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Tali Duer

@taliduer

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PT owner @proxtherapy 🤲
Movement specialist
OCS, DNSP, CI
Artist 🎨
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Balloon breathing is a highly effective neuromuscular re-education exercise, that utilizes external resistance to fix a rib flare, optimize intra-abdominal pressure (IAP), and build deep core stability. When your ribs flare, your diaphragm is pulled into a flattened, sub-optimal position, diminishing its ability to act as a spinal stabilizer. Blowing up a balloon forces a prolonged, resistance-backed exhalation that recruits your deep abdominal wall, bringing the ribs down and restoring the diaphragm’s ideal alignment. Try incorporating controlled balloon breathing into your warm-up before squats or deadlifts to practice breathing and trunk control under load. #DNSRehabilitation #CoreStability #DiaphragmaticBreathing #NeuromuscularReeducation #FunctionalTraining by @taliduer
Three years after a motorcycle accident that resulted in a right above-knee amputation, Reed Christy continues his rehabilitation at Pro-X Physical Therapy. Above-knee amputation changes biomechanics, sensory feedback, and weight distribution, requiring new strategies for balance, stability, and coordinated movement. Our rehabilitation approach focuses on neuromuscular control, core stability, gluteal activation, and functional strength through targeted exercises: Sit-to-Stand with Latissimus Pull: Challenging posterior oblique sling engagement, trunk-pelvic coordination, and controlled weight transfer. Pilates Reformer – Side-Lying on Long Box: Promoting hip control, gluteal recruitment, and pelvic stability while minimizing compensatory movements. Each exercise helps Reed develop the strength, coordination, and movement control needed to improve functional independence and confidence with his prosthesis. #AmputeeRehabilitation #AboveKneeAmputation #NeuromuscularRehabilitation #PhysicalTherapy #FunctionalRehabilitation by @taliduer
#fascia#steccofascialmanipulation #physicaltherapy #health #pain by @taliduer
A leg length discrepancy can contribute to pelvic asymmetry and compensatory spinal curvature, affecting posture, weight distribution, and movement mechanics. In this patient, a shorter right leg is associated with pelvic obliquity and spinal asymmetry. Using Dynamic Neuromuscular Stabilization (DNS), we focus on improving postural control, trunk stability, and coordinated movement through targeted developmental positions. High Oblique Sitting: Emphasizing left-leg loading while challenging trunk stabilization, intra-abdominal pressure (IAP), and coordination of the oblique muscle chains. Standing with Left-Leg Loading: Developing pelvic control, hip stability, and dynamic spinal alignment through controlled weight-bearing. These exercises aim to improve load distribution through the pelvis and spine, strengthen neuromuscular coordination, and reduce compensatory movement patterns associated with the leg length discrepancy. The goal is to develop greater stability and movement efficiency during everyday activities. #ScoliosisRehabilitation #LegLengthDiscrepancy #DynamicNeuromuscularStabilization #PosturalControl #PhysicalTherapy by @taliduer
The punctum nervosum, also known as Erb’s point, is a key anatomical region where superficial sensory branches of the cervical plexus (C2–C4) emerge along the posterior border of the sternocleidomastoid (SCM). These nerves provide sensation to areas of the neck, ear, scalp, and shoulder, making this region clinically relevant when assessing pain and sensory symptoms extending beyond the neck. The Fascial Connection | Stecco Fascial Manipulation From the perspective of Stecco Fascial Manipulation, the cervical region is part of an interconnected myofascial system that contributes to movement coordination and force transmission throughout the upper body. The deep cervical fascia surrounds and connects with structures including the SCM, trapezius, and surrounding cervical musculature, with anatomical continuities extending toward the jaw and temporal region. Restrictions in fascial mobility, altered muscular tension, and increased tissue sensitivity may affect local movement mechanics and contribute to irritation of nearby neural structures. How does this relate to pain? Dysfunction in the cervical myofascial system may be associated with: • Headaches and pain around the temples
• Jaw and facial discomfort
• Neck pain and restricted cervical mobility
• Shoulder pain and altered movement patterns
• Sensitivity or radiating symptoms along cervical sensory nerve distributions At Pro-X, we assess fascial mobility, cervical muscle function, nerve sensitivity, and movement coordination to identify potential contributors to these symptoms. Understanding the anatomical relationships between fascia, nerves, and muscles allows us to develop a more comprehensive approach to evaluating and treating myofascial pain. #FascialManipulation #SteccoMethod #MyofascialPain #NeckPain #ManualTherapy by @taliduer
Repetitive throwing places significant demands on the shoulder. When the kinetic chain is not effectively transferring force throughout the body, it can contribute to shoulder pain and altered throwing mechanics. This young quarterback presented with right shoulder pain. Our assessment identified scapular dyskinesis, reduced shoulder stability, and weakness in the anterior and posterior oblique muscle slings, which play important roles in coordinating movement between the lower body, trunk, and throwing arm. Using Dynamic Neuromuscular Stabilization (DNS), we are addressing these deficits through developmental positions that emphasize: • Intra-Abdominal Pressure (IAP): Coordinating diaphragmatic breathing and abdominal activation to improve dynamic trunk stability. • Joint Centration: Improving shoulder stability and joint control throughout movement. • Oblique Sling Function: Strengthening and coordinating the diagonal muscle chains involved in rotational stability and force transfer. • Neuromuscular Control: Developing efficient movement patterns and coordinated muscular activation to support the demands of throwing. Our rehabilitation approach integrates trunk stability, scapular control, and cross-body coordination to improve throwing mechanics, reduce excessive stress on the shoulder, and support a safe, progressive return to football. #QuarterbackRehab #ShoulderRehabilitation #DNSRehabilitation #ThrowingMechanics #SportsPhysicalTherapy by @taliduer
