Posts by James Anderson

PRI Integration for the Home is updated and expanded.

Nearly 40 new techniques have been added to the existing 75 techniques available in our flagship affiliate course PRI Integration for the Home. This course continues to focus on successful PRI integration for geriatric, chronic pain and frail patients in home, inpatient and also outpatient settings. Highlights include gait integration via new hamstring specific, adductor specific, glute medius specific and glute max specific standing resisted techniques. They also include new right serratus anterior, left serratus/left low trap and right low trap techniques that unlock torsional thoracic patterns to restore upper half gait mechanics and functional balance to the geriatric athlete. 

It was a pleasure to return to Nebraska to collaborate with our superstar Home Integration model Irene, who's beautiful smile makes balanced gait and reciprocal activity seem effortless. Thanks for being so patient with our tedious photo shoot and all our weird requests. But mostly I'd like to thank you for your kind hospitality and your willingness to host us once again as we work to find better ways to deliver successful rehab outcomes to this awesome patient population.

Come and experience the updated Home Integration course during one of our 3 remaining offerings this year: Salem, Oregon on August 21-22, Seattle, Washington on October 15-16 and Warner Robbins, Georgia on October 29-30.

Posted July 11, 2016 at 2:42PM
Categories: Courses

Ryan Holleman and the staff at NC State outdid themselves once again, hosting a course that became more of an event than a course because of the high quality of everything they did all weekend. We had plenty of space on the very open and very comfortable Club Level of the beautiful Carter-Finlay Stadium, home of Wolfpack Football. There were over 60 attendees in the course, but it only seemed like about 25 because everything was so nice and because the course attendees were so great. Thank you Ryan, Murph and all the rest of the NC State folks for being such great hosts and for making such a supportive and professional #statement.

Since we all had such an awesome view of the 60,000 seats in Carter-Finlay Stadium, we started the day talking about the influence of the roughly 20,000 diaphragm contractions we experience per day. These persistent and consistent breaths directly affect the posturing of our core axial frame in three planes and also the size and shape of the pelvic cavity, the abdominal cavity, the cranial cavity and especially the thoracic cavity. It may have even been a segway into one of my favorite jokes about The Police's well known ballad, "Every Breath You Take". You know me, anything to make a memorial point and get a laugh from the crowd.

A big thank you to Kentaro Ishii, MS, ATC/L, PES, CES, PRT for the opportunity to collaborate with you as as you work to translate the course content into Japanese and as we both work together to become better instructors. It is my pleasure to be your mentor and I want to thank you for spending part of your 31st birthday with us before heading back to Kansas City to be with your family. I've known you personally for nearly 9 years now and I must say its an honor to have you as a good friend, a protege and a peer. Thank you for representing PRI so well as we expand our reach and our presence in your home country Japan. Also, thank you to Lisa Mangino, Jennifer Smart, Josh Olinick for your help as lab assistants. I appreciated all the help. North Carolina is one of the areas of the country where PRI has had a strong influence for a long time. In fact, there are rehab professionals in the Raleigh/Durham area who have been a part of this institute nearly since its inception. I think I counted 13 people who have had over 10 courses, many of whom are now certified in PRI as either a PRC or a PRT. It was a great experience presenting this institute's flagship course, Postural Respiration, to such an experienced and PRI savvy group. And I'm especially grateful that so many of them reported that this course gets better and better each time they take it. I hope thats true, because I know I loved getting into all the neurology, the breathing and thorax mechanics and the treatment interventions with such a great group. Thanks North Carolina, I can't wait for our next chance to get together.

Posted June 16, 2016 at 4:45PM

Had a great weekend in Duluth with Karen Swanson, PhD, PT, ATC at the beautiful College of St. Scholastica, who teamed up with Shannon Sharpe from St. Luke’s Hospital to host Myokinematic Restoration. So great to get to spend time with Karen, a friend and longtime associate of mine, whose PRI roots extend back to the early days of the Institute when we were both faculty members teaching Protonics courses starting in 1999. Her friendship, hospitality and kindness are a part of what has always made PRI Nation so great. I’m excited to brainstorm further research ideas with you Karen and to work together on some of the collaborative research possibilities we discussed.

