Respiration Revisited Preview

Respiration, and how it impacts movement, is a topic of dear interest to me.

I scoured a bunch of resources to better understand how this process works, and I figured I’d record a talk on how I am applying these concepts.

Basically, I do the work, you reap the results #tistheseason

Here were some of the topics I discussed in this talk:

  • The anatomy of respiration
  • The physiology of respiration
  • Alterations in physiology and anatomy as respiratory demands increase
  • How to simply assess how movement is affected by respiration
  • Easy to implement treatments to favorably impact movement

If you want immediate access to the remainder of the nearly 90 minute talk, and a FREE 27 page PDF file of my talk notes, fill out the form below.

Without further adieu, here is the first 30 minutes of the talk.

Resilient Movement Foundations Course Review

I recently had the pleasure of attending a class put on by my fellas at Resilient Performance Physical Therapy.

A jolly old time with old friends and new

I went to this course for a few reasons. First off, I of course support the home team. I can’t even front, Douglas Kechijian, Trevor Rappa, Greg Spatz, and I go way back, and are very much related through IFAST family and directly (Doug is my younger older brother, Trevor is my son, and Greg is my stepson #dysfunctionalfamily).

That said, there is were a couple big things I wanted to take away from this course, which I did in spades:

  • Mastering basic movement
  • Program design

In these two areas, the Resilient fellas delivered in spades. Knowing what good technique is in the basic movement patterns, how to coach, and how to regress, are all underappreciated topics that these guys teach quite well.

So should you take this course? An emphatic hell yes. I give a more indepth review as to why in the video below, so go ahead and check that out.

Once you got the verdict, check out my favorite takeaways in the course notes, and then for the love of God sign up for a course of theirs!

Click here to check out the Resilient Seminar Page

Continue reading “Resilient Movement Foundations Course Review”

Stress Response, Proximal First, Sensation Loss, and Your Health – Movement Debrief Episode 12

Let me guess, you are devastated you missed last night’s Movement Debrief.

You should be. It was by far the most interactive debrief we had yet. Loved how active everyone was, and definitely some people help me get better.

Kudos to Steve, Jo, Yonnie-Pooh, and the many others who commented on today’s Debrief.

Here’s what we talked about:

  • How the stress response impacts many areas
  • Treatment hierarchies
  • How to restore sensation loss post-surgery
  • Functional Medicine
  • Why taking care of your health helps others

If you want to watch these live, add me on Facebook, Instagram, or Twitter. (occasionally) They air every Wednesday at 8:30pm CST.

Enjoy.

Master Sagittal Plane, Coaching Progressions, Detaching, & TFL Inhibition – Movement Debrief Episode 5

Did you miss Movement Debrief live yesterday? Though much more fun live, I have a video of what we discussed below.

This debrief was quite fun, as we had an impromptu viewer q&a. Thank you Alan Luzietti for the awesome questions! If you follow along live on Facebook or Youtube, I will do my best to answer any questions you ask.

Yesterday we discussed the following topics:

  1. Why you should emphasize sagittal plane activities longer than you think
  2. How to coach exercises to maximize client learning and compliance
  3. Why detaching from your client encounters makes you a better clinician
  4. Viewer Q&A – “centering from the chaos” & TFL Inhibition

Lastly, if you want the acute:chronic workload calculator I spoke about, click here.

Without further ado:

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:

  1. The importance of reflection
  2. Using similar language to the patient.
  3. De-threatening that language
  4. Restoring sagittal plane control
  5. A case for manual therapy

Enjoy!

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 seriously just took it
I seriously just took it

 

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. Continue reading “Course Notes: PRI Postural Visual Integration: The 2nd Viewing”

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.

The power of the ultimate orthotic compels you
The power of the ultimate orthotic compels you

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!

And especially missing it with this group. Come on people!
And especially missing it with this group. Come on people!

I have way too many gems in my notes to discuss, so here are a few big takeaways. Continue reading “Course Notes: Cantrell’s Impingement and Instability, 2015 Edition”

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.

Especially when tempted with soufflé. Ooooooohhh Lawwwwd
Especially when tempted with soufflé. Ooooooohhh Lawwwwd

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?

There's no going back Ron
There’s no going back Ron

 

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.

