Posts by RJ Hruska

The greatest part of being a part of the Postural Restoration community is the people. It always has been and always will be. The people within this community are open minded, passionate, eager to learn and not afraid to push the envelope. They care for their patients and client’s well-being sometimes greater than their own. And, what amazes me daily is the global reach this community has. On a daily basis I find myself in contact with like minded individuals in places like Egypt, Iran, Spain, Italy, Germany, Poland, South Korea, Hong Kong, Japan, and so many others. Attending this years AAPMD Collaboration Cures conference in Atlanta, our 4th meeting to date, seemed to me as wide reaching as our expanding global community. Especially after 2 years of diminished in person contact. Meeting people and reuniting with past collaborators and friends in person is more important now than ever, and it was sorely missed.

This community of integrated minded professionals allows us to present an introduction of PRI concepts to Dentists, Dental Hygienists, Myofunctional Therapists, Myologists, Speech Pathologists, Occupational Therapists, Medical Doctors, Neuro Optometrists, and others. To many the introduction of neck neutrality, body position, grounding (whether through the floor of your mouth or the floor under your feet), or arm wing among other common concepts we strive to teach and grow, are often welcomed and already being looked at and discussed but in different ways through different models. And sometimes individuals have never considered these things at all, and often times prefer to not go there. This dichotomy of professions coming together to agree and disagree from numerous perspectives on numerous subjects, is truly fun to be a part of.

Thanks to Brad Gilden, who has been instrumental in our involvement over the years, Ron Hruska was given the opportunity to teach twice over the course of the three-day PT Track and meeting. His talks included “Malposition of Airway Axial Alignment and Stomatognathic Common Compensatory Conflict” and “Peripheral Visual Cortical Influence on Central Ventilation”. And for the first time we were joined by faculty member Louise Kelley who has become involved in the AAPMD through her recent webinar and presentation of “Connecting Ground Sense and the Airway Through Arm Swing”. It was such an honor to have her presence, alongside ours, to not only present things through her own light but to strengthen our mission of collaboration as an institute with many of the individuals and organizations in attendance. If you have the chance to join Louise for a PRI course, her didactic yet easily understood ability to present material will not go unappreciated.

Posted September 30, 2021 at 8:20PM
Categories: Science

Jennifer Smart, DPT, PRC is one of three speakers for this year's 12th Annual Interdisciplinary Integration Symposium. This symposium topic came together as a result of the extraordinary work she has been doing with those managing Parkinson’s Disease in her community, and the engaging discussions she has had with Ron over the past couple years. Jen is a clinician at heart, but also one who is current with the research and medical advancements that have been made for those experiencing extrapyramidal symptoms.


Her growing interest in Parkinson’s Disease began around 2015 when her best friend was diagnosed. This was the year she completed the PRC credentialing program, and shortly after neurologist, Dr. Jay Alberts, published research showing how, when a person with PD rides on the back of a tandem that is being pedaled at a cadence of 80-90 RPM, a variety of their PD symptoms decrease. After dissecting the research, Jen bought a tandem bike, and her and her friend rode for over an hour 3 times a week at the specified cadence. Others with PD heard what they were doing, and she ended up getting several tandem bikes and set them up on stationary trainers at a local gym, where she coordinated having members of the local cycling community ride on the front to set the cadence while people with PD rode on the back. “Park’n Ride” was officially started as a non-profit in January 2015.


Based on the success of this cycling program, Jen has become a regional expert on Parkinson’s Disease, where individuals have moved to her small coastal town of Oriental, North Carolina after their diagnosis. She became certified in LSVT BIG, Parkinson’s Wellness and Recovery (PWR!) and Rock Steady Boxing, which are all evidence-based, Parkinson’s-specific programs. Jen has attended the Parkinson’s World Congress and has even volunteered for a week with Becky Farley, PT, PhD who developed LSVT BIG and PWR. In 2017, Jen received a grant from the National Parkinson’s Foundation to organize and run a two-day event, called the Parkinson’s Exercise Program (PEP) Retreat, which was designed to help both patients and medical providers better understand how to use exercise as an evidence-based treatment for PD.


