How do we make {the ideal} diaphragmic breathing pattern autonomic?  To be able to just do it, without have to think about it?

How do we improve the autonomic function of the soft core? How do we get them to fire more efficently with all movements? For proper soft core, I take it we need diaphragmatic breathing in place first?

…..is asking the client for a diaphragmic breath during exercise not consious control?

My first impression of the message was to think about choosing to use the word autonomic rather than automatic. I thought you would mean automatic, but when breathing is automatic in terms of not requiring cuing or coaching, it is because it is compliant with the autonomic nervous system.

What is interesting and exemplary when it comes to breathing that it’s musculoskeletal action can be trained through various methods and repetition.  Following the motor learning literature in terms of random practice is probably best practice at this time.  And as you progress from cognitive to associative to autonomous, it is one of the few links directly to the ANS. Eye training, which I am several weeks into for myself, is another keyhole that links muscular to neuro.
Progressing from simple to complex, fast to slow, more or stronger fixed points to less are progressions in which to engage breathing.
You have the DNS positions.  You have slowing down multi-tasked drills like the Turkish Getup and Chops/Lifts, along with extreme mobility like yoga or extreme stability like some pilates or anti-motion positions where you can practice breathing.

Breath and Go Green.

Basically, the suggestion is that you can drive the ANS with a positive musculoskeletal input from the conscious breathing training, shift to the green, and get a positive neuromuscular output via “automatic” breathing.

The motor skill, reaching an assumed standard, is an example of joint centration.  It is trained muscularly but yields a CNS response.

Social stress is an enormous input to the ANS, and that would be a direct competitor to your breathing training. This is just as powerful an example as someone following a hip and t-spine mobility program and regularly sitting 8-12 hours @ work.
In terms of “correcting” breathing, sometimes the more potent intervention is what you DON’T do (don’t get stressed) rather than what you do.  And stress can be lifting with bad form, social stress, inefficient nutrition, overtraining, the list goes on.

Garbage into the system regardless of the form will jack up breathing.

Considering nose vs. mouth breathing, I believe the nose has far more baroreceptor pathways than the mouth, thus keying into the CNS at a more powerful clip.
Why any one individual has disturbed sleeping is always up for assessment.

Potentially effective to breath through the nose and get dumb people to stop speaking.

While some are still fairly staunch with the TA and multifidus training, I think this will continue to fall behind the curve in favor of the diaphragm being the primary focus of inner core training. It continues to completely baffle me how one can push the draw-in and expect to facilitate the diaphragm and intra-abdominal pressure.
Yes, there is more than 1 way to skin a cat, but there’s also good-better-best. And there’s also benign and useful.

Something that I have recognized sociologically is that when you look at folks that push TA and multifidus, I don’t see too many folks that have ever held serious weight in their hands, ran really fast, or done anything more athletic than pilates. I think this is a missing piece in either understanding and/or accepting that the diaphragm is the starting piece to breathing and the musculoskeletal keyhole to the ANS.

We've seen this fellow before. We will continue to make fun of him and any other individual thinking the draw-in is useful.

How do you assess a patient to see if they have a leg length discrepancy? If they do, what could it mean exactly? (Is it an instability in the hip, a muscle locked short or long, etc) If it is not a true LLD, would you attempt to fix it? If so, what would you do? Lastly, do you think trainers should be looking at this before we begin a session and trying to fix it?

There are probably a couple ways to measure leg length, but the valid by my standards (I don’t know what the literature says) is this.
Tape measure from ASIS to medial malleolus.
For better at least intra-rater reliability, I would suggest thumbing up from underneath the bony landmarks, and measure from where the button starts to jut out. This way you can have a good shot at measuring the same way every single time.

I'm saying medial malleolus to ASIS

You can measure standing bilaterally, standing on 1 leg, and then laying down in the both positions also.
If there is a consistency, then there is really a leg length difference. If there is a difference standing vs. unloaded, it’s a muscular tension somewhere.

If it is a very real structural difference, the shoe can be built up.  Or you can have an osteotomy somewhere if you want.  That might not be preferrable though.
If it’s a muscular dysfunction, it can/should be fixed.

I would say you probably don’t need to be looking at it, especially at first, because if it’s real, I’ve got to think the person already knows. If it’s functional, it will come out in the wash with the FMS asymmetry.
I typically discard anyone that tells me they have a leg length discrepancy especially from another clincian. It’s part arrogance on my part, and part I know the reality that it will come out as we go through the movement screening and assessment. Leg length itself is a Test. It doesn’t tell me enough.

