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Yesterday I highlighted common problems that may occur when initiating a Myokinematic Restoration program.  Today I will cover common dilemmas in a Postural Respiration program:

1.  Can’t reduce left rib flare

Open right low back – inhibit right quadratus lumborum.
Right Superior T4 manual technique or two person Infraclavicular Pump with emphasis on proprioceptive integration of inhalation on right and exhalation on left.
90-90 abdominal integration without use of hip flexors.

2.  Can’t realize 70-80% of passive right HG IR

Restore left horizontal abduction and cervical axial rotation to the left.  Guide right humeral internal rotation with hand placement on volar forearm to inhibit HG ER guarding.
Supine Resisted Right HG IR with Left HG ER to fatigue right teres minor and infraspinatus, followed by Supine Resisted Right HG IR with Weighted Left HG ER.
Two person Right Subclavius manual technique.

3.  Can’t achieve 45% of left upper extremity horizontal abduction

Supine Hooklying T8 Extension
Paraspinal Release
Standing Hip Flexor Stretch
Sternal Positional Stretch

4.  Can’t expand right chest with left chest wall resisted expansion

Improve right thoracic rotation with technique that places a rolled towel along the left paraspinals when in supine.
PRI Supine Weighted Punch (right serratus anterior) with Right Apical Expansion and (left latissimus dorsi) Left Resisted HG IR.
Two person Superior T4 with right arm distraction from mid range flexion to full flexion (end range) during inhalation.

5.  Can’t blow up a balloon without pinching balloon neck

Allow patient to blow balloon and pinch neck during inhalation at first.  Then practice tongue up during pinch. Then attempt again normal balloon process with epiglottis sealed by tongue.
Can they perform Supine Hooklying Restorative Synchronized Resisted Glute without arching back?
Consider blowing up a balloon correctly in seated position first to allow for posterior mediastinal expansion.  Then go back to supine hooklying position.

Tommorrow we will end this series on Common Dilemmas with a Cervical-Cranio-Mandibular Restoration program!

Posted November 4, 2008 at 11:15AM
Categories: Courses


For those of you tuning in the last few days, we have been discussing common dilemmas that occur with a PRI program.  Today we will highlight dilemmas that occur when instructing a Myokinematic Restoration program and offer suggestions on how to correct the dilemma:

1.  Can’t find and feel left hamstring

In a 90-90 position use the isotrainer ledge or similar set up to disengage paravertebrals
Blow up a balloon in a 90-90 position with right arm reach and toes off the wall

2.  Can’t find and feel left adductor

Allow the patient to ‘roll’ entire torso and hip back upon Right Sidelying Left Adductor Pull Back during inhalation.  Upon exhalation, contract the left abdominals - left knee into right thigh or ball
Right Sidelying Knee to Knee – we often forget about this co-contraction adductor technique
Left Sidelying Knee Toward Knee with Left Trunk Rotation – move knee with left abs on and during state of inhalation

3.  Can’t find and feel right glute max

Single Leg Wall Left AF IR with Right Glute Max
Standing Supported Right AF ER with Right Glute Max
Left Retro Stairs with left AF IR Stance, left foot one step higher than the right.  Focus on right AF ER / glute max facilitation

4.  Can’t abduct right leg without right low back activity

Un-Resisted Single Leg Lateral Dip - emphasis on simultaneous right cervical and left thoracic abduction
Sidelying Swiss Ball with Passive Apical Expansion - focus on contracting left IO/TA’s upon inhalation, hold and then attempt to raise right leg with hip abductors
Standing Resisted Adductor Pull in -left leg in left thoracic abduction

5.  Can’t inhibit left TFL or left hip flexors

Single Left Leg Kneeling with right hip flexion
Right Sidelying Left Glute Med in Hip Extension - push left knee into the wall above
Right Sidelying Left Anterior Glute Med with TFL Inhibition - push left thigh into post

Tommorrow we will highlight common dilemmas that take place with a Postural Respiration program!


Posted November 3, 2008 at 11:16AM
Categories: Courses

During the 1st annual PRC conference that took place in Minneapolis, Minnesota, Mike Cantrell, Holly Spence and Jen Poulin took a break from the action and happily demonstrated their ability to squat!  We are so proud of them on so many levels…especially Level 5!!

1st Annual PRC conference

Posted October 30, 2008 at 8:57AM
Categories: Clinicians

"System Integrational Dilemmas" was the title of the presentation Ron Hruska gave to the PRC therapists this past weekend.  Over the next few days, I will share with you topics highlighted during this presentation. 

