Posts by Skip George

Chiropractor

The "Biggest Little City", Reno, NV at the University of Nevada, sponsored its first ever PRI course July 14-15 in the Nevada Physical Therapy Sports Medicine Complex. Attendees were not only local in number but traveled from Utah, Indiana, Washington State and Southern California to attend Postural Respiration. This weekend had a powerful combination of didactic class work balanced with lab every step of the way during the weekend. PRI concepts were discussed and demonstrated to bring experience to what assessment and treatment of tri-planer respiratory function looks and feels like when a person is "lateralized", "sagittalized" and then achieving neutrality with non-manual and manual techniques. One of the students who volunteered to be assessed and treated demonstrated to the class that some cases in clinic are more challenging than others. For example, non-manual techniques were not working to allow his femurs to adduct. He was a strongly patterned Superior T-4 with an athletic background. Then, manual techniques did not work including a two person infra-clavicular pump. A brief discussion on footwear, occlusion and vision followed with no progress on his femurs adducting or any other tests becoming neutral. After a break, a 90/90 hip lift with right arm reach and a balloon (without the stress of being a lab subject in front of the class and any performance pressure) provided immediate neutrality of his pelvis and improvement of BC testing. The big take away is to always stick with it and think outside the box of possibilities including a basic PRI non-manual technique that provided much needed inhibition to his neurologic/respiratory system. My mentor and friend James Anderson, P.T. said in my first PRI class, Postural Respiration, that your patients just want to relax! Sticking with your patients and not giving up plus practitioner and patient relaxing is a strong step towards effective clinical outcomes! Shout out to Jay Henke for doing all of the behind the scenes work to make this first ever PRI event at UNR! And shout out to all of the students for being such a solid class, helping each other out and adding this power tool to their clinical tool belt! The response from the locals at UNR is that they want more PRI courses to follow!

Posted July 18, 2018 at 2:34PM
Categories: Courses

This past weekend I had the pleasure to present Postural Respiration to a diverse mix of new attendees and "veterans" of PRI at Pro Sport in Redmond, WA. I would rename this weekend "Superior T-4 Syndrome in Seattle" considering how many course attendees presented with this patho-mechanical respiratory compensation and asked so many questions about patho-mechanical rib kinematics as it relates to this subject! We had an opportunity to demonstrate in front of class at least four students that looked like they could possibly be patho-mechanical in terms of their respiration and body type.

One take away is you may suspect a positional issue but always test and retest. Two of the students demonstrated the definitive assessment of decreased left apical expansion after a Superior T-4 manual technique. Superior T-4 came up during discussion on Saturday and was a topic that came up often during the entire weekend on how to define, assess and then treat it both manually and non-manually. One of the students that had non-manual techniques provided experienced the left side of her body in a way that she expressed with an enthusiastic smile and a new place that she could feel and find in her body! In addition, she felt a bit "unstable" when she first started walking and liked it! Welcome to variability! She not only found neutral, but she experienced transitioning right to left side and back again, alternating and reciprocating, lateralizing and realizing what tri-planer position, gait and breathing is all about. What a lesson for all to see, experience and what it means to reduce the reliance on end-ranges driven by asymmetries, respiration and patterns driven by neurology!

The enthusiasm and new awareness of Superior T-4, especially for students new to PRI, was totally fun for all involved including this instructor! Thank you PRI dedicated veterans Erin Rajca and Michael Ball, both PT's and PRC's, for their help and knowledge.

This course was a joy for all with them in attendance providing energy, experience and caring. Thank you Cory and Amanda for hosting at PRO SPORT and all of your hard work! And shout out to all of the students in attendance for your most outstanding questions and persistence in wanting to understand PRI principles especially regarding Superior T-4.

