On PRI and Spasmodic Exhalation…

I have two new patients that have a “spasmodic” exhalation and a cough with exhalation.  I think this was mentioned during a course but wanted to clarify the reasoning for it.

I really believe there are two components of coughing or “spasmodic” activity with deep exhalation or during or following PRI manual techniques to the chest wall. One is the oral or pharyngeal reflexes that could be stimulated and the other is the actual ‘pull’ on the hyoid, pharynx, cricothyroid and esophageal area because of overall tissue shortening/tightness of the anterior neck region, secondary to forward head posture, enlarged tongue base, accessory respiratory muscle overuse, airway narrowing (obstruction) or torsion of cervical tissue or all of the above. I see this a lot and after maintaining cervical neutrality the cough – or exhalation issues diminish.

-Ron Hruska