brian bradley has listed no financial ... - inside egoscue · egoscue p: pain free: a revolutionary...

Brian Bradley has listed no financial interest/arrangement that would be considered a conflict of interest.

Brian Bradley has a direct affiliation with Egoscue, Inc. but has no affiliation with Dr. Kolar.

Tuesday, March 8, 2011

Brian BradleyVP, Therapy Protocol

Egoscue, Inc.


Brian Bradley

800-995-8434

[email protected]

www.patchfitness.com


mailto:[email protected]

mailto:[email protected]

http://www.patchfitness.com

http://www.patchfitness.com

Assures proper O2-CO2 ratio during normal daily breathing and is especially important during bouts of exertion or exercise.

O2=Low Acidity CO2=High Acidity The more efficient you breathe, the more

cardiovascular fitness you have. This translates into a more stable spine.(McGill)


The diaphragm was first described as a respiratory muscle with a postural function by Skladal, et al.(Liebenson C, Rehabilitation of the Spine. 2007)



The coordinated function of the diaphragm with the abdominal muscles is crucial for the anterior stabilization of the lumbar spine.(Kolar)




Horizontal by 4th month of life.




Horizontal by 4th month of life.

*Spinal extension(non-pelvic induced): inhibits the abdominals and the diaphragm from stabilizing the spine anteriorly.


Maximum load bearing, i.e. The best possible distribution of the load at the articular surfaces. (Implies maximum contact of the articular surfaces during each position in the course of movement.)


Maximum load bearing, i.e. The best possible distribution of the load at the articular surfaces. (Implies maximum contact of the articular surfaces during each position in the course of movement.)

Shoulder, spine, hip, knee, & ankle joint centration are accomplished ONLY when correct posture and joint position are achieved.


A faulty relationship of the various parts of the body which produces increased strain on the supporting structures and in which there is less efficient balance of the body over its base of support.

Florence Kendall, Muscles Testing and Function with Posture and Pain, 2005.


Attachments: *Central Tendon *Lower 6 Ribs and

their cartilage *Xiphoid process1-4 Lumbar bodies and

discs *Arcuate Ligaments


Diaphragmatic breath is always 3-Dimensional. An expansion that encircles the lower ribs, moving them without needing to enlist the intercostal muscles of the ribs.(+) In fact, there should be an actual spreading of the ribs.(palpation)

“Belly breathing”, commonly taught, causes the belly to distend forward and the drag it exerts can actually inhibit diaphragmatic breathing.(-) This movement is easier and often the path of least resistence. (Kolar, Liebenson, 2007)


The “bracing” of the abdominals during normal breathing should occur involuntarily.(TVA vs. Rectus Abdominus)


The “bracing” of the abdominals during normal breathing should occur involuntarily.(TVA vs. Rectus Abdominus)

Practicing a method to improve one’s posture, causing a better balanced muscular action, can create this needed, unconscious pattern to occur. This motor program can be altered by poor posture

and dysfunctional movement patterns.


Upper trapezius Levator Scapulae Internally rotated and Hinged Humerus Shortening of Pectoralis Compression of SC and AC joints


Rising up of the entire rib cage Chest movement dominates

over abdominal movement No lateral movement of the

lower ribs Reversed breathing movements

of the abdominals(paradoxical) Inability of the abdominal

muscles to “brace” the movement

Sighs and yawns are frequent OBLIQUE movement of

diaphragm


Negative pressure develops, especially in the upper fibers of the lungs.



During inhalation, the scalenes become primary stabilizers to prevent an inward movement of the upper rib cage.




SO…is posture relevant?




SO…is posture relevant? Is C-Spine curvature relevant?




SO…is posture relevant? Is C-Spine curvature relevant? Is Pelvic function relevant?


T-4 is the actual beginning of cervical spinal function.

Thoracic spine involved in flexion, extension, side flexion and rotation of the head.

(spinalis cervicis, semispinalis capitis, splenius capitis, splenius cervicis, longissimus cervis…T-4,5,6)


Prone crawling facilitates postural extension(Umphred, 2001)

Brugger, Janda, Kolar, Vojta, Lewit(Tonic/Phasic) Phasic(6 weeks to 4 years complete)

Functional chains of movement for developmental reflex locomotion Creeping Pattern Rolling Pattern Crawling Pattern


In co-activation of the diaphragm and the abdominal muscles, IAP is produced.

Very important role in anterior stabilization of the lumbar spine.

In order for pelvic floor, psoas, and a coordinated juncture at the thoracic-lumbar spine…IAP must be achieved.


Let’s talk about the direct muscular link from the Scapulae…down the thorax…to the pelvic floor.



Scapula position is directly dependent upon normal thoracic spine extension.

Increase in flexion of thoracic spine causes anterior tilt of scapula.

Results in an inability to facilitate efficient movement due to oblique angle.



Common Functions: Upward Rotation of Scapula(LF), Downward Rotation of Scapula(UF), Protraction of Scapula, Depression of Scapula, Stabilizes medial border of scapula during arm movements at the shoulder.



Interdigitates with Serratus Anterior & Lat

Unilateral Functions: Lateral thoracic & lumbar spine flexion, C-rotation of trunk

Bilateral Functions: Thoracic & Lumbar Flexion, Abdominal wall support, Forced expiration



Overlooked Function: Form the punctum fixum(fixed end point) for the deep stabilizing system(Kolar, 2007)

Basically explains the need for a fully functional, efficient scapula and shoulder.

You must “anchor”


Supine Rib Lateral Movement Test

Sitting Rib Lateral Movement Test

Movement of the Sternum Test

Pullover Test(shoulder flexion)


Feet straight—a MUST! Pillow-Knee /

maintained Elbow pressure to block Unilateral movement of

upper extremity causes abdominal wall and lumbar spinal stabilizers to facilitate(hip translation and rotation movements).


Hips off of heels about 6 inches.

Knees and heels hip width apart.

Joint CENTRATION Roll hand over and

press elbow into floor. Breathe posteriorly

expanding the rib cage.


Feet wider than hips and pointed straight.

Slow, deliberate movement with slight pause at start position and at the end point of twist.

Relax upper body, especially upper back.

Watch for sternal tilt!


*Lumbar spine stabilization.

*Femur rotation*Humerus Centration*Scapular downward and

inward movement*Thoracic spinal change

as the e-cise progresses.

*Posterior breathing to facilitate a better pattern of movement.


Primative Movements www.patchfitness.com


Egoscue P: Pain Free: A Revolutionary Method For Stopping Chronic Pain. Bantam, 1999.

Egoscue P: The Egoscue Method Of Health Through Motion. Harper Collins, 1990.

Liebenson C: Rehabilitation of the Spine. Lippincott, Williams, & Wilkins, 2007.

Kendall F, Muscles Testing and Function with Posture and Pain, 2005.

Shirley D, W. Hodges: Spinal Stiffness Changes Throughout the Respiratory Cycle. J of Applied Physiology, 2003.


brian bradley has listed no financial ... - inside egoscue · egoscue p: pain free: a revolutionary...

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