Postural Restoration Institute and The Seven Chakras: Helping a Client With Superior T4

I woke up this morning and read a response from my client, Athena, on a post I tagged her in from Mike Mullins (If you don’t follow him, you should). Athenas reply was amazingly insightful. I literally can’t put into words the immediate monumental “ah ha” moment I had after reading it. Athena is a brilliant physician, mother, yogi, lover of earth, gardener, violin player, vocabulary phenom…this list could be a mile long. Her eccentricities are as varied and beautiful as one would hope for in their own life. Here is a picture of Athena and her son, Julian, and husband, Amir.

Athena began seeing me years ago as her trainer. She lived in a state of persistent pain. Her back and neck were constantly flared up and she was chronically fearful of the next “episode” that would leave her physically and emotionally debilitated. I wanted to help her so much, but just did not have the tools. I was extremely diligent and tried to be “safe” with her exercises but I knew absolutely nothing when it came to her compensatory strategies. I had been training for 15 years and I couldn’t have even explained what a compensatory strategy was!

Fast forward a couple of years. My first PRI course was in late summer 2017. My brain was on fire with the concepts I learned in Myokinematics and the primary courses helped me gain some perspective and start to really make changes in my clients that were lasting. Athena was improving but I knew there was something that was not making sense and clicking for me and her. Two weeks ago I took Cervical Revolution with Mike Cantrell. I can’t say I absorbed everything at first, but it gave me a new perspective I truly needed in order to see the entire picture.

I asked Athena if she could bump up to seeing me 2 times a week at no additional expense to her, if she would allow me to use her as a case study and fumble my way through my own learning. She agreed. I went back to my manuals and sat for hours thinking of what might be going on with her. I had a very strong suspicion that she might be a superior T4 and that I had been missing it even though I learned about it in Respiration. Something about Cervical just allowed it to all come together. In addition, I emailed Mike Cantrell and Mike Mullins asking for advice. Cantrell graciously emailed me back right away with a plan of action to get me on course. Mullins also graciously emailed me back with an offer to discuss her issues over the phone when we could find a mutual time. At some point over that week I also read James Andersons article on Superior T4 and the alarm bells went off.

I went back to the drawing board. My evaluations / assessments with clients over the past year had become a hodgepodge of tests as I struggled to see things clearly. I did a full assessment of Athena using the evaluation form in the manual. Yes, the massive one with 32 assessments! I made notes next to all of her tests regarding potential compensations, strategies, weaknesses, etc. When I finished, I sat back and just looked at it and it was as if I could see every single thing I had needed to see 2 years ago. I had an exact direction I needed to go.

Athena arrived at my house right 30 minutes before that moment, vulnerable and open to being my guinnea pig. I was elated that I had a sound course of action. We started with the superior T4 manual technique / test for T4.

Her Left HG IR (humeral glenoid internal rotation) went from 45 to 80 and her positive Left ADT (adduction drop test) was negative after 5 breaths. I chose a standing exercise because I have always felt Athena does better with the reference of her feet and gravity. She performed a wall reach, left hip back, left zoa and right reach. At first she struggled and her neck started flaring up, particularly her right SCM. I had her place 70% of her weight on her left leg and as she breathed I could see her thorax going back to the right. I remembered from cervical the need for occlusion and Cantrell mentioned placing a card on the left side of her molars. I gave her a folded up post-it to put in between her molars on the left to give her more reference. She repeated the exercise with complete success! I rechecked her HG IR after one cycle of 5 breaths and it was greater than 90.

I got a call from Mike Mullins regarding my email that same afternoon and we discussed my uncertainty regarding which non manual exercises worked best for keeping her out of her Superior T4 position as well as the effect on her cervical spine and a few other amazing nuggets of information that he shared with me. Here is one of the pages in my respiration manual that he reference for me to take a look at. Sometimes the manuals can be so confusing that I forget where to find things.

That night, I came home and tagged Athena in the above mentioned post that Mike had made regarding autonomics and emotions. Athena’s response to that post was profound to say the least.

“Katie Stuart St.Clair. Thank you! Firstly, youre the bomb! Secondly this is powerful impactful work. The physical and metaphysical interplay is very real for me. The way I’m grounded (or not) in my body correlates with my emotional and spiritual state. Too much laxity or flexibility results in instability and compensatory rigidity elsewhere…physically and emotionally. Too much constriction in the neck and shoulders affects breathing and also limits self expression…and vice versa. The reunification of breath, position, and autonomics in PRI ironically circles back to the ancient concept of the chakra…as a root of a set of properties and functions embodied at a particular structural nidus…and it is very much a two way conversation between the body and the mind. For many, myself included, a not so pleasant conversation that’s takes a heavy toll. I’m excited and hopeful to be on this journey with you.”

Athena is an avid yogi and has a love for the teachings in both a physical and emotional sense. Not being a yogi myself, I had to google “what are chakras”. This was the first picture that came up.

A lightning bolt struck my brain and I actually started crying. Here I was, staring at a picture of something Athena new all too well and I suddenly realized I was staring at her! The irony of this situation is beyond comprehension. I immediately created a graphic of the chakras and PRI compensatory strategies.

Evidence of the Chakra system originated in India between 1500-500 BC. Postural restoration concepts originated from Ron Hruska’s brain in the 1980’s and was created as an Institute in 2000. It is ironic to me that two concepts separated by over 3000 years have so many similarities. Chakras are either believed in whole heartedly or dismissed as hokus pokus. PRI definitely has had to struggle to become mainstream and I know that Ron early on was in the business of “convincing” physicians. The chakra system is concerned with balancing the “life force” or energy to create emotional and physical well being. PRI is focused on balancing and managing asymmetries, which ultimately affect our central nervous system, in order to create a greater parasympathetic or exhalation state, resulting in emotional and physical well being. As, Athena, so intuitively pointed out “The reunification of breath, position, and autonomics in PRI ironically circles back to the ancient concept of the chakra…as a root of a set of properties and functions embodied at a particular structural nidus”. Both PRI and the Chakras start with a nidus that can lead in many different paths.

I am sure there are even more comparisons that can be made regarding the individual chakras and individual compensatory strategies and I look forward to delving deeper down that rabbit hole. But for now, I am grateful to see the correlation between the two, which has opened my mind to a new understanding of the physical body that I would not otherwise have realized if it were not for the inspirational insight of my client, Athena.

For all the PRI trainers, coaches, physical therapists, occupational therapists, dentists, ophthalmologists, and physicians, who are struggling with the concepts I have a few words of wisdom (if you will take them from someone with much less intellect and education than you):

  • 1. If you are struggling to connect the dots and considering giving up, I would urge you to keep going down the rabbit hole. It will come.
  • 2. Reach out to anyone you know is clearly more well versed in PRI than you and do not be shy about asking for help. This community is amazing.

    3. If you don’t have a resume beyond a B.S. and feel intimidated, as I often have, put your ego aside and embrace being the “dumbest person in the room”. Fear leads to great things.

    4. Find whatever correlations to whatever system you understand to help you see the big picture. (Chakras = Compensatory Strategies)

    5. When you see someone who is online implementing PRI concepts that you question, know that they are making mistakes and that is part of their journey which they are amazingly vulnerable enough to share. Like their posts and support them because they need to keep going so they can help others.

    6. Educate your clients and assume they are capable of understanding. When we educate others we learn for ourselves.

    7. If you realize you have missed a big piece with your client, don’t be hard on yourself. Know that even the simple things like a 90 90 hip lift to get them out of extension are helping them.

    8. When you leave a course and feel overwhelmed and doubtful you will ever understand, meditate for 20 minutes to calm your nervous system and then open your manual.

    9. Celebrate every achievement you have with each client. Every time we are lucky enough to help another human being’s existence become less painful without the use of surgery or medicine, we have exceeded our own humanness.

    10. Reach out to anyone you can and create your own PRI community. If no one in your town is using these concepts then reach out online. If someone is willing to go down this rabbit hole without intention of financial gain, trust me, they are the real deal and they will embrace you. They truly just want to help people.

    11. Drink lots of coffee!

    Posterior Chain Workout

    The posterior chain is a fancy term for the muscles on the back side of the body. These muscles are often underworked and over lengthened in the general public and, specifically, in those who sit for long hours at work. This workout is designed to get those muscles working to allow you to “reset” back to a happy standing posture! A few notes on this workout.

    1. During all planking motions, make sure your pelvis is tucked under (think belt buckle to chin) so that you do not use your low back to do the work.

    2. During all bridging make sure your low back is not arching. We want to give those glutes and hamstrings a chance to really work and that requires shutting off the low back. When you lift up your back should not arch. Feel the glutes and hamstrings doing the work. Also, pulling the opposite knee in really helps!

