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PRINation welcomed me back this past weekend in Providence, RI for Pelvis Restoration. It is hard to believe the last course I taught was in November of 2016! Course schedules and Family obligations allowed me to take a respite from teaching and I definitely was more than ready to get back out and help my students learn about PRI as it relates to the frontal plane control of the Pelvis!

One of things I love about this course is not only the structure of course materials but the integration of respiration of the pelvis with the thorax. It allows me to really connect the dots for the student. The in-depth discussion of the frontal plane control of the pelvis as it relates to both the LAIC patterned individual and the PEC patterned patient is very comprehensive as it relates to human performance.

I had the privilege of working with Sean Fitzgerald, PT, DPT, PRC. Sean is an old friend from VT. He reminded me that Chris and I were the first to expose him to PRI and took him to his first PRI course when he was a student of Physical Therapy in 2002! He brought along Johnnie Earls, DPT. I taught Johnnie his first PRI course at UVM last year as he was graduating from UVM that same year. It was not common in 2002 for students to be taking PRI courses, but it is now having a student in a PRI course is almost commonplace today. It always amazes me how much PRI has grown in the last 20 years!

This course was made up of more "seasoned" PRI students. Only 5 out of 20 were "newbies" to the science of PRI, but all had seen PRI in practice. This always makes for an easier more relaxed course as these students were eager to learn more about the When, Why's and How's of treatment evaluation and progression.

A big shout out to my host Tom Dubuque, PT and the staff of University Orthopedics for welcoming me back.

Terry Morena Toste from their staff was attending her first PRI course and dyed her hair purple for the occasion! ;) Now that is a future PRC for sure! Terry and I had great fun as we both were UVM grads!

I also had some fun using a shout out to my UNC Tar Heels to emphasize the important reference center for upright frontal plane control! Go Heels!

All of my students were great this weekend! I have a renewed sense of passion for teaching PRI. I will be back on the road in a few weeks to teach Myokinematics of the Hip and Pelvis to my friends at Northeastern June 10th and 11th. Until then.... PRI Nation!

Posted May 24, 2017 at 1:46PM by

Grounding from an Electrical, Postural, Breathing, and Emotional Perspective

By Heather Carr, DPT, PRC, NTP

The concept of “being grounded” is becoming a common phrase that is being expressed these days. The connotations associated with “being grounded” are that it is a healthy and beneficial phenomenon. However, what exactly does it mean? The purpose of this article is to explore “grounding” from an electrical, postural, breathing, and emotional perspective.

The human body is constantly generating free radicals via oxidative reactions which if unchecked can contribute to immune and inflammatory stress. Anti-oxidants that serve to neutralize these reactive oxygen species do so by donating electrons. The earth’s surface has a net negative electrical charge characterized by an excess of electrons. Therefore, the earth is a natural repository of electrons to supply our bodies with anti-oxidants thus mitigating oxidative stress. However, this ultimately requires direct contact of our skin to the earth or the use of conductive sheets/pads/wrist bands (Earthing products) that are connected to the grounded component of an outlet.

Modern living subscribes to a plethora of toxins that we ingest and are exposed to through our foods and environment requiring significant anti-oxidant retaliation. Consider this relative to how the natural human electrical discharge mechanism between the ground and our bodies has become mostly obsolete. Until recently, throughout much of our human existence we walked barefoot and slept on the ground. Our shoes, particularly rubber soled, pose a barrier for this electrical conductance pathway. Furthermore, most of us are walking on artificial surfaces. There are many individuals who never or rarely experience barefoot contact on real earth. This is one of the reasons why walking barefoot on the beach is so enjoyable and relaxing for people. Not only are you experiencing wide open space (in contrast to the typical close-up, indoor, focal work we do on screens) and the natural multi-sensory rhythms of the ocean (as opposed to the artificial dissonance created by modern technological devices) but you are also absorbing electrons from the ground to neutralize free radicals in your body.

