Day 3 was the first appearance of James Anderson, and this dude knocked it out of the park.
Ron is, well, the king. Lori is the empathizer. Cantrell has patience. J-Poo (THE Jen Poulin) helps you apply. And James makes things visual.
And none of them will baby you.
They’re some of the best teachers in the world, and James made sure we knew that.
Thoracic Scapula Gait Kinematics
PRI is an iceberg.
When Bill first exposed us to it at IFAST several years ago, we saw the tip of the iceberg.
“Oh, so you should foam roll your right adductor, do right clamshells, and left adductor pullbacks.”
The Myokinematic Restoration manual lists a treatment algorithm based on position and pathology. Seeing and feeling the changes from repositioning had me hooked immediately. So, naturally, we had an exercise for each of the first four sections and everyone did them. But can you break stuff down that easily?
Turns out you can’t.
Our initial vision only saw the tip of the iceberg. Now that I’m underwater, I can appreciate just how broad and complex this PRI thing is. My goal with these blogs is to convey this complexity to all of the people who invest their time reading my words.
I try not to post much directly from the manual because I think you should get it and go through it for yourself, but the following list opened the Day 3 section of our manual and I think it is a good representation of the depth of the PRI rabbit hole:
Right Brachial Chain (R BC) or Posterior Exterior Chain (PEC) gait patterns reflect:
body structure (endomorph, ectomorph, mesomorph)
bilateral or hemi – paravertebral extensor tone
breathing pattern (ZOA opposition)
frontal plane dysfunction
cranial neurological orientation (conscious and subconscious)
girdle impingements (temporal, scapula, or pelvic innominate)
(PRI AI 2014 Manual, p. 162)
Are you considering all of the possibilities?
Bet you didn’t consider the possibility of this picture
Here are the main concepts of this section
The upper body gait affects the lower body gait
The trunk consists of about half of our body weight
If the upper extremity is not stable and mobile, you’ll create a new set of feet on your hands.
Okay, so on to gait. When during gait is my head directly over my feet?
Midstance, correct. Now when is my potential energy highest?
Mistance, correct, because center of gravity (COG) is highest there. What makes it higher?
Thoracic extension, correct. Man you’re good at this. So if I drive more thoracic extension, my COG will go up. If I start up higher like this, but I still need to control my gait, what is needed?
More kinetic energy, correct. Because energy is conserved and, during gait, it is shifted between potential and kinetic energy based on where you are in the gait cycle. This is a simple view, but still effective for learning. Now can I access the kinetic energy I need if I am unable to flex my thorax?
No I can’t, you are correct. So I can’t transfer energy well. Picture efficiency of gait as being like water. Dissention and fighting the forces of nature does not help you, you need to learn to go with the flow.
Normal sagittal plane motion of the shoulder during gait is 6 degrees of flexion and 24 degrees of extension (PRI 2014 AI Manual, p. 166). If I don’t have that arm swing, do you think I’m walking effciently? No way. I don’t have the arm swing to help decelerate trunk rotation and my back has to start working overtime. I’m walking with two feet on my feet and two feet on my hands. I’m no longer a biped.
Same goes for all of those other bullets we talked about. Can’t flex your thorax? You suck at making kinetic energy during gait. Can’t IR your left hip? Can’t IR your right shoulder? Can’t rotate your thorax? Maybe I only notice my right visual field and these limitations are driven from that.
What about those people who can’t stop looking at the ground? As I was giving some exercises to one of our more tenured clients the other day, her positions looked great, except that her head was down. Way down. When I asked her to bring it up and look at the garage 75 feet away, she broke down. Her shakes made it look like a deadlift PR. She needs help learning how to manage space.
Because, you see, if she’s looking down (cervical flexion), then her thorax is extended. In order to flex the thorax, she needs to appreciate appropriate cervical extension. Instead of referencing the ground with her feet, she uses her eyes.
“You need to learn how to push on the floor or the floor will push on you.” -James Anderson
If we don’t help her learn how to manage space, she’ll use her neck. Do any of your clients have neck stiffness? I know mine do.
