Clinical Practice Guidelines, Periodizing Sessions, and Muscle Imbalances – Movement Debrief Episode 33

Movement Debrief Episode 33 is in the books. Here is a copy of the video and audio for your listening pleasure.

Here is the set list:

  • Do I use clinical practice guidelines and treatment-based classification system for managing patients?
  • How much time do I devote to developing specific qualities in a typical physical therapy session?
  • Where are muscle imbalances prioritized on my program design?
  • Is there validity in testing specific muscles based on work/sport specific demands?

If you want to watch these live, add me on Facebook, Instagram, or Youtube. They air every Wednesday at 7:30pm CST.

Enjoy!

Zac Cupples iTunes                

Here were the links I mentioned:

Clinical Practice Guidelines

Neck Pain Treatment-Based Classification System

Treatment-Based Classification System for Low Back Pain: Revision and Update

Practical Pain Education

How to Design a Comprehensive Rehabilitation Program

Thoughts on Manual Muscle Testing

Rocketbook

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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 impactful in my overall happiness and well being. I just wish I took this quote to heart much earlier in life.

Hike of the Month

Hiking frequency has gone down a bit because it’s so…dang…cold, but I had a dope hike at Joshua Tree.

#throwback to older times, fam

It wasn’t the most challenging hike, but had a wide variety of things to see. Whether it was an old mine, or climbing a mountain, you could definitely get your nature gains on point.

And the Joshua Trees themselves, Hyoooge. Way bigger than any of the others I’ve ever seen.

Rehabilitation

Is keeping up with evidence realistic? Welcome to a Blog I’d Like to Read

Peter Attia is one of the most interesting MDs I’ve come across. While most of this blog talks about his plans for the future, his thoughts on keeping up with the evidence are worth the read alone.

Destruction of a medical divide with “Complimentary and Alternative Medicine” Belongs on a Tombstone

Douglas Kechijian just keeps killing it with content. In this post, Doug provides coherent critiques on the supposed separation between CAM and EBM. The two aren’t as far off as you think.

Here are Three Reasons to Consider Travel PT

Here are the reasons why I considered this wonderful job style.

The struggles of keeping up with the EBP Joneses.

With the shear amount of journal articles released on a given day, it can be near impossible to stay fully evidenced-based.

Here is a quick little tip on how I keep up with the research if you aren’t already doing this.

Research shows breathing critical for survival

So you should probably master the basics on how to do so. Daddy-O-Pops Bill Hartman put out a great article this week titled Breathing Exercises to Move Better and Reduce pain.

In this joint, pops goes over why breathing retraining is important, how it can impact movement, and how to master the basics.

Definitely check this one out.

How to reach like a legend

I found quite an effective cue that I’ve been using as of late to enhance reaching-based activities.

Many times, peeps will round their back as opposed to retracting the thorax, but if you use this cue, the problem is often solved.

Give it a shot!

Performance

Do you even recover, bruh? 

All Pain, No Gain: Why High Intensity Training Obsession Has Failed Us All thinks otherwise.

I was first made aware of the constrained theory of energy expenditure by Mike Roussell, and Joel Jamison takes the concept to another level. This article made me really think about how I am approaching building my own fitness, and just how important recovery is.

Excited to make it through the series as it comes out.

What these coaches want from a strength coach.

Monitoring players for fitness and fatigue: what do coaches want helps bridge that gap.

One of the most challenging aspects I had with sports science is getting buy-in from the coaching staff.

Here, Yan Le Meur boils it down to the most important aspects that a coach wants to know, as well as which variables are most actionable from an intervention standpoint. It’s an infographic I wish I had while in the league.

Insights on assessment

Thoroughly enjoyed Dean Somerset’s take on What Assessments Work Best.

I love how Dean preached individualization in regards to the assessment process. Many times we seek models that place clients into buckets or patterns, but Dean reminds us to keep the client’s goals in mind. This cannot be emphasized enough.

Sports science overrated???!?!

Hearing Doug Kechijian’s podcast with Fergus Connolly definitely has me thinking so.

In this podcast, Fergus talks about why it is hard to make decisions on sports science data, why you should sleep on technology for awhile, why the art of coaching is still relevant, and so much more.

You and your science. pshh.

Personal Development

The One Key to Happiness

Moving from Impressing Others to Impressing Yourself was a very salient read for me.

Many times we all fall into the trap of saving face, of looking good in front of other people. Trent Hamm provides a coherent argument against this type of thinking in order to curb spending.