In the Journal of Environmental and Public Health, Chevalier et al (2012) describe in “Earthing: Health Implications of Reconnecting the Human Body to the Earth's Surface Electrons” the numerous health benefits of this phenomena. Such effects of “earthing” that have been demonstrated include beneficial changes related to sleep, pain, cortisol level, autonomic nervous system activity, immune function, osteoporosis, heart rate variability, hypercoagulable blood, and glucose regulation. In addition to personally sleeping on an earthing sheet, as a Physical Therapist I commonly recommend them to my patients, particularly those who are experiencing pain, inflammation, and have difficulty sleeping. Thus far, in addition to myself, my family, friends, and patients have reported significant improvements in these areas since incorporating earthing practices.

From a postural perspective, “being grounded” means your body is authentically aware of where the ground is and its positional and gravitational relationship to it. This is the responsibility of our postural system which is primarily comprised of our visual, auditory, vestibular, and sensory-motor systems. Our postural system and essentially all of the systems in our body, work in the realm of patterns. Our brain-body is a dynamic habit centered organism. Furthermore, our neuromuscular system works in patterned “chains.” This means that groups of linked muscles fire together in synergized mechanisms to accomplish our functional needs to be upright against gravity and move. Our primal human essence of movement is walking which is comprised of two polar phases-being on the left leg and being on the right leg. This has an accompanying predictable neuromuscular firing pattern from the foot all the way up to the head including the visual and vestibular systems.  Each side is essentially a conjugate of the other with opposite patterns occurring simultaneously.  When the left leg is on the ground it is in the “grounded” phase when the right leg is in mid-air, and thus ungrounded. The opposite occurs for the right stance phase of gait.

Our postural system is intimately linked with our breathing (respiratory) system. Just like our alternating left/right walking, breathing also exhibits an oscillatory essence characterized by inhalation and exhalation. When we inhale the front of our rib cage elevates into external rotation as the diaphragm contracts and lowers. This is in contrast to exhalation where the front of the rib cage lowers. During exhalation the diaphragm relaxes as it returns to a upward domed position in apposition to the internal surface of the rib cage (referred to as the “zone of apposition”). Authentic and efficient breathing is characterized by being able to alternate between a full inhale when the diaphragm lowers and a full exhale where the diaphragm rises up into apposition with rib cage. This requires synchronized activity between the abdominal and pelvic floor musculature to control pressure and positional relationships throughout the trunk. These same muscular patterns are also involved in managing the process of walking. Therefore, how we breathe effects how we posture and move. Likewise, how we posture and move effects how we breathe.

Let’s take this a “step” further. When we walk our pelvis and rib cage rotate in opposite directions. This means when the pelvis is rotating to the right the rib cage is rotating to the left and vice versa. When the rib cage is rotating to one side it exhibits a twist in which the left and right sides are in opposite phases. For example, when we are on the left leg our rib cage is concurrently rotating to the right. This means that the front right side of the ribs are in an open, elevated, inhaled state while the left front ribs are in a closed, lowered, exhaled state. The best way to understand this is to place your hands on the front of your ribs and feel this opposing motion when you turn your torso to one side or the other. Likewise, when we are on the right leg our thorax is concurrently rotating to the left in conjunction with the left ribs being in a state of exhalation while the right is in inhalation.  This comprises a pattern of whatever leg is “grounded” the corresponding side of the rib cage is in an exhalation state.  This means that exhalation correlates to the postural phase of being “grounded.”

The current trend of postural and breathing dysfunction amongst our modern living society is characterized by being in a chronic state of inhalation. Many of us are functioning in a stressed out mode characterized by excessive sympathetic nervous system activity and holding our breath. Consider what we do when we are startled or experiencing fear-we gasp! This is in contrast to “a sigh of relief” when we exhale into a calm and relaxed state of being. Unfortunately, this inhalation pattern has become a chronic breathing behavioral habit vs an acute transient one (such as if we were startled by a predator as was the case in our paleo times). This means the rib cage is excessively elevated and open in the front, closed in the back, with the diaphragm locked down in a perpetual contracted state, preventing a full exhalation and thus relaxation to occur. This means poor breathing excursion and airflow. It also translates into excessive tension in the psoas, hip flexors, back extensors, and neck musculature as the diaphragm is fascially and functionally connected to these muscle chains. Positionally, this pattern is typically accompanied by an excessive anterior pelvic tilt, lumbar lordosis, protracted scapula, and forward head posture. This is ultimately an “ungrounded” posture.

