Today we get wild and crazy and talk about scoliosis and the like; the last day of AI. For day 1, click here For day 2, click here For day 3, click here Scoliosis Variations The entire day focused predominately on treating scoliosis, which oftentimes amounts to exaggerations of the common patterns PRI discusses. Because scoliosis is an exaggerated PRI pattern, one must beget the question if the pattern or scoliosis came first? This question obviously cannot be answered, but for our intents and purposes we ought to assume pattern precedes curve. That way we may be able to alter the impairment. The scoliosis we can alter is often functional aka rotational. These types are ones that everyone has; the question is to what degree. Nonpathological Curve The nonpatho curve is an exaggerated version of the LAIC/RBC pattern, oftentimes with superior T4 syndrome involved. In this pattern the left ribs are externally rotated and right internally rotated. This reason is why 98% of scoliosis has right sided rib humps. A rib hump is akin to excessive rib internal rotation. In this case, the spine looks like so… Here we can see how the spine excessively right orients up to T8-T9, then rotates left superior to that. These patients will present with typical Left AIC and Right BC test results along with typical right lateralization. One difference may be the right shoulder is not as low as typical with most patterned individuals. This change is due to compensating for the excessive curve. When
Read MoreTag: breathing
Advanced Integration Day 3: Thoracic-Scapula Integration
Day 3 was all thorax and scapula. Here we go! For day 1, click here For day 2, click here A Philosophical Ron Intro Since the day began talking thoracic-scapula, Ron started us off by showing all the T-S connections in the body. Temporal——-sphenoid Thoracic———sternum Thoracic———scapula Tri-os coxae—-Sacrum You will notice that the thorax is very connected to many of these areas. Therefore, it is very important to control this area early on; especially if one’s problem is in the cervical spine. The “pattern” dictates the thorax governing the cervical spine because the neck follows suit with the rotated left thoracic spine. Thus, if we restore position to the thorax, oftentimes neck position will clear up. From here, my man James Anderson was introduced, and we started off the discussion with a bang. Brain, Brain, and a Little More Brain The first hour was spent talking about a subject much needing discussion: PRI’s cortical foundation. James really hammered the fact that our brains are what drive us to the right. None of the previous mentioned material matters. Zones don’t matter, left AFIR, right shoulder internal rotation, nothing, if you can’t get the brain to change out of a left hemispheric dominance. How do we do this? Per James, let’s get a zone of apposition (ZOA) in a right lateralized pattern. Say what? All the talk you have been hearing involves getting out of this right-sided dominance. But think of PRI activity in this fashion. We are most comfortable with performing right-sided activities. So why not use graded exposure to slowly
Read MoreThe Post Wonderful Time of the Year: Top Posts of 2013
The Best…Around Time is fun when you are having flies. It seems like just yesterday that I started up this blog, and I am excited and humbled by the response I have gotten. Hearing praise from my audience keeps me hungry to learn and educate more. I am always curious to see which pages you enjoyed, and which were not so enjoyable; as it helps me tailor my writing a little bit more. And I’d have to say, I have a bunch of readers who like the nervous system 🙂 I am not sure what the next year will bring in terms of content, as I think the first year anyone starts a blog it is more about the writing process and finding your voice. Regardless of what is written, I hope to spread information that I think will benefit those of you who read my stuff. The more I can help you, the better off all our patients and clients will be. So without further ado, let’s review which posts were the top dogs for this year (and some of my favorite pics of course). 10. Lessons from a Student: The Interaction This was probably one of my favorite posts to write this year, as I think this area is sooooooo under-discussed. Expect to be hearing more on patient interaction from me in the future. 9) Clinical Neurodynamics Chapter 1: General Neurodynamics Shacklock was an excellent technical read. In this post we lay out some nervous system basics, and
Read MoreAdvanced Integration: Day 2 (Triplanar Activity)
For day 2 we discuss more and more the areas that help support ZOA establishment. Read on comrades. For day 1, click here Neutral Neutral can be described as a position in which certain muscles are disengaged; those that make up chains in the human system (i.e. left AIC, Right BC, right TMCC). It is neutrality that allows us to function out of an unbiased non-lateralized position. We will never be fully symmetrical because we are neither built as such nor function cortically as such. But being able to be as symmetrical as possible may allow our bodies to function favorably. Achieving neutrality is only step one in the process. It allows for someone to accept triplanar movement. Once one can reach neutral, then you may teach them how to move with the left and right sides of the body. Is it possible to be too neutral? The answer is it depends. Mike Cantrell, one of PRI’s instructors, discussed a sprinter he was treating. Mike was able to get him neutral, but once this occurred his times worsened. This result goes back to part 1’s discussion regarding variability. In this case, being neutral, being too parasympathetic, made him slower. We could akin this to almost parasympathetic overtraining. The crazy thing? This sprinter’s sister had died earlier in a week he was scheduled to see Mike. The guy came in as neutral as could be. His nervous system shifted him towards this state as a way to disengage, thus leading him
Read MoreCourse Notes: Advanced Integration Day 1 (Synchronous Breathing)