    3. On any pulling motions make sure to keep your ribs pulled down and do not allow them to flare. It is definitely possible to open your chest without flaring your ribs! Take and exhale, engage your abdominals and keep them engages as you pull. At the end range focus on your back muscles and opening of chest while still maintaining abs.

    Wellness Words Book 1: The Slight Edge (Book Discussion Chapters 1-4)

    If you are looking for a bit of inspiration to help you on your journey, welcome to our first addition of the Wellness Words Book Club!  Prior to reading this post it would be beneficial for you to pick up a copy of The Slight Edge, by Jeff Olson.  This first discussion is for all of my clients following along and for anyone on the inter-web looking for a bit of motivation and focus on their health journey.  If you feel like this could be helpful to you, read Chapters 1-4 and follow the discussion below.  For current in person and online clients, head on over to my Wellness Words Forum and register to take part in the conversation.  Without further ado I give you the first 4 chapter discussion of our very first book…

    Wellness Words Book 1

    The Slight Edge by Jeff Olson


    Week 1 Discussion


    In the introduction of The Slight Edge we are told abut the shoe shine woman wishing she could afford to send her daughter to cheerleading camp.  She is used as an example of someone that could have a better life and give her daughter the things she needed if she understood the slight edge.  With so much information available on how to live your “best” life why isn’t she succeeding?  The author contemplates how different her life would be if she only knew the theory of the slight edge and put it into practice.  He then explains that the slight edge is not about availability of information but rather how to use that information to develop success.  

    There are hundreds of 1000’s of health books on how to get fit, lose weight, and achieve the healthy body you desire but we live in a country with 75% of the population obese or overweight, 100 million pre-diabetic or diabetic,  and 610,00 dying of heart disease every year.  So if everyone knows how to lose weight and stay healthy then why aren’t we all healthy?  What is preventing us from putting this information into practice?  Could it be the slight edge?  

    He tells the story of the frog that chooses not to give up and eventually churns the cream into butter to save his life and of the water hyacinth as an understanding of compound interest.   He then tells the parable of the dying man and his two sons and their choice between an immediate $1 million dollars and 1 penny.  The first son loses all his money and the 2nd son chooses the penny doubled.  The 2nd son becomes rich because he has “learned habits of thought and action that will allow him to choose the penny doubled every time”.

    Question 1

    How can you create habits of thought and action that will allow you to choose the penny doubled every time?  When we think about our health, weight, nutrition, etc., how can we create thoughts and actions that will allow us to make decisions that double our health, life expectancy, weight loss, etc., every time?  What are some thoughts and actions that you can think of in your own life that would help you achieve success and improved health?

    Chapter 1

    In chapter 1 the author discusses how there are no secrets to health, weight loss or living a better life.  The secret ingredient is to change the way you think (your philosophy). It’s attitudes behind actions that matter and you need to understand these attitudes. He gives the following equation:

    Philosophy + Attitude + Actions = Results = Lifestyle

    Question 2

    When you make a decision to eat healthier and have a moment of weakness where you allow yourself the doughnut or cake or pasta or bread what is your attitude behind the action of making this decision?  

    When you choose to go to the gym and eat veggies and protein only for dinner what are the attitudes behind the actions of this decision?

    Can you look back on small unhealthy decisions or small healthy decisions you have made over the past year and see how those compounded over time and manifested in your life?

    Chapter 2

    In chapter 2 he suggests that successful people do “simple things that are easy to do”.  He poses the thought that although every action is easy to do it is also easy NOT to do.  If you eat the pasta, or skip your workout today, it won’t kill you. Making that choice is more comfortable and easier not to do than choosing the salad or getting 20 minutes of exercise.   It’s relatively easy to eat well but it might be a little bit easier not to eat well.  These little decisions to not eat well add up over time to big things like weight gain and heart disease.  Conversely, skipping the pasta and getting 20 minutes of exercise every day can add up to a healthy body and mind for the rest of your life.  Little things that feel like they make no difference in the short term actually do!

    Question 3

    What are the little things in your life that you can do to alter the course of your health and give you the slight edge?

    Chapter 3

    In chapter 3 he discusses the secret of time and says that willpower is overrated.  He says that everyone wants to plant seeds and see a harvest but they aren’t willing to cultivate.  I loved his quote “success is a progressive realization of a worthy ideal”.  His graph of simple disciplines and errors in judgement over time leading to a more positive or negative life made me think of how impactful our choices are.  He says to base your choices on your philosophy and not on what you see. (This reminds me of Janis Newton during HCC saying “walk by faith, not by sight” as a way to encouraging you not to look at the number on the scale as your measurement of health but to trust in the process and your daily decisions.)

    Question 4

    Are their times when you base choices on what you see instead of what you know? How can you make choices based on what you know and not what you see?

    Chapter 4

    In chapter 4 he discusses famous figures, Rosa Parks, Stephen King and how they started with a small decision that had a huge impact.  He says you have to do something in order to achieve anything.  He says the critical decisions in life are always the tiny ones which is why so many people miss them.  Do something that makes you feel 1 penny’s worth better or even just .003% better.  If you make this decision after 1 year you will be twice as successful.

    Question 5

    What can you commit to everyday to make you feel 1 penny’s worth better or even .003% better?  If you did this everyday for 1 year how would you feel and what would this look like in terms of your health at the end of a year?

    The Keto Crux: How more fat and less plants has become healthy.

    Of all the ridiculous diets available to mankind, I might believe the ketogenic diet, as a means of achieving health, to be the worst of all. I’d like to put it up there with Atkins, actual starvation, or that crazy documentary where the guy ate only McDonalds for 30 days straight.

    While I realize extreme measures to lose weight may be warranted in certain situations (i.e., the excess weight is causing major health problems leading to severe CVD or other life threatening diseases), I would like to take a moment to make a few statements regarding possible outcomes of a ketogenic “diet”. Also, you should know I use the word “diet” loosely, because I hate 😡 the word “diet” in general and feel even that word gives it too much clout.

    So, while I appreciate the fact that you may have lost 20lbs, have better mental clarity 💆‍♂️ or feel that you are now on par with a superhero or ninja warrior I would like to offer a devil’s advocate view of WTF is happening to you in the long term while you take all important nutrients and minerals in your body and replace them with fat, sodium and a fake supplemented version of healthy eating (exogenous ketones). It’s important to me that my clients and the people that I care about understand the benefits and RISKS. Likely, unless you have a degree in nutrition or biochemistry, or have taken the time to understand these things from evidence based research, you are being manipulated into only hearing the benefits by someone selling a book or working for a MLM company 💰.

    Without further ado, I will give you some things to 🤔 so you can make a truly informed decision on going into ketosis to improve your health. 🙄(For the record, I can think of 💯 different ways to feel like a superhero, lose weight, and move like a badass, while still being able to eat Rainier 🍒 and 🍅, two of my summertime favorites!)

    Possible Long Term Consequences of a Ketogenic Diet:

    • A typical ketogenic diet recommends 65-75% Fat, 15-25% Protein, and 5-10 % Carbohydrates. Animal and refined plant fats contain NO Potassium, Calcium, Magnesium, Folate or Vitamin C! It doesn’t take much analysis to understand that this scenario could lead to a deficiency of some sort pretty quickly! I’d bet my 💵 on 2 weeks before someone could start developing deficiencies.
    • The major minerals we need to get from food to have balanced electrolytes are Sodium (Na), Potassium (K), Calcium (Ca), and Magnesium (Mg). To keep it simple, electrolyte balance is basically essential for keeping your body performing so you can do cool shit🧗‍♂️! Unfortunately when you put your body in ketosis, you can also cause major electrolyte imbalances and guess what? Your body is no longer able to do 😎 shit like contract muscles, build strong bones, regulate nerve function, blood pressure and heart rate! I don’t know about you, but I would rather be able to 🏄‍♀️ a big wave, 🏋️ , play with my kid, or simply survive, than be 10lbs lighter with an electrolyte imbalance.
    • Beware! Exogenous ketones will add 1000 mg of sodium or calcium to try to alleviate an electrolyte imbalance. Shocker!… adding this to a drink just doesn’t cut it. Believe it or not, biochemistry is waaaayyy more complicated than that. So if you think you can outsmart the body, guess again!☝️ It’s called electrolyte BALANCE for a reason. Na and K / Ca and Mg go together like Abbott and Costello, Ginger Rogers and Fred Astaire, Ross and Rachel….. When these couples don’t work the world is in disarray! Keto fans call this the KETOFlu🤒 . YES, that is actually a thing! Hard to believe that a diet that gives you a temporary flu has become so popular, I know! 🤷‍♀️ And get this, there is a massive amount of information on line on how to cure the 😷. So basically you want me to eat lots of fat and protein, no carbs, get the flu, then stop exercising, eat more salt, and drink nasty tasting exogenous ketones to get past the flu so I can lose weight?! What the 🤬!
    • A Ketogenic Diet (especially one supplemented by exogenous ketones with excess sodium and / or calcium) is a dangerous place for a healthy relationship between Na and K or Ca and Mg. I mean you could possibly end up in a total breakdown of the relationship! All that Ca with no Mg to help it find it’s way is a sad state of affairs. And poor potassium is virtually non existent in Keto Land (remember fat has ZERO potassium) and sodium is running rampant with the addition of cheese, processed meats and supplements. And don’t even get me started on the poor kidneys responsible for keeping these relationships in check.
    • Let’s talk about POTENTIAL RENAL ACID LOAD (PRAL) and the poor kidneys living in Keto land 😩! As the 🥩, 🍗 and 🧀 goes up the body becomes more acidic. And while we could easily counteract this with wonderful things like delicious 🍎, 🍌, 🍅, 🥦, 🍆, in Keto land these are 🚫❌❌❌ bad bad bad! For more information on PRAL, I will refer you to Precision Nutrition
    • So what’s the big deal about an acidic body? Well 😬.. quite a bit, actually! Lilke I said before the body isint easily outsmarted so it will find a way to keep things working 🧐. In order to keep a more copacetic environment it will just head on over to those BONES and take a bit of calcium, or better yet, we can break down muscle tissue in order to synthesize glutamine which ultimately is used to synthesize ammonium ions that remove protons in order to lower acidosis. I don’t know about you but I prefer to have my 🎂 (aka: bone and muscle) and eat fruits and vegetables too.
    • Let’s talk about FOLATE. There is no folate in fats or protein! 1 cup of cooked broccoli has about 100 mcgs of folate, so 4 cups is perfect to meet your daily intake but OOOPS!… that would mean your carbohydrates would exceed 20 grams and that would be TERRIBLE 🤦‍♀️. Who needs a micronutrient that helps you have a healthy baby, prevents anemia, helps absorb B12, prevents cancer, cardiovascular disease, Alzheimer’s, and depression? I guess I’m willing to forgo all the wonderful benefits of an extremely important micronutrient to lose an extra 10 lbs by way of ketosis. 🤔

    In conclusion, I don’t actually care about those of you already convinced that your Keto Diet is the 🐝 knees. If you are only trying to lose 20 lbs and gulping down exogenous ketone drinks 🤢, and avoiding the wonders of nature 🥗🍎🍇🍓🍠, I realize, my thoughts on what constitutes healthy living is not going to 🤯, because, clearly, you are willing to do whatever it takes at whatever cost to lose weight. And, as I stated above, if you are knocking on death’s door 💀 because you are obese and this is the way you want to get that weight off then I will 👊 pump you all day long! I wrote this for my clients, my friends, and my family.

    This is for those I counsel on exercise and nutrition that want to feel like a badass superhero. My goal for you is to live, love, and appreciate your body’s amazing abilities to move and the earth’s amazing abilities to produce beautiful food, not to punish yourself for the sake of 5lbs or even 50lbs. There are other ways to lose weight and they don’t have to include elimination of plants and fruits and they can maybe even involve a slice of 🍕 or 🍰 once in a while. There is a lot of kool aid to be drunk these days on the World Wide Web so buyer beware! Sometimes these seemingly magic pills turn out to be all smoke and mirrors. Or worse, metabolic and nutritional deficiencies that can change the course of your health in a way you can’t get back.

    Postural Restoration of an Ironman – A Week by Week Case Study

    One of the things I’ve really wanted to do since doing my continuing education with Postural Restoration Institute was to openly share a complete exercise program I would create for someone using the PRI method as part of their training.  Enter, Coo (Catherine) O’Sullivan who is my main sidekick!  I am so excited about this for a few reasons: 1. She is one of my closest friends and we’ve worked together as trainers for over 11 years! (Coo, can you believe that?!!) 2.  She is an awesome trainer and gives everything to her clients and she deserves some LOVE too! 3. She completed her first FULL Ironman last year and she is incredibly gifted at all things endurance.  I want to see her continue to compete as long as she can because it’s amazing and she loves it. So we need to start digging in to all of her “issues”.  4. I know she will be compliant because she loves to exercise. Makes my job super easy!  5.  She’s got a lot of issues and lightbulbs are going off everywhere in my head! “Ah-ha moments”, “ding-ding-ding’s”, and “of course’s”, were just rolling off my tongue after her evaluation.

    Here’s Coo during her Ironman last year.

    She literally ran through the finish line smiling and waving her arms in the air!  AMAZING!

    Here are the notes I took on her regarding her basic complaints and body issues.

    Catherine is a competitive triathlete who completed an Ironman 6 months ago. She has right shoulder / neck pain she has been dealing with for 3 years. She says her c7 is tender to the touch all of the time. She also has a left hamstring strain she has been dealing with for some time. She has a 1 cm neuroma on her right foot and a 6mm neuroma on her left foot that caused her lots of pain during her last Ironman. She loves triathlons and wants to continue to compete without pain if possible.  

    Below is her complete evaluation, which will only be useful for the PRI Fam 🤓 who are reading this right now.  Feel free to skip past the technical evaluation and I’ll break it down in a very understandable explanation.

    Each week or two I will post my notes and the exercises I chose so you can get an understanding of how all this PRI stuff works and how I use it as a coach to help people strength train while addressing their asymmetries and compensations. If PRI is not something you are familiar with and you want to learn more because you think it may be useful to you as a coach here is the website and here is an article I wrote.

    Click here for easy to understand version that skips the technical part.



    This is an algorithm that PRI utilizes to help me see the big picture of Coo’s asymmetries and areas of weakness.  When I first look at this I try to summarize what I see in my brain and use that to decide what areas to focus on first.  These goals will likely change as we progress and get more specific, but to give a better understanding for those interested, here are my notes / initial thoughts below (For the record these notes are just very initial thoughts and, by no means, are all of these things addressed at once.  They just help me see from a broader lens so I can decide which exercises to start with):

    Here are my PRI notes based on her full assessment.

    Again, feel free to skip this part and move on to the non-professional / non-PRI explanation!

    I did a full assessment using Myokinematic and Respiration assessments from PRI. Catherine was a PEC with limited FA internal rotation, more limitation on the right. She uses her TFL to actively internally rotate and has excessive hamstring flexibility. She is a bilateral BC. She has a lot of trouble breathing into her posterior mediastinum and it is slightly harder for her to get air into her right side. She uses her neck to breathe and expand through her chest to get air and may overuse her SCM and scalenes during inhalation. She has a narrow infrasternal angle. Her left ribs were lower than her right and she had a rib out on the right. There may be compensatory action from her right scalenes and SCM that is pulling her right rib cage upwards or she may have possible inferior T-8 syndrome which would cause greater flare of her right lower ribs.  

    What the hell does all of that mean?!!

    English Please!

    Let me try to break it down as simply as possible in non PRI lingo.  Coo’s hips tilt forward. (Slightly more on the left side – this pic does not show the shift to the right side from the greater left tilt).  0139CD84-014C-4BCA-A34B-4B6431C517F3

    For the record, Catherine does not look like this picture, this is waayyy exaggerated, but it gives you an idea of what happens to the lumbar (lower) spine when she is standing.  PRI always says not to trust your eyes but to trust the tests.  Because she is further tilted forward on the left she is slightly rotated to the right which causes her to put more weight onto her right leg.  Picture the statue of David below.


    If we look up the kinetic chain we see that Coo’s rib cage is flared. Typically, based on the algorithm from PRI we would expect that she would have greater elevation on the left but she actually has slightly higher elevation on the right.  Overall Coo has elevated and externally rotated ribs on both sides.  The slightly more elevated right ribcage is unusual and may be a result of her clever compensations that get her through her amazing feats of endurance!  In addition both of her scapula (shoulder blades) are anteriorly tipped, protracted, and depressed.  Think winging scapula!  Here is what her ribs and scapula look like: (Again, I will state the obvious, Coo does not look at all like these individuals but I am giving extremes so you can see the big picture when we look at the much more subtle changes in Coo’s anatomy.)



    Coo’s external rotation of her femur (thigh bone) in her acetabulum (hip socket) during sitting is adequate and she is relatively symmetrical but her internal rotation is slightly limited on her right leg

    .  1E9FB21E-E6C8-4BC5-A02B-61895B5E219C

    When placed supine with knees at 90 her internal rotation was much more limited. (I would like to retest her internal rotation in a prone hip extended position next time I meet with her.) She also uses her TFL (Tensor Fascia Latae) to actively internally rotate her femur in her hip socket on both sides.  When the TFL gets overactive and overused it can affect a LOT of other muscles.  I mean you might start breathing with your eyeballs?!  Basically it’s job is to flex the hip (lift the leg up), abduct (move the leg to the side) and internally rotate (rotate the leg inward).  That’s a big job, especially if you are working by yourself!  But wait, TFL is most certainly not in it alone, in fact it’s really not responsible for these actions on it’s own at all.  It’s supposed to be getting help from the glutes, hamstrings, adductors, and hip flexors and just come in a bit here and there to give a little assistance.  TFL is such an overachiever!