Posted May 8, 2018 at 4:14PM
Categories: Courses

Exo's in Frisco, TX was the location for Postural Respiration last weekend. This course was attended by students from California, New York, New Jersey and especially Texas! Lab assistant James Guzman, PTA, MS, CSCS, PRC came up from Houston and was an essential component to the success of this weekend and enhancing the experience for all students. This class had 1/3 students brand new to PRI ,and for most of the rest participating, this was their first intro to Postural Respiration. The feed-back from the class was that Respiration really reinforced Pelvis and Myokin and reinforced the questions "can a femur adduct, can a ribcage rotate, and can a pelvis and ribcage separate movement to reciprocate and alternate?" These students took the concepts of the didactic material and applied their experience to PRI principles through testing, re-positioning and applying manual techniques. Through the process, they discovered how the PRI principle of lateralization actually occurs and what makes it so important in assessing and providing not only bilateral movement but tri-planer respiratory function as well. As always, Superior T-4 is a hot topic and lab assessment and demonstration helped the entire class discriminate between a patterned LAIC/RBC individual and one that is compensating with scalenes aided by the little muscle the could and will, subclavius. One of the huge take-away's was how Superior T-4 Syndrome affects orientation of a neck and that the bridge from respiration to cervical spine in testing is the Cervical Axial Rotation test. The class got a chance to hear Taylor Lewis MA CSCS, PRT, RKC II discuss PRI applications with Cystic Fibrosis. Thank you Brittani Cookinham, PT for all of your help in hosting this course. And thanks to all of the students, Carmela, Dana, Stephanie, Kelli, Michelle, Mario, TJ, Allison, Stephen, Alexander, Hsuan and everyone else for their spot-on questions and enthusiasm.

Posted March 28, 2018 at 3:50PM
Categories: Courses

Palm trees and a Santa Ana breeze was a refreshing respite for those who traveled from the cold parts of the country to Velocity in Redondo Beach Jan. 13-14 for Postural Respiration. Interdisciplinary was a theme as this course had P.T.'s, ATC's, D.C.'s, a D.C. Student, a DDS and an M.D. affiliated with UCLA who wants to learn PRI as part of a research project for high risk pregnancy. There was an added bonus: Chad Moreau, D.C., CSCS, PRC, the only other chiropractor who is a PRC, attended as a lab assistant. This was also the first time having two Chiro PRC's in the same course! Chad is a quiet force who also is a strength and conditioning coach for the L.A. Kings.  His clinical expertise and insights to his approach with his athlete patients painted a picture of how to apply PRI to high level athletes.

In addition, Miguel Aragoncillo, CSCS, PRT came out from Boston to assist. He is a PRT and will be entering PT school in the fall.

Chad and Miguel made the weekend a success for all of the students.

First time attendees can all relate to how overwhelming a primary course paradigm shift can be. This group asked questions (Shout out to Locatelli, Allyse, Beth, Waleed and everyone else!) that helped clarify scapular/rib positioning and TS/ST movement. This is a challenging issue for everyone then adding Superior T-4 on Sunday further paradigm shifts the group into the pathomechanics of respiration and rib/spine rotation. Thanks so much to Misao Tanioka for facilitating this weekend. She anticipated every need of the students and really helped make the weekend run smoothly. In addition, this was her first course as well! Needless to say, I love L.A.!

Posted January 18, 2018 at 9:22PM
Categories: Courses

Salem is a beautiful city about an hour's drive south of Portland depending on the traffic and time of day. My GPS routed me through rolling hills of fall colors, farmland, vineyards and past Klamath Falls. This course was hosted at Salem Health in their new rehab facility which is so busy that they are outgrowing the space just two years after construction. The facility is state-of-the-art with large windows looking at trees turning fall colors outside with green everywhere you looked. The real show was the participation of the students that had diverse professional backgrounds that included physical therapy, chiropractic, athletic training, strength and conditioning and massage therapy. There were five athletic trainers that represented two teams from major league baseball and their questions came in fast, accurate and intelligent with no curve balls! Members of the rehab team from Salem Health represented their facility by not only providing this venue but bringing energy to the whole weekend. Shout out to Mark Kucey for his recipes for an autoclave and his engineer mind with restates and questions. In fact, this entire group of students was quick with restates and questions that mattered to the rest of the class and lifted everyone's game including this faculty member! Huge kudos to lab assistant Tina Haiser, DPT, PRC and super Lisa Davis, PTA for doing the behind-the-scenes hard work of food, signing people into the course and making the weekend run smoothly for all involved.

Every course can use more time in lab is a general consensus. This weekend was no exception however lab time was ample enough to give everyone a chance to be introduced to and practice the Three Big manual techniques including L AIC, Superior T-4 and Subclavius release.