Mind Blown My mind is still racing from PRI’s annual Advanced Integration course. It is over these four days that we linked all the chains learned in the basic courses into one interdependent system. As I have not taken all the PRI courses yet, I was very fortunate to have Bill Hartman, Doug Kechijian, and Young Matt to help me through the rough patches. Courses are so much more enriching when taken with friends. There was way too much material covered over the four days to write in one post. So here is the first of a four part series on this excellent class. Read on. Autonomics and the ZOA The first day’s primary objective was establishing a zone of apposition (ZOA), the diaphragm’s cylindrical aspect that lies along the chest wall. Establishing this zone is of utmost importance, as it allows for favorable respiration. Respiration influences movement by allowing better change of direction and variability. If I establish and maintain a ZOA, then I can effortlessly maximize movement in all three planes. When I cannot perform in this way, then I have less triplanar activity when I move. When one does not establish a ZOA, one must greater rely on the autonomic nervous system (ANS). Depending on what your goal is, this shift can be well and good. Take an example I got from Bill and my friend Eric Oetter. A sprinter or powerlifter who moves in one direction would not like much variability in how they move, thus
Read MoreChapter 5: Interaction of Psychological and Emotional Effects with Breathing Dysfunction
This is a chapter 5 summary of “Multidisciplinary Approaches to Breathing Pattern Disorders” by Leon Chaitow. The second edition will be coming out this December, and you can preorder it by clicking on the link or the photo below. Intro This chapter is dedicated to showing the connection between the body and consciousness; how our psyche is influenced by breathing and vice versa. This chapter was easily my favorite out of the entire book. Breathing Strategies Optimal breathing involves moderate abdominal expansion, some intercostal involvement, and minimal involvement of accessory muscles. Conversely, chest breathing is dominated by accessory muscle use. These two breathing styles are merely end points on a continuum rather than discrete categories. In terms of which strategy is used, chest breathing is often the preferred route for consciously mediated intentional breathing; whereas abdominal breathing is the main route for relaxed, automatic breathing. One reason you would want to override automatic breathing is to prepare for sudden action. At the onset of exercise, ventilation immediately jumps. This change occurs via three phases, with the first phase occurring independent of exercise load. This phase is a conscious exercise preparatory action. The other increases occur as exercise demands increase. When we are in an emergency situation, these breathing phases change. Prior to the initial pre-action deep breath comes a breath holding phase, which helps increase sensory organ stability. These preparatory breathing changes are great for imminent danger or action, but problematic when threats are non-physical and in the future. While
Read MoreCourse Notes: PRI Impingement and Instability
Soooooooooo Dense It has been a long, busy, and great few weeks for me. After attending a cluster of courses, playing around with some new jobs, moving, and working, I got some time to settle down and review PRI’s I&I material. I traveled to Phoenix to take this course. My man James Anderson taught and several good friends attended. James did not disappoint. I&I was easily one of, if not the best course I have ever taken. You did it again PRI! The only real disappointment was leaving Arizona. The temperature was in the 80’s and the sun was shining. Now here I am in the Midwest with the temp in the mid-20’s. Why did I stay here again? 🙂 This course combined and fleshed out the concepts of respiration and myokin, and added so many more layers onto what we previously learned. I&I was what DNS C should have been. I left the course with many answers, but double the questions. You truly cannot appreciate how complex the nervous system is, and how the total body responds to perceived threat until you delve into this material. I am so excited to learn more. This course had so much information regarding the entire body that there is no way I could post all the relevant info and do it justice. It really was a 4 day course done in 2. So here are a few of the gems I got from this weekend. The PRI Basis The course started off
Read MoreChapter 4: Biomechanical Influences on Breathing
This is a chapter 4 summary of “Multidisciplinary Approaches to Breathing Pattern Disorders” by Leon Chaitow. The second edition will be coming out this December, and you can preorder it by clicking on the link or the photo below. Loose-Tight Chaitow likes to use the loose-tight concept as a way of visualizing the body’s three-dimensionality while assessing. He likes to look at comparing structures as tight or loose relative to one another. Those areas which are loose are often prone to injury and more likely to be nociceptive. If we try to see which muscles have a tendency towards tightness or looseness, stabilizers tend towards laxity and mobilizers to increased tone. Obviously, all muscles function in both capacities, and some even stay more towards the middle (scalenes). But the tendency depends on which function is more dominant. Posture and Respiration (Not PRI, Peepz) Taking the previous concepts, Janda’s crossed syndromes can have a role in ones breathing function. With an upper crossed posture, the slumped upper body position negatively influences breathing function. Lower crossed syndrome will put the diaphragm in an anterior facing position, thus affecting diaphragm length-tension and breathing function. Facilitation Facilitation is an osteopathic term for a process involved in neural sensitivity. There are at least two forms of facilitation: spinal (segmental) and local (trigger points). Once facilitation occurs, any additional stress the individual undergoes can increase neural activity in the segment. There are several ways to observe facilitated segments. You can observe these via palpation: Goose flesh
Read MoreCourse Notes: DNS C
