Vidcast Wednesdays: Why Someone Else Should Examine You | Modern Manual Therapy Blog

Vidcast Wednesdays: Why Someone Else Should Examine You

Just look at that amazing hinge!

I recently experienced insanity. It turns out I was doing the same thing over and over again and expecting a different result.

I have tried many different things to improve the mobility of my right hip. Everything from psoas release, QL release, repeated hip flexion, IR, extension, repeated stretching with diaphragmatic breathing, SGIS to the right. Most held temporarily, but I always felt so "tight."
DP MSE, limited hip extension in right hip

Last week we were reviewing the SFMA with our current batch of newbs in the clinic and my MSE as usual was DP, easier with right LE forward, DN, with min loss, with left LE forward, was DP, major loss. When we got to the breakouts and my business partner actively and passively tested my right hip in extension, I was shocked to both feel and see my hip have EXCESSIVE extension, especially when measured passively. I kept asking if I was hinging at my lumbar spine. I wasn't.
DN, left hip extension, still hinging at lumbar spine
Lola says, "Fail!"

When performing the MSE test again, I took a large diaphragmatic breath, blew out through pursed lips to make sure the 4 core kicked in. Instead of feeling my usual "very tight" hip flexors, there was minimal tightness, and I was DN, with only mild loss. I now repeat this several times throughout the day, also wrapping my proximal thigh with an EDGE Mobility Band. Seems to lock in the extension "loss."
PPFffffffffff!!!!! Wife says, "What the heck are you doing?"
Blow out and move!

I am actually performing the MSE breakout with both UEs overhead when I am doing the deep breath with pursed lips (really challenges the diaphragm)

edit: Just found today marks my 700th post in almost 2 years (blogiversary is in 5-6 weeks or so!) Please continue to pin, share and tweet my posts and have me hit my goal of 1,000,000 views before mid July 2013!


  1. Dr. E,

    What are your thoughts on PRI? I haven't taken the course yet, but a lot of the problems you were having I believe are the same things they state are the most common things and have their own set of correctives for it.

  2. Eric Matuszewski,DPTMay 29, 2013 at 9:10 AM

    Good to see an example of this concept in a patient. Reminds me of Anatomy Trains.
    Do you get any change with the Re-set into flexion in this pattern or does nothing happen the full MSE pattern until you do the diaphragmatic breath?

    Congrats on the approaching 2 year mark!

  3. It's not that nothing happened, it's just something I've been working on for literally years and nothing crystallized the improvements until I did standing extension with the pursed breathing.

  4. I got the pursed breathing from their concepts, but haven't taken their courses yet, they first two I plan on taking sometime very soon via their home studies. Very interested! Have you taken them?

  5. Not yet, but would be interested to hear what you think about it!

  6. Eric Matuszewski,DPTMay 29, 2013 at 1:15 PM

    Crystallize! you're speaking my language! Haha

    Would be curious to see the lasting change in a few weeks. I get the impression that getting it to last is where many skilled clinicians are falling short.

    Consistent ability to get a client to a lasting change should be the goal that all physical medicine clinicians should be striving toward.

  7. Interested in having PRI approach have lasting effects or my hip extension? Guess that's both but I didn't do the AIC correction

  8. I'll be sure to review my thoughts on their home studies as I've just registered for Myokinematic Restoration