    Coo’s main area of pain during her Ironman were the Morton Neuromas in her feet.  They are what prevented her from having the most amazing ironman ever.  The run was very difficult and painful and she had to change her shoes multiple times to get through the pain.  Morton’s Neuroma is basically a thickening of the nerve between the metatarsals of the foot, typically between the 3rd and 4th metatarsal.


    It’s very possible the neuromas formed because of excessive irritation from running with compensation on a high arched foot.  She has proper foot support but has very high arches which can cause compression on the nerve between the bones of her feet during stance phase of gain (when her foot hits the ground).  Also, her lack of control due to weakened glutes, hamstrings, and adductors, during stance phase of gait is likely adding more pressure on her forefoot.  Back to the anterior tilt and overachieving TFL!

    I’ll sum it all up with this equation below.

    Breathing and Diaphragm Dysfunction = Flared Rib Cage + Anterior Tilt + Overactive TFL + Weak Glutes, Hamstrings, and Adductors + High Arches + Extra Pressure on Stance Phase of Gait = Morton’s Neuroma’s (Ding! Ding! Ding!)

    So where do we start!!

    We have got to get Coo breathing before we do anything else!  “Breathing is Walking” and “Respiration wins every time” are two of the quotes by Mike Cantrell that ring loudly in my ears after my Postural Respiration Course in Atlanta and definitely apply in Coo’s case.

    Enter Zone of Apposition – ZOA

    For all the PRI nerds, Coo needs to take her bilateral brachial chain and restore a badass zone of apposition on both sides of her diaphragm.

    In plain English this means that she is not great at getting her diaphragm in a good position to pump air.  See picture below.  The diaphragm needs to contract and relax just like any muscle and the body needs to be in the right alignment to allow that to happen.  If Coo’s hips are tilted forward and her ribs are flared it’s going to make it really tough for her diaphragm to do its job.  If the ZOA is lost then we start compensating.  Compensations are fine until there are just too many to handle.  The bones and muscles begins to change shape and function to help you get air and the cycle continues until you fix it or just decide not to move anymore because you are in so much pain.  So the goal is to restore breathing and diaphragm position by strengthening abdominal muscles and turning off neck and back extensors.  Once we have that restored we can start working on the appendages.


    Exercise Prescription

    I worked with Coo on how to breathe in general and also taught her basic balloon breathing to give her a better feel of what she should be feeling.  If you are interested the research behind balloon breathing, click here.  For our purposes we kept it pretty simple.  Coo can choose to breathe with or without the balloon depending on what she feels works best for her.

    The basic breathing instructions I gave her are as follows:

    1. Inhale gently through the nose for 4 seconds.

    2. Exhale in the form of a sigh (think of making the ahhhh sound) for 8 seconds. As you exhale gently feel the contraction of your lower abdominals and obliques (think TVA and Internal Obliques)  Try to feel entire contraction from the left to right side.

    3. Hold the air out while pushing your tongue onto the roof of your mouth behind your teeth for 3 seconds. Keep your abdominals engaged.

    4. With abdominals engaged and tongue on the roof of your mouth, inhale gently through your nose trying not to allow the rib cage to lift up and pushing air into your back.

    5. Repeat for 5 breaths.

    Once we established proper breathing technique I gave her 3 exercises to focus on to help restore breathing into her posterior mediastinum.

    Basically the goal of these exercises is to maintain abdominal contraction during inhalation and to push air into her back and not allow her to use her neck and chest muscles to breathe.  We want her to use her diaphragm to breathe and her neck, chest, and back to relax.

    1. Seated or standing against the wall with both arms reaching, focus on breathing into back and contracting abdominals to draw pelvis posteriorly.

    PRI Wall Short Seated Reach
    PRI Wall Supported Squat – I had her do a bilateral reach with no hip shift.

    2. A modified version of the Paraspinal Release with Left Hamstrings.  I made this bilateral and had her stay seated in a chair and just dig opposite heel while she reaches with opposite arm to get the same effect without her neck kicking in.


    3. PRI All Four Left Posterior Mediastinum Expansion in Left Trunk Rotation.  All fours with left hand elevated.


    Coo is instructed to do 5 sets of 5 breaths of each exercise 1-3 x per day.  I also recommended she do these after exercise or athletic events.


    Below are my basic goals as of now and these are by no means all happening at once!  These are just the things that I would like to address at some point.  For now, I am just touching on goals 1-3.

    Goals: 1. Restore breathing and increase posterior mediastinum expansion. 2. Increase ribcage mobility through alternating reach exercises and strengthen serratus to improve shoulder stability and reduce use of neck muscles for breathing. 3. Use TVA and IO’s to pull pelvis posteriorly. 4. Facilitate hamstrings to maintain neutral pelvis. 5. Strengthen hamstrings eccentrically to help late phase stance of gait. 6. Strengthen ischiocondlyar Adductor on left while stretching posterior hip capsule on left to decrease left hamstring strain. 7. Inhibit TFL on right and left so glutes can fire correctly. 8. Facilitate right glute max to prevent further valgus of right knee.

    For Coo’s first week, I kept it simple and I am not having her do anything but the three exercises above.  She will, of course, still be running and biking and swimming to her hearts desire.  I plan on giving her some strength training and load as soon as we can get her breathing on point.

    Here is Coo doing her exercises and of course smiling!



    Stay tuned for a follow-up blog as we progress Coo into an optimal ZOA badass triathlete!

    If you would like to receive these blog posts to your inbox as they are released click here to sign up.

    Part 2 – From Fit to Super Fit: What exactly is that coach, body builder, or fit mom and dad eating everyday?!

    If I could have a dollar for every time I’ve had a client ask me to tell them exactly what to eat or give me a specific meal plan I would be rich.  This meme sums up my general internal reaction when someone asks me for this information.


    Telling someone exactly what to eat is about as helpful as sending them down a blind alley.  People need to understand why and what and how they should eat so they can make smart decisions on a regular basis that positively impact their health.  In Part 1 of my article I discussed how to take your body from “Fit” to “Super Fit”.  I gave you reasons why you may not be getting the results you want and I gave you some tried and true takeaways for dialing in your nutrition so you can make 2018 the year to get to that next level.

    In Part 1, I did not give you specific diets and I didn’t tell you exactly what to eat.  However, I did make some pretty significant suggestions, such as, paying attention to carbohydrates (how much and when to eat them), planning food and exercise for the week, and following the 80/20 rule.  These ideas were not just taken from thin air. I did a little leg work and my own research using four amazing “super fit” subjects that I know personally.  These subjects were kind enough to give me their sample daily diets and open up their lives so we could get a glimpse.  I extrapolated their calories, macro nutrients (fats, carbs, protein) and gave a comparison of their overall nutrient intake.  The most interesting portion of the data was that their carbohydrate intake had the least amount of variance.  The mean carbohydrate intake was 27% with a variance of only 10. The mean protein intake was 35% with a variance of 35. The mean fat intake was 38% with a variance of 45.6.  It seems their ability to stay lean may have more to do with their carbohydrate intake than their fat or protein intake.  For any trainer, dietician, or strength coach who is currently banging their head against the wall in frustration after being asked “exactly” what to eat to get lean, please refer your client to this article.  They can have a field day studying every minute detail of four extremely fit people.  They can then choose to eat exactly as they eat and treat this as a meal plan or read the takeaways and model their diet around these concepts.

    Drumroll please!!!


    Below are the daily diets of 4 super fit people. They have kids, and jobs, and school, and lots of life commitments that keep them busy. They have different levels of super fit but they all look great, move well, feel happy, maintain a lean body, and eat well for their activity levels. We can all learn a lot from how they do it.  It’s your choice!  You can follow their diets and eat only what they eat or you can use this information to extrapolate the big picture so you can become smarter and more educated about how to fuel your own body.  Please enjoy and make sure to read all the way through so you can get the main takeaways at the end!


    Nate Edwards, MS, CSCS, USAW, CF-L1 – Nate is an amazing full-time strength coach with his own business, Grind to Shine. He lives in Shreveport, LA with his wife and 3 young kids, and he hits it hard in the gym. He’s probably one of the strongest trainers I’ve ever met.


