Posts by Ron Hruska

In the later part of 2004 I met with Stan Babel through Karen Jiran MPT, PRC and Carrie Langer MPT, ATC, PRC. Stan who owned and managed Physical Medicine Diagnostics Rehabilitation (PD Midway) and wanted to build a pool. At that time I was really interested in hydrodynamics and had countless discussions with my brother who is an engineer regarding pump power, jet nozzles, etc. And more importantly I wanted to design a pool for patterned neuromuscular isolation and inhibition through the use of directional water to maximize specific aquatic afferentation, as well as compensatory push and pull recognized by the autonomic and central nervous systems. My first PRI Sequential Movement (PRISM) pool design was developed and constructed through Stan. All eight of the stations provide neuromuscular isolation and feed forward activation of groups of muscles to resolve postural related dysfunctional autonomic and physiologic behavior through the flow of water. With the arrival of this pool and its science, PDR Midway, became IMPACT Physical Medicine and Aquatic Center.


Presenting course material that is related to the brain’s lateralized hemispheric specialization and the autonomic nervous influence on our central nervous system’s compensatory behavior, fifteen years later, made my amygdala related emotional, sentimental and nostalgic feelings flow uncontrollably. Stan and his wonderful staff over the years has enabled me to continue to move in directions that I patiently outlined, ballooned and flowed with. I feel so indebted and grateful to him and his staffs over the years. Many of those affiliated with this integrated minded center were in this class.


This particular class also made me feel somewhat sentimental, because I have known most, if not all of them, for so many years. They were watched, observed, tested and judged by me. They were my independent, dependent and constant variables for my research effort on knowing when, how and what to deliver to get where we were on November 2nd, 2019. There were 18 Credentialed providers in the room that affectionately tolerated me being somewhat unfiltered regarding autonomic and central nervous systems and their influence on each other and our patterned behavior.  


This course is such a joy for me to teach and resonate around. Just as aquatic flow can re-balance, re-engage, and re-tense us, so can mandibular latero- molar trusive contact, sphenoid (pterygoid) and temporal (temporalis) oscillation, and palatopharyngeus  (diameter of the pharynx) and tensor veli palatine (diameter of the eustacian tube) ANS control. Before Stan, before the pools, before PRI certification, I remember a quote by Socrates that remains with me today. “I cannot teach anybody, I can only make them think” and I am grateful for those who continue to flow and follow thought processes that make them sequentially think.  

The staff at IMPACT are always such wonderful hosts. The morning breakfast, break food and afternoon warm cookies (thank you Stan) are so appreciated. Christie Amundson PT, DPT, HFS,PRC and Mara Brandsoy OTR/L, PRC have a system in place for courses like this. Their and their fellow team-mate’s effort does not go unnoticed.  I also want to thank Amy Pennaz PT and Catherine Shelton PT for their willingness to work with me in demonstrating how to resolve postural related dysfunctional autonomic behavior.

Posted November 19, 2019 at 10:03PM
Categories: Clinicians Courses Science

On page 16 of the Cranial Resolution manual, there is a bullet I wrote that states ‘If we don’t balance rotational events through hemispheric oscillation, occipital alternation or lateralized rhythm, we remain resolved to compensate for our rewarded over-reaction and autonomic drive to repeat.’ 

Yet there were 14 PRCs, 1 PRT and the rest of the class who have taken a minimum of 7 PRI courses. Needless to say, they were “repeaters”. Their drive to continue to learn how to balance rotation with frontal oscillation is on a continuum. The host couple emulates this drive. Thank you Josh and Katie Olinick for hosting another PRI course in the manner you did. (The coffee was just a tad bit cold. Just kidding. I did not need the sugar. Your sweetness diffused into my body before my first sip.) Your hospitality and reception is truly reflective of “home”. Sangini Rane PT, PRC thank you for bringing a patient for all of us to evaluate and make suggestions reflecting autonomics and the course material. Everything about this course I love. The material has been strengthened over my last 30 years of clinical practice. And the messages are being delivered to a body of people who now can appreciate what my autonomic and somatic nervous systems were integrating 30 years ago, with a platform, called ‘PRI’. Any time I get a hug from Susan Henning PT, PRC I feel better than a cold cup of coffee. 

