Trial and Error, Triplanar Movement, Networking, and Mentors – Movement Debrief Episode 11

Did you miss yesterday’s Movement Debrief? We had a lot of fun. The first time I went on facebook, twitter, and Instagram simultaneously. This debrief was a bit different, as it didn’t involve as much reflection on my patient care, but more on the wonderful continuing education weekend I had. I got to spend time with all my friends learning about a lot of different things. And it led to some great reflections. Here’s what I talked about: Why trial and error is important Being outcome-focused How triplanar movement impacts single plane movements Why having a good network is important Keys the networking The importance of mentors If you want to watch these live, add me on Facebook, Instagram, or Twitter. They air every Wednesday at 8:30pm CST. Enjoy.   Trial and Error Triplanar Movement Networking Mentors

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Movement Debrief Episode 1: Meet the Patient at Their Story

A Live Movement Video Series Hey party people. I recently started doing some live feeds on the interwebz. You can check me out on Facebook and Youtube if you want to see me live. Otherwise, I thought I’d share with the very first episode of “Movement Debrief.” Here we dive into the following topics: The importance of reflection Using similar language to the patient. De-threatening that language Restoring sagittal plane control A case for manual therapy Enjoy!

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The Ultimate Guide to Treating Ankle Sprains

A Humdinger No Doubt   Ankle sprains. Such a bugger to deal with.   Ankle sprains are one of the most common injuries seen in basketball. The cutting, jumping, contact, fatigue, and poor footwear certainly don’t help matters. Damn near almost every game someone tweaks an ankle. Treating ankle sprains in-game provides quite a different perspective. Rarely in the clinic do we work with someone immediately post-injury. Instead, we deal with the cumulative effects of delayed treatment: acquired impairments, altered movement strategies, and reduced fitness. The pressure is lower and the pace is slower. You shed that mindset with the game on the line. You must do all in your power to get that player back on the court tonight, expediting the return process to the nth degree. I had a problem. Figuring out the most efficient way to treat an ankle sprain was needed to help our team succeed. I searched the literature, therapeutic outskirts, and tinkered in order to devise an effective protocol. The result? We had 12 ankle sprains this past season. After performing the protocol, eight were able to return and finish out the game. Out of the remaining four, three returned to full play in two days. The last guy? He was released two days after his last game. It’s a tough business. The best part was we had no re-sprains. An impressive feat considering the 80% recurrence rate¹.    Caveats aside, treating acute injuries with an aggressive mindset can be immensely effective. Here’s how.

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Course Notes: PRI Postural Visual Integration: The 2nd Viewing

Would You Look at That It was a little over a year ago that I took PRI vision and was blown away. A little bit after that, I went through the PRIME program to become an alternating and reciprocal warrior. I had learned so much about what they do in PRI vision that I was feeling somewhat okay with implementation. Then my friends told me about the updates they made in this course. I signed up as quickly as possibly, and am glad I did. This course has reached a near-perfect flow and the challenging material is much more digestible. Don’t expect to know the what’s and how’s of Ron and Heidi’s operation. And realistically, you probably don’t need to. Your job as a clinician is to take advantage of what the visual system can do, implement that into a movement program, and refer out as needed. This blog will try to explain the connection between these two systems. If you want more of the nitty-gritty programming, I strongly recommend reading my first round with this course. Otherwise, you might be a little lost. Let’s do it.

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Course Notes: Cantrell’s Impingement and Instability, 2015 Edition

Third Time’s a Charm  A trip home and hearing Mike Cantrell preach the good PRI word? I was sold. Impingement and Instability is one of those courses that I could take yearly and still get so many gems. In fact, I probably will end up taking it yearly—it’s that good. I took I&I last year with Cantrell (and the year before that with James), and the IFAST rendition was a completely different course. Cantrell provided the most PRI clinical applications I have seen at any course, which is why he continues to be one of my favorite people to learn from. Basically, if you haven’t learned from Mike yet, I pity you. Get to it! I have way too many gems in my notes to discuss, so here are a few big takeaways.

