We have moved the course scheduled for May 1-2 in St. Louis, Missouri to Loveland, Colorado! If you are in the Loveland area, you’ll be happy to know that we will be there presenting Postural Respiration on May 1-2!
We received this great question last week from a clinician who has attended a PRI course. He brought up an interesting perspective…
During a conversation with a colleague a confusing issue came up. PRI stuff is interesting and one of the things that is most interesting to me is that they pretty much say “everyone has this presentation” (left anterior, tension in right hamstring, anterior tilt, etc…). If you have ever read Wolf Schamberger’s “Malalignment Syndrome”, he actually talks about the most common presentation being people anteriorly rotated on the right, posterior on the left - which is opposite to PRI’s thought process. Who is right? I think it is okay to notice trends (I have actually seen more people fall in the presentation from the Malalignment Syndrome - anterior rotation on right), but to group everyone into the same presentation is a bit strange.
It’s all a matter of perspective, which is what PRI challenges the most. Humans lateralize their center of gravity to the right more than to the left because of many objective reasons. If one establishes a neuromuscular pattern of stable, secure foundation through the right lower extremity, utilizing the right vastus lateralis, right hamstring, right adductors and right gluteus medius, you will find an anteriorly positioned or oriented innominate on the right. Subsequently, the left ASIS may “feel” more anteriorly rotated on the left and possibly the evaluator may “find” the right innominate more posteriorly rotated on the right. Inter-rater reliability in these situations, without further integrated objective testing is poor at best. In this case, in standing, the evaluator would find more lumbar-thoracic lordosis on the left.
If one becomes lordotic bilaterally, as often is seen with those who are tight and over-active with their posterior exterior chained paravertebrals (PEC patients) the right and left innominates move in an anteriorly rotated direction around the frontal axis going through both central acetabulums. Discussing axis of the sacral rotation complex, varies in every individual and has no validation in today’s research. This individual will now need to begin moving the left innominate out or externally rotated it around the vertical left SI axis to offset weight distribution to the right, resulting in:
Hyperactive right quadratus lumborum activity
Hyperactive left gluteus maximus and TFL
Hypermobility and possible laxity of left pubefemoral and iliofemoral ligament and soft tissue
Inhibition of left adductor and hamstrings
A left ASIS that feels “posteriorly” rotated compared to the “anteriorly” rotated right innominate
I am fairly certain, this compensatory activity associated with the human characteristic pattern of bilateral innominate anterior rotation (lumbar-thoracic lordosis) is what the “Wolf Schamberger’s Malalignment Syndrome” is all about.
Again, it’s all about perspective, position and pattern of the tester and the tested. Please realize that palpating ASIS’s and PSIS’s of those in sitting, standing, on one leg, supine, etc all result in various, ambiguous outcomes…a whole different discussion and set of circumstances.
Over the past 10 weeks we have had the privilege to work with an incredible illustrator, Elizabeth Cunningham. In her short time here, she has finished several amazing illustrations that were inspired by the science behind the Postural Restoration Institute. She has also developed images for the coloring sections of our Myokinematic Restoration and Cervical-Cranio-Mandibular Restoration courses. We are sad to announce that this will be her last day here at PRI but we are happy to know our relationship will continue while she pursues a career in Boston.
Dr. Rutledge will be presenting at our Rest Integration course being held April 17th, 2010. He will be presenting on his clinical experience with sleep disorders and treatment. Read more about Dr. Rutledge below:
Dr. Rutledge is board certified by the American Board of Psychiatry & Neurology with over 35 years of clinical experience. He has taught medical and nursing students as well as psychiatric residents at St. Louis University. In addition to office practice, he has had a special interest in complex cases that involve neurologic, endocrine, and sleep disorders which complicate anxiety and depressive illness.
He obtained his MD degree at St. Louis University. Residency training was at the University of Pennsylvania Hospital and St. Louis University Hospital. His training was based on psychodynamic therapy with extensive additional study in psychopharmacology. Dr. Rutledge credits his experience with both for his ability to identify sleep disorders at the rate of two to three per month. He believes that sleep disorders are the most overlooked cause of treatment resistant depression.
In his free time, he and his wife enjoy time with their three married children and four, soon to be five, grandchildren. As time allows, he enjoys DIY home projects, yard work, or just relaxing with his wife and Old English Sheepdog.
We recently attended an in-service given by John Macy, PT, PRC on Visceral Manipulation and Postural Restoration. This was a fascinating in-service on how visceral manipulation can be incorporated into a PRI program. John describes visceral manipulation as “the use of only minimal force to enhance the inherent motion of a particular organ or tissue in order to restore the body’s ability to self correct dysfunction.” Following the in-service, we asked John where we could get more information and he suggested checking out The Barral Institute. Another great resource is the book, Visceral Manipulation, written by Jean-Pierre Barrel.
In a conversation between Ron Hruska and his daughter living in New York City, Ron describes why we associate smells with memories:
“Hi Rachelle! I enjoyed reading your tumbler message to me about the dry cleaners smell of your oxford shirt and the memories it stirred up. I walked by a bakery in Warsaw and immediately thought of grandma Rita because of the bakery aroma. When I smell tractor grease I immediately think of my dad and when I smell freshly cut alfalfa in the field I immediately think of my grandpa John. When I smell freshly turned soil in the garden I think of grandma Rose and picking up potatoes that were just dug up, when we were little. When I smell new crayons exposed for the first time by opening their box lid I think of my school days at Dist. 31. These smells are so precious to me. These odors and smells enter the nose and are recognized by the olfactory sensors and the signals are sent to the olfactory bulb that is located right above the eyes. From there the sorted smell information is then sent to the limbic system, the primitive part of the brain that includes areas that control emotions, memory and behavior. As the same information goes to the cortex or the outer brain for conscious thought, it is sent to the sensory cortex to create the sense of flavor. The message sent to the cortex and the limbic system triggers memories that are stored in the hippocampus, and through relational memories your blue oxford shirt reminded you of me. Thank God for the hippocampus! - Love Dad”
We are passing around another great book here at PRI! Dental Management of Sleep Disorders written by Attanasio and Bailey is a highly recommended book for those of you studying sleep disorders.
“The book begins with an overview of sleep medicine, providing the reader with a solid foundation in the human sleep cycle, classification of sleep disorders, and related medical and dental conditions.”
If you are attending the Rest Integration course in April, this would make a great resource! If you are interested in purchasing the book, you can do so HERE!