There is so much to consider when one focuses on the interplay between our autonomic nervous system, our somatic nervous system and our central nervous system. And, there is so much to get excited about when the interplay of these systems can be modified, re-integrated, re-oriented and re-calibrated through oscillation of novel conscious and un-conscious sensory afferentation. Our behavior, i.e. psychology of the conscious, revolves and resolves around fluctuation of brain lateralization, hemispheric specialization, dominance (subjective experience) as it relates to our brain’s individual unique asymmetrical and emotional processing. (page 31 of Cranial Resolution). According to the authors of ‘The Intersubjective Perspective’ (thank you Michael Zhao), focus on inter-related subjective experience unveils forms and patterns that conscious experience repetitively and unconsciously assumes over time (page 101). Therefore, our subjective experience of resolving conscious experience and patterns of behavior and biology through novel integration of these three nervous systems could generate “access to the underlying structures and organizing principles and patterns that unconsciously govern psychological life”. I absolutely love discussing behavior as it relates to evidence based autonomic research. The attendees at this course in NYC gravitated towards behavior as it relates to the limitation of subjective frames of interrelated and integrated nervous systems and their respective developed references. Thank you Borbala Suranyi for being my avatar! Thank all of you in attendance who asked poignant and clinical questions. The award to the one that asked the most insightful and driving questions that pushed us into wonderful engaging response from the entire group, goes to Jeff Eckhouse. Finally, thank you Alicia Ferriere and Finish Line for hosting another PRI course in NYC. I definitely feel at home when I am there.  

Cranial Resolution, New York City, Postural Restoration Institute

Posted August 21, 2019 at 9:11PM
Categories: Clinicians Courses Science

Having the opportunity to reflect on some of our PRI Non-Manual techniques that originally were put together back in 2003, with the understanding, consent and support of my gracious patients is always a privilege. A proud one. These photos of patients that have now become engrained and etched in our minds were taken more than 25 years ago, and not with a cell phone. As grainy as some are, and as imperfect as some now appear, they will always be the photos the Institute will use with the respective non-manual technique they are paired with; because they are related to stories, to people with behavioral and biologic history, and to individuals with hope as they struggle to understand and appreciate the steps and desired outcome associated with the technique that they will forever be infamous for. A few weeks ago Josh Olinick PT, PRC who works in Cary, North Carolina saw a patient that came to his clinic for a PRI re-assessment and intervention program. She was seen in 2004 by myself and agreed to have her photo taken for one of the PRI techniques I designed for her and this Institute. Josh, looked at her, and said, “Don’t I know you?” After further discussion, he realized who she was and what technique she was associated with. He sent us an updated picture of her performing the same technique she has been unassumingly known for. It was terrific that she found Josh, and more terrific that he could communicate and approach her the same way that she was treated when I assessed her 15 years ago.

The other person I reflect on every time I have given this workshop (this was the third time), and every time I will give it in the future, is Bobbie Ninneman, oops I mean Rappl.  She was my “Patient Program Coordinator” back in 2003, before she became the Institute’s Clinical Education Coordinator and now our Director of Clinical Development and Public Relations. Her oversight and insight is as important today, as it was then; no matter how many children she and her husband Mark raise. Her ‘children’ and my ‘children’ are also these people and these associated techniques and wording that tie them together. They are stories, events, chapters, accounts, and initiatives that change other people’s lives and processes. These techniques will remain consistent and constant, no matter, who and how many try to change the pictures, wording or association with other activity. Evolution depends on recognition of what started the journey and these techniques make me sentimental and grateful. I am grateful for Bobbie and all the “Bobbies” of my life that preceded anyone’s use of their guidance, consistent content and hope they offer.

Dan Houglum, who knew me before I started the Institute, and is now a faculty member teaching Myokinematic Restoration, summed up his weekend like this...
"The actual activity selected is not as big of an issue as I had originally thought. The real issue is can I reference the activity properly for them so they can sense what the need to sense in that activity. It was so great to be sitting next to Dave because he pointed out that every activity has so many potential 'referents' and 'references' in them, that you can use the same activity for two different patients, but use and reference the activity completely differently for each person to achieve the necessary outcome for that individual."

A few other testimonials shared by course attendees this past weekend...

     "This course should be a requirement for people who use PRI Non-Manual techniques. This course changed how I will practice a lot. Awesome course. Thank you so much!"

     "What an amazing course! Every PRI-minded person must take this. I had no idea how some of the techniques were meant/executed. Thank you very much!"

     "The reference/referents discussion will completely change my patients' experiences with the non-manual techniques.