Now it’s time to connect our emotional system to breathing and posture. A study done out of Northwestern University lead by Dr. Christina Zelano demonstrated that during inhalation people are more likely to learn fear based memories compared to the exhalation phase of breathing. Inhalation was shown to facilitate the amygdala and hippocampus in the brain (involved with emotional processing and memory) to encode and retain stressful events significantly more than during exhalation. This relationship can also work in reverse where emotional patterns incorporating fear and anxiety can impact how we breathe, our posture, and thus our “grounding.” Individuals who experience anxiety related disorders tend to function in an inhaled state of breathing and its correlational postural pattern. Therefore, anxiety and stress states are typically “ungrounded.”

In order to potentiate one’s ability to be “grounded,” one must consider the behavioral, postural, breathing, and emotional dimensions that ultimately create it. Behaviorally, we can increase our electrical contact with the ground either naturally and/or through the use of Earthing products. We can also attempt to reduce our free radical production in that we have some degree of control over the amount of toxins we ingest and are exposed to.  By restoring appropriate postural and breathing patterns one can improve their ability to authentically “ground.” The method of the Postural Restoration Institute (PRI) is heavily focused on creating these grounded relationships. An important component to this is to establish a full exhalation to allow the diaphragm to achieve a relaxed domed position in contact with the internal rib cage. Furthermore, because the diaphragm is part of a continuous chain of synergistic muscles from the foot all the way up through the head, a portion of or all of these chains may need to be re-educated to ultimately create this grounded pattern. This typically requires practicing specific postural restoration techniques so that the brain-body can learn a “grounded” pattern. Finally, by addressing fear based emotional patterns one can also influence their breathing, posture, and thus ability to “ground.” Likewise, one can positively influence anxiety and stress via better postural and breathing function. It’s all connected!

Chevalier G, Sinatra ST, Oschman JL, Sokal K, Sokal P. Earthing: Health Implications of Reconnecting the Human Body to the Earth’s Surface Electrons. Journal of Environmental and Public Health. 2012;2012:291541. doi:10.1155/2012/291541.

Postural Restoration Institute: https://www.posturalrestoration.com/

Earthing Products: https://www.earthing.com

Posted May 22, 2017 at 9:01AM by

Thrive Proactive Health is a Postural Restoration Certified Center and a privately owned small boutique wellness clinic in beautiful Virginia Beach, VA. We are growing and looking to expand and grow our Physical Therapy Team!

Ideal candidate must enjoy learning and communicating with other PTs, PTAs, and massage therapists that look at human biomechanical relationships through a Postural Restoration®(PRI) lens. We focus on providing individualized care using a team approach and incorporate various tools and therapies to treat hyperactivity and impaired mobility including Graston, Dry Needling, and Vacuum Cupping. Postural Restoration is a specialized form of PT that all of our staff members are trained in and every patient is evaluated using a PRI framework. 

There is a lot of opportunity for professional growth for those that may be interested. We are looking for someone who is excited to grow with an innovative practice and we welcome ideas for program development. Our mission is to responsibly optimize health and wellness care delivery by focusing on enhancing the customer experience. We strive to provide quality, innovation, and teamwork to be industry leaders helping more people THRIVE in a culture where healthcare is changing. 

Virginia State License is required and minimum of two years of experience along with experience with Postural Restoration® is preferred. A variety of employee benefits are available for team members that qualify, which include health care, paid time off, bonuses, and incentive pay based off of team performance.