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Course Notes: PRI Cervical Revolution REMIX

Note: I made some errors on the first rendition of this blog that were corrected after speaking with Eric Oetter. Courtesy to him, Lori Thomsen, and Ron Hruska for cleaning up some concepts. Four Months Later When the Lori Thomsen says to come to Cervical Revolution, you kinda have to listen. I was slightly hesitant to attend since I had taken this course back in January. I mean, it was only the 3rd course rendition. How much could have changed? Holy schnikes! It is simply amazing what four months of polishing can do. It was as though I attended a completely different course. Did I get it all figured out? No. But the clarity gained this weekend left me feeling a lot better about this very complex material. This is a course that will only continue to get better with time; if you have a chance to attend please do. Let’s now have a moment of clarity.   Biomechanics 101 The craniocervical region is the most mobile section of the vertebral column. This mobility allows regional sensorimotor receptors to provide the brain accurate information on occipital position and movement. The neck moves with particular biomechanics. Fryette’s laws suggest that the cervical spine produces ipsilateral spinal coupling in rotation and sidebending. The OA joint, on the other hand, couples contralaterally. C2 is the regulator of cervical spine motion; much like the first rib regulates rib cage movement. C2 is also important for the mandible, as it balances the cervical spine during mandibular

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Course Notes: BSMPG 2015

#Bestconferenceevaahhhhh I shipped off to Boston to attend my first ever BSMPG summer symposium. And it was easily one of the best conferences I’ve ever been to. There was an excellent speaker lineup and so much of my family. Art Horne really put on a fantastic show. If you haven’t been to BSMPG before, put it on your to-course list. It is one of the few courses that has a perfect combination of learning and socializing. I hope to not miss another. Instead of my usual this person talked about that, let’s look at some of the big pearls from the weekend.   Why Sapolsky Doesn’t Get Ulcers In one quote Robert Sapolsky summed up my current foundational premise to rehabilitation and training: “The stress response returns the body to homeostasis after actual or potential threats.” ~ Robert Sapolsky   Regardless of what your malady is, it can probably be linked back to the stress response gone awry. The specifics become irrelevant because the stress response occurs nonspecifically. This response works best against acute crises. Guess how we screw it up? Chronic stressors. Human stressors are quite different from other species’ as we have the capability of inducing this stress response psychosocially. Gazelles on the Serengeti don’t have to worry about student loans.   We can see how chronic stress becomes an issue when you look at what occurs in the stress response: Glucose travels to the bloodstream to mobilize energy. Increased cardiovascular tone, heart rate, and blood pressure. Decrease long-term building projects such as

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Course Notes: PRI Interdisciplinary Integration 2015

A Stellar Symposium Back in April I had the pleasure of finally attending PRI’s annual symposium, and what an excellent learning experience. The theme this year was working with high-powered, extension-driven individuals. The amount of interdisciplinary overlap in each presentation made for a seamless symposium. Common themes included the brain, stress response, HRV, resilience, and drive. These are things altered in individuals who are highly successful, but may come at a cost to body systems. If you work with business owners, CEOs, high-level athletes and coaches, high level positions, straight-A students, special forces, and supermoms, this symposium was for you. And let’s face it; we are both in this category! There were so many pearls in each presentation that I wish I could write, but let’s view the course a-ha’s. The Wise Words of Ron Ron Hruska gave four excellent talks at this symposium regarding high performers and occlusion. Let’s dive into the master’s mind. People, PRI does not think extension is bad. Extension is a gift that drives us to excel. Individuals who have high self-efficacy must often “over-extend” themselves. This drive often requires system extension. Extension is a consequence, and probably a necessary adaptation, of success. If this drive must be reduced to increase function and/or alter symptoms in these individuals, we have to turn down the volume knob. How can we power down these individuals? Limit alternate choices – These folks take a wide view of a task Set boundaries – These folks attribute failure to external factors Making initial

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The Road to an Alternating and Reciprocal Warrior: You down with ENT?

This spans an entire treatment over a year’s time. Here’s part 1 Part 2 Part 3 Part 4   “Yeah you know me.” ~ Naughty By Nature  You know how sometimes when you are treating someone that individual eventually reveals fairly important information that he or she forgot about. Yeah that was totally me. I’ve always had a stuffy nose as far back as I can remember; especially in the winter. The only time breathing felt incredibly easy was when I was eating paleo in college. I have progressively been losing my sense of smell as well. Must be old age right? When I spoke with Lori Thomsen about my recent experience, she mentioned at Pelvis that attaining neutrality in certain areas but not others could lead to a “pressure cooker” phenomenon. For example, if I have someone with a neutral neck and thorax, lower extremity symptoms may possibly be more common. In my case, I had a neutral pelvis at the time my wisdom teeth were pulled. Pull out wisdom teeth and my nasal airway goes crazy. Guess where the pressure went? It was time to see an ENT. ENT Begins After viewing my CT scan and airway, my ENT concluded I have patho-scoliosis. More specifically, airway scoliosis. He found a deviated septum and some enlarged turbinates. These two factors could have a large impact on my breathing capabilities. To me this made a lot of sense. If you read this article, a nostril will drive air to the ipsilateral lung.

