Posts by Robert George

Chiropractor

Postural Respiration was presented at the Postural Restoration Institute May 28-29 to a large zoom audience of students as well as live participants. It is always a pleasure to have students from around the world in different time zones staying up late or getting up early to participate in this flagship primary course. There were students from Australia, Europe and coast to coast from North America and a large percentage of students were first time attendees to a PRI course, and for the majority of students, first time to Postural Respiration.


Delivery of air pressure sense and its effect on pelvis, ribcage and diaphragm shape, form and function are central themes that are returned to over and over in this course as it relates to neurology and ultimately biomechanics.
I taught Postural Respiration two weeks before in Chandler, AZ and there were similarities in terms of lab and demo with one student in each course presenting with almost exactly the same exam findings and same treatment guidelines as defined in this course for Superior T-4.


Often this patho-mechanical compensation can seem daunting to identify and treat, however, in both courses with both attendees, following the course guidelines with a detailed and repetitive description of both non-compensatory respiration and contrasting with patho-mechanical respiration made this difference very clear. Both students remained positive in their PRI testing on day one even after non-manual and manual AIC treatment regimens.  Then, on day two following Page 50 guidelines to determine if these individuals were in fact presenting with Superior T-4, a subclavius release with infra-clavicular pump was performed and all tests became negative with both cases.  No pressure, but the instructor is always relived when this occurs!


The overuse of accessory muscles of respiration became very clear to all attendees in both classes knowing that scalenes, for instance, need to act more like initiators of the first rib to signal rostal to caudal sequential rib elevation and not become primary rib lifters attempting to direct and deliver air inappropriately  into a right chest wall. Superior T-4 became very clear as to just one more step in the treatment guidelines for effective and balanced delivery of airflow pressure sense. This allows then alternating and reciprocal function into the entire physiological, neurological and biomechanical systems.


All in all it was a wonderful course especially the time and attention all of the students provided and "spot-on" questions that were asked. Thanks to all of our students especially on zoom from  different continents and time zones.  And the course was facilitated so well by RJ Hruska as he makes the process go so easy for students and instructors!

Posted June 2, 2023 at 3:16PM
Categories: Courses Science

Postural Respiration was presented April 15-16, 2023 at Spooner Physical Therapy in Chandler, AZ to an enthusiastic mix of PT's, Chiropractors, OT's and fitness professionals. There were students from Alaska, California and Idaho that made the trip to AZ. Dr. Victor Elmurr, D.C. was the motivating force in contacting the staff at Spooner several months ago and facilitated the return of PRI to the Phoenix area.


Among the new attendees to PRI, most of the students were new to Postural Respiration and their purpose was to understand and integrate delivery of airflow into the thorax with their knowledge of pelvis, lumbar spine and femur myokinematics. The response from them, and understanding that this course is the flagship of PRI, was that this course completes a picture of diaphragmatic function and how it affects not only delivery of air pressure sense into the thorax but the position, posture and movement of the entire axial skeleton.  


Since posture is not a static concept often thought of in a normal sense, the dynamic, tri-planer function of air flow pressure and sense allowing alternation, reciprocation and variability were all defined and experienced by every student.


As with every Postural Respiration course, Superior T-4 is the patho-mechanical portion of the weekend that is explored in detail on day two.  Rhythmic airflow and it's physiologic effects are discussed on day one in terms of dynamic airflow considerations.  Next, the importance of the first rib, especially on the right, is discussed in this context of rhythmic airflow and the first rib being an "initiator" of rostal to caudal rib movement.  With overuse of accessory muscles like the scalenes, the first rib will be lifted out of "sync" with the ribs below leading to patho-mechanical respiration as described in this course.


One of the students was used as a "demo" on the first day of the course for PRI exam, NMT and then a left ZOA manual technique. The inability to adduct a femur along with positive BC testing after NMT and manual techniques on the first day lead into day two of the course to explore if this individual was a Superior T-4. With definitive testing and after following the treatment guidelines on page 50 in the course manual, his Superior T-4 was discovered, treated and resolved for everyone to experience the progression to resolve patho-mechanical respiration considerations.