Day 3 Conclusion
I hope the physics talk about gait and energy helped you (I know it helped me to go through it).
The majority of James’s talk was on the Superior T4 Syndrome patient, where the right neck becomes overactive. There are complex implications in the position of the rib cage, rotation of the thorax, and various thoracic musculature. You’ll have to get him to tell you about those things. I went over some of it in last month’s Elite Training Mentorship video.
Other bullets from Day 3:
On rectus abdominis: “I can’t tell if it’s my back or my abs, but the truth is… it’s BOTH.” -James Anderson
You need a pec to develop power, but not to move a thorax.
When you see a varus (like in the tibia or the calcaneus), you know they need to overpronate if they’re going to find the floor.
Day two was all about frontal and transverse integration and consisted of great presentations from Mike Cantrell and Lori Thomsen. I can’t say enough good things about these two.
I’ve met Mike before and there is not a single person in this world that cares more about teaching you than he does. I like to think that I am similar, but this dude blows me out of the water.
I had the pleasure of finally meeting Mrs. Lori Thomsen during Advanced Integration. She may not think she’s funny, but some of the most hilarious antics I have ever been a part of went down that weekend. And they were all her doing. Very excited to welcome her to her new home away from home in Indianapolis when she comes to teach the Pelvis course in March (you better be there).
I’m going to break this day down by each of the speakers and some of the highlights they had to say.
DISCLAIMER: this post will reference PRI tests. If you are unfamiliar with them, you will be lost.
The biggest take home point is that pathology occurs when you can’t maintain flexion while moving in the frontal and transverse planes.
For those who are unfamiliar with PRI, they have three foundational courses: the leg course (Myokinematic Restoration), the arm course (Postural Respiration), and the pelvis course (Pelvis Restoration).
Lori put together the pelvis course, so she went through the pelvis tests with us.
The Adduction Drop Test: can the left innominate of the pelvis get to neutral?
The Pelvic Ascension Drop Test: can the left innominate extend? Can I get into stance phase of gait?
The Passive Abduction Raise Test: can my innominate get into swing phase?
Important clarification: these tests tell me a lot of things in addition to the bullets listed above. I will not go into all possible presentations and what they mean. It is helpful for me, however, to think of these tests in terms of the gait cycle as Lori presented them.
Moving on, we talked about PECs. This acronym signifies a person who uses their back a lot.
DEFINITION. PEC: posterior exterior chain of muscles; person with these muscles facilitated.
This PEC pattern drives extension. Very active people often fall into this category because strong backs lead to strong people. The purest example of a PEC is a 100m sprinter.
You may not want to take that away from a competing athlete because it may make them slower. If they need greater movement variability (i.e. their sport/activity has more frontal and transverse plane demands), they probably need to learn how to shut down that PEC.
Some PECs are just locked up, and Lori suggested using alternating activities to help free these people up. The caveat, however, is that they need to have at least a 1/5 on the Hruska Adduction Lift Test, or else they don’t have abs for alternating.
After the PEC is inhibited, the person regresses to a left AIC or to neutral.
DEFINITION. Left AIC: left anterior interior chain of muscles; L diaphragm, L psoas, L iliacus, L vastus lateralis, and L biceps femoris; drives contralateral stance phase.
DEFINITION. Neutral: “the human body posture is in a position in which a set of muscles [left AIC, right BC, and right TMCC] is disengaged.” (AI 2014 manual, p. 78)
Lori also went through the Respiratory Adductor Pullback non-manual technique and explained how it was a frontal plane exercise. This was an AH-HA! moment for me because it has always looked like a transverse plane exercise to my feeble mind. The following picture diagrams the exercise for those of you who are familiar with it. Basically, we “inhale and pull back” to put the exhaled left posterior outlet in a state of greater inhalation, and we “exhale and push the knee down” to put the inhaled left anterior inlet in a state of greater exhalation. This allows the pelvic diaphragm to rise on the left and helps us achieve stance phase on the left side.
