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Category: Breathing (page 2 of 2)

Impingement and Instability – A Recap

I spent this past weekend in lovely Phoenix, Arizona to reunite with old friends, meet the legend that is James Anderson, and learn all the things. Check out the Twitter action.


Phoenix is seriously 40 degrees warmer than Indianapolis and seven thousand less percentage humidity, so I was immediately caught off guard. Though I didn’t have my physical therapist friends test me right away, I’m pretty sure the unpredictable environment would have stolen my neutrality, had any remained after four and a half hours on a plane.

It didn’t.

I don’t get to put things in practice as much as most of the other attendees, so this overview is both for you to become aware of what the Postural Restoration Institute is doing, and for myself to cement the information.

I’ll give you some of the highlights of my notes in bullet form. Quotations will not be attributed to any one person to protect anonymity. You can assume I said the inappropriate things and that James said the intelligent things.

“PRI is neurology, but the mechanicoventilatory system is used to regulate neurology.”

This is a big deal. A lot of people think PRI’s system is just to strengthen some well-illustrated muscles. This couldn’t be further from the truth. The concept of neutrality is the centerpiece. This neutrality isn’t just a pelvis that is in the right position, but a brain that doesn’t perceive harmless stimuli as threatening. We can use these muscles, your shoes, your eyesight, and a million other things to get you neutral. My good friend and hotel-mate, Zac Cupples, gave me neutrality (albeit only for a short while) by softly saying, “Lance, just go neutral, bro.”

“Ron Hruska puts his hands on a joint – and he’s not thinking about that joint.”

That joint is the farthest thing from his mind. This ties into the previous quote. Neutrality is neurology, not biomechanics.

“Girl, that ganglia’s so hot.”

The new pickup line for women who are stuck in extension. James quickly illustrated this point to us by having my table neighbor, Maegan, stick her arms into some bands running vertically down a stretching cage. The bands represent the sympathetic trunk. Maegan’s arms represent closing of the posterior mediastinum from extension. An extended spine forces the vertebrae anteriorly, which compresses the contents of the posterior mediastinum.

Mediastinum transsection

A side note that I want to mention: this is why PRI is my crack addiction. James prioritized. He opened with the neurology talk and vividly has Maegan demonstrate to us the detriment of an extended posture. As someone who helps others learn anatomy, I admire the teaching ability of the presenters.

“Don’t fight the brain.”

This was something Mike Cantrell opened my eyes to last month at Postural Respiration. A big breath is worth nothing if it’s perceived as a threat, even if you’re doing a manual technique at the time. The purpose isn’t to get as much air in as possible. So if you see someone fighting through inhalation with their neck muscles, you need to stop that. Slow inhales. Let it come in – don’t make it come in. The same can be applied to putting weight on your right leg. You don’t need to only have your left leg down for PRI techniques to work.

“When I wear these shoes, my arm freeze up.”

Frontal plane support at the heel helps you maintain neutrality. Your soft Nike Frees could be throwing you into a state of extension. Check out the 2013 Hruska Clinic recommended shoe list.

“When I squat the way the strength coaches tell me to, I can’t get off my right quad?”

We discussed the bro mentality that more weight is always better. James suggested looking at the objective outcomes like 40-yard-dash time and vertical jump and seeing what actually improves those measures.

“How come I’m squatting heavy, but my vertical is going down?”

See above.

“Make a neurological wedding between the left heel and the floor.”

This alludes to the six reference centers they discuss. If your client can feel those, you’re doing things well. These reference centers are going to be useful when coaching exercises.

“I got Apollo Ohno right butt syndrome.”

Apollo Ohno has to turn left to be good. His right glute max is working well in the transverse plane instead of the general PEC patterned individual’s “sagittal plane only” right glute max.

“‘Trunk’ means above T8.”

This was something I had struggled with for a long time. Now the semantics make sense.

“The key to triplanar performance rests in a triplanar ZOA.”

The Zone of Apposition (ZOA) is not found unless it is found in all three planes. Thoracic abduction (a frontal plane translation), lateral flexion, rotary orientation, and extension all need to be taken care of. Abs are not a good thing if you have them without a triplanar ZOA. Use exhalation to get good abs.

“That’s my favorite weight belt called bilateral low trap.”

Picture the spine as a flagpole. Each low trap can prevent the flagpole from tipping over (in the frontal plane). A right arm reach can orient the spine back to the left. It can also get you a triplanar zone if you couple it with exhalation. Hold the reach. Inhale. Then you get right trunk rotation with filling of the right mediastinum. Right low trap is important to consider because it’s being lengthened from both ends (scapula protracts, IRs, anteriorly tilts while spinous process moves away).

Appreciate the lower trapezius!

“Serratus without low trap day at the gym? Stay home.”

The upper body musculature works together to intricately. Right upper trap opposes subclavius. Low trap is useless without serratus and vice versa.

Look at that serratus sling!

Right serratus anterior acts as a sling on the side of the chest. When this contracts, it pushes the thorax to the left side. A movement called left thoracic abduction. The left low trap pulls the spine into left thoracic abduction at the same time to reinforce this movement. And this is only the frontal plane.