Itsyabloig
Itsyabloig

 

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=1st rib = Nate Dogg (RIP)
C2 = 1st rib = Nate Dogg (RIP)

C2 is also important for the mandible, as it balances the cervical spine during mandibular opening. The reason this occurs is because the mandible and C2 are at the same fulcrum level.

images

 

Pathomechanics 201

Often triplanar motion will decrease amidst progressive respiratory demand or threat. These changes help promote neck stability while simultaneously increasing demand on the mandibular elevators, extraocular muscles, and vestibular system

If these changes occurs long enough, sensory issues may become prominent.

Stability can occur through increased sagittal plane activity in the upper cervical spine and cranium either one of two ways:

  • O on A via posterior cranial rotation
  • A on O via forward head posture

Both strategies attempt to flex the cranium, but both are undesirable if occurring underneath a lost cervical lordosis.

OA hyperflexion is often seen in those who sit in front of monitors for long periods of time. The visual system helps promote stability.

Aka actually sit in your freakin' chair!
Aka actually sit in your flippin’ chair!

OA Hyperextension is an attempt to create an airway. Cranial protrusion may be utilized as a way to open up the airway under stable conditions. This position passively raises the hyoid bone, which often depresses when one uses a mouth-breathing strategy. These individuals rely heavily on the dentition for craniocervical awareness.

Aka get a larger monitor
Aka get a larger monitor, and possibly a haircut.

Of course, these are not the only ways undesirable neck stability can occur.

You might have a stable neck if:

  • You have a narrow palate.
  • You have a cross bite.
  • You have a narrow airway.
Just think if Jeff Foxworthy were a dentist.
Jeff Foxworthy coming to a dental chair near you.

 

Patterned Mechanics 3037

 The TMCC is the foundational polyarticular muscle chain at the neck, with the right side generally more active than the left.

The normal RTMCC pattern presents with the following at the neck:

  • C2-C7 orientation in the transverse and frontal plane to the right, with compensatory rotation and sidebending to the left.
  • The OA joint is sidebent to the right and rotated left as a passive orientation.
Yep, that's you.
Yep, that’s you.

The RTMCC may be present in isolation or with various cranial strains.

A cranial strain may occur if the left SCM sidebends the OA left within the RTMCC pattern. This compensatory movement occurs to attempt to reduce OA rotation and upper cervical strain.

If you weren’t sleeping during the biomechanics section, you will notice that this goes against Fryette’s laws. In order for this compensatory strategy to occur, the right alar ligament and posterior capitis muscle must become lax. This movement does help reduce torsion and compression on the upper cervical segments, but may create a cranial lesion in the process.

This compensatory movement is a precursor to a left sidebending cranial lesion, and this lesion along with others are quite prominent.

According to a 2008 study by Timoshkin and Sandhouse, 72% of individuals have a cranium that is in a sidebend or torsion pattern; with left sidebend and right torsion being the most common.

Of those two cranial strains, the left sidebend will be the most common. Let’s dive into that pattern more.

Using whichever diving face you prefer.
Using whichever diving face you prefer.

 

Left sidebend (LSB)

The LSB lesion is named for the sphenoid’s greater wing position. In this case, the greater wing is high on the right and low on the left. The occiput matches this orientation.

Where these bones will differ occurs about a vertical axis; as the sphenoid externally rotates while the occiput internally rotates.

The mechanical change at the atlas drives this position. The sphenoid just goes along for the ride.

A prime example of this cranial strain would be the lovely Garey Busey.

Though his personality is a bit more right torsion
Though his personality is a bit more right torsion

Right Torsion (RT)

RT’s also have a low left greater wing of the sphenoid, but the big difference is at the sphenobasilar joint.

Since the RT is a progression from the LSB, the occiput will attempt to sidebend right to level occipital position.  Since the sphenoid stays in position, torsion through the sphenobasilar joint occurs.

This twist is driven by the sphenoid as means to create pseudo-facial symmetry via extension.

Lorimer Moseley is actually a perfect example of this type of cranial position, as many facial features are flipped from a LSB face.

For the sake of science, I hope he is not offended.
For the sake of science, I hope he is not offended.

 

This is a Test

The only way to truly determine which cranial strain one has is through imaging, but PRI testing can guide us down a treatment path.

Admittedly, the cervical tests are not the most reliable of the PRI bunch. To attempt to offset this limitation, we shall imply a test battery to determine position.

There are four essential tests in the TMCC algorithm:

  • Cervical extension: Checks cervical lordosis presence; goal is 30-35 degrees.

If limitations are present it is likely that SCM hyperactivity is reducing the normal lordotic curve.

I think of this test as the extension drop test of the cranium. It tells you if you are working with someone who is sagittally lax or not.