In her own words, “What I have taken away from all of this training, from working extensively with this population, and from the currently exploding literature regarding the benefits of specific exercise programs for PD, is that, perhaps unknowingly, the components that make each of these treatment techniques so effective, are the components that are based on the science of PRI. People with PD, just like all of us, need to be able to rhythmically alternate, but their disease, or somewhere along their journey towards developing this disease, this ability to rhythmically alternate was compromised so they needed to develop involuntary tics, muscle spasms, tremors, restless legs, dystonia and/or postural changes to help them to get to the other side, to help them to alternate. This is now the message that I am trying to get across in both the prevention and treatment of Parkinson’s, and so many other, syndromes or diseases.


Learn more about Jen’s upcoming presentations at our 12th Annual Interdisciplinary Integration below.


Practical Implication of Intervention and Management of Patients Who Have Been Diagnosed with Basal Ganglia Disease
-Jennifer Smart, DPT, PRC
The first half of this presentation will review a variety of diseases involving basal ganglia dysfunction, examining both their common and uniquely different motor and non-motor manifestations, while exploring not only the current and experimental pharmacological, surgical and physical treatment techniques that are being employed to treat them, but also the underlying reasoning behind each of these interventions.  The second half of the presentation will focus more on a variety of evidence-based physical treatment programs, compiling the common effective visual, auditory, postural and respiratory components from each physical activity program. Emphasis will be placed on assessing how each technique addresses the temporal, lateralization and pressure regulatory deficits seen in people who have been diagnosed with Basal Ganglia Diseases (in order to unlock, through oscillatory function, the axial skeletal system from the appendicular skeletal system in an attempt to better balance the autonomic nervous system with the central nervous system).

A Clinical Perspective on Geocentricism, Lateralized Linkages, Sleep, Timing and Weight Shifting
-Jennifer Smart, DPT, PRC

The research states that the Basal Ganglia is involved in the perception of time, but what does that clinically mean? It means that a person with a Basal Ganglia disease, such as Parkinson’s, does not know how to navigate through space since such movement is inextricably linked to time, not only for understanding when to move but also at what speed (since speed is distance per unit of time) but also for knowing where they are (“five minutes from home”) and how to integrate all their moving parts. For example, knowing when to supinate and for how long to experience appropriate weight shifting in order to avoid over lateralization relies on timing.  This presentation is going to discuss clinical ways to address the various issues involved with timing deficits, through visual, auditory, positional, and respiratory cuing, in people with Basal Ganglia deficits.

Clinical Case Study Presentations
-Jennifer Smart, DPT, PRC

This presentation will be a discussion of the treatment and management of several patients who have been diagnosed with Basal Ganglia Disease, either Parkinson’s Disease or Progressive Supranuclear Palsy (PSP). A few of the cases were ones in which Jennifer Smart had the opportunity to collaborate with Ron Hruska. Management discussion will include group exercise application, in addition to individual rehabilitation considerations.


   

Posted March 17, 2021 at 6:38PM
Categories: Courses

January 25th was recorded as the second highest daily snowfall in Lincoln of all time, dropping 14.8 inches of snow at a record rate. Between phone calls and emails while working from home, all of us at the Institute were busy “Digging Out”, while at the same time being driven further into a pattern. This same system (of snow) hit much of the Midwest by varying degrees, and many of you, like me, may be feeling the effects after hours spent pushing and plowing our entries back to the outside world. There are many considerations to keep in mind while performing any repetitive, patterned driven activity, and in respect to clearing snow, they are heightened by the exertion and work needed to move the literal mass in front of you. Any activity occurring “in front of you” poses challenges in itself because of the linear forward movement which is often repetitive. Many of these activities and considerations are highlighted in our “Restoring Alternation in Your Daily Lives” Patient Guide which was published last year.


When it comes to pushing snow, be mindful of the following.

When pushing snow on a flat surface, consider first your hand placement and center of mass, in relation to the mass being moved in front of you and the ground below you. The most natural position will be for you to instantly lower your right arm nearest to the blade of the shovel, and your left arm closer to your body. This will lead to your COM to shift over your right leg causing you to work through Right AF IR, Left Trunk Rotation, and Left AF ER positioning, while further driving your pattern.


Instead, consciously start by reversing the above position, lowering your left arm further down the shovel and placing your right arm nearest your body. This will allow your COM to shift to the left, leading to Left AF IR, Right Trunk Rotation, and Right AF ER positioning, while helping to minimize the above pattern. Over time it is likely that you will naturally re-adjust back to the first position as it is what your body is asymmetrically driven to. When possible alternate between these positions as much as possible to minimize some of the common aches and pains that occur from pushing snow in a patterned position!