This course was such a pleasure to teach and thank you to the staff at Spooner especially Jessica who got there early and stayed late to lock and clean up. Thank you also to Carly, Sarah and the rest of the Spooner crew and thank you Ben for allowing us to share PRI with your clinic and the community. 

Posted April 20, 2023 at 8:21PM
Categories: Courses

The first Cervical Revolution course of 2023 was presented at the Postural Restoration Institute to an international group of students. Attendees present were from all around the globe including China, Japan, Singapore, Canada, England, Ireland, Germany and Bulgaria as well as from every part of the U.S.A.  Professions included physical therapists, chiropractors, strength and conditioning professionals, an osteopath and a medical doctor to learn PRI concepts of the cervical, cranial and occlusal system.

Cervical Revolution is the introduction to the PRI concept of "top down" while acknowledging that "bottom up" is always at play since humans need to manage upright posture, gravity and gas! One of the biggest topics is that if you lose the floor then a new ground up into the cervical spine, cranium and even jaw will occur. When this over reliance on the neck occurs, cranial torsion or pathology is almost certain. This course unlocks the path into the cranium and a deeper dive into neurology which is then presented in tertiary PRI courses.

During the weekend, PRI examination of the cervical spine was then integrated with repositioning techniques that addressed position of the cervical spine, occiput, sphenoid and temporal bones all at the same time. This is part of the magic of this course in understanding how to integrate many parts to restore alternation of the whole with oscillation of atlas and occipital bones, freedom of a sphenoid, wobble of temporal bones and jaws that can freely swing or truse! Louise Kelley, PT assisted me greatly in this endeavor with lab exam, PRI techniques and answering tough questions from curious students.

  

For over a year, Louise Kelley, DPT, has been training with me to teach Cervical Revolution. This past weekend was her last training course as she will be "flying solo" in May to teach this course on her own. During this time working with Louise I have been so impressed by her knowledge and dedication to the science of PRI. Over the weekend and over the past year I have watched her grow into becoming a stellar faculty member especially in her understanding of PRI principles as well as describing and breaking down techniques to restore alternating cervical and whole structure alternating function. I will miss spending time with Louise and she will be a brilliant Cervical Revolution teacher! 

Posted March 9, 2023 at 4:32PM
Categories: Courses Techniques Science

Divergent Physical Therapy and Wellness in Wellesley,MA just out of Boston proper was the location for Cervical Revolution on Oct. 22-23, 2022.  Cervical Revolution is the introduction to "top-down" PRI concepts of neurology especially autonomics and how the cervical spine at the atlas and occiput directs the cranium and ultimately occlusion. Since this is a complex system, there is also a connection on how occlusion and the cranium can also direct the entire body and all of it's postural and physiologic systems especially when the sphenoid becomes "fixed" and oriented while the rest of the axial skeleton compensates when in a pathologic state. The A/O runs the show until over-referencing with occlusal and cranial consequences drive pathomechanics.

 


What a great group and facility. Wellesley is a beautiful town and was surrounded by forested neighborhoods turning fall colors. Divergent is a state-of-the-art therapy and training center and lends itself to a perfect environment for learning.

This course was unique in that we had 7 PRC/PRT's that made for high level clinical discussions. There were students that were local from the east
coast as well as SoCal, Honolulu and even Alabama. Shout out to Alan, Cody and Paige for the long travels and especially Cody from Honolulu and a 10 hour flight. Neil Hallinan, PRT came up from  'Jersey and always has his expertise and knowledge that adds to the discussion. Thank you to Mike, Connor, Garrett and Cameron for providing their facility to all of us. Big thanks to Louise Kelley, DPT, PRC who brings energy, needed details and technique application to the course. And last but not least, thank you Karen Taylor-Soiles, PT, MA, PRC for providing a warm home, wonderful food and a seasoned provider's insight to the weekend. Louise and I are grateful to you and all in attendance.