“Breathing is gait and gait is breathing.”

If you don’t use the mechanicoventilatory system as a tool, you’re making things hard on yourself.

“Left pec is a stupid muscle.”

Why is he trying so hard to get air in? Just get a left ZOA instead.

 

I love PRI. It is my addiction. See you at the next course! They’re coming to Indianapolis next year…

This may have further confused my search. What should I do with the rest of my life? Well, I don’t know, but I want to be able to get people neutral. What’s the best avenue for that?

You Want to Give Me a Mouthpiece for My Foot Pain?

UPDATE (11 Dec 2013): Click here to see more recent research.

 

The problem with having specialists in so many different areas these days is that the whole problem gets neglected.

Steve has foot pain. He’s referred to a podiatrist who says, “We need to open up your foot.” Foot pain comes back after surgery because his flat feet are being driven from the top down: an anteriorly rotated inominate, internally rotated hip, knee valgus, and excessive pronation at the feet.

But how far can we extend connections like these?

It’s not too difficult to get from the hip to the foot. Brian Rothbart doesn’t stop there. (2008; Rothbart 2008)

Poor “teeth coming together-ness” associated with foot position. If that isn’t cool, I don’t know what is.

Rothbart looked at the foot, the hip, and the cranium and drew relationships between them all. The summary is that when you look at a person (more specifically, a young Mexican subject), their more pronated foot is associated with shorter vertical facial dimensions on the same side.

Looking at it in more detail, a pronated foot is linked with an anteriorly rotated innominate via the mechanism I mentioned above. It is also associated with an anteriorly rotated ipsilateral temporal bone (think bringing the mastoid process up and making it less palpable, a.k.a. counterclockwise rotation in the photo below). The sphenoid is pulled downward, and the maxilla is pushed upward. There we have it: short face! There’s a helpful radiograph in the article linked above.

 

The skull

A right innominate

Pelvic bones and temporal bones look pretty similar, don’t they?

He briefly mentions a fix for malocclusions. Check out the video below for an introduction to Advanced Lightwire Functionals.

The DO lady in that video mentioned using the ALF to treat people with autonomic problems. The central goal of the Postural Restoration Institute – as I understand it – is to get at the nervous system. We want the body to have sufficient variability to do what it wants to do. We don’t want to be stuck on our right leg. We don’t want to be stuck in extension. We don’t want to be sympathetically toned up. Realigning your temporal bones, innominates, and feet are just neutrality acting on the nervous system.

Consider another article from Rothbart (2011) where he describes a foot condition.

On a side note, does anyone have a problem with him naming this condition after himself?

In people with Rothbarts foot, the first ray (that is, metatarsal up through big toe) hovers over the ground even when the talus is neutral. The big toe can’t feel anything underneath it, so when walking, the foot pronates hard to “find the floor”. These videos on rearfoot varus and forefoot varus can help you picture it.

The neurophysiological model which Rothbart proposes helps explain why proprioceptive insoles can make people better. Contrary to traditional orthotics that offer support, these insoles simply give the foot something to feel. Rapid pronation every time your heel strikes the ground holds the body in a state of extension. Good input on the bottom of the foot sent up to the cerebellum helps keep the person’s system neutral.

And as we already talked about, this can help a lot of things. From feet, to hips, to teeth!

Make sure you step back and look at the whole person when you’re helping them; getting too focal traps you into the specialist mindset. Better to be the person who sees everything than the person who misses the big picture.

 

References

Rothbart, B. a. (2008). Vertical facial dimensions linked to abnormal foot motion. Journal of the American Podiatric Medical Association, 98(3), 189–96. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18487592

Rothbart, B. A. (2008). Malocclusions Linked to Abnormal Foot Motion. Positive Health Online. Retrieved from http://www.positivehealth.com/article/bodywork/malocclusions-linked-to-abnormal-foot-motion

Rothbart, B. A. (2011). Primus Metatarsus Supinatus (Rothbarts Foot): A common cause of musculoskeletal pain – Biomechanical vs Neurophysiological Model. Podiatry Review, 68(4), 16–18.

Breathing vs. Anxiety

By a suggestion from Bill Hartman, I’ve started to pick up on Leon Chaitow’s blog. The most recent topic was brought to him from a recent paper by Zieman and colleagues (2009) entitled The Amygdala Is a Chemosensor that Detects Carbon Dioxide and Acidosis to Elicit Fear Behavior.

He states:

So we have overbreathing leading to anxiety, which leads to overbreathing……. a real chicken-and-egg situation that demands attention to the causes of anxiety, as well as the mechanics and causes of overbreathing, to achieve ultimate restoration of health.

Underbreathing can also lead to anxiety as well.

We can find overbreathing in those who are chronic chest breathers (don’t use their diaphragm, which is the muscle on the bottom of the picture below), have irregular breathing patterns (find themselves out of breath when talking), and other things.

Diaphragm

Try to keep your CO2 levels in your lungs in order by slowing things down and taking slow, deep breaths with your belly. This can help you in your fight against anxiety.

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