Lastly, there was another brilliant takeaway in coaching wall squats: If they can’t feel their quads, they’re using their backs.
The “hips back” cue is becoming more and more scarce in my coaching.
Seriously, Lori is fantastic. Can’t wait to see more of her at IFAST in March.
Before we get too far into what he talked about during Day 2 of the course, I want to mention that Mike received an award for being such a great teacher. Nobody is more deserving than this man.
Mike started by asking us if we though SI fusion was usually a good strategy for treatment. The class consensus was no, at least before trying less invasive treatment.
“Why are ya’ll fusing SI joints then?”
He then talked about the “posterior gluteus medius” for a long time. I put it in quotes because it was really a talk about the frontal plane.
“The dirty little secret of PRI is that we’re not good at right stance either.”
We are not good at getting to the left, which makes us bad at left stance, but we’re also OVERlateralized to the right, making us bad at right stance.
Summary of this talk: if your right glute max doesn’t put you in your left hip, you’re just fusing an SI joint.
He also broke down the Hruska Adduction Lift Test, going through all of the frontal plane for which you could ever ask. Sometimes you just need to put them in sidelying and WATCH THEM SWEAT.
Here’s a sweet picture of that talk.
After day two, an unnamed accomplice helped us break into Ron’s office that night, where a few of us abused his desk.
After days of heavy information, travel, and other matters, this break for laughter was much needed. I am eternally grateful to have been a part of this.
Though I think the gold is supposed to be a secret, this picture shows how funny it was:
One of the things that sets PRI apart from other courses is their ability to teach. There’s a whole section in the Advanced Integration manual where you color a bunch of anatomy by what “family” they are in.
Frontal – Adduction
Frontal – Abduction
This instructor-guided color coding helps you understand the integration of anatomy so well.
I was just talking about this yesterday with my coworker Jae Chung, but anatomy is one of the more difficult pieces of this model to understand. With this difficulty, however, comes a huge payoff which cannot be overvalued.
Day 2 Conclusion
Think in the frontal plane. And learn your anatomy.
Foreword: This is part 1 of a four part series of posts. All parts have all been published, so here is part I, part II, part III, and part IV.
Over a month has gone by, and I’m still going through the material from PRI’s 2014 Advanced Integration course.
You know, it’s funny: during the course, I thought I was grossly underprepared to take much away. It was as if Ron Hruska, the primary presenter and founder of the Institute, was continously devouring my brain. By the end, he was just picking at a carcass.
Look at that carnivore. And my neurotic note taking habits.
But after reviewing some things, I don’t feel as bad. There’s still a ton I missed, but there’s also a ton I gained.
Disclaimer: This post is for people who want to learn and explore about the human body. I don’t know this stuff well enough to make it simple. I also ask that you think of this post as more of a conversation, as I’m not tied down to most of the information in here.
Rationale for reading: Hope to improve my ability to keep clients accountable. Recommendation from Zach Moore.
Book summary: Quote from Ariely: “Our irrational behaviors are neither random nor senseless—they are systematic and predictable.” (p. 239)
Review summary: Use relativity to your advantage. Set a new anchor and be more like Starbucks. Don’t switch between social norms and market norms. Keep your clients feeling positive emotions. Shut the doors that suck your life force away. Manage expectations.
Suggested audience: Anyone who interacts with people, especially if you coach them to change their habits.
Dan Ariely became interested in behavioral economics after he was hospitalized, sustaining injuries from an explosion.
If you want a visceral reaction, just think about how painful it must have been to have bandages ripped off of his entire body. Over and over and over again. As someone who has been in a moderately-severe motorcycle accident, the effect this thought has on my body is amazing.
“Predictably Irrational” is an amalgamation of Ariely’s research that provides insight into how our minds work. There’s a lot in this book, so I’m going to pick a few points I think are more applicable to fitness and talk about those.
Product Decoys and Dating
Relativity is a great way to illustrate how reality is based on our perception of the things around us. Take this picture, for example.