And thank you to Megan Bollinger, PT, PRC and Jesse Ham, PT, PRC for working with me as my lab assistants for this course. You both did a great job helping the course attendees appreciate the finer points of patient evaluation and treatment and helping to give them keys for success. Jesse, I also appreciate the opportunity to mentor you as you finalize the process of becoming an instructor for this course. You did a great job and will be a great Myokinematic Restoration instructor.  

We discussed the three-dimensional control of the acetabulum over the femur and the reasons why it can be more common to want to jump off the left leg (a late stance performance activity) when the common pattern is so dominantly driven towards the right. We also discussed why it can be so difficult to jump off the right leg because we get so lateralized to the right and essentially get “buried” in the right hip joint (an early stance performance activity). This highlighted the need to have people reclaim right late stance performance with Right AFER Glute Max and left early stance performance with Left AFIR Ischiochondylar Adductor Magnus following left AFEXT Hamstring training.

We also outlined the use of ligamentous muscle to stabilize pathologically lax hip joints.  We talked about what is required of the AF joint and the FA joint during different phases of the gait cycle on both sides of the body and related these requirements to what we test for with the Hruska Adduction Lift Test and the Hruska Abduction Lift Test. We also came to appreciate the muscles that oppose the left AIC pattern and the specific planes that are the most necessary for each one of the hip rotator muscles on both the right and left sides of the body.

Posted May 31, 2016 at 1:30PM
Categories: Courses

Stephanie Huntsman and the good folks at The Cirque Du Soleil outdid themselves this time around hosting a great weekend of Impingement and Instability. It's always great to return to my hometown Las Vegas, and this weekend did not disappoint. In large part due to Stephanie's kind hospitality in arranging great seats for Karen and I to see two great Cirque shows. We absolutely loved The Beatle’s musical and visual experience "Love" at the Mirage and could not believe how amazing "KA" was at the MGM Grand. Incredible stuff! Performers and acrobats as talented and athletic as anything I’ve seen.

And this course had quite the international flare as well. Luke Worthington, CSCS traveled all the way from London, England. Kan Sugiyama, ATC, CSCS traveled all the way from Tokyo, Japan. Takuto Kondo, ATC, CSCS, DNSET, PRT traveled all the way from rural Japan. And Jacqueline Walt, PT traveled all the way from Toronto, Ontario Canada. Its awesome to see such a developing interest in the science of PRI in so many places, both national and international. Lucy and David, thanks for joining us again from Gym Laird Strength and Conditioning in Lexington. Donna, thanks for coming down from the Great Falls Clinic to represent the great state of Montana. Clete Sigwart, ATC, thanks for your strong interest and for representing the Cincinnati Reds so well. And Mike Zhao, thanks for bringing all those great biomechanical questions all the way from New York City. You guys were all great.

Impingement and Instability allows us to discuss the various areas of the body that can become unstable and fall into both predictable and unpredictable patterns of compensation. We had a great discussion and also demonstration of calcaneal posture and patterns of neurological reference through the foot. This foundational discussion provided a basis for the femoral instability discussion, the ilial instability discussion and even the scapular instability discussion. Thank you to my old friend Nick Valencia, PT from Foothills Sports Medicine and Physical Therapy in Gilbert Arizona (aka Nick Cage) for helping me get both sides of the rib cage internally rotating like it should. This rib activity allows a well positioned and mobile Zone of Apposition and really helps to stabilize the central pillar of core strength for all types of movement. Its so great to see all the good that results when ribs rotate like they should. Nick Cage helped us all learn what rib cage mobility can do to direct proper movement sequence, proper patterns of airflow and the use of neurological reference centers in all parts of the body. Awesome stuff.

Posted May 20, 2016 at 2:38PM
Categories: Courses

I had a great weekend in Quebec with the professionals at CoreXcellence in beautiful Montreal. I was given first class treatment by our host, Don White, and the rest of the CoreXcellence team, Vito DiCosola, Oz Beneli, Rich Thaw, Chris Latham, Iordan Krouchev, Leah Mamane, Jeff Saibil and Dr. Ora Loeub, B.Sc., D.O., DSc.O.,CAT(c). You guys were fantastic and are a very forward thinking group that are doing wonderful things with the science of PRI. Thank you for helping me clarify the differences between a Canadian Certified Athletic Therapist and a US Certified Athletic Trainer. Thanks again for all of your support and for being such a great host site for PRI training in Eastern Canada.