Posted November 1, 2022 at 9:02PM
Categories: Courses Clinicians Science

Cervical Revolution came back to Lincoln this past weekend with a large zoom audience spanning internationally from Asia to North America to Europe. I had the pleasure of teaching to a live audience as well as having the added assistance of Louise Kelley, PT to help breakdown PRI concepts including  the finer parts of technique for de-rotation of the Right TMCC as it relates to not only the cervical spine but the entire system as well. In attendance was an impressive interdisciplinary group including movement specialists, strength and conditioning professionals, massage and soft tissue professionals, chiropractors, physical therapists, an osteopath, two dentists and one RN who is also a CSCS wanting to expand his horizons!


This is a course about the cervical spine and the need for revolvement that maintains alternation side to side, brainstem oscillation, temporal bone "wobble" and a jaw that can freely move side to side to keep a neck and nervous system in balance of an asymmetrical human that can stand erect and move fully and freely. Atlas and occipital bones make up a highly neurologic articulation with a brainstem and autonomics that are intimately connected to this highly reflexive region. This course is the gateway to the cranium and the introduction to top down as well as bottom up concepts of PRI. The cervical, cranial and occlusal systems are all integrated in this course and an impressive demonstration for all, especially the dentists, was provided with a simple mouth guard that Ron made for Louise the day before the course started. I demonstrated this stomatognathic example with Louise by first testing her cervical spine with a mouth guard that gave her right molar contact and reinforced her RTMCC pattern resulting in positive tests of her cervical spine. Another mouth guard was then utilized that dis-occluded her right molar contact while giving her left molar contact sense and all of her tests became negative immediately. This demonstrated the neurologic effect of a simple mandibular appliance on not only the cervical spine but the entire neuro-respiratory-biomechanical system.

Needless to say, this was communicated to me by a student as 'mind blowing' and brought an experiential example of the power of this course. Thank you to RJ for expert facilitation of this course over the weekend, Louise Kelley for being such a great lab assistant and team mate and Ron Hruska for spending Friday before the course reviewing advanced PRI concepts. Most of all, thanks for all of the students in attendance especially from international locations that stayed up really late or got up really early and for all of the diverse professions that contributed their advanced thought and experience to the enrichment of this weekend.

Posted September 13, 2022 at 8:12PM

After a three year Covid 19 hiatus, PRI was back at Lindebergs Academy in Munich, Germany to present Postural Respiration and Cervical Revolution in July of this year.  I had the privilege to teach both courses in Munich and it was the highlight of my career filled with many highlights as a faculty member for PRI. 

Students representing diverse disciplines and professions from all over Europe were in attendance.  Germany was well represented as well as Austria, Norway, Ireland, Britain, Australia and even a student who rode a bus for 10 hours from Slovenia!  Shout out to Naja for making that long trip on a bus.  There was even a physical therapist, Paula, who came in from Australia.  Francesca came all the way from Norway and Maria and Julia came in from Vienna and another small town in Austria!  I can’t forget Rob, and no one else will either, from Dublin!  And Beth made it from America on the F1 circuit in Europe!

The interdisciplinary approach of PRI principles spans many specialties and professions and in these courses we had physical therapists, athletic trainers, pilates instructors, personal trainers, kinesiologists, a speech therapist and two M.D.’s that integrate PRI into their practice models.

As a faculty member I was so impressed with the curiosity, energy, warmth and enthusiasm not only from the students but the staff at Lindebergs Academy as well.  Regina was so gracious and helpful with facilitating these two courses providing set up of tables in the course room and great food.  Also, Regina lent me her bicycle so I could ride all over Munich to really get a sense of this magnificent city.  Lindebergs is a state-of-the-art facility and to have the support of Regina and the entire Lindebergs crew is a faculty member’s dream.

Daniel Muller is a PRI veteran and has been vital in our presence at the Academy, Germany and Europe at large.  He was instrumental in making sure these courses were successful and that student and instructor needs were fulfilled beyond expectation.  Daniel also took me around Munich and provided friendship for a stranger in a foreign land for which I am eternally grateful. 