It was a Long Week After an incredibly long 5 days, I finally got the chance to assimilate what I learned from the Prague folks at the C level DNS course. Despite coming out with a few good exercise tweaks, I left disappointed. I will need some extreme convincing to continue on with their course work. A man I respect a lot, Charlie Weingroff, likes asking a question regarding interventions: “Can your treatments beat my tests?” With that in mind, I looked at DNS’s capability to beat my tests, which are predominately making changes to PRI objective measures. The answer: Mostly no. I felt a lot of activity with many of the exercises, but if we cannot make measurable changes, then the intervention is not effective. And with the DNS “objective” measures, positive change is attributed visually only. I don’t care how good your eyes are, you can never know if a joint achieves maximal bony congruency by just watching movement. Granted, I did get a few things that I will use regularly. But to get 4 or 5 takeaways for a $1000 price-tag, I feel there are better ways to spend money. Like on shawarma and stuff. Here are my likes and dislikes. Days 1 & 2 aka DNS A & B The first two days were predominately review of the A and B courses; looking over developmental positions and reflex locomotion. It was nice to review old concepts, but does it really have to take two days to
Read MoreCourse Notes: DNS Summit
Why? In my short time out I have gotten heavily into the influence that breathing has on the nervous system. Obviously PRI has been my favorite explanation thus far, but the DNS approach had me intrigued. The summit is the first of two DNS courses that I took this past week. This summit was the first of its kind, and was an amalgamation of many different speakers. Unfortunately, this summit was mostly review and wrought with little innovation. Here are some of the big points I got from a few of the speakers. “Developmental Kinesiology: Three Levels of Motor Control in Assessment and Treatment of the Motor System” by Dr. Alena Kobesova There are three levels of development: spinal, subcortical, and cortical Spinal level of motor control is primitive reflexes; subcortical motor control is core stability; cortical motor control includes individual patterns. DNS suggests inhibiting primitive reflexes instead of facilitating them for function. Core stabilization occurs first at 4.5 months development, then locomotion follows. All movement patterns are either ipsilateral or contralateral. The former develops in supine, and the latter in prone. “DNS Among Elite Athletes – MLB” by PJ Mainville Didn’t get much out of this one except PJ dancing around PRI 🙂 Recommended using theratube around the wrist so you can perform hand movements with PNF patterns as such. “DNS in Gynecological and Obstetrics Disorders” by Martina Jezkova When in quadruped, the pelvic floor does not create a base for the trunk and had no postural function. The
Read MoreChapter 3: Biochemical Aspects of Breathing
This is a chapter 3 summary of “Multidisciplinary Approaches to Breathing Pattern Disorders” by Leon Chaitow. The second edition will be coming out this December, and you can preorder it by clicking on the link or the photo below. The Focus When talking about breathing biochemically, the focus will be shifted toward oxygen delivery to the tissues and carbon dioxide removal. Maintaining these gases is a complex body task due to their constant fluctuations. Looking at pH is a great way to get a glimpse of the the entire body. We know the pH scale runs from 1 to 14, with the physiological normal being between 7.35 and 7.45. If we have a value at 7.5 or above, our body goes into alkalosis. An example of this would be in the case of hyperventilation. If our pH drops to 7.3, we go into acidosis. Carbon Dioxide (CO2) CO2 determines blood acidity, and comes primarily from the mitochondria. It is the biological equivalent of smoke and ash. CO2 levels can vary with exercise, as more is produced when we are training. However, pH stays balanced because oxygen demand increases. The opposite occurs when we are not exerting ourselves because CO2 is not produced as much. Another example of changing CO2 levels is during breath holding. More is not necessarily produced, but CO2 levels rise because we are not exhaling it away. This rise is what we feel when we hold our breath. Metabolic Alkalosis and Acidosis Aberrant breathing can cause respiratory
Read MoreChapter 2: Patterns of Breathing Dysfunction in Hyperventilation Syndrome and Breathing Pattern Disorders
This is a chapter 2 summary of “Multidisciplinary Approaches to Breathing Pattern Disorders” by Leon Chaitow. The second edition will be coming out this December, and you can preorder it by clicking on the link or the photo below Intro This chapter’s goal is to cover both normal and abnormal breathing patterns. Often, breathing disorders can seem similar to serious disease when in reality the patient may not be getting an adequate breath. In fact, hyperventilation syndrome (HVS) and breathing pattern disorders (BPD) have the following incidence: 10% of general medicine practice patients have HVS/BPD as their primary diagnosis. Female:male is about 2:1 to 7:1; most commonly in the 15-55 year age group. Acute HVS only makes up about 1% of cases. Normal Breathing The normal resting breathing rates equate to around 10-14 breaths per minute, which moves around 3-5 liters of air per minute through the airways. Not so Normal Breathing HVS/BPD can be defined as a pattern of overbreathing where the depth and rate are greater than the body’s metabolic needs. In some cases, such as during exercise and organic disease, hyperventilation is an appropriate response. It is when these causes are not found that we attempt to affect these breathing patterns. There are a large number of symptoms that may coincide with HVS, but none are absolutely diagnostic. Oftentimes these symptoms are exaggerated when one has a hyperventilatory episode. I will break the signs and symptoms into the following categories: Neurological Headache Numbness and tingling Giddiness/dizziness
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