Impingement and Instability allows us to discuss the study of sensation and the human sense organs. We outline stabilization centers or neurological reference centers as key elements to organize and control movement. We outlined 2 or 3 key restrictions or limitations to normal right vs left patterns of human movement that PRI evaluates very closely: 1) unexhaled air maintained in one side of the thorax, 2) hypertonic polyarticular muscle chains on one side of the body and 3) poor neurological perception of our body’s right side vs left side position via compensatory reference centers. If you can’t remove the unexhaled air, inhibit the overactive muscle chain and sense your body’s position in space relative to the ground on both sides then your movement patterns are likely to be compensatory.

We had a great discussion and also demonstration of calcaneal posture and patterns of neurological reference through the foot. This foundational discussion provided a basis for the femoral instability discussion, the ilial instability discussion and even the scapular instability discussion. Thank you to our willing volunteers for showing us your non-summertime legs to demonstrate femoral vs tibial rotational alignment. And thank you to the entire class for being willing to walk through the right train station to left train station feed forward gait exercise. Also appreciate the volunteers who allowed us to demonstrate the value of full rib internal rotation on both sides of the thorax and the role that rib rotation plays in muscle inhibition. You were great sports and your participation helped us all learn together the value of proper movement sequence, patterns of airflow and the use of neurological reference centers.

Posted May 6, 2016 at 3:02PM

Tom Tardif, DPT and Summit Orthopedics were great hosts for the introductory course, Postural Respiration. Minneapolis has long been a hotbed for PRI training and PRI activity and it was good to be back in the friendly confines of such good people doing what we do. There were a lot of first time attendees, which reminded me of the early years of PRI training, when so many good relationships were nurtured in this area. And a big thank you to Stephanie Kinsella, DPT, PRC for being an excellent lab assistant throughout the course. 

We talked about the airflow pattern and rib cage mechanics one sees when the thorax moves into a patterned hyperinflated state of inhalation and the influence this type of extended thoracic posturing has on the pelvis, the abdominal wall and resting scapular position. The externally rotated rib posture tends to elevate the thorax and move it forward, as the front of the elevated rib cage expands upward and outward and the back of the rib cage closes down and becomes restricted. This faulty position of the anterior rib cage lengthens the abdominal wall, changes the shape of the normally domed diaphragm and moves the diaphragm forward outside the pillar of core stability. We talked about how the restoration of this rib cage and diaphragm alignment, a concept called obtaining a Zone of Apposition, is not only powerful biomechanically, but is especially powerful neurologically. 

We illustrated the frontal plane and transverse plane differences of the lower trap on the right vs the lower trap on the left, as well as discussing its sagittal plane influence on the above mentioned pillar of core stability. We illustrated the sagittal, frontal and transverse plane differences of the Serratus Anterior on the right vs the Serratus Anterior on the left. We were also able to break down the many important thorax performance functions of the Serratus Anterior, like addressing compensatory neck tone on the right, the ability to translate a deflated rib cage posteriorly on the left side, the ability to translate a rib cage laterally from right to left (right Serratus Anterior), and the ability to activate the abdominal wall in the frontal and transverse planes on the left (left Serratus Anterior and left Low Trap) and in the sagittal plane on the left (left Serratus Anterior).

We had lots of “ah ha” moments during both the testing component of the hands on lab and also the treatment component, where we performed our manual rib cage restoration techniques. Stephanie Kinsella, DPT, PRC was invaluable as we worked through the details of these manual techniques. The right BC treatment guidelines sheet was our friend throughout the second day as we worked together to get our heads around what to do clinically to address these rib cage patterns. A great group with a great attitude for learning new and different things made for a great weekend indeed.

Posted April 22, 2016 at 3:07PM

Had a super weekend in San Francisco at the University of California, San Francisco teaching Myokinematic Restoration. The UCSF School of Medicine was a wonderful host all the way around and it was a pleasure to have Dan Houglum, MSPT, ATC/L, PRC and Carol Cahn, PT, PRC in attendance working as lab assistants. Thank you to Mark Yanai, PT, for coming all the way from Hawaii to get first hand experience with PRI, based on the recommendations of the shady character, Randy Fukuji. Thank you to Ray Gorman, DPT, for your thoughtful insights and comments throughout the course and for representing Northern Nevada, even though you don’t love my alma mater, UNLV as much as I do. And Tiffany Asp, DPT, you were also a great addition to the course, with your detailed questions and insights. You represented Stanford University very well.  And a big thank you to Kyle Hardwick, DC and LaMar Sheppard, for representing the Chiropractic profession. Its always a pleasure to learn with and learn from you guys. So many great attendees with so much to offer.

