Revolutionary Approach to Physical Medicine

Finish Line Physical Therapy, the go-to rehab and recovery clinic for runners in the NYC area, played host to last weekend’s Postural Respiration course.

Attendees across multiple disciplines (PT, chiropractic, strength and conditioning, coaching), working with a wide range of patient populations (runners, cyclists, pediatrics, pelvic health, post-partum, musicians, general orthopedics), learned about the wonder and magic of our thoracic diaphragm. We even had a rowing coach in attendance, eager to nudge the rowing world away from its outdated warm-up and cross training techniques and, instead, towards a paradigm that is far more effective in preventing and treating injury.

Over the course of two days, we explored numerous concepts related to how an individual manages their upright existence. We presented examples of ineffective diaphragm position (i.e. lacking a full zone of apposition), stemming from poor opposition from IO/TA activity, including excessive belly expansion or neck muscle activity. These individuals can no longer alternate and reciprocate their center of mass. They move themselves with overactive chains of muscles whose activity our brain is unable to sufficiently suppress. The result? Hyperinflation, sympathetic nervous system dominance, and inefficient forward locomotion and all other dynamic activity.

We had ample lab time for assessment of tests and implementation of program design to address issues associated with patterned respiratory neuromechanics for optimal kinetic outcomes. I know I speak for all of the attendees when I say fellow PRC Josh Speckman’s assistance throughout the weekend was SO helpful and much-appreciated!

-Louise Kelley ...

Spooner Physical Therapy in Chandler is a familiar hosting location that is perfect for presenting PRI courses with a physical therapy staff always pushing for more knowledge and this weekend was no exception. This diverse group of practitioners from physical therapy, chiropractic, occupational therapy and even Feldenkrais Method attended Postural Respiration with "spot on" questions and observations every step of the way during the weekend.

The topics of anatomical asymmetries, delivery of airflow sense, and the fact of lateralization to one side of the body driven by dominate polyarticular chains of muscle directed by "functional cortical dominance" was completely new to many. The form and function of the thorax driven by delivery of air into the chest wall as it related to center of mass to one side of the body is always a critical point as well as remembering that it is a neurologically driven system along with anatomical asymmetries and asymmetrical air flow that affect movement and function of the entire physiological system.

Thank you to all of the students for attending this weekend and we hope to see you further down the road on your PRI journey of exploring and discovery!

@robertskipgeorge ...

Another wonderful class attending Pelvis Restoration last weekend in Atlanta! They appreciated the details and analytical design of the course to understand the pelvic inlet and outlet to assist with forward movement and function. They had amazing questions and enthusiasm for learning. This enhanced how the PRI tests could assist them with clinical outcomes. This group gave me energy! Thank you!

Thank you Tassie Cantrell for assisting me this weekend. Your expertise and experience is a gift.

To Karen and the rest of the staff at One on One Physical Therapy—thank you for hosting and for your interest in the science of PRI. You all rock!

– Lori Thomsen ...

Attendees gathered with curious minds to learn about the human species’ propensity for patterned, inefficient respiration that directly leads to patterned, inefficient movement for our recent Postural Respiration rendition. PRI experience among attendees ran the gamut, from in-person attendee Jodi Reerink, PT, PRC, who has been around since PRI’s inception, to Drake Krogh, PTA, who was in-person for his very first continuing education course out of school.

Attendees gained newfound respect for the most important, and arguably least-understood, skeletal muscle in the body: the thoracic diaphragm, with its left-side/right-side differences in form and function. The diaphragm partners with other key muscles to direct airflow in and out of the body. This alternating, cyclical compression-decompression is sensed, not only within the lung tissue and rib cage, but also within our extremities and its corresponding joints and muscles. This sense informs the brain about position so that the brain, in turn, can direct the neuro-muscular system to preserve upright orientation.

When we lose hemi-diaphragm form and function, our movements become hijacked by overactive chains of muscles – namely, the right brachial chain, left anterior interior chain, and bilateral posterior exterior chains. As these chains exert their over-influence on movement, we become vulnerable to many of the syndromes that we treat: shortness of breath, headaches, thoracic inlet/outlet, and chronic overuse injuries. Our PRI tests and observations reflect these chains’ overactivity. Our PRI techniques re-establish the hemi-diaphragms’ form and function, the key to subduing these chains. If you aren’t incorporating airflow assessment and treatment into your patients’-clients’ programs, then you are depriving them of the key piece to rehab and recovery.

I am grateful for Katie Hedlund, Hannah Horne, Dale Jensen, and Megan Kirwan, for their willingness to act as patient models for lab demonstrations of assessments and techniques. Thank you to all who asked questions, allowing deeper discussion of concepts. I hope to see many of you again at future courses!

-Louise Kelley ...