    Grind to Shine



    Meredith Bearden, Landscape Architect – Meredith lives in Charleston, SC with her husband and two toddlers. She is a full-time mom, landscape architect and runs her own business, High Ground Design. Meredith loves exercise and it shows. She does circuit training, boot camps, strength training and pure barre. She typically works out 4-5 x per week.



    Jamie Lynch – Jamie lives in Mount Pleasant, SC with his wife and 2 young girls, ages 10 and 8. He works at his family business, Envirosmart Inc. Jamie loves working out, specifically Olympic weight lifting, which he does 3-4 days a week. He also finds time to do 1 day of cardio and / or yoga a week. Jamie says sports have always been a big part of his life and have served as a source of motivation and stress relief for other parts of his life that require 100% of his effort.



    Nicki Carter, CPT – Nicki Carter lives in Charleston, SC with her husband. She works as a cytogenic technologist and personal trainer at MUSC Wellness Center and she has competed in NPC physique competitions for 3 years. She entered the world of fitness later in life after her mother suddenly died at the early age of 47. She says this was a wake up call in her own life. To say she is super passionate and committed is an understatement! Check her out at Fit Nick Training!


    Here is a comparison of their overall nutrients and percentages.


    A few points they all have in common:

    • They all drink lots of water and they all drink coffee.
    • They all let loose and eat whatever they want 10-20% of the time depending on the week.
    • They all eat to fuel their workouts and to recover from them.
    • They all start their days with very little carbohydrates.
    • They all end their day with a very healthy well-rounded dinner.
    • They all avoid any processed carbohydrates like bread, sugar, cereal or pasta.
    • They all listen to their bodies and eat what feels best for them.
    • If they have a big night out they get right back to it the next day and don’t let it derail their goals.
    • They all workout consistently and really push themselves in the gym.
    • They all focus on what they are gaining and lift heavy weights with a focus on getting stronger not getting smaller.
    • They all are organized with food preparation and making time for exercise.

    For even more information on how to find balance and get lean, check out Part 1 of my article.  Educate and empower yourself to understand the body and it’s needs and you will develop life long habits that help you get to that next level of fitness.

    Let 2018 be the year you go from fit to super fit!


    Click here for Part 1 of this article!


    Author: Katie St.Clair


    Katie St. Clair has over 20 years experience coaching athletes, fitness enthusiasts and everyday men and women looking to live a healthier lifestyle. Katie received a B.S. in Exercise and Nutritional Science in 2001 where where she also worked as a student athletic trainer. As a competitive gymnast for 12 years and lifelong athlete, Katie learned through her own experiences with pain that nothing is more valuable than learning to treat and prevent disfunction while still maintaining a very active lifestyle. Her passion is working to help people achieve their goals while preventing pain and empowering them with the tools they need to keep their body in correct postural alignment. She has extensive education in body alignment and postural correction as well as nutrition. Katie is a mom, wife, and business owner living in Charleston, SC. She loves to challenge her body in the gym, surf, snowboard, travel and spend time with her family on their boat. For more information check out her website at


    Fit to Super Fit – A guide to taking your body to the next level – Part 1

    As we head into 2018, I wanted to give my readers some sound information on nutrition and exercise and how to take it to the next level!  Who doesn’t love a little New Years fitness motivation!  It’s the perfect time to kickstart great habits and there is just something about the new year that gets people chasing after goals.  So let me play my part and give you a little motivation for 2018!!  In Part 1 I’ll break down what it takes to be Super Fit.  In Part 2 I’ll give you concrete evidence and a sneak peak into some extremely fit trainers, moms and dads, and even a bodybuilder’s actual lifestyle.  I’ll literally give you their daily diets and workouts and let you see just what it takes.

    Part 1 – From Fit to Super Fit

    Americans are more divided in fitness and nutrition than ever!  Whether perusing social media, working out at the gym or training my clients, the distinction between the superfit over-exercisers and those struggling just to walk in the gym and stick to a mediocre diet is palpable. I’m hardly surprised at this contrast given the amount of information available at the touch of a key. We are inundated with messages about diet and fitness at every turn. “Lose weight fast.” “Gain muscle with these 10 tips.” “Sugar is bad.” “Gluten is toxic.” “How to get a six pack in 6 days”. There are endless videos of super ripped trainers, shirtless, performing ridiculous amounts of sets and reps and exercises. The programming seems pointless and we never hear about pain or diet or sacrifices they have to make to be that “fit”. It’s all noise creating disillusionment among those trying to make real solid changes and adding fuel to the fire of those likely to over train because “more” is always better. As a trainer for 18 years, I have watched this industry change from the days of step aerobics, Tae-bo and hi / low classes to HIIT (High Intensity Interval Training), Bootcamp, and CrossFit.

    9B85670D-6C25-44D3-93CB-EA713DFC04DFThose leotards!!

    I  vividly remember the Seinfeld episode with the non fat yogurt mystery!


    The FDA had us follow the food guide pyramid and said low fat / high carb was the way to go. 

    The Food Guide Pyramid

    Today the pyramid is slightly different, but I still refuse to put my trust in the FDA. Let’s be real, they haven’t really been great advisors in the past.


    Americans are living in a world of far lefts and far rights, lacking in middle ground.  This divide is unmistakable in the fitness industry and I have watched the separation increase with every year that has passed. “When it comes to fitness and healthy living, I feel like a lot of people are always living in extremes. This is not sustainable.  I’ve personally been there.  We must find what we enjoy, what we can sustain, and what works for us.  We must find balance.  Balance is the key”, says Nicki Carter, CPT and physique competitor.  I hope I can dig through some of the noise for you and give you some tried and true information on how to be super fit and balanced in your life.  I’ll show you that being able to lift more, move better, achieve your goals, and maintain a healthy, muscular, lean physique is achievable to everyone (even working moms like me).  I hope to inspire you as we get closer to the new year and give you a balanced, realistic approach that has a touch of “letting it loose on the weekends” and a dash of “blood, sweat, and tears”. The information I’m about to offer is not for achieving the physique of an elite level athlete or fitness competitor. Nor, will I tell you to start doing weekend warrior, vomit inducing workouts. It is sound information for having a rock solid body, mindful attitude about fitness, and the ability to keep up with work, family, kids, dogs, and all the other chaos that takes over our lives.

    I will break down my rationale for healthy eating habits and healthy exercise habits based on the following percentages of information:

    1% = what the government says
    19% = Nutritional Science (let’s face it, we’ve had some bad apples here too, and even scientific journals can be misleading if special interests are backing the research, but I think they have more cred than the government)
    40% = what my body is telling me I need.
    40% = what I’ve seen successful athletes, coaches, and friends who have maintained a healthy weight and active lifestyle do on a daily basis.


    I could go through a litany of scientific journal articles regarding nutrition, metabolism, and biochemistry but I’ll save you snores and having to scroll through most of this article to get to what you and I will find most valuable: how to listen to what your body needs, and learning from those walking the walk every day. I’ll give you specific daily diets and examples of people I personally know to be super fit and find balance. I’ll show you that the diets and workout habits of athletes, body builders, iron-men, and moms and dads who are really fit are not all that different from one another. Read on to find a no nonsense middle ground approach to get super fit.

    3 Reasons you may not be seeing the results you would like.

    Reason 1: You don’t move enough.

    You are exhausted all the time. You push snooze six times in the morning and constantly yawn and feel down about life most of the time. You work an 8hr a day job sitting at a desk and you struggle to get through the workday without feeling like you need a nap. You get off work and head home and have just enough energy to watch tv and make a few trips to the fridge for snacks. A couple of times a week you take a class at the gym and maybe hit the treadmill one other day.


    You are not getting enough physical activity! I’m going to be real with you. If you want to be toned, athletic and agile the bare minimum will be three vigorous workouts a week involving full body lifting and interval type activities as well as 2 sessions that get you breathing and moving. These could involve your favorite sport or a spin class or just a run outside, but they definitely need to be slightly vigorous. And your days off should still be centered around an activity that gets you moving. (i.e. long walks, taking a bike ride, playing outside with your kids). While I’m sure this sounds daunting, you may notice huge benefits in the rest of your life. You will likely have more energy at work and be motivated to eat well to fuel your amazing workouts. I also suggest working out before work or during your lunch break. You will be less likely to skip and the early mornings will encourage you to go to bed early, leaving less room for late night snacking. Jamie Lynch (super fit dad) says, ” I exercise everyday at lunch By choosing this time of day, I don’t have to give up family time and I can return to work energized and ready to tackle the rest of the day.”

    Reason 2: You are getting way too much physical activity and not enough rest.

