Coronavirus / COVID 19 Update (Last Updated May 21, 2020):

We are closely monitoring information that is being released by the CDC, WHO, individual states' Department of Health & national and state government officials regarding the COVID-19 virus pandemic. We have cancelled or re-scheduled all live PRI courses scheduled through August 1st. We have postponed our 12th Annual Interdisciplinary Integration Symposium and 20th Anniversary Celebration to April 22-23, 2021. We will continue to monitor the developments each day, and provide updates if any additional live courses are cancelled or re-scheduled. We will make decisions regarding courses scheduled in the coming months no later than the 4 week deadline. We apologize for the inconvenience this has caused. If you have any questions, please feel free to reach out to us directly at 888-691-4583.

We do have online home study courses available for all three primary courses and we have also added live stream courses. Live stream courses are limited to 100 attendees. Upcoming live stream courses include:

Impingement & Instability - June 13-14th (SOLD OUT)
Cervical Revolution - June 27-28th
PRI Integration for Geriatrics - July 18-19th
Occlusal Cervical Restoration - July 31-August 1st
Impingement & Instability - August 22-23rd
Cranial Resolution - October 24-25th

Please stay tuned for additional live stream course dates!

Find a Course Near You

(Click Below)
reset AK GA HI CA OR WA ID NV AZ UT NM CO WY MT ND SD NE KS TX OK MN IA MO AR LA MS TN KY IL WI IN MI AL FL SC NC VA MD DE PA NJ NY ME VT NH MA RI CT OH WV

Upcoming Events

Image illustrating provider locations on a map of the united states

 

Find a Provider Near You

Find a Provider

Recent Posts

The annual PRI Credentialing Scholarship application deadline is June 15th! This $2000 full scholarship is available to candidates who may otherwise be dissuaded from applying for PRC or PRT credentialing solely by their current financial circumstances. To apply, please submit a scholarship essay sharing your story, your current professional situation, and why you feel you are deserving of the scholarship. Essays can be emailed to Jennifer Platt at platt.jennifer@posturalrestoration.com. All essays will be reviewed by the PRI Board of Directors and the scholarship recipient will be notified by July 15th. If the recipient of the $2000 full scholarship does not accept the scholarship and complete the credentialing application and testing within the year, the scholarship will be awarded to an alternate. Depending on the number of applications each year, the Board of Directors may choose to select more than one scholarship recipient.

If you have any questions with the PRI Credentialing Scholarship, or any questions with the PRC or PRT credentialing process in general, please contact me!

We are taking a break from our Tuesday night "PRI Breathing Mechanics in COVID Times" webinar series this week, as Ron Hruska will be presenting on the American Academy of Physiological Medicine and Dentistry (AAPMD) webinar!

The title for thir webinar is "AIRWAY MANAGEMENT: Implementing Interdisciplinary Concepts Associated with Forward Locomotor Movement". This webinar discussion will outline how the body is moved forward during forward locomotor effort and how this effort influences and auto-regulates nasopharynx, oropharynx, hypopharynx and larynx airflow. Three questions will be addressed.

  1. How does forward locomotor movement (FLM) influence pharyngeal and laryngeal movement of air?
  2. How can one implement change in FLM patterns and improve pharynx and larynx air flow? 
  3. And finally, how can attributes of FLM be maintained or optimized by “airway” inter-disciplinary minded professionals when FLM ends?

This free webinar is tomorrow, May 19th at 9pm ET/8pm CT. To register, CLICK HERE!

Posted May 18, 2020 at 12:47PM by
Categories: Science

In light of what is going on around all of us and the associated uncertainty of this virus that will no doubt continue into the summer months, we have made the difficult decision to once again postpone the Interdisciplinary Integration Symposium.

We do not feel that it is in the best interest of the Institute, the Speakers, or PRINation to try and host it this August, like we had hoped would be possible when we initially rescheduled. We really want to host this as a live event, rather than a streamed event. Each of the speakers have such strong messages that will be reinforced by live participation from both the other speakers as well as a full room of course attendees. This is what makes these Symposiums so special year after year. We also feel, because of so much uncertainty regarding our economy, transportation and US CDC guidelines, there would be many individuals who would not feel comfortable attending this August. Therefore, we are re-scheduling the Symposium to April 22-23, 2021. This year’s topic on Parkinson’s Disease and Extrapyramidal Disorders has garnered a lot of interest over the past several months, and we have no doubt that next year’s symposium will be one of the best ones yet!