  • Cervical axial rotation: Checking C7-T1 rotation, which reflects C2 position. Looking for symmetry at about 30-35 degrees of movement. This test determines the TMCC pattern.

Limitations will be present due to the cervical spine’s compensatory rotation and sidebend to the left. Placing the patient supine on a table rotates the spine further to the left, which places a RTMCC patterned neck in an end-range position. Hence, normally left cervical axial rotation is limited. We would see bilateral limitations in a BTMCC.

When performing this test you want to make sure that you do not give the patient a lordosis, for this can create false negatives.

  • Midcervical sidebending: I think of this test as the great comparer between the cervical spine and the cranium. Looking for symmetry at about 30-35 degrees. This test gives you a frame of reference for our next test.

In the RTMCC pattern, this test is limited to the right secondary to an arthrokinematic block. If the cervical spine is rotated left on the table, the neck cannot sidebend to the right. That’s Fryette’s laws brah!

  • OA sidebending: This test looks at cranial position. Looking for 8-10 degrees bilaterally.

More than 10 degrees of sidebending would indicate alar ligamentous laxity.

A  RTMCC individual would have limited right OA sidebending due to a bony block. In someone with a LSB however, you would have limited L OA sidebending because the left SCM pulls the OA over to the left. A RT could present with just about anything, as pathology is quite prominent in these folks. 

Cranial Destraining

 RTMCC repositioning and retraining goes about the following progression:

Cervical spine → OA joint → Mandible

The neck is the top priority because its mobility maximizes cranial sensory activity.

Moreover, most cranial activities are integrated multi-joint movements. Spending time doing “basic” PRI sets the foundation for one to combine complex movements.

But sometimes that's what you gotta do
But sometimes that’s what you gotta do

Mandibular movement is often normalized by the time the neck is cleared. The reason TMJ mobility may be limited because of craniomandibular discord.

In the RTMCC pattern, the right lateral pterygoid works with the right anterior capitis and right SCM to deviate the temporal bone and mandible to the left whilst the occiput (and sphenoid) are “stuck” in the left sidebend position. In a neutral system, we would expect the occiput and sphenoid to move to the right during this cranial movement. This tonal issue could limit mandibular movement.

Thus, a neutral cranium often restores normal TMJ mechanics. If problems still arise, then mandibular re-education may be necessary.

Sometimes you need a Dentist

 

Must be LVI-trained.
Though not all appreciate occlusion.

Of the two common cranial strains, RTs will most likely need integration.

With normal occlusion, one side of teeth should touch while the other discludes. This alternation creates lateral shifting in both the mandible and the cranium.

The canine teeth act as guides for where the jaw ought to be in space. When canines touch during shifting, molar contact follows as the teeth drop into position. This action is called group function.

Teeth touching is kinda important.
Teeth touching is kinda important.

If group function cannot occur, it is likely that a dentist may need to be involved.

Splint therapy is generally recommended in these cases. More specifically, mandibular splints are the go-to (which I spoke about here and here).

Maxillary splints are generally the devil. These splints tend to increase tongue activity and mandibular clenching to hold the splint in. The one major case that may warrant a maxillary splint is the presence of tori.

Wolff's law at its finest.
Wolff’s law at its finest.

Even if not using PRI splints, there are four essential pieces needed from a dentist:

  1. Don’t lock the mouth into a position.
  2. Move head back and jaw forward with canines.
  3. Feel one side occlude while the other side discludes.
  4. Have group function and anterior guidance between incisors.

Note – anterior guidance is when the incisors touch the molars disclude

 

#Explainocclusion

 You might be wondering how I educate people about this stuff in a nonthreatening fashion. I got this neat little tidbit from the Ronimal:

“Periodontal ligaments are so sensitive that a hair will throw off your gait.” ~ Ron Hruska

Think about that statement the next time you get something stuck in your teeth. Drives you crazy right? If there is something undesirable going on with your teeth, you will know about it in some way. Some output will occur.

Yes, it's called a chiari malformation
Yes, it’s called a chiari malformation

Moreover, think about what occurs at the dentition when stressed. Do you clench? Reducing this muscle over activity by splint therapy introduces a salient stimulus that could reduce the stress response, if the craniocervical region is involved.

Hint: It usually is.