Our lab assistant was the incomparable Kazu Nishimura.  Anyone who can speak two languages impresses me but Japanese, German and English?  The quality of Kazu’s help was another layer of support and enhancement that added to the most positive experience of these two courses and helped enrich the learning experience for everyone in attendance.  He rode a bus for six hours from Berlin!

Munich has been the PRI hub of Europe and once again interest, energy and enthusiasm is growing for more courses.  As a result Pelvis Restoration with Lori Thomsen will be taught next May and then in July  Dan Houglum will teach both Myokinematic Restoration and Impingement and Instability.   The Interest in those three courses was a resounding “we can hardly wait” for PRI to come back.  And as an Institute, we can hardly wait to go back to Munich and continue to build PRI Nation internationally.   Thanks to Ron, Jen, RJ and Hannah for your hard work to help make this trip professionally and  personally satisfying for me.  At the end of teaching I took 10 days to explore and hike the Austrian Alps and the Dolomites of the Italian Alps.  Every moment was quintessential and an irreplaceable lifetime experience to explore and discover a new land, different cultures and spending time in beautiful cities, small towns and hiking in achingly beautiful mountains alone and with friends that live in Europe. 

 

Posted August 29, 2022 at 3:31PM
Categories: Courses Science

Huntington Beach was the location of the California Chiropractic Association’s (CalChiro) annual sports symposium on May 21-22. There were a wide range of topics including shoulder diagnosis to sports psychology to treating Marfan’s patients and then on to several approaches of functional movement specialties for rehabilitation and sport performance in a chiropractic practice.


I had the privilege of representing the Postural Restoration Institute and the topic presented was on the “The Two Roles of the Diaphragm in Chiropractic, Rehabilitation and Sport Performance”. This topic with lecture and lab had an enthusiastic response and many of the attendees that had taken a PRI course before were “fired up” to learn more. Those who had never heard of PRI or were unfamiliar with our approach were very curious to learn more especially regarding the thoracic diaphragm, breathing in sport performance and pelvic floor dysfunction.


This was the first time PRI was represented along with DNS and SFMA in the same venue at a chiropractic symposium. I got to know Michael Rintala, D.C. who teaches for DNS and Greg Rose, D.C. who developed the SFMA and it was a pleasure to get to know these two highly dedicated and competent practitioners on a personal and professional level.

 
I was more than thrilled to represent PRI to progressive chiropractors open to having an integrated practice approach. It was also a thrill to have Drs. Rintal and Rose in attendance to share more of what PRI can offer regardless of one’s practice approach. I enjoyed learning more about DNS and refreshing my knowledge of the SFMA. In addition, this weekend was a treat for me to see my colleagues and friends Drs. Richard Cheung and Jeff Tucker who were both, in part, responsible for my journey into PRI certification and ultimately into becoming a faculty member. I will always be grateful for their support.


And last, this past weekend was the 10th anniversary of taking my first PRI course, Postural Respiration, and what a meaningful journey it has been!       

Posted June 29, 2022 at 8:36PM
Categories: Science

It is not often that almost an entire group of course attendees are not only new to PRI but nearly the entire group is new to Postural Respiration. In addition, a large number of the course attendees where affiliated with the host site and staff at the University of California at Davis sports medicine department. The combination of new course attendees and the cohesive group from UC Davis made for an entire group experience that this faculty member will remember for a long time!


Respiration is the heart and soul of PRI and how we manage pressure sense neurologically is a post graduate subject that this group new to PRI grasped immediately.  For new students there where questions through out the weekend that re-enforced all of the concepts of this course and the basics of PRI.  Everyone of us can remember their first course and how daunting a "paradigm shift" can be.  This group of students shared this shift in a step-by-step journey into the wonders of this course where it appeared that all were pulled along by each other in this endeavor to learn.  Was it and is it always daunting for new students to be introduced to PRI for the first time or to a new course?  Yes but the energy and attention held throughout the weekend was impressive to say the least!  And, the UC Davis team now can share, practice and grow in their PRI journey together to provide care to their athletes and each other.  I look forward to returning to Davis one day and to see this community of professionals grow in taking all of the primary courses and moving on to secondary and tertiary courses in the future.  Thank you much to Melissa, Sammatha, Doug, Lisa and the entire UC Davis Sports Medicine Team for hosting. 

