Posts by Skip George

Chiropractor

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

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
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