    You feel exhausted but drink coffee all day long to keep going so you can get everything done and still never actually catch up. You wake up at 4:30 in the morning to hit the gym at 5, lift weights plus do high intensity intervals for an hour and then head to work for 8 hours. As soon as you get off you head back to the gym for another hour of cardio or maybe to take a spin class. When you leave the gym you head home to get dressed to go to dinner with friends and then get home and hit the bed at 10 just to do it all over again. Or worse, you have 3 kids and as soon as you get home you spend the rest of the afternoon going non-stop: cooking, cleaning and making their every dream come true. When you are lucky and get them all to bed at 8, you spend the next 2 hours doing the stuff you didn’t get done due to kids and then finally fall asleep around 11.

    6 hours of sleep with high levels of activity and lots of caffeine are not a good mix. Cortisol is not your friend! Your body and mind will break down at some point and make it very difficult to make improvements in fitness. It’s time to get some balance. You shouldn’t have to work out 2 times a day to be fit, and if you do workout for 2 hrs, you should be certain you can go to bed at 9 to recover. I’m not going to tell you to take 2 days off a week if you love exercise and it makes you feel good and you have the time. Some people need exercise and activity for mood and other benefits. However, you should balance your intense workouts with very light cardio, relaxing yoga, or just running around with the kids a couple of days a week. Every workout does not have to be a marathon or make you feel like you can’t sit down on the toilet without cringing about the pain in your quads.

    Symptoms of Over-Exercising:

    1. It’s difficult to complete your normal workouts
    2. You are getting sick more often
    3. Persistent muscle soreness and fatigue
    4. Exercise drains your energy instead of increasing it.
    5. Depression, irritability, anxiety or insomnia
    6. Your resting heart rate is higher (or lower) than normal for an extended period of time. 
    7. You start to experience more workout overuse injuries.
    8. You experience headaches more often.
    9. It takes longer to recover from hard workouts.
    10. Your interest in exercise has diminished.

    Reason 3: You are not eating to fuel your activity level.

    Your workouts feel like drudgery and you don’t actually sense hunger or fullness. This is tricky. There can be a fine line between ideal weight and fitness levels and nutrition. If you resonate with reason 1 and are basically a couch potato, then your diet has to be really good to not gain weight. Even then, you will probably never get to any level of fitness because movement is required. If you find you are in line with reason 2 then you may find you either overeat because you are constantly hungry from too much cortisol or you under-eat because you don’t take the time to be prepared with healthy food or you cheat by living off of shakes and bars and nutritional supplements.

    Listen to hunger and satiety cues and take the time to eat slowly. Fuel your workouts with the right nutrients and eat a healthy after workout snack. Enjoy your food and eat real unprocessed food. I love this quote from strength coach Nate Edwards, MS, CSCS, “If it had parents, walked, swam, or flew, eat it! If it came in a box, bag or doesn’t go bad within 2 weeks, try to stay away from it. Eating is the answer to recovering from whatever sport and activities you do.”

    Top takeaways for dialing in your nutrition and exercise so you can make 2018 the year to get the super fit body you’ve always strived for!

    Be structured, organized and consistent! 

    • Saying I’m going to eat healthy and exercise more this week is not enough!  Workouts need to be planned and need to include intensity, hitting all areas of the body, focusing on goals (i.e. gaining strength, gaining endurance, becoming quicker, gaining balance and agility…) and proper recovery.  You may need the help of a great trainer to help devise a plan for you.
    • Food needs to be planned out for the week.  The fridge should be stocked and ready for the week with lots of healthy protein and veggie options cooked, cut and ready to grab.  All your dinners should be planned out and you need to go to the grocery with a list in hand. This may take an extra hour on the weekends but it is non-negotiable to get to that next level.
    • Consistency is everything!  You can’t have a good week followed by a bad week.  You also should not have a bad day.  Maybe you plan on a night out with drinks, burgers, and dessert. You can have it all, but focus on getting a workout in and eating clean until dinner as well as the day after.  Post hangover fast food is a deal breaker if you want a body that is rocking! Remember 80-90% of the time you should be eating clean. Meredith Bearden (super fit mom) says, “My hobby is making time for girl’s nights with my mom crew where we indulge in good food, good wine and lots of laughter.  I consider it a treat to myself after all my hard work of challenging myself to keep a healthy balance of exercise and nutrition.  Work hard! Play hard!”

    Focus on how you feel!

    • Exercise should energize you, not make you completely wiped out.  Conversely, you have to move enough to see and feel visual and physical benefits.  Track your workouts and pay attention to your goals.  Push yourself when you have extra energy and time to rest.  Take time for yoga, meditation and long walks when you feel overworked and over stressed.  These slower mindful forms of exercise are your time to pay attention to how your body and mind are feeling.

    Pay attention to carbohydrates.

    • The one thing all my super fit people have in common is zero processed carbs (i.e. bread, pasta, chips, white rice) and eating most of their non processed carbs (i.e. fruits, veggies, and whole grains) pre and post workout.  Your diet should consist of mainly lean meats, fish, beans and legumes, healthy fats, and veggies.

    Prioritize your gains not what you are losing.

    • Although, I admit, seeing a lean physique in the mirror is super motivating, it won’t sustain your healthy lifestyle.  Focus on gaining muscle, strength, agility, power, balance, coordination, and energy.  These goals will keep you going even when the scale stops moving.  focusing on the positive gives you tangible motivation and reinforces a positive reward system in your brain.

    Eating and moving to lose weight = negative reinforcement

    Eating and moving to feel strong = positive reinforcement 

    Finally, if you are struggling with motivation seek the help of an amazing trainer or nutritionist.  If either of these options is not accessible to you or too expensive then ask a friend that is fitter than you if they can help. In my experience, most people who feel great love to pass it on.  I’m sure any of my subjects above would be happy to help.  Here’s to a super fit body in 2018 and forever!

    For specific research and a sneak peak into the subjects I used for this article check out Part 2!



    Katie St. Clair has over 20 years experience coaching athletes, fitness enthusiasts and everyday men and women looking to live a healthier lifestyle. Katie received a B.S. in Exercise and Nutritional Science in 2001 where where she also worked as a student athletic trainer. As a competitive gymnast for 12 years and lifelong athlete, Katie learned through her own experiences with pain that nothing is more valuable than learning to treat and prevent disfunction while still maintaining a very active lifestyle. Her passion is working to help people achieve their goals while preventing pain and empowering them with the tools they need to keep their body in correct postural alignment. She has extensive education in body alignment and postural correction as well as nutrition. Katie is a mom, wife, and business owner living in Charleston, SC. She loves to challenge her body in the gym, surf, snowboard, travel and spend time with her family on their boat. For more information check out her website at

    Live. Move. Breathe.

    Want to live bigger?

    Do something you can’t do. Find something that scares you 😳and try it. If you aren’t good at it, keep going, even if it sucks REALLY bad😩, until you are better at it and find success in it.

    Key Point: It must scare you just a bit! If it is easy and you can do it in 2 weeks then the success of it won’t be enough to change you. Get better at being nervous, scared, extremely heightened in a sympathetic state so you can get better at getting right back to a chill, hell yeah, enjoying parasympathetic life-ness, bad ass BOSS state.💁‍♀️

    Want to move more?

    Find all the ways you can’t move and learn how to improve those movements. Move every joint and see where limitations exist and work really hard to find more range of motion and movement variability.

    Key Point: You won’t feel like an amazing athlete 🏃🏻‍♀️and you may feel like you are a huge loser🚶🏻‍♀️ because you can’t raise your arm overhead with more than 10lbs. Just say F*## it because better movement progressively and slowly overloaded is way cooler than lifting 50lbs overhead with shitty form (aka: banging your freaking head against a wall non stop and still feeling pain).🙈

    Want to breathe better?

    Take a long sighing exhale 😤and put yourself in a position to find your abdominals, hamstrings and your glutes, preferably all at the same time. Try to inhale without any of this turning off. If you can’t breathe or you feel like your breath is like sucking through a straw with a piece of ice stuck in it🥵, then you are doing it right. Just keep trying and your body will get better at widening that straw in this position and learning to breath in it.

    Key Point: If it is really easy to inhale in whatever position you are in, then get in a different position and retrain your breathing. If you are completely lost by this one, keep your feet and knees together, reach forward and squat to the floor, keep your chest down, now inhale. If you can’t do this go back to moving better. 👆

    Want to feel amazing?

    Shut the world out for at least 10 minutes a day and preferably 30. 💆‍♀️ I don’t care if you take a walk, meditate in an open field surrounded by daisies🧘🏼‍♂️, follow headspace, pray to whatever god you follow, or have sex, but give your brain a well earned break from constant thought.