To help you better understand the information presented in this talk you should appreciate the difference between a system and a dilemma:

System – The human body regarded as a functional physiological unit

Dilemma – A situation that requires a choice between options, usually equally unfavorable or mutually exclusive

Most PRI dilemmas are reduced or resolved (albeit temporarily) by:

1.  Not approaching the dilemma as ‘head on feet’ or ‘feet influences on head’ issues.
2.  Focusing more on frontal plane muscle that is not integrating with it’s ‘family’.
3.  Co-contracting left IO’s and TA’s during inhalation in a lumbar-thoracic flexion state.
4. Facilitating ‘Left Stance in Right AF IR Position from the Right AIC Pattern’ or by delaying ‘Left Stance in Left AF IR Position from the Left AIC Pattern’ (see previous Techniques of the Week).
5.  Reinforcing proprioceptive and mechanoreceptor ‘feel’ and movement of right apical expansion in a left thoracic abducted state.

Stay tuned to learn the other five reasons PRI dilemmas are reduced or resolved…

Posted October 30, 2008 at 8:53AM
Categories: Courses

If you caught yesterday’s blog…here are the other five reasons PRI dilemmas are reduced or resolved:

6.  Leading with left hand and right leg to encourage right arm extension (right thoracic rotation).
7.  Achieving a reverse squat from a PRI level 4 Squat Test.
Squat test
8. Occasionally focusing on a target with left eye during upright (standing or seated) diaphragmatic breathing.
9.  Keeping tongue up with right upper extremity demands.
10. Walking counterclockwise periodically throughout the day with calcaneal stabilization footwear and mid arch contact.

Next week we will discuss common Myokinematic Restoration, Postural Respiration, and Cervical-Cranio-Mandibular Restoration dilemmas.

Posted October 30, 2008 at 8:50AM
Categories: Courses

If you are registered to attend the Cervical Cranio Mandibular Restoration course in Lincoln, Nebraska on November your hotel reservations now!  The hotel room block will end this Friday the 31st!  To contact Chase Suites, click here!  To receive our discounted rate, ask for Roxanne!  See you in November!

Posted October 29, 2008 at 8:59AM
Categories: Courses
  • Failure to address pain and hypomobility
  • Failure to follow progression steps
  • Failure to ensure proper patterns of movement
  • Failure to ensure proper muscle firing sequences
  • Allowing incorrect movement patterns
  • Failure to understand the mechanics of selected movements
  • Failure to understand demands of patient’s functional activities
  • Failure to involve the whole kinetic chain
  • Failure to rehabilitate deceleration and acceleration components of movement

Scientific foundations and principles of practice in musculoskeletal rehabilitation. Magee, Zachazewski, Quillen. 2007

Posted October 28, 2008 at 9:02AM
Categories: Courses

For those that attended the Impingement and Instability course in Minneapolis, Minnesota this past weekend and would like the information on Cervical Afferent Reflexes, click here!  To obtain the information on Type I treatment guidelines, click here!

Posted October 25, 2008 at 9:29AM
Categories: Courses

We recently re-opened two courses that we’re previously listed as “full”. Our Impingement & Instability course this weekend in Minneapolis now has one opening. Also, our Advanced Integration course scheduled for December 4-7 has 6 openings. Please register at your earliest convenience as space is limited. We hope to see you soon! Thanks.

Posted October 24, 2008 at 9:33AM
Categories: Courses

What are your favorite activities to isolate the left abdominals and to inhibit the hip flexors?

60-60 Supine Twists
60-60 Supine Twists

60-60 Sidelying Twists
60-60 Sidelying Twists

Sidelying Crossovers
Sidelying Crossovers

Right Sidelying Knee Toward Knee with Balloon
Right Sidelying Knee Toward Knee with Balloon

Left Sidelying IO/TA Foot Toward Foot
Left Sidelying IO/TA Foot Toward Foot

Sidelying Hip Lift
Sidelying Hip Lift

Sidelying Trunk Lift
Sidelying Trunk Lift

Left Sidelying Supported Hip Lift
Left Sidelying Supported Hip Lift

“These are my favorite activities to give individuals with juvenile kyphosis, scoliosis, spondylolisthesis, PEC patterns, and runners”.

What is the most consistent, reinforced, feed-forward integrated muscle group in PRI?
“Left IO’s and left TA’s.”

What is the most common muscle group missed in a PRI integrated program?
“Left abdominals.”

To learn more about PRI non-manual techniques, click here!

Posted October 23, 2008 at 9:54AM
Categories: Techniques


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