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Course Notes: Pelvis Restoration Reflections

Pelvises Were Restored It was another great PRI weekend and I was fortunate enough to host the hilarious Lori Thomsen to teach her baby, Pelvis Restoration. Lori is a very good friend of mine, and we happened to have two of our mentees at the course as well. Needless to say it was a fun family get-together. Lori was absolutely on fire this weekend clearing up concepts for me and she aptly applied the PRI principles on multiple levels. She has a very systematic approach to the course, and is a great person to learn from, especially if you are a PRI noob. Here were some of the big concepts I shall reflect on. If you want the entire course lowdown, read the first time I took the course here.  Extension = Closing Multiple Systems  This right here is for you nerve heads. It turns out the pelvis is an incredibly neurologically rich area. What happens if a drive my pelvis into a position of extension for a prolonged period of time? I’ve written a lot about how Shacklock teaches closing and opening dysfunctions with the nervous system. An extended position here over time would increase tension brought along the pelvic nerves. Increased tension = decreased bloodflow = sensitivity. We can’t just limit it to nerves however, the same would occur in the vasculature and lymphatic system. We get stagnation of many vessels. Perhaps we need to think of extension as system closure; a system closing problem. Flexion will be

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Recognizing and Changing Nonverbal Communication Disorders: An Interaction Approach

I was at my local coffee shop the other day chatting with my barista as she prepared my drink. Once it was all said and done and I paid, she wished that I had a glorious day. Glorious is not a word you hear often and definitely caught me ear. You might even say it was salient! I have this thing when someone uses an uncommon descriptor. When this occurs, I typically try to use an even more ridiculous descriptor. I especially like to apply this method to wish someone a better day than I. For example: Joe Blow: “You have a good day.” Me: “You have an even better day.” Glorious is a bit more difficult to top, but in the blink of an eye I was able to respond: “You have a splendiferous day.” Stupid? Yes. Did I get a laugh and a smile? Absolutely. Me doing this silly little thing with people is irrelevant. What is relevant is the speed that I was able to apply this quip. I spouted this word quickly because it fit a common pattern. Pattern recognition is huge in athleticism, medicine, and a multitude of other life facets. But how often do we think of pattern recognition when we interact with individuals? Being able to differentiate what both verbal and nonverbal communication one uses is critical in ensuring a favorable interaction with someone. And if your patient or client doesn’t like you? Fugetaboutit. Let’s look at a very common pattern that if you allow

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It’s the Salient Detection System, Stupid

 Can you tell the difference among pain, depression, and pleasure? From a neurotransmitter perspective, the answer is no (see here and here). How is it that three very different states can be so neurologically similar? I feel the commonality that the nervous system purports reflects a system that responds to stimuli that are deviations from the norm. We call these instances by this word: Salient. Doesn’t that make your loins quiver? Let’s discuss how it works. Here’s your recommended reading. 1. The pain matrix reloaded: a salience detection system for the body (Thanks Sigurd) 2. Stress signalling pathways that impair prefrontal cortex structure and function (Thanks Son) 3. From the neuromatrix to the pain matrix (and back) [Note: Most of this article is an amalgamation of the three articles that I cited above and my own thoughts. Rather then cite every sentence AMA-style, I’ll give the credit to these guys above. Read ‘em and figure out how I put this together. For those who are sticklers for proper reference formatting, the type I am using is KMA-style citation.*] The Pain Neuromatrix Myth Hate to break it to you, but pain ain’t so special. Here’s why. If you follow modern pain science, you may often hear the term pain neurosignature or neurotag. This phrase is meant to describe a cluster of brain areas that are active during a pain experience. Information that can contribute to a pain experience travels to several areas. Some of the big players are the primary and secondary somatosensory cortices (all the

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