Posts by James Anderson

It was a high honor for me to teach the updated Impingement and Instability course for the first time at Pro-Active Physical Therapy in Ft. Collins, Colorado. Preparing for this course over the last couple of months with Ron has been one of the more exciting and inspiring times in my career. I showed up on the first day of the course wearing a purple dress shirt, a color I have never worn for a PRI course in all my years as a presenter.

You may know that purple is the signature color of this institute, for many intriguing reasons. The color purple represents passion. It also represents royalty, and the institute’s longstanding acknowledgement of cortical function as the true king of human movement and performance. Wearing purple to this new updated Impingement and Instability course represented my newfound commitment to principles I have heard Ron talk about for nearly 20 years, but have not fully understood until I came to appreciate how he organized the new material in this updated course. I wore purple to declare that I am “all in” on concepts that I now realize have always guided Ron and that truly make this institute what it is, a neurological institute.

Impingement & Instability, Fort Collins, CO - James Anderson

We began the first day exploring the intriguing and powerful concept Ron has termed “functional cortical dominance”. On the surface it seemed like a novel concept. But in retrospect, it didn’t seem new at all, having listened closely to Ron develop and define this concept at essentially every Interdisciplinary Symposium since the institute started having them. We discussed sensory input from both sides of the body to both sides of the thalmus and midbrain, and the magic of the corpus collosum when assessing the pre-patterned sense our bodies and brains experience before they become a pattern. We also discussed the concepts of interoception, egocentric sense, esoteric sense, corporeal sense and compression sense to round out a truly “mind-blowing” sensory morning.

Postural Restoration, Impingement & Instability, James Anderson

And then our learning took on a new dimension when we brought Hilary O’Conner, PT up front for an exploration of some of these new concepts. Thank you Hilary for being willing to demonstrate your lack of intuitive sense on and for your sinister side, your inability to perceive your non-routine hand when standing on your routine leg and your inability to sense compression, centering and grounding on your incorporeal side because you lacked the necessary compressive sense across both of your scapulas. And all of this made it difficult for your hands to direct properly sensed and sequenced forward locomotor motion (a dynamic integrated full body sensory experience I used to inadequately refer to as mechanical gait).

Impingemenet & Instability, Postural Restoration Institute, James Anderson

Postural Restoration Institute, Impingement and Instability

Wow, really? Did I just say all that? We need to take a serious time-out at this point and state the obvious… this post sounds more like Ron Hruska than Ron Hruska himself as I look back at what I’ve just written. But the way he has designed the new course content really helps me appreciate more clearly what he has always been trying to convey to persistent and loyal PRI learners like myself. And he advanced my understanding of sensory integration and cortical function, without losing any of the longstanding content we have all come to appreciate in the Impingement and Instability manual, making the old material look quite new. Pretty cool Ron. Two words… patient leadership.

With many other things that could be said about the updated Impingement and Instability course, let me just summarize this course write up with the following. It’s a personal testimony in the form of a question posed by a very attentive and intuitive course attendee on the morning of the second day. Ben Hendricks, PT raised his hand and asked, “Is it possible that a person could feel more grounded on the left side just by listening to your presentation yesterday?” All I could do was smile and laugh as I looked around the room and saw the concepts sink in just a little further. From Ben’s written evaluation survey at the end of the course, I share the following: “Mind blowing! I was able to go to my left leg for the first time, just by listening to the lecture. Afterwards, by hearing to get onto my left leg over and over during that first day of lecture, and going back to the right leg felt different, as if I couldn’t go there as good as before. It doesn’t get more neuro than that.” 

Posted March 19, 2020 at 5:01PM
Categories: Clinicians Courses Science

Enjoyed a great weekend at the University of Missouri teaching the primary course classic Myokinematic Restoration. This course is essentially an expanded and updated version of my very first PRI course, its the first course I learned to teach as a new Faculty member 20 years ago, with material that continues to mean a lot to the work I do on a daily basis. Thank you to Joe Pope, DPT, PRC for assisting me with the course and helping give all the attendees a great overall experience. Your additional comments from your own experience learning the science of PRI were very valuable and I could tell were much appreciated by course attendees.