Posted January 27, 2021 at 6:37PM
Categories: Science

We are excited to announce that registration for our newest secondary course "Forward Locomotor Movement" is now open! Make sure to visit the course page, to read more information about this new course! The first opprotunity to move forward with this material is schedule for October 3-4th, dont miss out!

Course Description

This course offers the attendee an opportunity to re-examine ‘gait’, ‘ambulate’, ‘walking’, ‘bipedalism’, and ‘locomotion’ by addressing the cortical coordination of the human limbs that are responsible for individual forward locomotor movement patterns. Neurological and physiological dominance is designed around introspective habituation and compensation, that reflects physical predominant hemispheric loading and cortical hemi-spatial flow. A comprehensive, and up to date, review of literature and research on cortical dominance and associated pre-existing dominance factors that define interlimb and intralimb interaction during forward movement of the body, is offered. Arm and leg control, and overall associated motor function of human swing, support and propulsion will be addressed through asymmetrical gravitational balance effort and anti-gravitational eccentric considerations. Both, arm and leg control, and function in human locomotion, will be dissected and described, as a novel introduction to integrated upper and lower extremity movement, and hemi-spatial awareness and hemi-chest activity will be outlined, for all phases of forward locomotor movement. Clinical recommendations for individual introspection of forward locomotor movement will be provided throughout the course. Eccentric control of functional cortical predominant patterned limitations on locomotor movement, along with multisystem guidelines for reweighting balance through limb use, will be provided through the use of PRI non-manual technique application.

Posted August 15, 2020 at 3:24PM
Categories: Courses Science


We are excited to announce the release of our newest product! The Restoring Alternation Patient Guide is now available! This guide has been put together to help bring awareness to the activities that we perform regularly in our daily lives.This 16-page guide outlines several daily activities which are commonly performed in dominant or patterned positions, and demonstrates alternate ways and instruction to perform them. Copies of this guide can be purchased through the Institute, to provide and discuss with your patients and clients, the importance of decreasing the over-dominance of one side of the body, and using both your left and right sides with alternation and balance.

Customizable Guide

 Customization, including your business logo and contact information is available on the back cover of the guide. Here are four examples of the templates available for customization: 1 photo, 2 photos, 4 photos and up to 8 photos (this template should be used if you want to display up to 6 staff photos/credentials).

Non-Customizable Guide

This version is non-customizable and includes the history and information about the Postural Restoration Institute!

Click HERE to preview the inside of the guide.

Shipping is included on all orders, and ships directly to the shipping address provided when placing your order. Feel free to Contact Us with any questions you may have! Grab your Guide today to help your patients and clients alternate in their daily lives!

A big shout out to Josh Olinick for his inspiration to complete this customizable guide!

Posted August 5, 2020 at 4:57PM
Categories: Products Science

“A Guide To Awareness & Modification Of Habitual Patterns Of Postural Behavior”
We are excited to start of the 2020 calendar year by making progress on one of our newest resources. This patient guide, throughout its 16 pages, will highlight activities in our daily lives which can be modified to restore more appropriate postural behavior. As anyone who has taken a PRI course knows, these positions often turn into patterned dysfunction and compensation. This guide aims to bring awareness to our unilateral lives, and restore alternation while performing our most common daily activities.

Most of these activities can be categorically derived into common PRI positioning. This guide will dive deeper into those positions and the associated behaviors performed within them. For example, walking, talking, sleeping, eating, as well as many other “living” considerations and of course at its core BREATHING! Not only are we excited to be compiling these activities into one patient guide, but we will also be adding several new considerations and recommended activities to the PRI Living section of our website to further build on the concepts within this guide.


This patient guide will be avalible for purchase in various quantities and packaging options later this year! We are hoping that it will help you as a practitioner clearly communicate some of the basic positional considerations of our science with your patients and clients, and it will also include an available marketing opportunity unique to your business on the back cover! Stay up to date with this and other projects, updates and course in reviews on our blog, via our social media accounts on Facebook, Instagram and Twitter and our quarterly newsletters throughout the year ahead.