Infamous Ron Quotes

  • “Every single bunion and ACL patient is a TMD patient.”
  • “I love dentistry, but I don’t like dentistry, but I like dentistry.”
  • “You cannot treat a neck if a neck can’t treat itself.”
  • “We are a product of how we move our cranium.”
  • “A bra strap will really mess a tongue up.”
  • “The worst thing you can do to a patient is splint their neck.”
  • “We still have a lot of goniometric minds.”
  • “What good is the polyvagal theory if you don’t understand the neck.”
  • “Don Neumann is the best book for 1% of the population.”
  • “Treatment starts when you appreciate frontal plane.”
  • “How can you treat a TMJ if you can’t control the T?”
  • “The vehicle you drive is not the problem, it’s the path your on.”
  • “A twisted levator is an untwisted neck.”
  • “Hallelujah you have a pattern.”
  • “When you lose your left ab wall the head and neck will pick up the slack.”
  • “You can learn a lot about cognition and personality if you look at a neck.”
  • “You can’t feel CSF flow if you lack a cervical lordosis.”
  • “Make sense out of sense.”
  • “A neck that can’t move will produce a cant.”
  • “Crossbites, pulled bicuspids, and high arches scare me.”
  • “Sedentary lifestyle and screens demand we go straight.”
  • “The pattern is sugar that tastes pretty sweet.”

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.

Oops
Good thing there wasn’t a bear rug near by.

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?

Now Zac, your right nostril is not older than your left.
I can hear Butler now: “Now Zac, your right nostril is not older than your left.”

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?

Who knew I was so constipated? #ohsorrywrongcourse
Who knew I was so constipated? #ohsorrywrongcourse

It was time to see an ENT.

ENT Begins

After viewing my CT scan and airway, my ENT concluded I have patho-scoliosis.

That...ain't...right
That…ain’t…right

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. So depending on what nasal airway is blocked may dictate whether I am a Right BC or a superior T4.

Moreover, sensory information through the nose travels to the contralateral hemisphere. In my case, my left airway is a bit more open than my right, which would increase sensory input to my right hemisphere.

Per the RTMCC pattern, I actually should have a more open right airway. So this finding would be considered patho per PRI standards. Hence the pathoscoliosis.

Could this abnormality be a contributing factor as to why I am solid on my left side but struggle when I go back to my right? Or even why I’m left-handed? Purely theoretical of course, but something I play around with in my head. I think weird shit like that.

I'm not normal
I’m not normal

Surgery is not the first line of defense, so we started with conservative measures. I was given a nasal saline rinse and couple nasal sprays to reduce inflammation and symptoms.

Let me tell you, I could notice a difference with the first rinse.

 Standing Supported Alternating Reciprocal Nasal Saline Rinse

The very first nasal rinse treatment opened up a whole new world for me. I cleaned out the sinuses and immediately measured my horizontal abduction:

20 degrees to 45.

I think I found a new repositioning technique.

The coolest thing? I could smell again. It’s amazing the scents in my apartment and the clinic that I could now pickup that I never noticed before. It was an incredibly rich sensory experience. Sleep quality drastically improved within the first couple nights as well.

Note to self: clean apartment
Note to self: now need to sterilize entire apartment

The only downside was the effects were not long lasting. It was time for phase two.

Read on to find out
Read on to find out

Nasal Adductor Pullback

About a month later I went back to the ENT and had an allergy test.

The good news is that I am not allergic to any foods. I can eat anything I want (yay). And actually I didn’t have many allergies at all.

Doesn't mean my manners will improve though.
Doesn’t mean my eating skills will improve

The bad news is that I have a large allergy to perennial rye grass, which is extremely common in AZ. I also have a couple allergies to a few other weeds or molds, but nothing major.

The next step is to try immunotherapy to see if I can reduce my sensitivity to these allergens. This basically amounts to me taking oral drops for the next three years. The hope would be that the threat these allergens are to my system would become nonexistent.

The new HEP
The new HEP

I ought to notice some changes over the next 6 months. If not much symptom-wise is changing, surgery to reduce the turbinates and align the septum will be the likely next step.

If only I could tell the ENT that my symptom was limited cervical axial rotation.

The experiment continues…

Just like the new Star Wars, we won't know the result until it happens.
Episode VII: A New Nose

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.

There's a few things going on here.
There’s a few things going on here.

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 the solution to open the system.

Not when you can utilize system flexion
Not when you can utilize system flexion

Synchronized Diaphragms

Pausing after an exhalation gives diaphragms time to ascend. Diaphragmatic ascension maximizes the zone of apposition (ZOA). The better ZOA we have, the less accessory musculature needed to take an adequate breath.

The two important ZOAs needed in this course are at the thoracic and pelvic diaphragms. We want to build synchronicity between these two diaphragms.