Three years ago, Reed Christy was my patient — before a motorcycle accident changed his life and resulted in a right above-knee amputation. He is back at Pro-X for rehabilitation. After an above-knee amputation, rehabilitation is much more than strengthening. The loss of the knee and distal limb dramatically changes sensory input, leverage, load transfer and movement strategies. The goal is not simply to make a muscle stronger — it is to help the nervous system organize efficient movement with a completely different mechanical system. That fits very well with the DNS, Dynamic Neuromuscular Stability approach we use at Pro-X. #DNSRehab #Amputation #PhysicalTherapy #Sport #Pain by @taliduer
The posterior oblique sling is a cross-body system connecting the latissimus dorsi on one side with the opposite gluteus maximus through the thoracolumbar fascia, helping transfer force diagonally across the body. Why do we test it? By challenging this cross-body connection and comparing both sides, we can assess for: • Poor diagonal force transfer • Reduced trunk, pelvic, or hip stability • Asymmetry and compensatory movement patterns • Deficits that may contribute to low-back, hip, or shoulder dysfunction This system plays an important role in walking, running, climbing, lifting, throwing, and rotational sports, where the opposite shoulder and hip must coordinate to create and control movement. At Pro-X Orthopedic Spine & Sports Therapy, we assess how the entire kinetic chain works together to better understand what may be contributing to pain or movement dysfunction. #PosteriorObliqueSling #KineticChain #DNSRehab #SportsRehab #PhysicalTherapy by @taliduer
When we evaluate limited shoulder mobility, we shouldn’t look only at the shoulder. The thoracic spine, rib cage, scapula, and glenohumeral joint work together to support efficient shoulder movement. In this DNS crawling position, controlled thoracic rotation is performed while maintaining upper-extremity support and shoulder centration. As the thorax rotates, the scapula must adapt to the changing position of the rib cage. Limited thoracic mobility can alter scapular mechanics, contributing to compensatory shoulder movement, reduced overhead range of motion, and increased stress on the shoulder. This exercise integrates thoracic rotation, diaphragmatic breathing, intra-abdominal pressure, scapular stabilization, and shoulder centration into one developmental movement pattern. #ShoulderStability #ThoracicMobility #DNSRehab #ShoulderRehab #PhysicalTherapy by @taliduer
The anterior oblique sling is a cross-body system that helps coordinate the trunk and opposite extremities to transfer force across the body. Why test it? By applying resistance across the diagonal pattern and comparing both sides, we can assess for: • Asymmetry and compensation • Reduced trunk and pelvic stability • Poor cross-body force transfer • Movement deficits that may contribute to hip, groin, pelvic, or low-back dysfunction This system plays an important role in walking, running, cutting, throwing, and rotational sports, where the trunk and opposite extremities must work together efficiently. At Pro-X Orthopedic Spine & Sports Therapy, we assess the entire kinetic chain to better understand what may be contributing to pain or movement dysfunction. #AnteriorObliqueSling #KineticChain #DNSRehab #SportsRehab #GlobalMovement by @taliduer
Using a Pilates rotation disk in a closed-chain position creates a dynamic challenge to the shoulder while applying Dynamic Neuromuscular Stabilization (DNS) principles. In DNS, shoulder stability is not simply about strengthening the rotator cuff. The goal is to create functional joint centration—optimal positioning of the humeral head within the glenoid while allowing efficient movement. As the hand maintains contact with the rotating disk, the shoulder must continuously adapt to changes in load and direction while maintaining: • Humeral head centration under dynamic loading • Balanced co-activation of the rotator cuff and scapular stabilizers • Serratus anterior activation and controlled scapular movement around the thorax • Proper thoracic and rib-cage positioning • Intra-abdominal pressure (IAP) for proximal trunk stability • Integration of the shoulders with the trunk, pelvis, and lower extremities The rotating surface introduces a controlled perturbation. Rather than allowing excessive translation at the glenohumeral joint, the patient learns to distribute the load through the scapulothoracic system and trunk. This also promotes irradiation—force generated through the supporting extremity contributes to coordinated activation throughout the kinetic chain. The DNS concept: Proximal stability creates the foundation for efficient distal movement. We are not training an isolated shoulder. We are training the shoulder to function as part of an integrated postural and movement system. Control → Centration → Stability → Movement #ShoulderStability #DynamicNeuromuscularStabilization #PilatesRehab #Sports #PhysicalTherapy by @taliduer
This week I’m continuing my education in Stecco® Fascial Manipulation, focusing on the superficial fascia and internal dysfunctions. Fascia is much more than the tissue surrounding our muscles. The superficial fascial system is richly connected with the skin, lymphatic and adipose systems, and sensory and autonomic regulation. The Stecco approach explores how alterations in fascial mobility and tissue organization may contribute not only to pain and movement dysfunction, but also to changes in fluid dynamics, autonomic responses, and patterns associated with internal dysfunction. What makes this course especially meaningful is learning in Padova, Italy 🇮🇹 — where the Stecco family developed Fascial Manipulation through decades of clinical observation, anatomical research, and dissection. As a physical therapist, I’m always looking beyond the location of pain and asking: Why is this tissue behaving this way? What other systems may be influencing it? And how can we treat the patient as an interconnected system rather than just treating the symptom? The more we understand fascia, the more we appreciate how interconnected the human body truly is. Padova, Italy Stecco Fascial Manipulation. Superficial Fascia & Internal Dysfunctions #FascialManipulation #physicaltherapist #SteccoFascialManipulation #holistichealth #pain by @taliduer

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