Both the blue circles are the same size, but the environment (black circles) around them make them appear much different.
Think about this in terms of selecting which gym membership you want. You have two options: (A) gives me 1x/month one-on-one personal training for $199 and (B) gives me 4 semi-private training sessions and full use of the gym during the month for $199. It’s difficult to compare A to B.
But let’s say I throw in a third option (B-) which gives me 4 semi-private training sessions for $199/month, but no use of the open gym. Now I may not know if A is better than B, but I surely realize that B is better than B-. And if B is better than B-, it’s probably better than A as well. People are more likely to pick option B.
How can I use this as a fitness professional? I can set up training packages in a way that drive people to the most beneficial package. I could include a free group forum so that clients can keep themselves and others accountable. I can see them for shorter times but at a higher frequency. The possibilities are endless.
Starbucks and Paying for a Trainer
Mark Twain once wrote the following about Tom Sawyer: “Tom had discovered a great law of human action, namely, that in order to make a man covet a thing, it is only necessary to make the thing difficult to attain.”
I’m reminded of the Romeo & Juliet effect from Cialdini’s Influence: Stop telling me I shouldn’t date her if you don’t want me to date her. All you’re doing is inciting a (predictable) fire of (irrational) passion.
Ariely presents the concept of arbitrary coherence, which is really just another illustration of perception.
Let’s say I have someone who has never worked out in their life, never worked with a trainer, and never even had a gym membership. What do they know about how much working out should cost them? Nothing.
Well, almost nothing.
They’ve seen commercials on TV and the billboards on their commute that say, “Join LA Fitness now for only $30/month!”
“Wow, exercise is cheap,” they think. Then when they come to you, they say, “LA Fitness costs $30/month. Your LOWEST price is $199/month. That’s ridiculous!”
They can’t see the added value that you bring that makes you worth the extra money. They think all exercise is just exercise. Now you must show and tell them why you’re better. Remember, if you don’t convince them to stay, you can’t help them.
In order to avoid the negative effects of arbitrary coherence, think about Starbucks. They’re a coffee company, right?
Not quite. What are they really? Are Starbucksand Dunkin’Donuts the same experience?
Starbucks sells pastries, tea, French presses, and whole coffee beans. They have all those fancy machines back there to make those Macchiatos, Frappuccinos, and Caffè Mistos. They sell a venti coffee, not a large coffee. For two places that both sell coffee, they couldn’t be more different.
Ariely calls this “setting” a new anchor and avoiding the old anchor. If they tried to come out and compete with a similar company selling a similar product, they would lose. But if they set themselves apart from the rest…
As a fitness professional, I must find a way to have more value. I must offer something that you can’t get anywhere else. I think the best way to do this is through personal interaction—show people you care about them. Look at Mark Fisher Fitness. They are the Starbucks of the fitness industry.
Social vs. Market Exchange
This section is about framing your relationship with your customers. A social exchange is like a friendship. A market exchange is like a business proposal. Ariely never defines a winner between the two, but he does make sure you know the difference and how they interact.
An example from the book is the scenario of asking your friends to help you move. If it’s a few boxes, or maybe just some of the big things, that’s fine. Asking them to help you move everything, however, is not okay. Pay someone and stop taking advantage of your friends. Similarly, asking your neighbor to get your mail for free while you’re out of town is acceptable. Asking him to do your taxes for free is not.
As a business owner, do I want to establish social norms or market norms?
Let’s say I establish a social relationship with my clients. They know I care about them. They love that about me. It’s easier to ask for referrals. However, it gets harder to ask for money from them. Harder to raise your prices. Harder to sell more services to them.
If I establish market norms, they expect my prices to rise occasionally and it doesn’t phase them. Conversely, I have more trouble establishing that personal relationship that gets great results in fitness. They aren’t as emotionally tied to me.
Either way has it’s advantages, but you can’t have it both ways. Don’t treat them like family and then sick your lawyer on them if their a few days late on their payment. It’s likely that they will feel betrayed.