I think the key here is this.  Always look at dynamic patterns first.  If the person moves well, that is all we care about in the first place.  If there are major problems or asymmetries that show up, they should be addressed.  Tag out if you have to.
But static postural tests and exams should only come after movement has been exposed to be in error.

Like most things, leg length should come out in the wash.

Recently…attended a [student] seminar put on………..who could come up with the best rehab program for a complete ACL tear in a female basketball player . The three teams were to present on the specif surgery that would be done and how they would handle the case. One of the common themes amongst every one was the use of isometric hip adduction while performing dynamic squats. Essentially they recommended performing a squat while squeezing a ball between there legs.

Good for ACL rehab according to the "literature." Thanks, APTA!!!

This is very foolish and old school.

1) The dated research that links ADDuctor isotonics to VMO cross-sectional area was 1) studied with open-chain movements, and 2) I believe was second to poor soft tissue quality in regards to binding of the ADDuctor Longus to the VM and VMO. That poor soft tissue quality is likely what led to the injury in the first place that warranted a belief for VMO attention.

Keep in mind that the VMO is a player in PF stability, as all knee structures are, however, it’s dysfunction is 100% reactive. A healthy neuromuscular system marked by centration never has a deficient VMO. Focusing on training it up is benign at best.  It is inhibited as a part of pain/injury/threat and recovery there of, while other muscles like the ADDuctors and RF become facilitated. Releasing or relieving the reasons for facilitated tone is the answer for restoring the VMO, not investigated local approaches. This does not work.
The VMO is not the problem before injury, and it is not the problem after injury. It is just the expression to get you to stop hurting yourself.
I mean is there anyone without an old school physical therapy or bodybuilding background that even still talks about the VMO?

It's like building up the floor without worrying about the roof.

2) If you aggressively ADDuct with something in between your knees and feet apart, try to visualize where the femur and midfoot would “want” to go if you removed the ball or pillow. You are cranking into valgus collapse, but there is an illusion of alignment because of the ball in between the knees. This is just straight out dumb.
We know in fact, we should probably be doing the opposite, banding the knees and demanding the valgus collapse be reacted to and met with femoral external rotation and mid-foot rotation.

There are times in which activating the ADDuctors in an effort to prime the core to stabilize prior to a pattern is useful. This hopefully temporary use of a high threshold strategy is supported by the Superficial and Deep Front Lines of Thomas Myers’ Anatomy Trains, mainly he Deep. The ADDuctors have concurrent neurological pathways through the fascia with many of the abdominals, so there is irradiation as a result.
However, in a technique such as the Toe Touch Progression in the FM System, the feet are as close together as possible to create a bony block against pronation and further valgus collapse. This brief approach is also used sparingly, and is reloaded with glute activation as soon as the hip hinge is satisfactory.

Maybe interested in pre- and post-VMO EMG with this…………….

3) Researching concurrent ADDuctor and glute medius activation is not interesting to me. It is typical contrarian nonsense to try to be a renegade and prove everybody wrong. Not everybody needs to be Galileo.
More importantly than that, the laws of reciprocal inhibition will dominate such a study, and dumb people will look at the research and make some silly attempt to rekindle ADDuctor isotonics just because they are “dimmed” when the glute medius is heavily activated.  In fact, we would want the opposite.  Luckily, this notion hasn’t really fallen into the hands of the Champions of the Stupid as much as some other things.
Just make the move look right and have good underlying mobility and stability. Don’t try to reinvent the wheel.  A centrated hip joint will have comparable muscle activation around all aspects of the joint.  A big EMG isn’t always a good one.
And how or why this equates to the VMO does not click to me.

These guys are far more important for the knee than the bogus VMO.

4) Squatting wide with toes out puts the ADDuctors into a better line of pull to be hip extenders and cover up for inhibited glutes. This may be desirable in unique static situations like powerlifting or some versions of KB swings. But this does not support the original idea of more ADD = more VMO.  In fact, it may support bigger glutes, which is really where the money is at in training after an ACL.

To bottom line it, if the knee hurts, and the VMO is soft, leave it alone and use what you know to limit the pain. In the mean time, spare the knee with hip-dominant patterns and core work.  Obviously post-surgically, there is room for Russian NMES and standing TKE, but not much more than that as I see it.

I think Coach Boyle wrote an article that ACL prevention, which is ACL rehab after the ACL is fixed), is just Good Training. I guess the students at the conference must have missed it.