Posts by Skip George

Chiropractor

Rosencutter Ultra Fitness, also known as Rosen-Cutting Edge Fitness, was the location of their second hosted PRI course this past weekend. Nick Rosencutter is always looking for a way to help his clients improve whether it is thru strength and conditioning, nutrition, the latest in soft tissue workand especially PRI as it applies to performance and rehabilitation. Rosencutter Ultra Fitness had six of their trainers in attendance including Nick and they have a team approach integrating PRI into client programming. Position prep is part of their programming to provide sense awareness for neutrality before, during and after workouts. We discussed this weekend that PRI loves extension for power and performance--we just don't want you to stay in extension. Equally, and perhaps more important, is the issue of rest and neutrality via flexing into neutral with adequate rib internal rotation.

The job of strength and conditioning professionals is to help clients and athletes become stronger, faster, more skilled at movement and especially durable whether you are a grandmother picking up grand kids or an olympic speed skater. Since this class was attended by so many strength and conditioning individuals, the issue of "saggitalization" was explored as well as the ability or inability to maintain or achieve competent transverse plane-ability in rotational sports. Since all sports require rotation for power and performance, the ability to orient a pelvis fully left and right then have adequate and full counter rotation of a ribcage is a must for what is known as separation of torso and pelvis.

Testing and non-manual techniques are always "ah ha" moments as they relate to position pelvis, femur, ribcage, scapulae and even neck. What is driving these positions in this course and the best answer when a student is called upon? The diaphragm of course! Manual techniques included the big three that we cover in Postural Respiration as well as a two person infra-clavicular pump that is often needed for a person that loves to stay in extension even after the best efforts via non-manual techniques to get them neutral. Also in attendance were physical therapists, a massage therapist and an ATC from Alaska who was travelling locally with the hockey team he works with. Shout out to Nick and all of his staff for their support and enthusiasm this weekend.

Posted September 19, 2019 at 4:05PM
Categories: Courses Techniques Science

"Wow" was the word of the weekend at Cantrell Center for Physical Therapy, Sports Medicine and Wellness. This was one of the most enthusiastic groups this faculty member has observed with half of the attendees being new to PRI. In addition, The Cantrell Center had half of the total number of students in attendance which made this a real team effort for their facility and created a stronger culture of PRI for their facility. What I loved about this group was the balance of great questions and re-states from every one of the new students as well as the "veterans". There were two PRC's, including lab assistant Ken Smith, who stated what we all experience attending a PRI course-no matter how many courses we have had is that there is always more to absorb and learn!

Cantrell Center Exercise Physiologist "Gentle" Giant Jalen Lawrence asked some great questions on how to apply PRI to power lifting and being able to learn how to better "axial load" when lifting. This was one of the most important questions for his athletes. In addition, we discussed that PRI loves extension for performance. We just don't want to live there all the time and that flexing and internally rotating ribs is needed to down-regulate a system and help restore autonomic balance. HRV or heart rate variability was discussed in the context of Postural Respiration concepts. Autonomic function with parasympathetic inhibition upon inhalation vs. parasympathetic facilitation upon exhalation was discussed as a needed balance for HRV. Since breathing is such a common dysfunction, considering most of our patients present in a hyper-inflated, neurologically extended state, understanding diaphragm function and airflow management is a critical issue. This is not only an issue with people that come into our clinics with pain and dysfunction. It is a performance/recovery issue as well. Shout out to Mehmet, Marion and Michael from Florida who asked great questions and brought great energy. Thank you to all in attendance for making my weekend flow so well with all of you especially the "Cantrell Gang" who can collaborate and apply PRI in a supportive setting. Ken Smith, PTA, PRC was golden as our lab assistant and his energy helped move all of us along. Finally, thank you Tassie Cantrell for such a beautiful facility, great food and wonderful staff that attended and helped all weekend with set-up and clean-up duties.

What a group of course attendees that came to Postural Respiration hosted by Alta Bates Summit Physical Therapy in Oakland, CA! First timers really shined in terms of curiosity and questions to absorb the foundations of PRI. There were students that traveled as far away as Alaska, Hawaii and Washington State. The course started out with definitions. What is posture and how do you define it? What is neutral rib alignment in a dynamic, tri-planer context? What does respiration have to do with posture and alignment?

Skip George presenting Postural Respiration for the Postural restoration Institute

Skip George demonstrating thoracic rotation at a Postural Restoration course

The veterans with PRI were exposed to the new and revised Postural Respiration course and the feedback from them was really enthusiastic. One of the new attendees wanted just a little more lab time so he was chosen as the subject of a review of all of the AIC/BC tests Sunday afternoon. Non-manual and single person manual techniques did not get him inhibit is neurological system and at 3:45pm on Sunday, a little PRI magic had to appear! After all, it was the bottom of the ninth, nearly 40 pairs of student eyes are watching and is the student going to experience what it is like to be neutral for perhaps the first time since he was an infant? Taylor Lewis, PRT, a veteran lab assistant (And great guy who uses PRI with Cystic Fibrosis patients) assisted with a two person infraclavicular pump. This young athletic man who was demonstrated on was also a prime example of what one would imagine as having perfect posture on visual inspection (could even win an award for it!) standing nice and tall. Problem was, all of his PRI tests were positive and he was neurologically extended head to toe! After this two person manual technique was performed, all PRI tests became negative, much to his delight including class attendees and maybe even the course instructor! He sat up and said "I feel sooo good and relaxed!".

