A wonderful followup to the QL Counterstrain. The key here is not to cause any pinching pain during the relaxation phase. Emphasize to the patient the need to reach up with arm on the treated side at the same time they reach for their feet with opposite side.
Also remember PIR is a relaxation technique, not a stretch, so follow release as it happens rather than applying lots of force into the system
![](https://i.ytimg.com/vi/5lOIRGatJm8/maxresdefault.jpg)