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. Stress Response Proximal First Sensation Loss Your Health
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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: Why you should emphasize sagittal plane activities longer than you think How to coach exercises to maximize client learning and compliance Why detaching from your client encounters makes you a better clinician 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: Master Sagittal Plane Coaching Progressions Detaching Refocusing TFL Inhibition
Read MoreMovement 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!
Read MoreCourse 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.
Read MoreCourse 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.
Read MoreCourse 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
Read MoreThe 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.
Read MoreCourse 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
Read MoreThe Road to an Alternating and Reciprocal Warrior: Wisdom Teeth Extraction
This spans an entire treatment over a year’s time. Here’s part 1 Part 2 Part 3 The Saga Continues I’ve been through vision, I’ve had dental integration, I’ve put in the PRI activity homework, maximized my PRI testing, and feel a new man. Yet neutrality eludes me. It is a state of mind I could once feel by the power of glasses and splints, but the nervous system learns and accommodates. I topped out. But of course, I knew that would be the case from my very first session with Ron. “You gotta get those wisdom teeth pulled.” ~Ron Hruska By virtue of the dentist I integrate with, the time came. And here are the results. Zac B.E. (Before Extraction) So at this point in my life the large HRV gains I initially had were dropping and I was still having some neck tension. Training was feeling so-so. Test-wise, the videos below show what I look like. Here’s my squat And my toe touch. Upper quadrant tests And lower quadrant tests Mandibular movements And some cervical movements My pelvis is consistently neutral and I can shift and squat with the best of ‘em. But I still present with restrictions in my thorax, neck, and mandible (BBC/RTMCC). These limitations are likely present because of a bony block called wisdom teeth. As you can see, the maxillary (top side) wisdom teeth limit the excurision of my lateral pterygoids for lateral trusive movements. My hope is by removing these guys I will get
Read More9 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
Read MoreCourse Notes: PRI Cervical Revolution
Where are all the People? I recently made the trek to Vermont for the first rendition of PRI’s Cervical Revolution course; a course in which the attendees doubled the population of the entire state. It was nice to go to the class with a bunch of old friends. You always learn better that way, and I couldn’t have been more excited to get the band back together. And even more so, I got to meet a lot of good folks for the first time. It was a real treat. This course was meant to update the former craniocervical mandibular restoration course (which I reviewed here and here), with extra emphasis on the cervical spine and OA joint. In this blog however, I will not touch much on the cervical spine positioning. I still have several questions regarding the mechanics. Some spots within the manual seemed to be conflicting; the blessing and curse of a first run-through. I will update this piece once I get these points figured out. That said, the revolution helped fine tune the dental integration process for me. I have been working a bit with a dentist, and I have a bit more insight in terms of what devices they are using for whom. Let’s go through my big a-ha moments. Smudging 901 The human body is symmetrically asymmetrical. When we have capacity to alternate and reciprocate, we are able to separate the body into parts to form a whole. If you lack integration, then there are
Read MoreCourse Notes: Cantrell’s Myokin Reflections
Third Time’s a Charm Mike Cantrell was in my neighborhood to teach Myokinematic Restoration by the folks at PRI. And I couldn’t resist. This is the third time I have taken this course, a course I feel I know like the back of my hand, yet Mike gave me several clinical gems that I want to share with y’all. This post is going to be a quick one. If you want a little more depth, take a look at my previous myokin posts (See James Anderson and Jen Poulin). Or better yet, take a PRI course for cryin’ out loud. Hip Extension, We Need That Yo. Sagittal plane is your first piece needed to create triplanar activity. Since this is a lumbopelvic course, we look at getting hip extension as high priority. If I am unable to extend my hip, here’s what I could try to use to do it: Back SI joint compression Anterior hip laxity Gastrocnemius and soleus. We use two tests to see if we have hip extension: adduction drop (modified ober’s test) and extension drop (Thomas test). The adduction drop will look at your capacity to get into the sagittal and frontal plane, and the extension drop test will look at your anterior hip ligamentous integrity. A positive extension drop is a good thing if you are in the LAIC pattern. It means you didn’t overstretch your iliofemoral and pubofemoral ligaments. Well done! The reason why this test is not a hip flexor length test has to
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