The course was taught at the Missouri Orthopedic Institute on South Stadium Drive across the street from the Hearness Center Basketball Arena and diagonally within view of the neighboring Faurot Football Field. Seeing this field brought back a memory from my college days that I may share just because its nice to reflect on the glory days, when Nebraska Football was dominant and we expected to win the National Championship every year. I'm also sharing this memory for those of you reading this who are not old enough to remember what I'm talking about, because its something you should know about.

The #1 ranked Nebraska Cornhuskers rolled into Columbia back in 1997 expecting an easy win and they ended up pulling out a squeaker that has come to be known as "The Miracle in Missouri". If you don't know what I am talking about (or even if you do), you should do an internet search and watch the spectacular (and very lucky) play called the "Flea Kicker". It's a signature memory for Nebraska Football fans in the 1990's and a pivotal reflection point for current fans hoping current Head Coach (and Flea Kicker Quarterback) Scott Frost will take the program back to its glory days. I think Matt Davidson still gets paid to retell the story of that play to anyone who will listen.

Another reason I tell that story is that 1997 was the year I met Ron Hruska. I was a student at the University of Nebraska Medical Center and we had a guest speaker come in one day to teach our physical therapy class about temporomandibular dysfunction. I had no idea at the time that I was listening to a man who would in time have a more dramatic impact on my career than any of the good professors I was being taught by in my current course of study. These professors gave me the fundamentals of joint structure and function, muscle function and general rehabilitation, but I remember wanting so much more in terms of "real-life biomechanics". And it wasn't until Ron presented courses on lumbopelvic and hip dysfunction that I started to feel satisfied thinking through what I thought was really going on.

This Myokinematic Restoration course was my first hook, because it answered questions about biomechanics and human movement that I hadn't even asked myself before meeting Ron. Questions like, "What is the position of the acetabulum relative to the femur on each side and why does it matter?", "What is ligamentous muscle and why is it necessary?", "What is the performance strength of the acetabulum in early stance on the left and in late stance on the right?", "How does the performance strength of the femur relate to the performance strength of the acetabulum?", "What actually is acetabular hole control?", and my favorite,..."What is the function of the obturator internus and what is its role in upright human function?"

All of these questions and more are answered in the current version of the Myokinematic Restoration course. How grateful I am that I was able to consider such important questions so early on in my career and that I, like Matt Davidson, so much later in our careers, still get paid to tell my version of the story to anyone who will listen.                                                                                                                                                                                                                                                                                          

Beautiful weekend in Oakland California talking PRI for the frail, the immobile and the chronic with a super group of medical professionals at the Alta Bates Summit Medical Center. A huge thanks to our host site coordinator Shaun Buchanan for thinking of everything and making sure we had a wonderful weekend. Your hosting was amazing Shaun. Also thank you to Tim Dempsey, CSCS, CPT, PRT who assisting me this weekend as a lab instructor and made sure the group had a good experience.

 The night before the course was fun and relaxing for me because I got to attend a Golden State Warriors basketball game in the new Chase Center arena. I have been to several games in the historic Oracle Arena in Oakland, but getting to attend a game in their newly completed arena across the bay in San Francisco was an awesome experience. After the game, I picked up a souvenir that helped me teach the course the next day. It was a Matryoshka or nesting doll painted as one of my favorite players, Klay Thompson. Klay turned out to be great asset for giving the class context for rotational diaphragm performance, lumbopelvic rotation and contralateral respiratory rotation through the rib cage during transitional activities and gait. Who knew?

This PRI Integration for Geriatrics course does a great job assessing and making treatment recommendations for different aspects of the human gait cycle. The design of the Seated Gait Integration Test is to determine early to mid stance performance and the design of the Seated Eversion with Abduction Test is to determine late stance/pre-swing performance for the geriatric athlete. These components of upright performance are essential for dynamic upright balance activities, transfers in and out of the standing position and delivering efficient gait mechanics. Seeing the L AIC/R BC pattern in context with different components of gait allows the practitioner to make meaningful changes to gait deficiencies and upright balance and transfer problems. Preventing falls in these populations is by far the most meaningful thing you can do to preserve upright function.