We are planning to have our Anniversary Celebration next April as well. As symposium speaker and PRC physical therapist Jennifer Smart said, “Twenty-one years is a special number to celebrate too . . . the Institute has really come of age once it hits 21!” We are hopeful that you will still be able to join us in Lincoln for the symposium and this special anniversary celebration. 

We apologize for having to re-schedule this again, but we do feel that we are making the best decision for everyone involved. A lot of unsettling discomfort is being felt as a result of this global crisis, but we are hopeful that we will all be able to come together stronger than ever next Spring and have a room full of attendees excited to embrace this topic without stressing over social distancing and social traveling. Enjoying each other, collaboratively, socially and professionally make these Symposiums and their associated memories very special, and we hope that you will be able to join us in April 2021 for this overdue symposium and celebration!

Posted May 14, 2020 at 9:05AM by
Categories: Courses

We had a great time last night on our first "PRI Breathing Mechanics in COVID Times" free webinar! We had around 250 people join us, and we look forward to hopefully growing this number in the coming weeks. If you missed the live webinar last night, you can access the recording on the Webinars page on our website. A PDF handout of the PowerPoint slides is also available on the Webinars page.

Below is the 3rd (of Ron's Top 10 Chest Wall COVID Breathing Techniques that we will be discussing further on these webinars) non-manual technique clinical reasoning break down. We invite you to review and try this technique a few times over the next week, as we will be discussing this and more on next Tuesday's webinar.

Standing Supported Left Glute Push

Let’s start with the title of this PRI Non-Manual technique.

This “standing” technique requires wearing shoes that provide good heel counter support, arch support and a toe box that will allow the toes and forefoot to easily spread out in the shoe. You will also need to push a table next to a wall to prevent it from moving forward as you push it forward with your hands (or you could use a kitchen or bathroom counter in your home). This PRI technique is designed to place one in a 'Valsalva-like' maneuver position between the exhalation and the inhalation phases, without blowing up a balloon and holding the expelled air or while pinching off the nose. 
 
In this technique, the force applied by the table and floor allow the tongue and mouth to close off the airway and properly use the abdominal muscles and the diaphragm to exhale and inhale without engaging the neck or back under moderate pressure created by closing off the pharynx with the pharyngeal muscle and the larynx/trachea with the tongue muscle. This voluntary control of the abdomen is maintained during the entire technique, without having to think about how to “hold” the contraction of the abdominals during both phases of the respiration cycle. It is a wonderful way to teach someone how to inhale with good opposition to the diaphragm so that its effectiveness on opening up the mid and lower chest wall is maximized, as the subconscious effort of maintaining abdominal stabilization is minimized.

The “support” of the upper extremities, offered by the stable table or counter, also allows one to lift the right leg up and the right foot off the floor as the left glutes "push” the body forward to further stabilize the lower trunk and pelvis as the right hip is raised up. This activity co-activates more integrative assistance from the right hip flexors, the right lower trapezius and long head of the triceps and left abdominal wall. When all said and done the tension and internal pressure created by the lengthened anterior shoulder and hip flexors enables one to breathe with the diaphragm under high compliance and forgiveness of lateral and posterior chest wall tension.
 
This technique is, therefore, a good technique because the lateral, posterior, apical and base surfaces of both lungs can expand easily upon diaphragmatic contraction, secondary to chest wall compliance and the gravitational force displaced on the abdominal contents. The internal organs fall anteriorly and off the front of the thoracic and lumbar spine. It is also, an excellent postural drainage technique for the posterior lobes of the mid to lower lungs, preceding the standing positional induced coughing that more than likely will follow with those who are experiencing difficulty breathing because of fluid-filled alveolar sacs.

Here are some additional comments about the steps that follow the title and pictorial examples, along with the reasoning for the procedural step.

Stand with your feet parallel to each other and directly under both hips. While keeping both heels on the floor lean forward to place your outstretched hands on the table in front of you. Now move your feet back so that your back is close to being parallel with the surface your hands are supported by, and the floor or ground you are standing on. You should feel a gentle stretch through the back of your heels and lower legs. Maintain heel contact with the floor or ground surface, especially on the left side.