Started the weekend Friday night in Oakland at Oracle Arena watching the very hot Golden State Warriors play my longtime favorite, Boston Celtics. The Warriors were undefeated at home this year and this game should have been their 55th consecutive home win, but the scrappy green and white Celtics pulled off the upset. This set the stage for a Saturday PRI course built around coloring pelvic and hip muscle attachment sites and lots of emphasis on the very important “green” Obturator Internus. I’m always looking for a reason to wear my Larry Bird socks.

We discussed the three-dimensional control of the acetabulum over the femur and also the use of ligamentous muscle to stabilize pathologically lax hip joints.  We talked about what is required of the AF joint during different phases of the gait cycle on both sides of the body and related these requirements to what we test for with the Hruska Adduction Lift Test and the Hruska Abduction Lift Test. We also came to appreciate the muscles that oppose the left AIC pattern and the specific planes that are the most necessary for each one of the hip rotator muscles on both the right and left sides of the body.

It was so great to have such an enthusiastic and engaging class of attendees in this course. They are going to do great things with the science of PRI. All in all, it was a great weekend in the San Francisco Bay area. Basketball, Biomechanics and Ghirardelli Chocolate. How do you beat that?

Posted April 19, 2016 at 3:48PM
Categories: Courses

Bill Hartman, Mike Robertson and the IFAST Family were fantastic hosts once again as PRI rolled back into Indy for our flagship course, Postural Respiration. Having worked together with Bill and the many professionals he has mentored and influenced over the years, I feel a certain kinship with the entire IFAST organization. In spite of all those great associations, I personally had not ever been to their facility or had the chance to rub shoulders with them on their home turf. This weekend gave me that opportunity and it did not disappoint.

We hit the ground running talking about the significance of internal rotation in so many different parts of the human body, including and especially the rib cage. This rib internal rotation is a primary driver for the properly positioned internal rotation we seek at the ilia, the femurs, the scapulas, the humeri and of course, the temporal bones. It was so great to have an IFAST performance partner, Dr. David Smith, DDS sitting on the front row right next to Bill Hartman learning how temporomandibular and cervicocranial function is influenced by ribs that internally rotate. Dave, you are a gentleman and a scholar, and our course was better because you took the time to be there. Thank you.

We talked about how respiration and movement of the ribs influences the autonomic nervous system and made a teaching tool out of an incredible yet true story of a grizzly bear attack that happened last fall in NW Montana. Thank you Grandma for teaching a listening Grandson that punching that grizzly bear in the back of the throat was his best option for survival. So now when we think about ribs that do not move into internal rotation, we can think about that scary moment in time when a Montana hunter had to punch a grizzly bear in the back of the throat! #sympathetic #backofthethroat

And with some help from my lab assistants, Louise Kelley, DPT, PRC, and Sayuri Abe-Hiraishi MS, ATC, LAT, CSCS, NASM-PES, CES, PRT we were able to explain and illustrate the frontal plane and transverse plane differences of the lower trap on the right vs the lower trap on the left. We reviewed the lower trap’s ability to work together with the internal obliques and the hamstrings to control thoracic position in the sagittal plane. We were also able to break down the many important thorax performance functions of the good old Serratus “Magnus”. We talked about its action on compensatory neck tone, its ability to translate a rib cage posteriorly, translate a rib cage laterally, and activate the abdominal wall in the frontal plane contralaterally and in the sagittal and transverse plane ipsilaterally. All in all, we came to the conclusion that the Serratus Anterior does more to drive human performance than meets the eye.