The demonstration for determining if a patient is a Superior T-4 Syndrome individual went very well considering the subject is a running coach and sees this issue in all of her patients. It was a first time for her in Postural Respiration and as a side note after the technique was demonstrated on her, she experienced a change in her neck symptoms and cuboid symptoms as well for the better. Needless to say there was no shortage of enthusiasm from the entire group and in short it was a faculty member's dream team of diverse professions sharing a common goal to help others while expanding their knowledge. One of the questions that came up is if an athlete has a pattern they rely on for performance will introducing a new pattern affect their performance? We don't want to take anyone's performance pattern away. We simply want to give them a place to find and feel new places to go in their body to rest, recover and restore.

Posted November 10, 2017 at 4:25PM
Categories: Courses

Fortius Sport and Health in Vancouver is not only a world class Mecca for athletes wanting to perform at the highest level and for patients recovering from an injury, but it is also a practitioners dream location for a progressive, state-of-the-art, and integrative environment to work in and hone their professional skills. Fortius was developed as an enormous community based sport rehab and facility in the suburb of Burnaby, near Vancouver, that includes several ice rinks, grass fields for field sports and a world class weight training facility including basketball courts and therapy pools. There is a vision center for concussion rehabilitation. Physical therapists, chiropractors, athletic trainers and sport performance specialists all work in an environment that is focused on mutual respect and collaboration to provide the very best in athlete/patient outcomes. Regular meetings are scheduled with all practitioners to discuss cases including having medical consultations available for athletes. This group of practitioners that attended, many of which were from Fortius, had their first introduction to PRI this weekend. One husband and wife team from the US had taken Postural Respiration through a home study course and loved it so much that they opened up their new clinic based on breathing and respiration principles. This was their first live course for Postural and having a hands-on experience was invaluable from their response. Jon Rowe, CSCS, PRT is the only PRT/PRC in Canada and drove 4 hours through the mountains to assist this weekend from a town called Kelowna. Jon is a quiet force and by Sunday was providing an amazing amount of insight and help to new students. Some of the questions that came up included what does PRI teach in terms of breathing? Well, let’s just start with an ability to exhale fully and pause before taking a full breath in. Combine that with a new neurologic and bio-mechanical re-position or non-manual technique and now unlocking the secrets to a balanced bi-lateral human being is possible. It seems simple to veterans of PRI that if you hope to master breathing, you must see for starters that a left hamstring, glute, IO/TA's are needed to create a left (and right) ZOA of a diaphragm. All the breathing techniques in the world aren't going to re-position, re-train or restore function and performance without this basic building block. This one concept was reinforced though out the weekend. Many thanks to Ryan Murray, DPT and Erik Torchia, DPT for hosting this weekend in such a beautiful facility, city and country.

Posted October 5, 2017 at 3:12PM
Categories: Courses

The Institute of Community Wellness and Athletics (ICWA) hosted Postural Respiration in Albuquerque, NM Sept. 9-10. This course was a faculty member's dream! Most of the class attendees were brand new to PRI or had only taken Myokin or a home study course previously. From the very start, the curiosity and attention was palpable and students followed closely every step of the way into a PRI weekend journey of challenge and discovery. Questions were plentiful with great re-states of concepts and honest feedback that, yes, the amount of information in this course can feel daunting for first time attendees but they wanted to hang in and work hard to really get it! The questions directed repetition from many angles that led to understanding of the basic principles of PRI. One of the many topics that vexes new attendees ( It certainly vexed me at first!) is Superior T-4 Syndrome. What helped was a strong foundation that everyone absorbed on rib kinematics driving a spinal column and that ribs are driven by respiration and respiration is driven by neurological patterns. These guys got it. What helped for the strength and conditioning group was that scalenes are like "Romanian Dead Lifters" lifting upper ribs creating a patho-mechanical pattern of respiration. Before lecture on James Anderson's page 50 in the Appendix on Thoracic Airflow, Typical BC and Superior T-4 Syndrome, the class had had a demonstration on a "long tall Sally/Sam" that demonstrated BC testing, then manual restoration techniques including Superior T-4 technique to assess for Superior T-4 Syndrome and then identifying when and why a manual Subclavius Release is needed. Then they assessed and practiced the two manual techniques after being shown what the reasoning behind the assessment and manual approach. The lecture into Page 50 just made sense to these new students since they could apply a concept to actual experience that they just practiced in lab and could now apply since they had a better picture in their minds as to what patho-mechanical respiration is and how to identify and treat with manual and non-manual techniques. The enthusiasm, especially on Sunday afternoon after an information/paradigm changing weekend can feel over-whelming, was just great. Thank you Nathanael Smith and Jonathan Esquibel for being great site hosts and especially Jessica Kisiel, PRT for assisting! In this faculty member's opinion, New Mexico will be a great new state for PRI and I hope to be invited back! Myokin will be there February 2018!