These first two steps are important because you are now in a position where anything you do from this point on will foster more uniform opening of the entire circumference of your chest walls. This position, as reflected by the person in the second photo, also indicates that the attachment sites of the latissimus muscle on the side of your chest wall is in its lengthened state, as both of its attachment sites are distracted from each other. In other words, the arms are moving away from the mid to low spine, as the spine is more rounded than “U” shaped in this position.

This is an optimal position for the diaphragm to be in for coastal or mid to lower rib cage expansion upon contraction. It also is a great position for one to sense the abdomen lift the abdomen up against gravity and feel how one’s own body weight can serve as an element for abdominal strengthening with optimal diaphragmatic influence on the chest wall mechanics for ideal ventilation and perfusion at the anterior base of each lung’s lower lobes.
   
Shift your left hip back in Step 3 to engage your right hand as a pusher and to sense, activate, and lengthen your left outside hip muscles in preparation of using these same muscles to lift your right foot a few inches off the floor. While keeping your back parallel to the floor, in other words do not let your mid back sag toward the ground, lift your right knee up and your right foot off the floor/ground. The weight of your body should now be felt through both wrists and hands, your left hip, your abdominals especially on the left, (if you feel your right abdominals more than the left, you need to push more with your right hand into the table you are supported by) and the entire bottom of your left foot. This ‘highly integrated contracted’ position replaces the need to do this activity by blowing up a balloon correctly using PRI methodology.

Now hold this position as you take a deep breath in through your nose as you “push” with the above musculature and reference sites, outlined in Step 3. Then blow out through pursed lips or your mouth slowly by pushing slightly more with above muscles and sites. The most important consideration in Step 4 is to transition slowly from exhalation to inhalation with a “pause” (Valsalva pause) in between the exhalation and inhalation phase, without losing the “push” from your body while breathing in this reciprocal state of glossal sealing and pharyngeal closing during respective inhalation and pre-exhalation reciprocal breathing.

Stay tuned for more discussion on Ron's Top 10 Chest Wall COVID Breathing Techniques on our upcoming webinars and blog!

Posted May 6, 2020 at 7:15PM by
Categories: Techniques Science

As we gear up for tonight's first webinar, below is Ron's breakdown with clinical reasoning for the second technique discussed in the free PRIVY trial video titled "Integrated Pulmonary Compliance". If you haven't yet checked out this free video, it is a great introduction to the webinar searies that begins this evening. Stay tuned, as we will be discussing more PRI non-manual techniques related to chest wall compliance in the coming weeks on our "PRI Breathing Mechanics in COVID Times" free webinar. To register for tonight's first webinar, please CLICK HERE!

Standing Wall Supported Resisted Ischial Femoral Ligamentous Stretch

Let’s begin with the title of this PRI Non-Manual Technique.

You will need to purchase approximately 5 to 7 feet of medium resistant therapeutic tubing. You can find information on the PRI Website under “Products” (and then click on "Materials") and purchase from Stretch Well, green colored medium elastic tubing. The Stretch Therapy Deluxe green tubing has hand handles included. However, you can perform this activity without band resistance, by placing your hands on the edge of a chair that easily slides forward as you reach forward. You will also need to find a book that is approximately 1 to 3 inches in height, at least 12 inches long and 7 to 10 inches deep.

When performing this activity in “standing” you will be able to use the floor as an anchor and a “wall” as “support” for distraction of your lower and upper posterior chest walls.  [This position on the floor and on the wall will allow you to primarily sense and focus on mid to low back lengthening as the accompanying posterior and lateral chest walls expand]. As you move your arms forward in performing the following outlined activity, the “ligamentous” soft tissue, including your accompanying hamstring muscle, that attaches to your “ischial” seat or sit bone and to your “femur” or thigh bone, more than likely, will feel tight. This tightness and/or “stretch” is the result of your abdominal wall of muscle contracting, as you reach forward with “resistance” from the therapeutic bands in your hands and the bands of elastic, soft tissue attached to your “ischial seats”. Therefore, the floor you are “standing” on, the “wall” your low back and hips are resting on, and the bands that are looped around the hands or the friction from the legs of the chair the hands are resting and pushing forward on, are all providing the forces needed for your left and right diaphragm leaflets, inside your two respective chest chambers, to open and expand and stretch both the inside and outside chest walls. This expansion, under the above guided resistance, allows one chest chamber to ideally open better when closure of the other chest chamber occurs, and vice versa. This PRI Chest Wall technique, minimizes pulmonary or lung static function, maximizes elastic tissue recoil of the chest walls, equalizes pressure when all four extremities are alternating or involved with lifting, and assists with optimizing immune responses.  