The way we do that is through the pelvic inlet.

Dat inlet yo
Dat inlet yo

The inlet links and adequately positions these two diaphragms via internal obliques and transversus abdominis (IO/TA).

To determine how this occurs, we must look at how breathing affects musculature.

This part here was a huge lightbulb moment for me. Muscle lengthening correlates with inhalation, and muscle shortening correlates with exhalation. So to create a stretch in areas you wish to lengthen, you may want to inhale, and to increase muscle contractility, you may with to exhale.

[Note: This is one reason in lifting exhalation is during the concentric phase and inhalation is during the eccentric phase?]

Now lets apply this concept to the pelvic inlet in an extended system. Let’s say the left innominate is forward (a LAIC pattern). My left IO/TA on would be eccentrically lengthened and in a state of inhalation. The left thoracic and pelvic diaphragms would be tonically active and form a v-shape.

I call this superior gluteal migration
I call this superior gluteal migration

This dyssynchrony explains why certain pelvic and thoracic tests correlate. The LAIC pattern suggests that I would not be able to adduct my left hip.

At the pelvis, this would occur because I have a “long” left anterior outlet and “short” posterior outlet.

The outlet and the thorax reflect one another. In this case, my anterior outlet is equivalent to the ipsilateral anterior chest wall and my posterior outlet is equivalent to the posterior mediastinum.

Guess what the tests will look like? I will have good left apical expansion and limited left posterior mediastinum expansion. I can’t adduct my left thorax or abduct my right thorax, much like I can’t adduct my left hip or abduct my right hip. These tests look at the same thing the pelvic tests do.

Only the tests have changed.
Only the tests have changed.

The Definitive Word on PRI Squatting

 We can look at one’s ability to actively synchronize the thoracic and pelvic diaphragms by one’s ability to squat.

The functional squat test is an excellent way to show if one is capable of maximal pelvic diaphragm ascension and can shut off extensor tone. It also is a test to see if one has a patho-compensatory pelvic floor; for if you can squat but can’t adduct your hips, you gotz problems.

Here is what the functional squat test is not: a position to go under load in the weight room.

The above was straight out of Lori’s mouth. So to all the people who talk smack about the PRI squat, your answer is above. It’s not looking at the same thing as a max effort back squat.

Done.

It's not that you don't know how to squat. It's that you don't know how to poop.
It’s not that you don’t know how to squat. It’s that you don’t know how to poop.

Here’s how to test it.

 

Sitting is Hahhhd

In PRI land, sitting is the most challenging position to be in.

Yeah uh no.
Yeah uh no.

Why? Because there are less points which one can reference. Sitting unsupported requires proprioception exclusively on your ischial tuberosities. Success here relies on alternating and reciprocal muscle recruitment. If I don’t have this, I will extend.

Some Quick Postural Eyes

Lori is a great at predicting how dynamic movements will look on the table. Here were a couple things that stood out to me in this regard, as well as a couple other random things.

  • Leg whipping means an individual likely has a femur stuck in adduction.
  • Patho-compensatory people usually have more narrow hips. Could possibly be more common in males for this reason.
  • People who lean to one side in gait need a glute med.
  • If one cramps during an exercise, think inhibition. We’d rather shaking.
  • Glute med is the needed ligamentous muscle if a hip subluxes laterally.
  • Furniture is made to fit people who are 5’8.
  • Hard orthotics = overrated. We want a soft heel cup and arch to be used proprioceptively.

Lori-isms 

  • “I like to refer to myself as your coach.”
  • “You can’t work the same muscle in a different position and expect the same outcome.”
  • “You know I’m going to have to spend some time on this little booger.”
  • “If you want to give more pelvic instability stretch hamstrings.”
  • “She trusts me and I make her shake which is all good.”
  • “PECs cannot breathe to the high moon.”
  • “Getting neutral is not treatment.”
  • “Her back needs to go on a holiday.”
  • “Run with ribs.”
  • “When you go run, run.”
  • “We like extension, just not 24 hours a day 7 days a week.”
  • “If your patients cannot breathe correctly, don’t do a PRI activity. They will fail.”
  • “Not everyone needs a pair of glasses. Some people need a diaphragm.”
  • “I’m not a comedian. I’m here to teach you.”
  • “We’re [the clinician] not in control. We’re just invited to the party.”
  • “I get excited when I feel my right glute max burn.”
  • “You normal human being you.”
What if the hurricane was named Lori?
What if the hurricane was named Lori?