Posted September 11, 2017 at 7:14PM

The University of Louisville Athletic Center has an energy that just motivates you to want to perform. Home of the Cardinal's, the athletic staff including Teena Murray, Sean Smith, Chris Hays and the rest of the U of L athletics staff hosted Postural Respiration last weekend. Many thanks for the Louisville staff for hosting PRI. This was a group that was heavily weighted with strength and conditioning professionals not only from Louisville but from nearby training facilities as well. There were several DPT's and PT's that work in a hospital setting or private practice. Sarah Martin, DPT, PhD was lab assistant and was critical in making this weekend a success. One of the participants, Molly Binetti, works with Louisville Women's Volleyball and Superior T-4 Syndrome was a critical topic for her athletes as well as for Josh Kesel who is a strength coach for his pitching and performance practice for baseball pitchers. TOS, or thoracic outlet syndrome, was discussed regarding high performance athletes who compensate with scalenes and are prone to Superior T-4 Syndrome. One of the demonstrations of the manual Superior T-4 technique, to determine if Superior T-4 Syndrome exists, was performed for the group to see if a left apical chest wall deficit as opposed to the right existed. Left apical expansion was limited and a Right Subclavius Myosseous Restorative Technique to restore normal BC chamber function was provided with all PRI tests becoming neutral after this technique was provided. This individual in lab could have not been a better subject and it is always a welcomed outcome for the instructor! Even though this was a Postural Respiration course, PEC issues were discussed in detail for performance athletes and Mike Cantrell's article on Inferior T-8 syndrome is a must read for everyone. There are always PEC's who love extension for performance and one of the attendees benefited from a two person Infraclavicular Pump performed by Sarah Martin and me.

Posted August 16, 2017 at 3:14PM

Sutter Physical Therapy sponsored their first PRI course this past weekend with 31 out of 40 students being new to PRI! Roseville is located near the base of the foothills of the Sierra Nevada of California not far from where gold was discovered in 1848. This location site was a real "nugget" when it comes to students eager to learn Postural Respiration. Suzie Maciel, PT is continuing education coordinator for this facility and this was her first course as well. She and her staff provided a great location and her support was so valuable. Thank you Suzie. In addition, she and Dan Houglum went to PT school together! Taylor Lewis, PRT and PRI faculty member Dan Houglum, who came out from Wilmette, IL, were lab assistants for the weekend. This course had "ton's" of lab with time to get into manual and non-manual techniques thanks to these lab assistants. Both were complemented on evaluation forms for their knowledge and skill with applying PRI principles.

The real show, other than the Diaphragm, or "Big D", were the students that attended. Taylor, Dan and I were more than impressed (astounded really) with the insightful restates and questions from this group of students who were always "spot on" with their questions in this course. Questions pertaining to what is the relationship with the Diaphragm and walking, how this work applies to COPD and Cystic Fibrosis, and some of the personal experiences of students learning techniques and how their bodies responded were impressive! One student, an ATC who works with a major league baseball team, took his spring vacation to attend Postural Respiration and is enthusiastic about implementing PRI with the players he works with. In addition, topics of system integration, sympathetic vs. parasympathetic as it applies to extended individuals and lateralization as it applies to the concept of neutrality and transition zones were explored during this weekend of PRI discovery!

Posted May 3, 2017 at 7:12PM

Dr. Skip George talks about how breathing compensation  (Superior T-4). He also talks about how to "unlock" the right side of the ribcage to allow airflow. He also talks about how activating a hamstring and ab wall can help along with a Gonstead adjustment.
"The brain is driving the whole show"

Learn more about Postural Respiration here.

Posted May 2, 2017 at 1:31PM
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