    Key Point: If your brain feels like it’s living in a blender on low speed, you wake up at night in constant thought on a regular basis, you snap at the smallest indiscretion, 🤨then it’s time to add some meditative activities to your daily routine. If this seems insurmountable go back to breathing better. 👆

    Wellness Words Book 1: The Slight Edge (Book Discussion Chapters 5-8)

    Week 2 Discussion

    Chapter 5

    The Quantum Leap Myth

    Chapter 5 discusses the myth of the “Quantum Leap”.  It says that the term Quantum Leap comes from physics where it is referring to the fact that “energy, after a period of time, will suddenly appear at another level, without our having been able to observe how it got there.”  Even though you couldn’t see it, there were millions of steps along the way that made the change in energy.  There is no big breakthrough and success is not a random accident like winning the lottery.  The ending of slavery, the creation of the light bulb and walking on the moon all took thousands of small steps.  “Believing in the “big break” is worse than simply being futile.  It’s actually dangerous because it can keep your from taking the actions you need to take to create the results you want.”

    In pursuing health goals, one of the major quantum leap myths that comes to mind is when you eat well and exercise for a week only to step on the scale and see no change.  Out of disappointment you may decide to stop taking the healthy steps and allow yourself to go off course.  If you had continued on course for 2 weeks the scale might have dropped 5 lbs and you would have been achieving the slight edge.

    Question 1 

    Where in your life have you kept a false belief of the Quantum Leap Myth and how has it held you back from taking small steps?  Have you had any quantum leap myths in terms of exercise, diet, or health?

    Chapter 6

    Two Life Paths

    Chapter 6 begins with Robert Frosts, “The Road Not Taken”.  This is a great example of having two choices in all aspects of life.  Life is always moving up or down, there is no straight line.


    One out of every twenty people will achieve his or her goals in life and regardless of what realm we are talking about, the average success rate is 5%.  We have to ignore gravity and all the “no’s” we hear in our lives.  If you are on the upper curve your predominant mindset is responsibility, gratitude, appreciation and focusing on the future and if you are on the downward curve your mindset is blame, fate, chance and focusing on the past.  “Step onto the upper curve, the path of success, and you will put any area of life on track within a handful of years at the most.”

    Question 2

    Which side of the Slight Edge curve are you on right now in terms of your health and wellbeing?  Take into account the way you eat, exercise habits, schedule and sleep, stress management…  Which side are you on with each of these aspects of health?  If you stayed on the upper curve day in and day out, how long do you think it would take you to achieve the health you desire.

    Part 2 – Mastering Your Life

    Chapter 7

    Mastering the Slight Edge

    Chapter 7 begins with an explanation of Mastery by George Leonard.  He says that Mastery is not an exalted state at the end of the path but is a state of mind that lies at the very beginning.  “Mastery is the act of setting your foot on the path.”  We are all born with Mastery.  There is a childlike willingness to keep going but when life gets heavy it can be easy to step off the path and make giving up a habit.  The more you give up the easier and easier it becomes.

    Wanting hurts but it is important to take a hard look at what you do want and feel uncomfortable with the fact that you don’t have it.  It may take being uncomfortable to get it. The tension between where you are and where you could be, Point A to Point B is uncomfortable. The choice is to move A closer to B, constantly towards your goals and dreams, or to move B towards A, let go of all your dreams and goals.  It is less comfortable to move A closer to B but embracing this philosophy will allow you to be far more comfortable later on.

    Question 3

    Can  you think of ways you are avoiding being uncomfortable in your health and fitness journey?  Are times in your life when working out or going to bed early or eating healthy are uncomfortable so you choose the down curve?

    Chapter 8

    Faces of the Slight Edge

    The more you understand and become familiar with the slight edge and it’s many disguises, the more you will come to see it’s influence in your life.  The powers of the slight edge are momentum, completion, habit, reflection, and celebration.

    The power of momentum is found when you do small things day in and day out, every single day.  Choosing small achievable habits you can succeed at each day will provide momentum.  If the task is insurmountable, like walking 2 hours a day and strength training for an hour, then it may be easier to stop which makes it harder to get going again.

    The power of completion helps you gain momentum and harness it to your advantage.  Incomplete promises, commitments and tasks inhibit your ability to move forward and keep you trapped in the past. Approaching incomplete tasks with the Slight Edge is the only way to deal with them.

    The power of habit can take you on the success curve or the failure curve.  Your habits come from the daily activities you choose and this is based on your philosophy. You have to take baby steps to create new and better habits.

    The power of reflection means you have to be honest and think about what you are doing everyday.  Instead of writing down what you are going to do you should reflect on what you actually did that day and if you were moving forward on the success curve.

    The power of celebration is to remind you of all of the positive steps you are taking.   Reflection helps you to catch yourself doing something right and acknowledge it and celebrate it.  “Make each successful right choice a celebration.”

    Question 4

    Are there any powers of the slight edge that you struggle with?  Do you struggle to consistently workout or eat healthy?  Do you reflect and celebrate your healthy habits no matter how small?



    MUSC Rooftop Workout

    This workout is designed to work on power, agility, and general strength and conditioning. I warmed up with a 1/2 mile run (3 laps around MUSC track) and 6 flights of stairs (3 1/2 flights each).

    Circuit 1 has 3 exercises: Pull-up (strength), Rainbow Floor Slam with Chest Pass (power and conditioning), and a Lateral Hop with Reach (agility and conditioning).

    Circuit 2 has 3 exercises: Pushups (strength), Russian Swing (power and conditioning), and Side Shuffle with Rotational Slam (agility, power, and conditioning).

    Superset 1 has 2 exercises: Sled Push (conditioning), Plank Row (strength).

    Superset 2 has 2 exercises: Hanging Leg Raises (strength), Power Step Ups (power, conditioning).

    I finished with a 1/2 mile jog (3 laps around the track)

    As always use a weight you can handle while maintaining good form and do not hesitate to message me for modifications. This workout is meant to be big challenge so modifications may be necessary.

    Postural Restoration of an Ironman – Session 2

    I met with Coo today after two weeks of her doing her respiration exercises. See the full evaluation and exercises I gave her here. She was very compliant and did her exercises everyday. She competed in a sprint triathlon in Paris Island where she took 1st place in her age group and 6th overall. Here are Coo’s stats for those of you interested. She did not have any pain in her feet, however, she previously reported that her feet were not an issue until mile 8 and her run was a quick 5K. Overall, she has reported better breathing and more awareness of her body’s asymmetries. Her left hamstring was still irritated and was her main complaint.

    So let’s get to the nitty gritty because Coo just committed to the 2018 Florida Ironman on November 3rd!

    Here’s Coo’s Retest for the PRI Fam. As always, feel free to skip the technical stuff and  move onto layman’s terms.

    Assessment – 2

    Coo had negative apical expansion on both sides, her first rib was much more mobile and her cervical rotation improved. Her infrasternal angle was symmetrical on both sides, less narrow and 45 degrees. She had a no improvement in her Myokinematic tests, although I was not expecting much based on her exercises and the intensity of her triathlon on Saturday. She was in a greater anterior tilt and both her FA IR and FA ER were more limited. She still was not feeling her anterior glute med during active internal rotation and her straight leg raise was even greater.

    English Please!

    Coo greatly improved her ability to get air and expand through her back without using the muscles of her neck. This improved the position of her rib cage and calmed down muscles that she over uses to try and get air. Her hips, likely as a result of her event, were in a greater anterior tilt. So she is actually starting to look more like this guy! NO BUENO! We need to intervene and make it our mission to get that pelvic positioning back to neutral


    However, the fact that her ribs no longer look as much like this is going to make it a lot easier for us to achieve a neutral pelvis


    Here is a picture of what we would like to achieve.

    Good posture means you have abdominals that are killing it, hamstrings that are doing their job, adductors that are ready to control that heel strike, neck muscles that can chill, and a diaphragm that is the boss of it all! Basically Coo can let her diaphragm breathe so all her other muscles can help her win her next Ironman! Whoop! Whoop!

    Here are my goals for Catherine this week:

    1. Have her continue to work on breathing and keeping her ribcage in a neutral position.

    2. Shut off her TFL’s (Tensor Fascia Latae / Hip flexor) so that she can reposition her pelvis a bit easier.

    3. Get her hamstrings working so we can get a little control over that straight leg raise that is off the charts! No more Loosey-Goosey hamstrings that “feel” tight but really are not tight at all!

    4. Get her left ischiocondylar adductor (hamstring portion of the inner thigh) and left anterior glute med (side of the hip) working like a boss when her left heel hits the ground during stance phase of her gait. This should help reduce some of that strain she is feeling on her left hamstring and eventually reduce the pressure on her fore foot that is causing her neuromas.