Another powerful aspect of this course if the time spent on Functional Routines in the Home from both a patterned and a preferred standpoint. Thank you John Maynarich, OT for helping our class stay functionally minded throughout the course and for representing the profession of Occupational Therapy so well. You were right, this material is well designed for OT practitioners and should be an important part of all geriatric care. Our ability to make positive changes in daily functional routines really is the whole point, isn't it?

Lastly, I wanted to give a shout out to our 3 first-time course attendees in the class. Thank you Tom Borremeo, Christina Cherg and Fabrice Rockich. You guys were amazing. And thank you Carol Cahn, PT, PRC for personally bringing your friend and co-worker Tom to the course. As I said, you 3 newbies are VIPs from my perspective and it was an honor to cater the content of the presentation to your level of understanding as we went along. Thank you for being willing to ask questions and for the great class discussions you helped to generate. You literally are the reason the Affiliate program exists and we thank you for being there.  

 We had a super group of performance professionals come together for this year’s PRI Integration for Baseball course at Salt River Fields in beautiful Scottsdale Arizona. Awesome to have course attendees representing high school, collegiate and professional baseball performance from all parts of the United States, the Dominican Republic and Japan. A big thank you to the Arizona Diamondbacks for the warm hospitality and professionalism in hosting the course. We couldn’t have been treated any better.

PRI Integration for Baseball - Arizona Diamondbacks

I started the first day introducing key PRI principles and concepts for first time attendees and others who are new to the science. Fundamental concepts of performance breathing like Zone of Apposition (ZOA), diaphragm function, abdominal integration and abdominal regulation for breathing and movement were discussed. The Left AIC/Right BC pattern of developmental asymmetry was also introduced and explained, including objective tests used to identify this pattern clinically. We then demonstrated the respiratory changes and the positional orthopedic changes that occur when a Zone of Apposition is restored.

PRI Integration for Baseball - Arizona Diamondbacks

Ben Hagar, DPT, PRC took over on the second half of day one to take us through the mechanics of throwing and hitting. Wind Up, Stride, Cocking, Acceleration and Decceleration/Follow-Through were all discussed, including analysis of slow motion video to break down the movement into functional pieces that were easier to digest. Tendencies in each phase of throwing and hitting were discussed, including the patterned tendencies for a baseball player as a result of their inherent Left AIC/R BC pattern. This understanding of the pattern included the specific early and late phase tendencies for both right and left handed throwers and hitters.  

Positional and rotational performance tests for baseball athletes were provided in the seated position, the quadruped position and upright in standing to help guide diagnosis and treatment. Specific treatments for R BC, Superior T4 Syndrome and Repetitive Rotation Superior T8 patterns were discussed, with the majority of our time and attention being spent on Superior T4 Syndrome, because of its high prevalence in baseball. Ben went on to provide training activities for performance deficits at different phases of throwing and hitting for both right and left handers.

PRI Integration for Baseball - Arizona Diamondbacks

It was an honor to be there with such a super group and again to be able to partner with someone as dynamic as Ben Hagar. He continues to impress me with his understanding of rotational performance and his ability to orchestrate learning and to clarify challenging concepts for large groups in a classroom setting like this. Well done Ben and thank you to everyone in attendance. Your attendance made each one of us a little better.

Posted December 16, 2019 at 9:19PM
Categories: Athletics Courses Science

Getting to visit the beautiful state of Alaska is always a gift and if you haven’t been there before, you get a taste of the rugged and majestic way of life the minute you step off your plane at the airport. A beautiful bull moose graces the main hallway and a world record 459 lb. halibut graces the wall as you head down to get your luggage. Both of these beautiful creatures instantly remind me of trips I have taken to Alaska with my Dad and my son to catch salmon and halibut and to enjoy the great big Alaska outdoors. Great memories for me indeed.

Historically, my trips to Alaska began in 2011 when I traveled up to speak at the Alaska Physical Therapy Association annual conference at the Alyeska Ski Resort. Over 100 people listened to Myokinematic Restoration that day and the group struggled to appreciate the value of the science and to understand how the principles of PRI fit into what they “knew”. To be honest, we may not have had continued opportunities to grow PRI in Alaska were it not for one innovative pioneer who quietly sat in that class named Joy Backstrum, PT, PRC. Thank you Joy. Thank you for your patient, thoughtful, open-mindedness and for your commitment to be a mentor to your peers. Thank you for the difference your drive and persistence has made in so many lives from that first course until today. It was special to see the members of this Impingement and Instability class recognize that you are the reason they are able to be so far along in their PRI journey.

