Posted 12/07/2011
I typically get my blog ideas for clinical experiences, and over the past week, I had a couple patients who were having trouble with their home exercise program that I had given them. Both patients were experiencing upper back/neck tension with the exercise shown below. This exercise should relieve tension (not cause it) when performed correctly. Therefore, I further analyzed the patient’s performing this activity. In both cases, the problem was that they were not exhaling correctly. One individual was exhaling with “pursed” lips, while the other was exhaling very quick and forcefully.
Those who have been to our clinic know that breathing is important with every exercise you do! Respiration is the foundation of the science of the Postural Respiration Institute™. Exhalation is the focus of today’s topic. There are several reasons why we emphasize patient’s breathing correctly with our activities, but most importantly to appropriately using the diaphragm as a respiratory muscle rather than a postural stabilizer, to help us get into a “neutral” or flexed position, and to minimize use of accessory (neck) muscles to help breathe on the next inhalation.
I had to teach both these patients to exhale correctly, and when doing so they had no tension in their upper back or neck performing the exercise. The exhalation phase of breathing should be about three times longer than the inhalation. If one does not fully exhale all the air, then “dead air” remains in the chest wall, your ribcage remains elevated and externally rotated, and muscle tension develops in your neck and shoulders. We sometimes use a spirometer to measure the amount of air you can exhale, which is often decreased. If you never get all the air out of your body, you cannot fully inhale because space in the lungs in being occupied by the “dead air”. Not only is this important for decreasing muscle tension, but air exchange controls oxygenation of our body. When we inhale, we supply our body with oxygen, and with exhalation we eliminate carbon dioxide. If you have “dead (non-oxygenated) air” in your chest wall, you cannot fully re-oxygenate on inhalation, and you may be fatigued easily, get out of breath with simple activities such as going up a flight of stairs, get headaches, not sleep well or wake up tired after a full night of sleep.
To help these two patients over the past week, I really encouraged a full exhalation. I am often saying “Blow all the air out, every last bit drop of air that you have in your lungs.” I often utilize tools such as a straw, party favor or balloon to help the patient realize they are getting the air out, as well as provide a small amount of resistance which engages the abdominals and assists with pulling their ribcage down into a depressed and internally rotated position assisting them to get all the air out. So, please consider, have you (and/or your patients) been exhaling correctly (and fully) with PRI activities?
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Posted 03/31/2011
Why is an Eye Doctor Working in a Physical Therapy Clinic? Why do we need our eyes?
Most people’s answers to these questions would be: “My eyes help me see where I am going”, “My eyes tell me where things are around me” or “My eyes help me see small things far away”. All very true and all very important functions of your eyes.
That’s just the beginning. The proverbial ‘scratching of the surface’ of what your eyes do for you as a whole person is often overlooked. Your eyes are actually a part of your brain! The information collecting cells in your eyes are formed from your brain during your development as an embryo. These cells make up what we call the retina. Only 20% of the entire surface of the retina is used to see the bottom line on the eye chart at the doctor’s office. That means that a relatively small area of the retina is used for central vision, and the remaining 80% of the retina surface is used to collect and send information to other parts of the body for non-seeing functions. In addition, 20% of the fibers of the optic nerve, which carry all the information from the eye to the brain, don’t go to the visual cortex at all. Twenty percent of the approximately 1.2 million nerve fibers of each optic nerve are there to control things we take for granted every day like postural adjustment, balance, coordination etc.
This fact makes you wonder what things all the other hundreds of thousands of connections are for, doesn’t it? Where does that information go? What does that information do? Research tells us that information from our eyes goes to areas of the brain that control bodily functions, including but not limited to: posture, emotions, muscle tension, body temperature, memory and attention!
If you are reading this and you have knee pain, back pain, jaw pain, shoulder pain, neck pain, dizziness, headaches etc., and are looking for a solution, then you may have had a light bulb go off above your head when you realized what you just read. You might have thought, “Well, if information from my eyes has an effect on those areas of my brain, then maybe I need to check into this more because I am tired of not living life to it’s fullest due to pain and discomfort.” The more we learn about how input from our eyes affects our bodies, the more we get excited about changing the lives of lots of people. Every time we get feedback from our patients about how our use of this information is helping them, we get excited because these successful outcomes by an optometrist or a physical therapist have never been outlined or summarized through traditional treatments!
Dr. Heidi Wise, like Ron Hruska, has dedicated much of her career to asking the question “why”? Now that she has teamed up with Ron and the other therapists at the Hruska Clinic and Postural Restoration Institute, many of the answers are starting to make sense. We are discovering how eyes have an influence on the rest of the human body. People who have not had long term success with other methods of treating their physical health problems are finding life changing answers at the Hruska Clinic and the Postural Restoration Institute. We have had tremendous success in treating patients, including physical therapists and professional athletes, from all over the United States.
We call this method of treatment Integrative Optometry. What we are doing is ‘integrating’ (mixing together) small changes in what your eyes tell your brain, with PRI physical therapy concepts. This causes physical changes in muscle tension and muscle patterns. These physical changes lead to improved muscle and joint function, and a decrease in symptoms like pain. This is what Dr. Heidi Wise and the physical therapists are doing for Hruska patients, and why ‘there is an eye doctor working in a physical therapy office’. The more she and the therapists learn about the power of integrating visual input with physical therapy, the more patients are being helped. The research and treatments being developed are the first of their kind, and exclusive to the Hruska Clinic. No one else is treating with these methods or with this kind of success. That is very exciting to all of us and our growing list of patients.
If you need new glasses or contacts for driving, or someone to treat your eye infection, then you should visit your local optometrist. If you want answers to problems such as headaches and migraines; dizziness; back pain and tension; difficulties sleeping; jaw, head and neck tightness and pain; eyestrain or a number of other physical ailments, then call the Hruska Clinic and see if we can help. If you have tried traditional physical therapy or other traditional treatments with limited to no success, call and find out if Integrative Optometry might give you some answers . When you do, we believe you may find solutions to your problems, even if you have been told that solutions don’t exist.
Posted December 7, 2011 at 10:49am by Jennifer Gloystein.