Posted January 9, 2020 at 5:53PM

Advanced Integration and specifically the Integration symbol itself, represent one’s ability to integrate not only the Primary Course concepts, but also one’s ability to recognize the asymmetrical patterns of behavior themselves. In fact your predisposition, perspectives and past experiences will all dictate how you perceive this symbol and consequentially appreciate this 4 day course. Advanced Integration allows us to come together once a year, for a detailed, didactic and sometimes difficult discussion of the most advanced considerations covered in Myokinematic Restoration, Postural Respiration and Pelvis Restoration throughout the year. It allows us to welcome individuals with various degrees of professional practice, differing levels of clinical understanding and multiple locations of living across the globe. This year we were joined by our PRI Family from 26 states, as well as the countries of Malaysia, Australia, Iceland, Germany and Japan. With Valerie Chai (PRC Class of 2019) traveling 35 hours to attend, the dedication of these individuals is something that is continually humbling, and appreciated beyond our measure.


Our Japanese family continues to grow and integrate their own understanding of these concepts as they are now offering all three Primary Courses, and working to present Impingement & Instability in the year ahead. We are also excited to announce the creation of the PRP, (Postural Restoration Provider ™ ) credentialing program that will be offered in Japan in the years ahead. Following these four days we were able to spend an additional two days with the PRC class of 2019, and welcomed 14 new providers from these countries.


The four days of Advanced Integration included some of the best presentations we have seen from Lori Thomsen, Jennifer Poulin and a special appearance by James Anderson representing the concepts they teach throughout the year in the Myokinematic, Pelvis, and Postural course work. If you have not heard these individuals teach this material I highly encourage you to attend one of their courses in 2020, as well as any other Faculty Member that may challenge your current understanding by receiving a different perspective from a different presenter.


The fourth day in particular allows us to reflect solely on Curvatures of the Spine and the effects that Torsion, Torticollis, and too much Torque can have on our already twisted systems. Lisa Mangino, Jean Masse, and Susan Henning have truly spent the better part of their collective careers to understand these concepts and the chance to learn from their intervention strategies was truly a gift to us all.


It is hard to wrap up an entire year of PRI course work through this one four day event. However the opportunity it gives us to come together as a family and challenge each other in a positive manner is one that we never take for granted. As you reach towards the year ahead, may you all appreciate the journey this past year has been for you as we do each December. May you reflect on those that mean the most to you along that journey, and welcome the challenges that will continue in the year ahead.

Our PRI Family starts with our Faculty and Staff and extends from there to all of you. I wish you and your Families a Happy Holiday Season and an Integrative year ahead!   

Posted December 18, 2019 at 5:57PM
Categories: Clinicians Courses Science

As one attends conferences organized by various boards and professional groups of education, it becomes apparent that many of them, no matter which organization is of the primary focus, are alike. This is now our second time attending the AAPMD Airway Summit, and it again was distinguishable from any other conference in the past. I believe it is important to understand the truly collaborative effort of all the organizations involved as the level of discussion was already set high because of the many disciplines present during these four days.


We were proud to join a long list of sponsors which included; The American College for Advancement in Medicine, The American Academy of Physiological Medicine & Dentistry, The Academy of Applied Myofunctional Sciences, The American Academy for Oral Systemic Health, The Institute of Physical Art, The Foundation for Airway Health, The North American Association of Facial Orthotropics, The International Academy of Oral Medicine & Toxicology and the American Academy of Craniofacial Pain.If you made it through the list above, it may be easier to understand the vastness of conversations had, professions in attendance, speaker topics presented and overall interest in integration. As I spent four days discussing and fielding various questions related to the relevance and strong presence of our Institute at this event, we immediately became aware of the potential and power that this science of Postural Restoration can have on a collaborative group of minds which we were surrounded by. After having these conversations between various Dentists, Oral Facial Myologists, Hygienists, Speech & Language Pathologists, Craniofacial Pain Physicians, and many other systemic health and physiology professionals, their desire for integrative and collaborative care was at an all-time high.