And thank you to the entire team at The Physical Therapy Place for being such great great hosts this weekend. You guys went out of your way to make sure I felt welcome and appreciated in every way. From making sure I had everything I needed to taking me to awesome Anchorage restaurants like Hearth Artisan Pizza and The Moose’s Tooth, you guys did it all.

This Impingement and Instability course went off quite well. We started the first day explaining how impingement and instability are actually good things, when seen in the proper context. Instability where you have previously experienced impingement and impingement where you have previously experienced instability are essential for the alternating reciprocal rhythm your autonomic nervous system seeks. Your sense of the floor and your sense of the PRI Reference Centers on both sides of your body help your autonomic nervous system appreciate this desirable rhythm.

Calcaneal instability, femoral instability, Ilial instability and scapular instability were all discussed in context with this desirable rhythm and variable autonomic function. When the body starts to look like a system where regions of the body rely on other regions of the body for what they need, then you can begin to move past introductory level PRI thinking into secondary and even advanced PRI thinking. This class is really fun to teach because it does such a good job bringing concepts together and it helps the course attendees advance to the next level without losing any fundamental components. If you haven’t taken Impingement and Instability in a while or at all, I hope you can join us for this innovative course in 2020. You’ll be glad you did.

Posted November 20, 2019 at 5:19PM
Categories: Clinicians Courses Science

Phoenix Arizona is a beautiful place to visit just about any time of the year, but early November in the Valley of the Sun is just about perfect. A big thank you to Jimmy Southard and the amazing staff of the LA Dodgers for hosting Postural Respiration, our flagship course. Also thank you to all of our wonderful course attendees and a special thanks to Aaron DeBord and Jim Wittekind for assisting me as lab instructors.

Postural Respiration hosted by the LA Dodgers, James Anderson, Postural Restoration Institute

The recently updated Postural Respiration course is fun to teach for many reasons. First of all, the research associated with the presentation on day one is comprehensive and clarifies concepts that have been fundamental to this institute since its onset. Emphasis on powerful PRI principles like Left Posterior Mediastinal Expansion, Right Apical Chest Wall Expansion, Autonomic Sense and Limited Functional Patterns take on new meaning in context with these newly included research articles.

Postural Respiration Primary Course, Postural Restoration Institute

Postural Respiration Manual Technique, Postural Restoration Institute

Another highlight is a new test to assess Standing Posterior Mediastinum Expansion. This group took the time to appreciate the the critical nature of this concept and to experiment with this new test and it really paid off. Many new ideas for utilization in a variety of settings were discussed and shared. Many eyes were opened up to what this institute has always been able to offer upright rotational performance and the autonomic variability for athletic performance and standing upright training activities. Fun to see and experience.

Standing Posterior Mediastinum Reach Test, Postural Restoration Institute

Thank you Jimmy Southard and thank you LA Dodgers! Always a world class organization with world class hospitality.

Posted November 13, 2019 at 4:27PM

This Geriatrics course is a refreshing Affiliate Course that frequently surprises attendees because all of the useful information it has in it. After the course C.M. writes, “This is one of the most influential PRI courses I have taken, providing a thorough overview of the science and concepts that challenge both the beginner and the experienced PRI clinician. Excellent.” B.B. said, “This was a great review of PRI which brought so many pieces together, while simplifying the exercises for geriatric patients.” CV said, “I love the evaluation and treatments, and they can immediately be applied to all patient types, especially geriatric and frail. The manual was easy to navigate and overall, this was a fantastic course. My favorite so far!”

James anderson teching PRI for Geriatrics in Seattle WA

Seattle Washington is is a great place to be most any time of the year. Loved all the chic waterfront restaurants and cool shops on this trip. A big thank you to the crew at Alpine Physical Therapy for being such great hosts, ...again. 3 PRC credentialed practitioners in the same clinic makes for a great learning environment. Thank you Jeremiah, Chris, and Eli. We look forward to being back next year in February for the other end of the spectrum when Lisa Mangino and I present the new Pediatrics Course. So excited to share this exciting material with all the cool practicians in the Seattle Area.