Posted March 23, 2016 at 4:34PM
Categories: Courses

Enjoyed a beautiful weekend in Bothell Washington with John, Anne, Carolyn, Kevin and the staff of Quality Care Physical Therapy. Thank you Cathleen Desmet, PT, PRC for all your help as a lab assistant as we moved into the examination and exercise portion of the training. Thank you to my friend, Randy Fukuji, PT for traveling all the way from Hawaii to participate in this course. Your insights and questions were a great addition to the weekend. And it was great to train 3 of the very sharp and fun PTAs who work with Betsy Baker Bold, PT, PRC and her team in nearby Everett. You guys were all great.
Many in attendance had already taken the Pelvis Restoration class from Jesse Ham and had learned a lot about pelvic inlet and pelvic outlet performance.  They were excited to add a couple of key hip performance elements to their PRI knowledge base, to put things together all the way down and/or all the way up the kinetic chain to the floor. It was great to add three-dimensional control of the acetabulum over the femur and also the use of ligamentous muscle to stabilize pathologically lax hip joints.  
We talked about the finesse needed for ligamentous muscle to stabilize a hip joint when capsuloligamentous laxity destabilizes it. We also talked about acetabular hole control in three planes and what is required of the AF joint during different phases of the gait cycle. We came to appreciate the muscles that oppose the left AIC pattern and the specific planes that are the most necessary for each one of the hip rotator muscles on both the right and left sides of the body.  All in all, it was a great weekend in the Northwest.
 

Posted March 10, 2016 at 7:43PM
Categories: Courses

I had some great feedback on this weekend’s course from some trusted colleagues I thought would reflect the weekend better than anything I could say. So Brian, Marci and Moon, thank you. Thanks so much to Rebound Sports and Physical Therapy for being such a great host site.


“I have taken several PRI courses. To this point, courses seemed to be organized into pelvis/lower extremities, pelvis and spine, and thorax/ribs discussions. Each primary course was very detailed and, at times, they were overwhelming with all of the good details, progressions, and exercises specific to these areas. I wanted to take this course initially because I thought that it would be a good review of general PRI concepts. After all, it is a course geared toward older adults. What could possibly be challenging about that? 
What I got was the most comprehensive, completely integrated course that I have ever taken. This class looks at a person from head to toe and clearly shows how to quickly evaluate that person in almost any setting, position, or condition (including frail, elderly, and/or chronically injured patients). It ties together how rib mechanics, diaphragm function, spinal movement, pelvis positioning, and even foot contact all completely sync together. The class shows how we can quickly come up with a systematic approach to restore function through respiration and alternating reciprocal gait. The class is designed to talk in more general terms and it can easily and instantly be utilized by just about any health care provider in any setting. It was the most thorough yet understandable course that I have ever taken and I highly recommend it to anyone who really wants to grasp how we truly should move and function.” 

Brian Benjamin, DPT

“I would describe this course as a compact advance integration course and over 75% percent of the information is clinical and treatment based.  The PRI principles were stated simply with no abbreviations.  Absolutely the best explanation of gait mechanics that I have heard in 15 years of practice, including my master's course work and DPT program coursework.  The information covered will change the way I treat all of my patients.  The home exercise instructions are simplified and use little to no props, which will make my home programs more successful.  This is course is not just for the home health therapist, but for any therapist who treats geriatrics in any setting and I will have patients of all ages using this program.  This course is not just for those who use PRI or have taken PRI course.  This material is for anyone who wants to maximize the performance of their patients or clients.  That performance could be transfers, gait, single leg stance, balance, running, or lifting mechanics. Phenomenal!”
Marci Heine, MSPT, PRC

“Thanks again for a great course. Truly my favorite to date. Maybe that's because I could just sit back and soak it all in and capture the nuggets as they came or just because of the content and delivery. Even being PRC it helped me to realize that I'm really over thinking concepts and exercise prescription half the time.  If you lose a ZOA and a hamstring and don't get upright and functional, you're program is sunk. The emphasis of function, function, function and integration was supreme. This course is an absolute must for everyone but especially those that are new to PRI or were frustrated after taking one of the core classes and getting hung up on acronyms and concepts. I feel like this course (and perhaps the fitness and movement class presents the same) is the best representation of PRI concepts and progression of alternating and reciprocal functional movement I've had to date. It is applicable across the age span and absolutely not just for geriatric care. I'd venture to guess that most people move around their kitchen and bathroom and sleep in a bed:).”
 
Moon Hemeyer, MS, MTC, DPT, PRC


"The real reason a PRI course held in Colorado during the winter is so great."

Posted February 24, 2016 at 9:54PM
Categories: Courses
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