foremost, and may impact a specific goal that you have. These are the tools of a generalist On the flipside, consider a surgical procedure, medication, etc. These modalities have a higher likelihood of meeting a specific goal first and foremost, but the system-wide effect is less certain. Though upon careful reflection on this thought, really anything we implement as a generalist or specialist is riddled with uncertainty. Both types of practitioners are necessary to maximize health, longevity, and/or performance. Quote of the Month “Ego is about who’s right. Truth is about what’s right.” ~Mike Maples Jr Ego is something I’ve been working on getting control of over the last year, and it has been most

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Kyphosis, Post-Rehab Total Hips, and Coordinating Three Planes- Movement Debrief Episode 26

Movement Debrief Episode 26 is in the books. Here is a copy of the video and audio for your listening pleasure. Here were all the topics: What treatment parameters should be considered when working with someone who is overly kyphotic What to look at when assessing a total hip arthroplasty What training pieces should be considered and focused on with a total hip arthroplasty Should anything be avoided on the training floor with a total hip arthroplasty? How do I restore shoulder flexion How do I use cervical rotation to restore cervical lordosis What exactly do I mean by restoring sagittal, frontal, and transverse planes? How do I assess the three planes How do I restore the three planes Can the ribcage and t-spine act independently? If you want to watch these live, add me on Facebook, Instagram, or Youtube. They air every Wednesday at 7:30pm CST. Enjoy.                  Here were the links I mentioned tonight Enhancing Life Bill Hartman An Anatomic Investigation of the Ober’s Test The Ultimate Guide to Treating Ankle Sprains Ipsilateral Hip Abductor Weakness after Inversion Ankle Sprain Method Strength Andy Mccloy  Trevor LaSarre Jeremy Hyatt Here’s a signup for my newsletter to get a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies:   Kyphosis Post-Rehab Total Hips Shoulder Flexion Cervical Rotation Coordinating Three Planes

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Impingement, Trusting Your Assessment, Noncompliance, and the Off-Switch – Movement Debrief Episode 15

If you are beyond sad that you missed last night’s Movement Debrief, number 15, I got your back. This time both audio and video are available #growing up. Here’s what we talked about: What impingement is How to treat impingement at any joint When do local inputs matter? Trusting your assessment process When to go beyond your assessment process Why context matters Making the most of noncompliant people Dealing with bad situations The importance of having an “off switch” If you want to watch these live, add me on Facebook, Instagram, or Youtube. They air every Wednesday at 8:30pm CST. Enjoy.   Here were some of the links I mentioned in this Debrief. The 3 Biggest Basketball Conditioning Mistakes Practical Basketball Conditioning How to Treat Pain with Sitting – A Case Study Neurocoffee Impingement Manual Therapy Trusting Your Assessment Noncompliance The Off-Switch    

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9 weeks with Bane, I mean Zac…Oops Sorry Wrong CI

Note from Zac: This is my first guest post, and to start things up is the one and only Trevor Rappa. Trevor was my intern for the past 9 weeks and he absolutely killed it. Here is his story. It’s very exciting for me to get to write a guest post for Zac’s blog that I have read so many times and learned so much from. The experience I have had with him over these past 9 weeks has been incredible and I hope to share some of it with all of you that read this. He challenged me to think critically in every aspect of patient interaction: how I first greet them, which side of them I sit on, the words I use, and how I explain to the patient why I chose the exercises they’ll go home with. All of this was to create a non-threatening environment to help to patient achieve the best results they can. He also taught me how to educate patients with a TNE approach, incorporate other interventions such as mirror therapy into a PRI based treatment model, and deepened my understanding of the neurologic concepts behind performance. Therapeutic Neuroscience Education Perception of threat can lead to a painful experience which will cause a change in behavior. It’s the PT’s role to introduce a salient stimulus to attenuate the perception of threat in order to cause a positive change in experience and behavior (Zac and I came up with that, I really like it). Pain

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Hruska Clinic II: The Follow-up

Six Months Later I have come pretty far in my journey since initially being treated at the Hruska Clinic (see day one, two, and three). I have developed a beautiful squat, am noticing less back issues when I lift, and just generally feel mo’ betta. I also have zero fatigue when reading or on a computer screen. That said, I was still getting some right neck tension and felt that my reading comprehension was not as good as it was. I was accommodating to both my orthotics, so I thought my next trip to Lincoln would be a good time to follow-up. If Youz Ain’t Assessin’ You Guessin’  Came through the door after a long flight and minimal sleep, and surprised even myself. Without any orthotics, I was neutral at my pelvis and thorax, but still had some left cervical axial rotation and right OA sidebending restrictions. I was also lacking the capacity to perform mandibular lateral trusion without kicking in my SCMs. The reason why I don’t have access to my pterygoids for this movement? Those DAMN wisdom teeth.   My wisdom teeth essentially alter pterygoid position and reduce my mandible’s capacity to move. When I protrude, I have to extend my OA joint and utilize a forward head posture to complete the movement. The same thing occurs with lateral trusion. When I attempt the movement, the bony block limits my pterygoids from performing the action. SCMs, in particular the right, try to pick up the slack. From a