I see the answer in fitness to be anywhere you want it to be. Personally, I lean more towards social norms because it keeps me happy and I attract the type of clientele that will stick around, but I don’t completely abandon market norms because I have difficulty asking for money as it is.
Get Clients Aroused (Wait, What?)
My friend, Jae Chung, and I just had a conversation the other day about hitting on the clients more.
Not actually hitting on the clients, but maintaining an appropriate level of banter. It makes the session more fun for the client; they don’t want to work with a dry personality. All you’re trying to do is to make them feel better than they would if they hadn’t come to see you. There’s a reason my Facebook profile picture has been up for so long: smiles, sun, and bright colors.
Man, I miss those sunglasses.
Ariely did some research on how his subjects perceive themselves and compared those responses to their responses when aroused (yes, in that sense of the word) and concluded, “They were simply unable to predict the degree to which passion would change them” (p. 97).
Stop right there.
I’m not suggesting you do—that—with your clients. What I’m suggesting is that you give them a positive emotional experience. My goal is always to make you feel better than when you came in. Change their emotions and you turn them into a new person. Change them the right way and you turn them into a happier person.
Keeping Doors Open
I helped a friend move things out of storage into his garage the other day. You’d be amazed at what people will hang onto. To an impartial outsider, it looks irrational—but it’s still predictable. Everyone does it.
Let’s take a trip back in time to 210 BC. Chinese commander Xiang Yu led troops across the Yangtze River in a fight against the Qin dynasty. Imagine yourself as one of Xiang Yu’s soldiers. Your group lands on shore and sets up camp for the night. After you lay down for bed, you start to dream of flames engulfing your ships. What a hellish nightmare.
Then you awaken to find it’s real.
You alert your sleeping mates and charge the attackers, only to realize that it is your commander who has set your ships ablaze.
He tells you, “Now that you have no ships, you only have two options: victory or death.” They went on to win nine consecutive battles.
Xiang Yu knew that if the option to retreat existed, his troops would not fight with everything they had. This is perhaps the most extreme example of closing doors that history has known.
How do we keep doors open in our daily lives? Well, my friend can hoard his old suitcase, or soldiers can leave an escape route open, but it can happen on a personal level as well. Do you have an ex who is still available to you? It’s not as hard to break up (appears temporary) as it is to cut them out of your life (appears permanent), especially when they were the one to dump you. Or you may have found yourself staying in a relationship for much longer than you should have because it’s safe.
Any doors that drive us crazy should be shut because they sap your energy away from the things that matter.
As it pertains to fitness, this principle means find new friends who support your healthy lifestyle goals. I need to be aware that keeping old doors open could be what is preventing you from reaching your goals.
If there’s vinegar in your beer, do you want to know about it? My prediction is no, at least not until after you’ve already had it.
There was an experiment that Ariely described where they let subjects taste test two different beers: one normal, one with vinegar in it. They controlled everything except when they told the subjects about the vinegar.
If a subject was told there was vinegar in the beer they had just drank, they were more likely to enjoy it. But if told prior to drinking, they had already decided that vinegar would make the beer gross.
Similar research has been done comparing Coke and Pepsi: people like Coke more, but only if they know they’re drinking more. The Coca Cola brand makes the product taste better. The Coke drinkers who knew what they were drinking had more activation in an area of the brain, the dorsolateral prefrontal cortex, that helps with associations among other things.
Drawing a correlate to fitness, this is a lot like the section on arousal. I want you to feel happy when you work out with me. So happy that you start to anticipate the happiness. I want it to be difficult for me to make you unhappy. I want to be the cue that triggers your habit to be happy.
Testimonials help this as well. As I’ve talked about before, this is social proof: “If it worked for other people, it can work for me.”
Instead of being wordy, I think one sentence from Ariely is a great summary of this book.
“Our irrational behaviors are neither random nor senseless—they are systematic and predictable.” (p. 239)
Pick up this book so you can learn to recognize these behaviors and use them to improve your results.
When was the last time you were irrational and should have seen it coming?