Ron Hruska just joined twitter! Follow him @RonHruska.
We received another great question on the treatment of right ischial tendonitis…
The reason we include a discussion on left ischial tendonitis and not right is because right ischial tendonitis is often ‘cleaned up’ or treated with a conventional myokinematic approach to the treatment of the Left AIC or PEC pattern. One would start with “pulling” the anteriorly rotated pelvis back to neutral with left hamstring engagement (90-90 Supported Hip Lift with Hemibridge) then proceed with right glute max activity to “shift” the pelvis to the left and “rotate” the pelvis into left AF IR and right AF ER, therefore, reducing strain on the contracting, shortened right hamstring and the proximal attachment of the hamstring on the right ischial seat.
So in essence you would treat the right ischial tendonitis issue by using the myokinematic hierarchy of lumbo-pelvic-femoral control for the Left AIC patient that is outlined and covered in the Myokinematic Restoration class. Remember under every PEC pattern there is a Left AIC pattern, so even if your patient had right ischial tendonitis and had limited SLR on adduction levels bilaterally, I would start with the above recommendations.
The left ischial tendonitis patient will need more concomitant cooperation from the right glute max and left medial adductor and left quadricep during left heel strike and push off, to reduce left hamstring strain.
We were recently asked a great question about some of the wording in our TMCC Non-Manual techniques…
What is the reasoning for the jaw moving forward and to the left in the ‘Supine Active Sacro-Sphenoid Flexion’ technique and forward and to the right in the ‘Active Left Lateral Pterygoid in Protrusion’ technique?
Many of our patients have cranial base function oriented to the right secondary to the human spinal pattern often seen in the human right upper brachium and cranium (Right BC and Right TMCC patterns). These patterns demand on the right lateral pterygoid (mandible often seen oriented to the left) and overdeveloped right sternocleidomastoid (head and neck often seen slightly side-bent to the left and turned to the left) can be reduced by activating the left lateral pterygoid. The left lateral pterygoid assists in rotating the sphenoid or cranium to the left through its attachment on the lateral pterygoid plate of the sphenoid, and the base of the skull and upper cervical spine to the left, through lateral movement of the mandible to the right.
Movement of the mandible to the right promotes good left lateral pterygoid function for meaningful chewing on the right with a balanced forward condyle to fossa relationship on the left during the actual downward power stroke. Movement of the jaw to the right is, therefore, promoted which is so often lost on patients who are very active on their right side when they chew. Right sided chewers over-activate their right lateral pterygoids immediately preceding opening and at the end of the downward power stroke on the right, by moving their mandible to the left after each power stroke. Alternative chewing on both the left and right, is advisable as is keeping lateral pterygoid function balanced, by reducing right neck activity through left lateral pterygoid non-chewing function during the day. The ‘Active Left Lateral Pterygoid in Protrusion’ is one way to keep balanced horizontal movement during mastication and the right cervical muscles relaxed because of the left lateral pterygoid indirect action on moving the cranium (sphenoid) and occipital base (OA/AA) to the left.
Because of the direct attachment of the stylohyoid, styloglossus and stylopharyngeus on the styloid process, moving the mandible to the left “pulls” the right temporal bone into external rotation and flexion, thus reducing intercranial torsion, and intraoral cants associated with the Right Temporal Mandibular Cervical Cranial (TMCC) pattern. This technique reduces hemi-extension of the cranium, restores symmetrical cranial respiratory function and provides a complete base for the tongue to function without compensatory glossus activity. By moving the mandible to the left, the hyoid, dorsal lateral tongue and pharyngeal thyroid cartilage move also to the left, promoting alignment of the airway and pharynx of the Right TMCC patient.
It’s that time of year again…NEW SHOES! Lori Thomsen, MPT, PRC will be updating her popular shoe list before the end of the year. Please check back for our blog story once it is completed.
Also, please take a minute to read Lori’s latest blog on the discontinuation of the ASICS Foundation and Evolution HERE!
We are excited to announce the arrival of Janie’s baby girl! Gwen Mary Ebmeier was born on September 5th, weighing 6 pounds, 10 ounces and 20 inches long. Janie, Ryan and big brothers Sam and Jack couldn’t be more in love!
“I would just like to give some positive feedback. I have taken 3 of your courses, and had been working with left hip pain issues for several years. I made progress on my own using your techniques, but still faced significant impingement pain. I am seeing Sangini Rane, PT, PRC presently to work on those, and she has done a wonderful job helping me. Over several weeks, the pain that I have had for many years is diminishing. She is a great therapist - willing to work with me so that I understand your techniques in even more depth. Not only are your techniques incredibly effective, but I believe that your practitioners meet very high standards, and I am very grateful.”
Michael Mullin, ATC, PTA, PRC sent us a testimonial he titled “Clarity” on his experience with PRI over the past few years.
“I have been fortunate enough to have spent the last 10 years growing and learning through the PRI “process”, and an incredible process it has been. Over those years, I have remembered and made notes of some key phrases which at times I would just stare at Ron, James or Mike and it might not really register what they were trying to get across. As I have become more proficient and gained an enriched knowledge of PRI, some of these statements have come through with such clarity that I feel like at times I have an “Ah-ha!” moment which only further enriches my understanding.” To read more, CLICK HERE!