If you are interested in learning more about the many 'referents' and 'references', and how to integrate them with the PRI Non-Manual Techniques, then I would highly recommend attending this workshop! It will be offered twice again in 2020 (both times in Lincoln, NE), so that I can have my side-kick, Jen Platt assisting me. Jen and I are already looking forward to it, and we hope you will consider joining us!

Ron Hruska PRI Non-Manual Techniques Workshop Postural Restoration Institute

Ron Hruska PRI Non-Manual Techniques Workshop Postural Restoration Institute

Ron Hruska PRI Non-Manual Techniques Workshop Postural Restoration Institute

Posted June 13, 2019 at 7:07PM
Categories: Courses

Sitting in the “audience” and listening and reacting with fellow faculty is such a wonderful time, opportunity and fulfillment for me. To do this with a host site that is as welcoming and friendly as a site could possibly be,  makes it very special.  Thank you Nate Dykema DPT, Kelly Marsman PT, DPT, Kevin Proctor DPT, and Craig Stasio PT so much!   To do this with a faculty member, whom I have developed so much respect for over the last few years, is even more life-affirming.  Skip George DC, CCSP,CSCS, PRC has been preparing and “dreaming” about teaching this course since he became a PRC in 2014. He has talked to  Mike Cantrell MPT,PRC , and me, about the course content and delivery of material since he learned he would be teaching it.   He has applied and postured himself, in my opinion, to do this type of work early on his career.  He has been a speaker for the Postural Restoration Institute since 2016 and has been so well received by his Postural Respiration course attendees.  I asked Hannah Janssen, our Education Coordinator, how would Skip’s course attendees describe him.  She quickly responded by saying, “ they feel that Skip works hard at making things understandable and he is passionate about the science and application of PRI”.   I agree with her so much. As a chiropractor he understands universal mindsets and applications.  We are so fortunate, as an Institute, to have him help us move forward these universal messages in the professional and personal manner he uses.  

I believe our understanding of the cervical relationship to pattern development, dominance and dysfunction of the cranium and thorax will be satisfactorily broken down from a PRI perspective by Mike and Skip.  They both have been instrumental in the present design, material covered and the flow of the delivery the last few months.   If there was an ‘Impingement and Instability’ course for the neck, it would be, in my mind, this one.   And both of these speakers integrate pertinent PRI universal concepts of vision, teeth, tongue, and the feet at understandable and applicable levels.   I am so grateful for this.

If you have not taken this course, and have met the requirements, consider taking it.  If you have taken this course and I was the presenter, consider taking it again from one of these two speakers.  The perspective and the manner in how it is presented will be worth your repeated time and expense.

Posted May 9, 2019 at 8:54PM
Categories: Courses

That’s another course, for another time.”

According to Kristi Jagels MS, PT, PRC this is a statement that I have made at many of the past courses she has attended. And I believe she is correct. 

Cupidity, or the intense desire for possessiveness, acquisitiveness, and avidness, usually interferes with our respect for the process that clarifies our appreciation for incessant curiosity and pedagogic gratification. We all need to struggle with novel approaches, new relationships and unfamiliar applications. There were thirteen PRI certified and trained clinicians in this course, as well as many more attendees, who have remained altruistic and content with familiar application of PRI principles and were, hopefully, ready for “this course, at this time”. 

Ron Hruska discussing Airway obstruction at the Cranial Resolution course at the Postural Restoration Institute

More importantly, they hopefully appreciate that this PRI course, which is about human dysfunctional oscillatory patterned behavior, would not have resolved their discipline outcome based discontentment, without trusting a thalamic process that was outlined by PRI objectives offered by previous courses that were required for this course attendance. The tag line following the title of each of those required courses, as well as this course, is “An Integrated Approach to the Treatment of…”  An appreciable understanding of human patterns is helpful in building a cognitive framework for the interplay between Autonomic and Central Nervous system integration in “treatment”. 

Ron Hruska Discussing the

I believe the framework offered by the PRI Primary and Cervical Revolution courses guides this interplay. Clinical “integration” of the Autonomic Nervous System and the Central Nervous System, using PRI based concepts, can have a significant influence on clinical interdisciplinary design and outcomes. After reading the comments from these course attendees, I believe they have gained a better understanding of the magnanimity associated with the words “that’s another course, for another time”.

Cranial Resolution IS that course, and worth your time!