But the lessons extend well beyond money.

Kill those unproductive days with Death Clock

Ever find yourself having a hankering to watch just one Youtube video only to find yourself watching 6 hours worth of cat videos? This app, which Tim Ferris exposed me to, nips that time waster in the bud by showing roughly how many days are left in your life. Like sand through the hourglass or something, fam (see what I did there?)

Turning 30 is all types of hell…

But my boi Seth Oberst makes the most of it.

Seth recently reflected on the 30 lessons he learned by age 30, and I found the post incredibly inciteful. I’d call it part rehab, part philosophical, part psychological, and full awesome.

Learning from a cat like Seth has made me a much more well-rounded clinician.

Confidence low? Become a philospher

More specificially, a Stoic philosopher.

In Eric Barker’s Stoicism Reveals 4 Rituals That Will Make You Confident, Eric discusses strategies that the Stoics used, which are also used in cognitive behavioral therapy, to improve confidence levels when things go awry.

My favorite has to be challenging distored thoughts. Way more productive than challenging your mortal facebook enemy on Dry Needling for the 17th time this month.

Appreciate stoicism and you too, may have a bust built in your honor someday!

The choice is yours…or is it?

Making decisions can be an overwhelming process.

So do fewer of them.

In Choosing without Deciding, Seth Godin briefly provides an effective strategy for deliberating on decisions that require deliberation, and leaving less important choices to easier means.

Health & Wellness

Helping save healthcare with Chris Kresser – Unconventional Medicine

More great Robb Wolf podcasts. This time, it was my boi Chris Kresser. I absolutely love some of the solutions he presents to saving healthcare, as well as how salient he creates awareness of the problem of healthcare.

Am I stressing you out? Doubtful according to Andrew Bernstein – The Myth of Stress

Stressors are a myth. It’s all in how you react to stress. Hearing that concept alone is worth the listen from yet again, another great Robb Wolf podcast.

Are you selling your sleep short?

If you only give yourself 7 totals hours in bed (with 1 hour of scouring the cats of Instagram), chances are your sellling your sleep game short.

In this great read called How to Get a Tiny Bit More Sleep, Melissa Dahl discusses the concept of sleep opportunity. Something we rarely consider when we are trying to catch those z’s.

You can have holiday cookies…

If you are getting after it the rest of the time.

In a wonderful post, Daddy-O Pops Bill Hartman talks about How to Eat Whatever You Want Over the Holidays and not Feel Guilty. Having the habits in place throughout the rest of the year is the key to enjoying the holidays guilt-free.

The benefits of a digital detox

If there is one thing I struggle with, being an internet cat and all, it’s getting too engrossed into technology.

In Digital Detox: How and Why to Recharge Your Mind with an Unplugged Weekend, Drew Housman discusses what his experience was like eliminating technology, and the incredible benefits he obtained from it.

The two things I am attempting to do: go hike more (no service no problems) and airplane mode the first 30 minutes of when I get up.

Your time restricted eating questions have been answered

Round 2 of Rhonda Patrick’s podcast with Satchin Panda talks about how coffee impacts circadian rhythm, practical implementations, the difference between 16:8 fasting and TRE, and so much more. A very fun listen.

Music

So uh, Blackbear released an incredible mixtape…

NOTE: NSFW, lots o’ foul language with this one.

So a cat who I’ve been really digging, Blackbear, released a new mixtape called Cybersex, and it’s unbelievable.

For those who don’t know who Blackbear is, imagine if Jason Mraz became punk, hip hop, R&B, all in one, then up the attitude by 1000x. Then you have Blackbear.

This album shows his range of talents, and he hangs with many of the awesome features, including Cam’ron (#diplomats), Rick Ross, 2 Chainz, Ne-Yo, and many more.

My top 3 tracks: Playboy Shit, Bright Pink Tims, and Gucci Linen.

So why aren’t you listening to CyHi the Prynce?

After I was sadly disappointed with Eminem’s newest album (which really hurts because he is my top emcee), I was lost. Was there going to be anymore good hip hop released?

Then I listen to No Dope on Sundays by CyHi the Prynce, and my faith was restored.

I tried to think of my top tracks, but really the album from start to finish is absolutely awesome. Even the trap-y tracks are rock solid. Amazing features, and street poetry at its finest.

No more sleepin’ on CyHi, fam.

Which goodies did you find useful? Comment below and let me know what you think.

Photo Credits

Sports Authority of India

J.D. Falk

Wikipedia

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.”