CLICK HERE to apply in confidence! 

Posted May 21, 2017 at 6:07PM by

Employment opportunity:

Physical Therapist Greater Burlington VT Area

Company:  Transitions Physical Therapy LLC is a Certified Postural Restoration Center providing specialized neuromechanical outpatient PT, to a diverse population, in 2 locations.

Mission: “To change your expectations about physical therapy by achieving better outcomes through conversations, the exchange of knowledge, delivery of neuromechanical therapy, and the building of relationships within a specialist PT practice.”

Our company is growing and seeking qualified therapists who are interested in immersing themselves in a highly educational, staff development oriented, PT specialist setting.  To join our team, a successful candidate will possess strong clinical reasoning skills with a background or interest in Postural Restoration.  Our unique value proposition for a successful candidate is a career development model consisting of clinical education and a professional development track culminating in specialist certification and opportunity for clinic directorship/ownership in 5-8 years. 

Job Description:  Staff PT: A successful candidate will be able to manage a case load of diverse patients including athletes, performing artist, and orthopedic patients from adolescents to the elderly. On a day-to-day basis, you will be expected to maintain daily electronic medical records, communicate with referral sources, establish the value of physical therapy with your patients, and be an active part of an engaged, fun, caring environment.

Requirements and Qualifications: You will be a Vermont licensed physical therapist or eligible to obtain a Vermont license.  You will have demonstrated strong skills in time management, organization skills, and interpersonal skills. You will exhibit lifelong learning characteristics, be motivated to further our profession, and enjoy working with patients.

Salary:

Direct Compensation: Base salary (commensurate with experience and credentials).

In-Direct Compensation: Incentives, quarterly profit sharing, bonuses, HSA contribution, IRA match.

Perks: Charitable contributions, memberships, entry fees, clinical education, flexible schedule.

Insurance: 50% of company plan.

If you are a successful candidate and accept a position with us, your professional development will consist of:

Clinical Development: Upon successful candidacy, you will be supported on a clinical excellence track that is aimed at attaining a PT specialization in 5 years, with special emphasis placed on Postural Restoration Certification (PRC). In addition, we encourage staff physical therapist to explore SCS, OCS, Pelvic Health, or Performing Arts PT.

Career/Business Development: Upon successful completion of a specialization, you will have the opportunity to choose a Directorship Track which entails managerial development and training. Upon successful completion of the Directorship program, you will be eligible to become a Director/Owner at a clinic.

How To Apply: 

Please contact Sean Fitzgerald by e-mail at: sean@transitionspt.com to receive an application.

Posted May 17, 2017 at 4:50PM by

Just enjoyed a beautiful weekend in Everett, WA working with a dynamic group of movement scientists at ATI Physical Therapy on the triplanar lumbo-sacro-pubo-femoral dynamics that encompasses Pelvis Restoration. Host PT's Jenifer Rhodes, Alexa Degel, Christopher Nicholson, Ashley Fulkerson along with excellent lab assist from PT, PRC Zach Hawthorne made for a tremendous learning environment, and we had a brief Betsy Baker Bold sighting!

This group took Pelvis Restoration in stride, engaging in discussions about theory, exercise technique prescription, integration and application of PRI to ADL's, strength training and high level dynamic stability of sports from bicycling to Cirque du Soleil endeavours. Thank you Ricky Morant, James Matson, Phillip Wehrman, Erin Bremond, Andrew Dingwall and Kaitlyn McNamara for your assistance with demonstration of various exercise techniques and principles of Pelvis Restoration. Excellent work Kate Johnson on the hands team, Julianne Clark for the posterior cranial vision showcase, Sam Briend and Lea Bell for your inquisitive and insightful addition to the class. Tina Mclean earned furthest travel honor and was a joyful contributor to discussion about clinical application during case studies as well!

Thank you to each from a very enthusiastic group who came to the Puget Sound area to enjoy Pelvis Restoration!

Posted May 10, 2017 at 1:45PM by

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