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Course Notes: PRI Integration for Baseball

Another Course in the Books Back in November I had the pleasure of attending a new Baseball PRI affiliate course, taught by my homies Allen Gruver and James Anderson. I really enjoyed this course because it was such a high-level affiliate and great prep for my PRC. We went into great deal regarding position, throwing mechanics, and treatment. A…lot…of…stuff. One of the most amazing pieces of the course was Allen’s ability to breakdown complex baseball movements into their basic biomechanical bits, And from that point show what compensatory things could occur if limitations are present. His eye for these things is unreal. That piece of the course is a post or two on its own, so I won’t touch it here. In fact, I probably won’t touch it at all. Go to this great class and be wowed by Allen. You will be motivated to become a better clinician. I know I was. Here are some of the big takeaways. PRI 101 v 3.0 I’ve heard this overview three times this year now, and it is amazing that I still pick up things from it. James really outdid himself here. The big piece this time around was space. We want space maximized. In the vision course we discussed maximizing left peripheral visual space because the pattern reduces this quality. The pattern in general reduces our ability to move through triplanar space. There are a few other reasons that we would be unable to shift into our left side. Overactive muscles

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Course Notes: The Last Craniocervical Mandibular Restoration Evahhhhh

You’d Think I’d Learn it the First Time Around You’d think, but CCM is one of the hardest PRI courses to conceptualize.  It didn’t hurt that my work was hosting the Ron’s last time teaching this course, as next year we will see Cervical Revolution instead. I took this course last February, and it’s amazing how different the two courses were. We had a room filled with PRI vets, and the Ronimal went into so much more depth this time around. It was such a great course that I would love to share with you some of the clarified concepts. If you want a course overview, take a look here.  The TMCC  The right TMCC pattern consists of the following muscles with the following actions: Cranial retruders/mandibular protruders Right anterior temporalis Right Masseter Right medial pterygoid Sphenobasilar flexors Left rectus capitis posteror major Left obliquus capitis OA flexors that maintain appropriate cervical lordosis Right rectus capitis anterior Right longus capitis Right longus colli If this chain stays tonically active, then there is better accessory muscle respiratory capacity present. These muscles provide the fixed point needed for an apical breathing pattern. We want the muscles on the other side, the left TMCC, to be active. Their activity will allow alternating reciprocal cranial function to be possible. We also call this gait.  Keep Ya Sphenoid Flexed One cranial goal we have is to achieve sphenobasilar flexion, but what does this mean? In the RTMCC pattern, the sphenoid is in an extended position.

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The End of Pain

I’m Done Treating Pain. Yes. You read that correctly. I’m over it. Several different thoughts have crept into to my mind sparked by what I have read and conversations I have had. I would like to share these insights with you. I remember when I was visiting Bill Hartman Dad a few months ago and we were talking about a specific treatment that is quite controversial in therapy today. He said something that really resonated with me: “Maybe they measured the wrong thing.” This sentiment was echoed in “Topical Issues in Pain 1” by Louis Gifford. Check out this fantastic excerpt: “Thus, pain can be viewed as a single perceptual component of the stress response whose prime adaptive purpose is to powerfully motivate the organism to alter behavior in order to aid recovery and survive.” Notice what I bolded there. Pain is a single component of the stress response. Not the stress response. Not a necessary component of the stress response. Just one possibility. Why do we place so much importance on pain? Many proponents of modern pain science (myself included) often use this statement against individuals who are over-biomedically inclined: “Nociception is neither necessary nor sufficient for a pain experience.” Agreed, pain is not always the occurring output when nociception is present. That said, pain is only one of several outputs that may occur when a tissue is injured. Just because pain is absent does not mean other outputs are also absent. Many different outputs can occur when an individual is

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Treatment at the Hruska Clinic – Initial Evaluation

For part 2, click here. For part 3, click here. “Do you produce enough saliva?” That was the first interview question Ron Hruska asked me; something I will never forget. I went to Lincoln, NE for almost a week to take a course, get treated, and observe PRI in it’s purest form. I wanted to see Ron out of curiosity and because I cannot achieve neutrality on my own. I have done most every exercise that could be thought of and been “worked on” by my fellow comrades and a couple PRI instructors in courses; nothing could budge. I knew I needed some type of orthotic to get somewhere; the question was which one? Subjective Complaints I do not have any pain really. My only complaints are a tight neck and I can’t seem to deadlift without feeling most of the effort in my back. I don’t see this deadlifting problem as a form issue necessarily. Interning with Bill Hartman at IFAST cleaned that up, and for a long time I could feel glutes and hamstrings all day when I deadlift. But not now. Other “issues” I have Left TMJ clicks; nonpainful. Clench jaw at night. Eye strain after reading on a computer too long (duh). By PRI standards, I am a classic PEC. I have no pathology anywhere, but I am limited in almost every motion.  I knew this and so did Ron. Objective Exam  First Ron had me walk and was pointing out some things to my student-to-be Trevor,

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