On respiratory mechanics with the Sidelying Scissor Slide non-manual technique
I was just teaching someone the left SL version of the Scissor Slide non-manual technique and got confused with the breathing. I was thinking that no matter which side someone is lying on, the left adductor push down (or up) would be with the exhale and the left AF IR would be on the inhale. This is not the case, though. Why so?
This is a very good question and provides an opportunity to expand on an email response that was posted on Sept 25, 2008. Our human neuromuscular tendency is to establish more of an infinity for left pelvis descension, even when we transfer our weight over to the left side, and right pelvis ascension, again without respect for which leg we transfer our weight to, upon inhalation. This pelvis diaphragm activity upon inhalation reflects our general urge to stand and position ourselves on our right foot and hip. This overuse of musculature that neurologically establishes ease for R AFIR and R pelvic outlet IsP ER (Ischio pubo external rotation)and R SI IR (Sacral ilio internal rotation); and L AFER and L pelvic inlet IP ER (Ilio pubo external rotation) and L IS IR (Ilio sacral internal rotation) during inhalation and exhalation phases of thoracic diaphragm respiration can be addressed by learning how to breathe when the pelvis floor is placed more into a state of ascension. Therefore activity that implements more left pelvis inlet extension, internal rotation, and inlet adduction, as well as more right pelvic outlet extension, external rotation and outlet adduction upon inhalation would be desirable to reduce this asymmetrical neuro behavior pattern associated with R AFIR, L AF ER and pelvis descension on the left.
When we place someone on their right side and have them inhale upon pulling their left leg back, we will essentially activate the left ischiocondylar adductor and iliacus to extend, internally rotate and adduct the left ilium or establish left inlet IP IR, as the left pelvic outlet is flexed, externally rotated and abducted (IsP ER) by the left pubococygeus, obturator internus, and iliococcygeus muscles as the pelvis diaphragm ascends. Inhaling during this maneuver enables the posterior mediastinum and posterior pelvis/hip capsule region to “open” up. Exhaling as you maintain the above postion reinforces respiration with more overall pelvis ascension. When you place someone on their left side and have them exhale as they move or push their right leg forward you are essentially asking them to move their pelvis, into a right pelvic outlet ischio pubo internal rotation state or a R AF ER state, through activation of the right piriformis, coccygeus, and gluteus maximus musculature. You would ask the patient to inhale to help maintain more of a right pelvis descension state during inhalation, to help offset the neuro positional pattern of this pelvic diaphragm, that overall is acting more in an ascension state, regardless of which leg one stands on. Slightly lifting your bottom leg or knee during inhalation will engage your left ischiocondylar adductor and compliment the pulling action of this muscle on the pube for right femoral and acetabular advancement, as right pelvis descension and left pelvis ascension positions are maintained, during thoracic diaphragmatic respiration. - Ron Hruska, MPA, PT