To see more photos from this course CLICK HERE

There is probably no one that has over 35 years of “breathing experience” as it relates to lower back dysfunction or chronic disease than Rosalba Courtney. I have referenced her, written about her, studied her work, and continue to read her material. She has always been a person I am mindful of when contemplating the role the ANS has on regulation and vagal tone. She was mindful of autonomic dysregulation long before the term “dysautonomia” or “persistent postural perceptual dizziness (PPPD)” became widely noted or understood. She always related neurophysiological disruption to the scientific evidenced-based perspectives of non-pharmacologic healing methods. This is what drew me to Rosalba. Her deep, deep respect for resonance and rhythmic respiration. It is such an honor to have her accept our invitation to come to Lincoln, Nebraska as our 2019 Interdisciplinary Integration Symposium keynote speaker. If there is one word that I correlate patterns and positions to, it is ‘oscillation’ largely because of individuals like Rosalba. Oscillatory activity occurs to help coordinate a system of “oscillating body systems.” After our personal conversation with her, I am sure this noted Australian will enlighten our sense of vibratory need.

To read more of Rosalba's work, I would invite you to visit her website. What's even more exciting is that Rosalba is no stranger to PRI, as she has attended all of the courses we have hosted in Australia in the past few years. I am very much looking forward to finally meeting her, welcoming her to Lincoln, and introducing her to more of the PRI family.

Rosalba's presentations at our upcoming sympoisum are titled:

Oscillations and Resonance Frequencies of the Breath and the Body- Part 1     
Our bodies live in ever changing conditions. For health and homeostasis to be maintained successfully we need to constantly adapt to constant change. Oscillations occurring within the functions of our various body systems help these systems to co-ordinate their functions so that they can work together to optimally react to change and maintain homeostasis. Breathing is an oscillating system that can influence the function and co-ordination of other oscillating body systems, particularly the autonomic nervous system, the cardiovascular system and the digestive system in ways that enhance or interfere with the function of those body systems. Every oscillating system has one or several resonance frequencies where unique capabilities emerge. Resonance frequencies of breathing can be used therapeutically to assist a range of health conditions including depression, anxiety, panic disorder, dysautonomia, asthma, fibromyalgia, chronic pain, functional gastro-intestinal and cardiovascular disorders.

Optimizing the Healing Effects of Breathing Rhythms, Frequencies and Oscillations- Part 2
The healing and homeostatic effect of breathing oscillations can be optimized by improving the functionality of breathing. People with dysfunctional breathing have difficulties harnessing the healing powers of resonance frequency breathing. We well explore how 1. psychophysiological, 2. biomechanical and 3. biochemical dimensions of breathing functionality affect the breaths ability to heal and restore homeostasis and learn some techniques for assessing patients for with tools that can measure these various dimensions of dysfunctional breathing. We will then explore ways of modifying the practice of resonance frequency breathing to assist functionality in these 3 key breathing dimensions.

The early registration deadline for the Interdisciplinary Integration Symposium is this Friday. CLICK HERE to register today!

Posted March 11, 2019 at 3:18PM
Categories: Courses

It was a very cold weekend here in Lincoln Nebraska, and as a result of the weather and having a weekend off from course instruction, I had the opportunity to read, reflect and integrate. Therefore, it was a great weekend. This morning, I am reflecting again on material I read and perused, some of which was written by our speakers who are coming to Lincoln in April for the Spring Symposium. It is difficult to focus on what I need to do this week, because of my excitement for this collaborative event. Each of the speakers I have met and talked to in one form or another, and they all are people that have so much in common and so much to offer because of their dedicated work and dedicated pursuance of advanced work that is built off of integrative collaboration. I look forward to you meeting them and learn how they will help you advance your effort with airway oscillation, incorporation of glottal alignment and regulation of vibration in treating conditions associated with postural asymmetry.

After spending a day with Ruth Hennessy and some of her vocal clients a few days ago, while in NYC, I received this text message from Ruth. “I have a voice student I Skype with in Australia who has, for several years, been telling me about her amazing osteopath and how we are so on the same wavelength. Yep, it’s Rosalba Courtney! My student has taken some of her breathing classes in Sydney. Small world!”

This weekend of cogitation has reminded me of how small of a world it really is, when you reflect on how our interpersonal lives are really tied to those with similar adventures, study, interests, habits and relationships. All of this year’s Symposium speakers have two things in common, breath and body position. And I can’t wait to see and hear them interact with each other and with you in the SAME room.   If you have not decided yet on whether or not to come to this opportunity, reconsider what I reflected on this weekend; this unique personal connection of our ‘small worlds’ WILL NOT happen again like it will on April 11th and 12th. For those of you coming, I am eager for you to meet these speakers and experience the energy they will bring you, and your clients or patients through this assembly. Over the next few weeks, I will expound on my personal reasons for asking them to participate, and expand and consolidate our ‘small worlds.’