Lab demonstration at Postural Respiration course

Lab this weekend with testing, non-manual techniques and manual techniques was totally fun for everyone and was a great balance to didactic learning going from concept to experience and then having this last lab to send everyone home with as to what is possible when you just keep exploring treatment options with PRI techniques. Thank you Taylor Lewis, PRT, Carol Kahn, PT, PRC as my lab assistants but also thank you ,Tim Dempsey, PRT, for attending while also helping as a third assistant over the weekend. These courses take a lot of work by the host site. Thank you Shaun Buchanan, PT, Marcela Larrondo, PT, Joan Sheppard-Mellows and the rest of the supporting crew from Alta Bates Summit Physical Therapy.

90-90 positioning PRI

PRI Lab demonstration

Mizzou Therapy Services located at the Missouri Orthopaedic Institute hosted it's first PRI course, Postural Respiration, this past weekend in a beautiful state-of-the-art facility. What made this weekend significant was that nearly two thirds of the attendees were from Mizzou Therapy Services or new to PRI. This holds the promise of a great opportunity for these therapists to collaborate, practice and potentially master the manual and non-manual PRI techniques taught this weekend.

This is the first time this instructor has taught a course with so many participants from the same facility and the energy and enthusiasm from these talented therapists was inspirational! Since most of the class was new to PRI and attending their first course, PRI principles were broken down in detail to provide a solid foundation to a brand new paradigm. Many of the therapists immediately saw the value of Postural Respiration with working with their COPD patients, athletes from the University of Missouri as well as geriatric populations.

Postural Respiration has been updated and revised just this year and Posterior Mediastinum could be another name for this course. Patterns, position and posture of the diaphragm affecting every vital system in the body were defined and explored this weekend. Columbia, MO is a great college town and has tradition at their sports games from their fans. On one side of a group of fans they will shout " M-I-Z" followed by the other group answering "Z-O-U!" for MIZZOU! This weekend the therapists at Mizzou Therapy Services have a new chant which is "M-I-Z" ---"Z-O-A!" for the new awareness of "Zone of Apposition" as described in Postural Respiration!

Many thanks to Joe Pope, PT, PRC for driving in from Eldon, MO to assist. His expertise and skill at describing and expanding on PRI principles and his lab assistance was invaluable. Joe is thoughtful and articulate with his responses and patience. Thank you to all of the staff at MTS including Lindsey, Laura, Mackinzie, Barbie, Katie and all others that helped to organize and clean up at the end of the day. Your energy and assistance with providing such a great facility was much appreciated.

Posted February 8, 2019 at 7:06PM

Santa Barbara is one of California's beautiful towns and would be considered one of our seaside gems. Prevail Conditioning and Performance Center was the location of Postural Respiration this past weekend. Owner and operator, Peter Blumert, provided a superior training facility for this weekend which followed his hosting Myokinematic Restoration last November. This weekend was a first for PRI! We introduced our latest revision of Postural Respiration. This course is packed with new material including a new test for posterior mediastinum inhibition called the posterior mediastinum reach test. There have been new documents added to support PRI concepts with loads of references for this course. In addition, case studies have been added and were a big hit with our students!

This was a course loaded with professionals in not only physical therapy, athletic training and sports performance but included an osteopath as well. Postural Respiration really describes how the diaphragm affects every system in the body. This course connects pelvis position to the ribcage and illustrates that breathing can be viewed as the gait cycle allowing ribcages to actually walk! That seems like such a far-fetched concept to those new to PRI on day one of the course and seems like such a bold statement. By the end of the weekend, every student could see that breathing is walking and the diaphragm and ribcage position and posture is key to tri-planer, dynamic, balanced gait.

We also had a chance to introduce the effects of the diaphragm and the ribcage to the cervical spine and jaw as well. The connection with Postural Respiration and the neck and jaw was experienced by a student when testing HGIR, or internal rotation of a Humerus in a glenoid fossa. She experienced jaw pain during HGIR testing and learned there was a connection of the Omohyoid with shoulder blade, neck and jaw. This was reinforced when the manual technique to release her subclavius muscle was demonstrated. Not only did this technique make her tests neutral but her jaw pain was gone. She also understood that with any manual technique, a non-manual technique and progression via treatment guidelines will be needed. Needless to say she was enthusiastic about continuing her PRI journey! Thank you to Aimee Miyazawa, ATC, PRT for being a seasoned veteran of PRI and a wonderful lab assistant. Thanks again to Peter Blumert for hosting this course as he welcomes Pelvis Restoration later this year.

Posted January 24, 2019 at 9:00PM

Diakadi Fitness located in the City by The Bay, San Francisco hosted its first PRI course this past weekend. Attendees came from as far away as Japan and Ottawa, Canada and represented a wide range of professions including physical therapy, chiropractic, dentistry, athletic training, strength and conditioning and massage therapy. Over 2/3 of the class were first time attendees to a PRI course with many in attendance their first time taking Postural Respiration. The shift in thinking from a more traditional orthopedic approach to concepts like lateralization, balancing asymmetries, neutrality, stabilization vs. motion control, the effect of the diaphragm on the direction a pelvis will turn with ribcage kinematic influence on spinal rotation and how to test and treat via PRI principles was profound for the group. As always, pathomechanical compensations for breathing defined by Superior T-4 syndrome were discussed in detail and presented a new "paradigm" or way of observing and thinking how reliance on accessory muscles can create dysfunctional patterns of breathing and movement. One new attendee volunteered and briefly discussed the effects that PTSD can have creating a sympathetic response affecting every system in the body. He was in the military for four years then a firefighter/paramedic for six years and the lesson is each person brings a unique history with them into our clinics. In addition, he grinds his teeth at night so integration with other health professionals is always a must when needed. Thanks to Caleb Chiu and Joe Cincinelli for lab assisting and Tiana and Andrea for helping with sign ups and hosting duties!

Posted November 7, 2018 at 10:55PM
Categories: Courses

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
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