Posted September 16, 2019 at 9:34PM
Categories: Courses Clinicians Science

Had a beautiful weekend with Kasey Aikin, DPT, PRC in my home state of Nevada teaching Myokinematic Restoration to a really great group. A big thank you to our generous host at the University of Nevada Sports Medicine, Jay Henke, M.Ed, LAT, ATC. He made us feel right at home in every way and even provided me with a list of his favorite local places to eat, which is a treat for a foodie like me. The University of Nevada Reno is nestled in the mountains and foothills of northwest Nevada, which is something you really need to see if you haven't been. As an alumni of the University of Nevada, I have really come to appreciate the northwestern Nevada beauty of Reno, Carson City and Lake Tahoe. Returning to my home state helped me again appreciate all the great people who live there.

And it was a treat to be able to co-teach with the newest PRI faculty member in training, Kasey Aikin, DPT, PRC. She does a great job with the Myokinematic Restoration course material and is really able to connect with the class attendees. She is from the great state of Texas and she brings a hospitality all her own wherever she goes. It was an honor to get to team-teach this course with her and to get to both teach and learn from her this weekend. She reaffirmed what I already knew about our PRI Faculty, that we are all unique with our own unique gifts, attributes and passions that allow us to connect in special ways with a variety of course attendees. Kasey is definitely passionate and she made the course experience great for everyone in attendance.

PRI Faculty James Anderson and Kasey Akin co-teaching Myokinematic Restoration

This Myokinematic Restoration course material is really useful for all types of clinicians as well as sports medicine and strength and conditioning professionals for a variety of reasons. First, it outlines which muscles are needed for non-compensatory gait mechanics when in the Left AIC Pattern and what the specific deficits are on each side. Second, it explains and outlines the use of Ligamentous Muscle as a powerful resource for stabilizing hip joint or pelvis instabilities. And third, it provides 2 powerful resources, The Hruska Adduction Lift Test and the Hruska Abduction Lift Test, to monitor pelvic and hip gait performance in all 3 dimensions.

Lab practice during the Postural Restoration Institute Myokinematic Restoration course, Reno, NV
 
I was first drawn to the science of Postural Restoration via the material in this course. It challenged my thinking and gave me a structural framework for prescribing movement and outlining performance that I rely on heavily to this day. The course is a great introduction to PRI for people from all backgrounds and it remains one of my favorite to review, utilize and teach.

Posted August 1, 2019 at 7:07PM
Categories: Clinicians Courses Science

Thank you Ryne Gioviano at Achieve Personal Training and Lifestyle Design for being a great host site to this most recent installment of Impingement and Instability. It’s great to have additional host sites pop up in the Chicago Area, or as several course attendees called it, “The City”. Even though people from many other cities might disagree with Chicagoian's claim to that particular title, we at PRI really appreciate the good people in and around Chicago and are grateful when we are able to meet, teach, and learn from more of them.

Impingement & Instability - Postural Restoration Secondary Course

This course is always a joy to teach because we are able to view and discuss things through a secondary level lens vs the primary level lens the 3 introductory courses are presented in. I like to tell people that this course is an opportunity for us to thank you and reward you for your ongoing commitment to learning the PRI science and your persistence sticking with the primary level material. It is one our first opportunities to have more advanced discussions about the fundamentals behind the PRI science to help you be even more successful with the material you have been learning in the primary level courses. In other words, questions that we might have redirected back to a more fundamental place in a primary course, we are now more than happy to discuss in full detail, with a more complete explanation of why a patient or client may have a particular problem and how we intend to intervene to solve what may be a more compensatory and neurologically unstable version of their original pattern.