Ron Hruska working with Ruth Hennessy and a voice student

Ron Hruska working with Ruth Hennessy and a voice student

Posted March 5, 2019 at 9:43PM
Categories: Courses Clinicians

There probably is not a place on the body that I want to put my hands and eyes on more than the neck. It tells me so much about the neurologic state of the body, the position the body resides, the pattern of respiration placed on the thoracic diaphragm and the anterior neck muscle, the appendicular compensatory probability, the demands placed on dental occlusion, the manner of visual and auditory processing, the pharyngeal airway limitation and the voice habilitation existence. Our character and personality is refined and reflected by our cervical function, or lack of.

Quite frankly, I can look at someone’s neck and become oriented to their orientation and probable individual needs for and from Postural Restoration integration and application. Our synergistic patterns of behavior are defined by the dimension and displacement of the vessels and their lumens and the string-like fiber of muscle, tendons, fascia, and nerves of the neck.

Last weekend's instruction and interaction with Skip George DC, PRC, who will be teaching this class with me on April 27-28 in Holland Michigan, allowed us to fully examine patterns of functional behavior that corresponds with limitations of cervical lateral flexion and axial rotation. I want to thank Alicia Ferriere DPT, PRC, Darlene Kalinowski PMA-CPT, Laura Paley PT, DPT, Yohei Takada DPT, CFMT, OCS, SCS, CSCS, Catherine Coelho PT, and Daniel Buron MS, CSCS for helping out with lab demonstration and class participation. I always enjoy having Michael Zhao BS, CSCS in my classes. His brain-centric view of the importance of including physiological, environmental and biologic political determinants in assessing synergistic patterns of behavior enlightens me. Thank you Michael for your ongoing participation and attendance after taking 17 PRI courses. Lastly, thank you to Finish Line Physical Therapy for your ongoing support of PRI and continuing to host several courses a year in NYC, my home away from home. 

Posted March 4, 2019 at 3:01PM
Categories: Courses

Every time I see, say or hear the word ‘airway’ I think ‘oscillation’, and every time I see, say or hear the word ‘oscillation’ I think ‘airway’.  Therefore, you can probably imagine how excited I am for the upcoming Interdisciplinary Integration Symposium and for the opportunity to engage with all the speakers who have dedicated their professional lives to these two words. 

A recent article in The New Yorker (February 11, 2019), written by Burkhard Bilger describes our orchestration inside of us.  His first two paragraphs of ‘Extreme Range’ sent me over my edge of containment...

“In a throat, a note is forming.  A puff of air, a pulse of the lungs, rushes up the windpipe and through the vocal cords, parting them like a pair of lips.  As the cords begin to vibrate, they’re stretched taut by muscles to either side, raising the pitch.  The diaphragm pumps more air, rocketing the note up the vocal tract, making its walls hum like the barrel of a woodwind.  The sound ricochets back and forth as it rises, gaining resonance with each rebound, till it bursts into the hollow chamber of the mouth, the ringing cavities of the sinuses, and careens off the palate into the open air.

The human voice is the world’s most astonishing instrument, it’s often said.  It’s capable of everything from a trill to a bark to an ear-splitting scream, from growling harmonics to liquid acrobatics, lofted on the breath like a lark on an updraft.  Instrument is the wrong word, really.  The voice is more like a chamber ensemble: winds and strings and blaring horns, strung together end to end.  It’s a pump organ, a viola, an oboe, and the bell of a trumpet, each instrument passing the sound along to the next, adding volume and overtones at every step.  Throw in the percussion of the lips and tongue, and the echoing amphitheater of the skull, and you have a full orchestra playing inside you.”

Over the next few weeks, I will highlight each of our six orchestrated speakers and presenters, and how their ‘Approach to the Production of Voice, Airflow, and Resonance Frequency Breathing’ strengthens our sense of self and self-satisfaction.  Postural satisfaction requires intimate integrated oscillation from our vocal cords, neck musculature, throat or airway and occiputs.  Highlighting is something I do with every article, book or journal I read.  I look forward to every one of our Spring Symposiums, but this year it will be hard to contain my excitement between now and one of the biggest highlights of my year.

Posted February 18, 2019 at 4:32PM
Categories: Courses
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