    Here are Coo’s Exercises for this week:

    1. All Four Belly Lift

    Coo should continue her breathing (posterior mediastinum expansion) and focus more on the tilt of her pelvis and contraction of her abdominals using the All Four Belly Lift. I instructed her to make a long “Ahhh” sound and to feel the deep abdominal muscles contract from one side to the other. I also, wanted her to focus on pulling her pelvis into a posterior tilt (belt buckle to chin) so she could relax her lumbar spine (low back) as she exhaled.

    2. Left Glute Med / TFL Inhibition (Right Sidelying Supported Hemi 90-90 with Left FA IR)

    This exercise from PRI is one of my favorites because it inhibits the TFL and facilitates the Anterior Glute Med at the same time. Here is my textbook instructions of the exercise but you can also click on this video from On Track Physiotherapy that does a great job of explaining the exercise.

    3. 90-90 Hip Lift

    The 90-90 Hip lift is one of my go to exercises for a LOT of my clients because it is a great reset post workout or anytime of the day to get your low back to relax and allow your body to get a break from lumbar extension. I am having Coo reach forward in this exercise so she can also work on her rib positioning (narrow infrasternal angle). Here is everything you ever wanted to know about the 90-90 hip lift from Zac Cupples. This is an incredible overview of the exercise. Here is a great YouTube video from Integrative Human Performance that can quickly guide you through. 90-90 from Integrative Human Performance.

    4. Left Ischiocondylar Adductor

    This exercise is working on the adduction of Coo’s left leg as well as the abduction of her right leg. I want her to focus on keeping her head, hips and foot in a line and not allowing her hips to rotate back. She is lifting her left knee off of the floor and feeling her left inner thigh and left outer hip engage. Here is a quick clip of me coaching this exercise with her.



    She sent me this text the next day and it definitely made me smile because I know she was struggling just to get that knee off the floor the first time we did this. img_1013Coo

    Coo is instructed to complete these exercises 1-3 times per day for 5 sets of 5 breaths. Here is a recap of the breathing technique from Session 1.

    The basic breathing instructions I gave her are as follows:

    1. Inhale gently through the nose for 4 seconds.

    2. Exhale in the form of a sigh (think of making the ahhhh sound) for 8 seconds. As you exhale gently feel the contraction of your lower abdominals and obliques (think TVA and Internal Obliques)  Try to feel entire contraction from the left to right side.

    3. Hold the air out while pushing your tongue onto the roof of your mouth behind your teeth for 3 seconds. Keep your abdominals engaged.

    4. With abdominals engaged and tongue on the roof of your mouth, inhale gently through your nose trying not to allow the rib cage to lift up and pushing air into your back.

    5. Repeat for 5 breaths.

    General Exercise Prescription

    In addition to these PRI exercises I also gave Coo some instructions on general exercises to add into her workouts.  She is currently doing 2 strength workouts a week and potentially could do more.  The load will decrease as she increases her Ironman training but for now this is fine. Because Coo is a trainer I didn’t go into a ton of detail but gave her the following guidelines.

    1.  Add adductor exercises.  One of my favorites is the side plank with adduction. Here is another one that I recently posted on Instagram. Crawling with adduction. 
    2. Add any hamstring exercises but focus on some eccentric hamstring exercises.  Eccentric hamstring curl on ball, hamstring curls on foam roller with eccentric roll out, bridge walk outs, etc.  And of course, deadlifts, and single leg deadlifts are always go to’s.

    Stay tuned for my next blog when we reassess Coo and see some great changes to her pelvis!


    Two weeks ago I was in the middle of a session with two female clients, Beth and Susan.  They are in their mid 50’s, intelligent and strong physically and mentally.  In random conversation I mentioned something regarding my “girl” friends.  Beth spoke up, “Have you ever noticed how women refer to each other as girls all the time?  Katie, you were just referring to your friends as girls.  Doesn’t that seem strange that we do that?  Men rarely refer to each other as boys and women rarely refer to men as boys.”  B64C1801-37A0-4C28-BA8D-31FE9F5BE56C

    Honestly this had never even occurred to me.  I think at one point we were all nodding in unison saying, “That is so true!  I never even thought about that, but it happens all of the time!”  As we continued to talk, I actually caught myself saying “girl” friends a couple more times out of pure habit.  Here we were talking about the demeaning nature of calling women girls and I couldn’t stop saying it! Thank goodness I had Beth there to correct me.

    The more I thought about it, I began to see just how prevalent this term is in the world and in the fitness industry.  We are living in the time of #metoo and the women’s marches and the fight towards equality for women.  At the World Economic Forum last week, women made up just 21%.  Do you think those women, especially Malala Yousafzai, would have felt heard and respected by Justin Trudeau during his feminist speech and womens equality meeting if he referred to them as girls?


    Women are thriving more than ever in the typically male dominated area of personal training, strength coaching, and athletic training.  Women are all over social media lifting heavy weights, talking about accepting our bodies, doing pull-ups, and focusing on what we are gaining and not losing.


    Yet, every time we used the term “girls” to describe clients, friends, workout partners and any other females in our lives we are degrading women in this industry.  Think of all the fitness slogans that are making millions by marketing the strength of women on the internet using the term “girls”: Girls Gone Strong, Girls Who Lift,  Lift Like a Girl, are just a few of the examples.  These sites, workouts and books are actually pretty amazing and celebrate the incredible ability of women to be strong and to be proud of a fit / not skinny body.  I have to assume they are just unaware of the discredit they give to strong women when they call them girls. Guilty right here!!!  🙋‍♀️

    If Beth had not pointed it out to me I would have continued on using the term girls without even thinking about it and every time I did I would have made a small unconscious concession on the part of women’s equality.  Wow!  I sure am glad she made me aware!  Sometimes as coaches, if our ears and hearts are open, we are fortunate enough to get trained on some pretty existential lessons from our clients.  This moment was one of those lessons for me.

    I’m not going to tell you it’s right or wrong to use the term “girls” as opposed to women or females in the fitness industry.  That is not my place.  However, I do want put it out there for all the strong women in this industry and have them contemplate how it makes them feel.

    Maybe it’s time to start a discussion?  What does it do to regress or progress our status and equality to men in the industry?  If one word in our vocabulary can make an impact on our station in life, should we make an effort not to use it in the wrong context?  If it ruffles feathers, or makes us look like crazy feminist freaks, do we really care?  Our mothers and grandmothers fought for the rights we have today.

    Women's Strike For Peace-And Equality

     After all, we aren’t supposed to give a shit about what others think of our bodies because its all about being strong women.  So, should’t we, at the very least, stop referring to each other as children?

    Here are a few stats I will leave you with as you ponder these questions.  In addition, I will be starting a women’s fitness movement hashtag.  If you are on board, post anything you want with the hashtag, #dontcallmeagirl.

    Instagram Hashtags:

    #girlswholift – 19,663,386 posts vs. #womenwholift – 1,257,734 posts

    #girlsgonestrong – 83,831 posts vs. #womengonestrong -555 posts

    #girlwithmuscles – 2,673,159 posts vs #womenwithmuscles – 146,608 posts

    Here is a snapshot of a certification available on the website.


    While their goals are on point and they definitely speak to women’s empowerment in the industry, they are still calling themselves GIRLSgonestrong!  Slight contradiction?  I think so!

    Here is a second screenshot from a popular fitness clothing line called Girls Who Lift.



    For the record, these WOMEN don’t look at all like girls to me.  In fact, if I had a girl, I would never let her out of the house dressed like this.  In addition, the entire women’s fitness industry is way over sexualized (I will save my feelings on this for another post).  Let’s not make it worse by using the term GIRLS to describe clothing that is also oversexualized!

    As a WOMAN in this industry I solemnly vow to stop using the term GIRLS to describe my friends, coworkers, other trainers, and anyone who is above the age of 18.  In doing so, I hope to elevate the stature of the professionals in our industry so we see more WOMEN speaking at fitness conferences, more WOMEN lifting heavy, more WOMEN as strength coaches and ATC’s, more WOMEN representing strength in all it’s forms.   In doing so I hope we can quiet the noise of large companies and infinite hashtags that make us just a bit smaller and less powerful by calling us girls.


    Katie St. Clair has over 20 years experience coaching athletes, fitness enthusiasts and everyday men and women looking to live a healthier lifestyle. Katie received a B.S. in Exercise and Nutritional Science in 2001 where where she also worked as a student athletic trainer. As a competitive gymnast for 12 years and lifelong athlete, Katie learned through her own experiences with pain that nothing is more valuable than learning to treat and prevent disfunction while still maintaining a very active lifestyle. Her passion is working to help people achieve their goals while preventing pain and empowering them with the tools they need to keep their body in correct postural alignment. She has extensive education in body alignment and postural correction as well as nutrition. Katie is a mom, wife, and business owner living in Charleston, SC. She loves to challenge her body in the gym, surf, snowboard, travel and spend time with her family on their boat. For more information check out her website at