Demonstration during PRI Impingement & Instability course

Demonstration time during PRI Impingement and Instability Secondary Course

Instability throughout the body was discussed in context with the lateralized influence of the Left AIC/Right BC Pattern, and the associated bias with neurological reference centers and asymmetrical respiration when in this pattern. A deeper look at the positional components of the gait cycle all the way up the kinetic chain from the calcaneus to the diaphragm on both the left and right sides helped explore these tendencies. We had great participation throughout the class, but a special thanks to Jim Peters, PT for being our model of calcaneal instability and later ankle/hip security after getting into a pair of appropriate footwear. We also were able to explore the scapular instabilities that can emerge when things like the Subscapularis is overlooked, or when the Lower Trap, Upper Trap and Serratus Anterior are functioning in the wrong plane(s) or not functioning at all.

A great weekend with a super great group of dynamic professionals. I would like to specifically thank Vivian Lea for traveling all the way from Hong Kong to be in attendance for this course. I know you had to be in America for other reasons, but even so, it was so awesome to have you with us while you were here. It was our pleasure having you in the course with us. Thank you to Julia Glick, PT from Lakeshore Physical Therapy for again bringing such a great attitude and for continuing to ask so many great questions. Thank you Skip George, DC, PRC for sending Chris Guar-in, CPT all the way from beautiful San Diego, California to take this course. He did a super job learning and participating on both days. He was a clear leader for the class and you would have been proud of him Skip. Also, thank you to Honami Abe, ATC for coming all the way from Southern Methodist University (go Mustangs!) and for your interest in collaborating with other PRI minded professionals in the Dallas area. I know you'll love getting to know Amy Goddard, PT, PRC and her great staff at Go Sports Therapy.

Posted June 10, 2019 at 8:32PM

This latest installment of the Postural Respiration course in New York City was notable for several reasons. First, the group was a very large and a very diverse and dynamic group of professionals, with 29 out of the 50 in attendance being first time attendees at a live PRI course. Second, my three lab assistants for the course were fantastic in every way. Thank you to Neal Hallinan, Sean Light and Brad Gilden. You three really helped to ensure a great learning and lab experience for everyone in the course. And third, the new updated version of this Postural Respiration course material really inspires, clarifies and defines the foundational principles of the institute in a meaningful way.

Postural Respiration Lab Assistants - James Anderson presenting a Postural Restoration Course

This updated course manual uses tons of great references to teach the concepts of static asymmetry, dynamic respiration and patterned respiration with clarity and authority. The well established history of PRI using objective tests to monitor position and respiratory function was further enhanced with the new Posterior Mediastinum Respiratory Reach Test. The group did a great job of picking up what we were doing with this new brachial chain test, and appreciated the reproducibility of the test for patient and client utilization on their own at home. Another highlight was the time spent on and clarification of both lower trap and serratus anterior function on each side and in each respective plane in the Left AIC/Right BC Pattern. The newly updated and expanded reference titled "The Influence of Patterned Respiratory Function on the Left and Right Abdominals, Lower Trap and Serratus Anterior" was especially useful in this regard.

Another highlight was how well the lab time turned out for everybody in attendance. There were plenty of treatment rooms and treatment tables and we scheduled enough time for each lab, whether it was an assessment lab or manual technique lab, to give everyone a good experience. Again, kudos to my excellent lab assistants for giving everyone the time and attention they needed to have a meaningful experience in lab. You three are top notch professionals clearly committed to sharing what you have come to know and that commitment made this course wonderful for all in attendance. And thank you for helping to explain how important interdisciplinary integration is when it comes to working with professionals who may not be licensed to perform manual techniques developing relationships with professionals who are. We always appreciate the interactive and interdisciplinary dialogue.

Neal Hallinan assisting during a lab demonstration - Postural Respiration

And lastly, I would like to thank yoga instructor Giulia Pline for your willing help in this course as a class demo and reference for our learning. You were willing to demonstrate patterned respiration in the Left AIC/Right BC Pattern using PRI special tests and then receive the manual techniques in front of the group to help us learn how to perform the tests and techniques in the lab. You were the prototypical Left AIC/Right BC Pattern, representing the underlying pattern that exists underneath all other compensatory patterns that could show up in our lives. After your assessment, it was fun to spend the rest of the course talking about rib immobility or compensatory patterns like Superior T4 Syndrome, with the goal in mind of becoming like you, on the way to becoming neutral, whether we used manual or non-manual techniques to get there.

Posted May 17, 2019 at 5:47PM
Categories: Courses Science
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