Many of them however were curious and sometimes cautious about where to begin, who to reach out to, and how those other professionals may benefit their patients overall plan of care and most importantly their treatment outcomes. Then comes “The Important Collaborative Role of PT and Airway Health” which was presented by Ron Hruska, Gregg Johnson and Brad Gilden. Which in and of itself was a milestone in the collaborative effort to introduce the important role PT’s have in viewing and treating airway and all other forms of dysfunction. Not only is the role of the physical therapist becoming more apparent but the roles of ALL individual professionals involved are becoming more appreciated. We were fortunate to have the presence of PRC, Steve Cuddy who has been practicing PRI and integrating with other disciplines in the Austin area for many years. Steve, it was truly an absolute gift to have you there as a representative of our credentialed providers across the country and abroad as these other professions look to you and others like you, who have become a PRI provider. The professionals mentioned above will be reaching out to all of you in the days, months and years to come, as a resource for integration of the science of PRI within their approaches of treating Airway Dysfunction and overall health!

“Attending the Collaboration Cures Airway Conference was an eye-opening, yet reassuring experience.  Eye-opening in the sense that the collection of airway-related issues is more complex and prevalent than, I believe, anyone truly understands.  Reassuring because I’m more confident than ever that we as PRI practitioners are uniquely positioned to play an integral role in the detection and treatment of obstructive airway conditions. Returning back to our homes, I’m sure that all attendees are more hopeful after listening to and meeting a wide range of passionate practitioners. This would include Ron who gave a few very insightful presentations.  I’m here to tell everyone in PRI Land that airway obstruction and the anterior neck are areas that we understand, thanks in very large part to the information that Ron has put together for us. My hope is that we make that clear to all allied airway health professions in our communities as we continue our own Postural Restoration journeys.”
Steve Cuddy

A huge thank you to Dr. Howard Hindin, and the AAPMD Organization for once again including us in this effort. Dr. Hindin was awarded the “Howard G. Hindin, Breath of Life Award” for his dedication and role in this collaborative movement and because of his efforts Airway Health has been brought to the forefront of Healthcare. Thank you again and we look forward to continuing our involvement with and alongside you all. Next year’s Collaboration Cures conference will be held in Seattle, on November 12-14th! See you there.

Posted October 23, 2019 at 4:44PM
Categories: Website Clinicians Science

As we prepare for the first ever PRI Integration for Pediatrics course this October in Chapel Hill, NC it is hard not to be excited! Anyone who works with children on a daily basis knows how rewarding it can be. However, when it comes to getting them to exhale into a balloon, or squeeze a ball between their knees it can become challenging very quickly. Lisa Mangino, PT, DPT, PCS, C/NDT, PRC has spent countless hours considering the many ways PRI can be incorporated into a Pediatric setting, and through the creation of this particular Affiliate course we can all learn her intervention stragies which she applies to a younger population of patients.

Check out the video below for a sneak peak of some of the ways Lisa incorporates PRI into her practice!

And for more information about this course as well as the dates and locations it is being held, check out the PRI Integration for Pediatrics course page!

Posted August 20, 2019 at 2:41PM

PRI Integration for Fitness and Movement found its way in the New England Region again last weekend in Boston, MA. The summer heat was hot, but our group was hotter! No for real, they were great troopers sweating through the weekend of jam packed labs! We had great space to utilize at Northeastern University to get some awesome lab time in. Thank you to the rockstar Huskies Sports Medicine and Sports Performance staff for hosting!! Their hospitality and commitment to excellence is evident and we are grateful for them hosting this course!

As a teacher you have to gather insight from multiple dimensions to evaluate the effectiveness of your course, looking into people’s eyes to make she they are following along in lecture,  having side conversations, and then watching how people participate in lab all are factors. This group rocked coaching each other in the labs!! The application seen in the labs was spot on and most fun to watch.  Our labs focus on training the abs and hamstrings to support posture and respiration and how to keep the asymmetrical human design balanced through the axial frame to best support and maintain the shape and function of the diaphragms, thoracic cage, and pelvis. We added some bonus lab time in and got 40 people to sled push for thoracic retraction and grounding and do lateral side stepping and retro stairs rhythmically in sync with one another to unlock the frontal plane.  It was a fun weekend!

 The PRI Integration for Fitness and Movement has a couple courses left for 2019. If you are interested, click here to register! We will be outside of Columbus, Ohio next month and Northern Colorado in September. Additionally, we are looking for host sites for next year! If you are interested, please contact PRI directly to let them know! 

Posted July 22, 2019 at 4:21PM
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