Posted June 16, 2022 at 9:35PM
Categories: Courses Science

Pro-Active Physical Therapy in beautiful Fort Collins, CO hosted Cervical Revolution this past weekend. This was a unique gathering of not only first timers to Cervical Revolution but seasoned veterans of PRI including a total of four faculty members and four PRC/PRT's. Included in the group was a local dentist, Dr. Behar Esmaili, who brought an enthusiastic perspective on how occlusion affects the entire physiologic and postural system. The subject of a stomatognathic consideration to the cervical, cranial and occlusal system with the cervical spine as the primary driver of the system was reinforced this weekend.

Postural Restoration is an interdisciplinary institute and that was reflected in the backgrounds of the attendees. Cervical Revolution bridges a gap, as does PRI, with many professions with respiration sacred to physical therapists, the atlas/spine with chiropractors, the cranium with osteopaths and occlusion with dentists. Mix in ATC's and fitness professionals for performance and this course, as well as every other PRI course, has a wide appeal and utilization for many health care disciplines.

Having four faculty members in attendance is rare unless a course is given in Lincoln and the energy with vast clinical expertise of Louise Kelley, DPT, Jason Miller, DPT and Craig Deperschmidt, DPT was appreciated by all. Louise Kelley, DPT will soon be ready to teach Cervical Revolution and her ability to describe testing and non-manual techniques, especially the Standing Stomatognathic Squat, was a "bonus" contribution to the weekend and was also greatly appreciated. The discussion of the A/O articulation being highly neurologic/autonomic went from a theoretical consideration in opening remarks to real lab experience when several "extension driven" students, with PRI Cervical repositioning non-manual techniques, got to experience first hand what neutral feels like. Thanks to all of the Pro-Active Staff for hosting this past weekend and this entire group of professionals that took time out of their schedules to "revolve" with us!

Postural Respiration was presented at Thrive Proactive Health to an enthusiastic group of diverse healthcare practitioners including PT's, PTA's, a DC, personal trainers, a massage therapist and a physician assistant  .  More than half of the attendees were brand new to PRI as this was their first primary course.

 
A student's first introduction to a PRI primary course can seem exciting, daunting and often like a quantum paradigm shift with an introduction to asymmetries, lateralization and neuro-respiratory driven biomechanics!  Understanding respiration is the key that has the potential to unlock the mystery of how we position a pelvis with a diaphragm, which leg we favor for stance, how we regulate airflow into chambers of the thorax and especially what drives "sense" position and pressure neurologically. Understanding and defining the multi-dimensional neuro-respiratory components of posture as it relates to the asymmetries that exist in the human body, what position we typically live in as humans and then learning how to test and treat objectively and effectively is a major shift in thinking about patient care as well as living in our own body.


It is safe for this faculty member to say that every time a faculty member teaches a course, in some small or large way, we all remember what our first PRI course was like and how new PRI concepts are to the first time student. That is the challenge and fun of teaching, watching "light bulbs" of awareness and discovery come alive in new students and new insights and skills being developed in returning veterans that keep coming back for more PRI as they build their skills and knowledge!

 
Thrive Proactive Health is an ideal location to provide courses and many thanks to Julie Blandin, PT for providing this state-of-the-art facility, enrolling her staff and especially being an experienced veteran of PRI, first rate lab assistant and sharing her clinical experience and competence with all attendees.  Many thanks to her staff for set-up and clean-up including Matt, Dante, Taylor, Karyn, Brittany and Kate!   

Posted November 22, 2021 at 9:58PM
Categories: Courses Science
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