Here are some additional comments about the steps that follow the title and pictorial examples, along with the reasoning for the procedural step.

Stand with your feet parallel to each other and with your hips directly over your feet. Place a book that is 7 to 10 inches deep between the door and the back of your heels.  The back of your heels will help you sense the wall you are about to touch with your low back and hips. This heel sense, together with the sense of the floor you are standing on, will provide the anchoring your abdominal wall will require for upon contracting as you reach forward with your hands to relax and open your posterior chest wall and or back muscles.   

By also anchoring therapeutic tubing in the door at a height slightly above shoulder level, and around both of your hands, you will begin to sense the need to engage your abs, lower your head and shoulders and move your upper chest walls forward as your mid back and chest walls simultaneously move back. The same type of activity will occur if you place your hands on the top of a chair or stool on wheels.  

If you have difficulty sensing your abdomen muscles contract and it is difficult to round out your middle to lower part of your back, your anterior chest wall is too elevated.  Place a rolled-up towel between the upper part of your thighs, as high as you can get it. This rolled-up towel should be wide enough so that when you bring your knees together your knees will not touch. By placing this bolster between your upper thighs and squeezing your knees toward each other, your back muscles will relax and your ligaments at the back of your hips will be more easily stretched out as you lower your body with your muscles that attach to the two ischial seats. These muscles are called your hamstrings and will enable you to maximize your diaphragm’s influence on chest wall mechanical activity that will enable better upright perfusion of oxygen into posterior and lateral lobes of the lungs, that may be ‘locked up’ because of over contracting back muscles used for postural stabilization. Therefore, by pulling your two hips apart with the bolster between the knees, that are moving toward each other, you are essentially decompressing not only the pelvis that lies between the hips, but also the spine that lies between both chest walls. This decompression of the ‘chest wall’ spine decongests the lung tissue associated with congestion of lung tissue (alveola) that is incapable of opening because of spinal compression. By squeezing the bolster between your thighs, as you are doing with this PRI technique, you are essentially reducing the ‘squeeze’ on the posterior lungs.  

To place as much low back on the wall that you can, in Step 4, you may want to slowly and carefully bring your knees slightly forward as you are exhaling through your pursed lips. Try to keep your heels and feet flat on the floor as you are reaching forward with your outstretched hands and arms. Many of you will not be able to place your low back on the wall, and may only be able to sense your rear on the wall, as you attempt to round your back while reaching forward with your arms and knees as your body gently lowers. The most important thing about Step 4, is to reach with your hands and arms, resisted or unresisted, while you “round” your mid to low back, during this exhalation phase of movement.

Step 5, is where the magic happens. The magic is when your inhalation effort through your nose, after performing Step 4, continues to open up the entire chest wall cavities on both sides, along with all the underlying alveolar tissue in your lungs. The position you worked so hard in achieving is now serving as a platform for diaphragmatic inhalation without resorting to muscles that over compress the posterior lung tissue. Those muscles lie both directly in front of your neck and in the back of your chest walls.  
As you continue to breathe in through your nose and out through your mouth, or through pursed lips, let the air move your chest. Assist this chest movement by drawing in the air (Step 7) and compressing it out by reaching further forward with your arms, as the weight of your anterior body opens up the posterior body (Step 8).

The resistance provided by the forces through the arms, the wall and the floor allow you to receive the floor, the wall and the space in front of your arms as the space inside of your chest walls expand and elevate your body; as it is being lowered gently, softly and peacefully to the ground. When you stand up, in Step 10, focus on maintaining “push” through the heels, the hands and the inner thighs as your entire chest remains opened, relaxed and uncoiled. Breathing should be effortless at this stage, because of true postural support offered by muscles that keep the posterior chest walls elevated, and the anterior chest wall opened and lowered, for maximum lung perfusion and ventilation.

Posted May 5, 2020 at 9:01AM by
Categories: Techniques Science

Products

Non-manual Techniques
Manual Techniques