Courses

 Surrounded by the tall pine trees of North Carolina and golf courses in every direction one can look, we had 2 full exciting days exploring the power of myokinematic restoration. Discussing how the acetabulum moves on the femur was an appropriate discussion in a community full of golfers when discussing rotation and the appropriate muscles of the hip complex to help achieve rotation. We learned about the inherent pattern (s) of the human body that position our pelvis and ribcage along with tests that help guide our treatment to restore these positions. We had a sharp group of attendees who remained interested and engaged through the last hour of the course which was impressive. We had attendees that made the trip from Canada which is always exciting to see the science of PRI spreading to other countries!


- Kasey Aiken

I had a great weekend hosting, teaching and mentoring Kasey at my home clinic Sandhills Sports PerformanceKasey Aiken did a great job introducing the principles of PRI as they relate to the hip and pelvis. We discussed a dominant left AIC and patho and non-patho compensatory patterns during upright activity as it relates to the Hip and Pelvis.

We were joined by PT’s, CSCS, SPTs, SPTA, ATCs, new graduate of PT, Massage therapist and a chiropractic physician!

Our clinic was represented by Pat Tanner, ATC, Jena Landgam, SPTA, Kelsie Giannoulis, DPT, Brooke Thomas, DPT and brand new to our group Pierce Adams CSCS and Johanna Nisenholtz.  Johanna was my PT student earlier this year. It was so great to have her in her first official PRI class. We look forward to Johanna joining our staff this year!

Thanks #PRINation for growing with us!

Posted March 12, 2020 at 9:50PM
Categories: Clinicians Courses Science

"Watching individuals with Parkinson’s Disease participate in boxing when I spent time with Jennifer Smart in North Carolina last Fall, reminded me of the need for the human spirit to elongate appendages while concurrent body contraction occurs. The movement of flexing a shoulder as the elbow extends disengages the neck, momentarily and reflexively. It is art, it is personal, it is rhythmic and it is limited coordination done by someone, who for a moment, recognizes a functional beneficial event that required regaining balance from a floor the arm uses to “strike”. Beautiful un-timed imbalance followed by a timed balance act for regaining postural control, without needing or requiring tremor. Such a rewarding basal ganglia bi-hemispheric activity to watch, but more importantly to experience. Shortly after arriving back to Lincoln, I bought and hung a bag in our clinic. Now if I could just learn how to dance around the bag as it pushes me around when I punch it, as it punches me. I decided that it probably would be best to wait and listen to Kristy Rose Follmar, a former World Champion professional boxer, before I hurt myself."

-Ron Hruska

rock-steady-boxing-pri-interdisciplinary-integration-symposium-speaker-spotlight

Kristy Rose Follmar, ACSM, CPT, EIM is a 2003 graduate of Ball State University, with a degree in Telecommunications/Marketing and Sociology, a certified fitness professional and a retired World Champion professional boxer. Follmar was approached in 2006 by Rock Steady’s founder, former elected Indianapolis Prosecutor Scott Newman, to help build Rock Steady Boxing, a non-profit exercise program dedicated to help ease the progression of Parkinson’s symptoms.

Newman, a young on-set Parkinson’s sufferer, discovered that intense exercise using a non-contact boxing-style training regimen was slowing down the progression of his symptoms. Follmar understands through her experience as a professional athlete the benefits that boxing style training can bring to people with Parkinson’s in addition to Parkinson’s specific exercise.   

Kristy Rose Follmar is one of the architects of The Rock Steady Boxing Method, a curriculum that combats the physical and emotional effects of Parkinson’s. Follmar uses her experience of professional boxing and formal education in the fitness industry to design curriculums specific to varying levels of Parkinson’s disease.

Kristy’s presentation is titled “Rock Steady Boxing: The Fight Against Parkinson’s & Community-Based Medical Collaboratives”. This presentation will cover our history and an intro to Rock Steady: our story, our methodology and message of Hope to help people with Parkinson's Fight Back against their disease.  Also, a discussion about how Rock Steady has developed a community-based collaborative between local healthcare professionals and community-based Rock Steady programs.

If you have not registered for the 12th Annual Interdisciplinary Integration Symposium, be sure to register soon. The early registration rate of $525 ends on March 26th!

Posted March 10, 2020 at 4:10PM
Categories: Courses

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.                                                                                                                                                                                                                                                                                          

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

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

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

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

Ron had the opportunity to spend a couple days with Jen in her hometown a few months ago, and had this to say about his experience, “Jennifer is probably one of the most, if not the most respected, individuals in this community. Everyone who lives there knows how much she cares about humanity in general, and how much she dedicates herself to each individual specific needs and limitations. Her compassion, her wealth of knowledge on Parkinson’s Disease, her multi-level of experience, and her successful outcomes are immediately recognized by anyone who observes her classes, talks to her patients or witnesses the respect wherever she goes in this community. I am humbled by all of this and my admiration for her selflessness is unsurpassed.”

Read more about Jen’s upcoming presentations at our 12th Annual Interdisciplinary Integration below:

An Overview of the Science of Movement Disorders as They Relate to Sensory Input and Autonomic-Driven Postural Compensations
This presentation will review various types of movement disorders, examining their association with each other and with other non-motor symptoms, which may appear independently or as prodromal symptoms for various movement disorder syndromes, such as Parkinson’s disease. Current theories as to the causes of movement disorders will be explored, including evidence supporting basal ganglia oscillatory dysfunction, how and why this dysfunction may occur and techniques that are being employed to influence it, including pharmacological, surgical (especially the use of deep brain and/or implanted spinal stimulation) and physical activity interventions. Emphasis will be placed on the evidence supporting how intrinsic oscillations are being altered by afferent stimulation.

Afferentation Techniques and How to Clinically Incorporate Them into the Treatment of Movement Disorders
This presentation will be more clinically applicable, providing information about the current, evidence-based programs that are being used for people with Movement Disorders, examining their common effective elements regarding the movements involved in the activity, the dosage (time and intensity) of the activity, and the auditory, visual and tactile cues that are being used during the activity.  Emphasis will be placed on using specific afferentation techniques during these activities in order to alter the need to use pathological postural compensations, or movement disorders, to create a sense of stability and/or a method of mobility.  

A Review of Perspective and Progression Influences on Treatment and Management of Patients with Parkinson’s Disease
In this presentation, Jennifer Smart and Ron Hruska will discuss treatment and management of patients with Parkinson’s Disease and review several cases in which they have had the opportunity to collaborate together. Management discussion will include group exercise application, in addition to individual rehabilitation considerations.

Posted March 5, 2020 at 5:33PM
Categories: Courses

If there are three bones that have always had an impact on my course of study as related to respiration, airway, occlusion, oral function, head and neck position, speech, vocal cord dysfunction, tongue compensation, nasal flow, autonomics in general, auditory sense and the soft and hard palates, it is the temporal and occipital bones. Three very important nerves go through the most infamous foramen of mankind, the Internal Jugular Foramen (IJF). When the lumen or congruence of this foremen is challenged our bodies know it. Cranial mal-position and underlying associated predictable human torsional constraint increases the need for compensation and  work around this malpositioned set of paired bones, on an accompanying occiput bone that orients and houses the medulla and brain stem in off-centered state of un-rest. This positional state of unrest feeds neurologic information to our mid brain and associated cortices that are directly associated with my course of study, outlined above.   

Re-orientation of these two paired IJFs can have a major impact on ANS, SoNS and CNS function and behavior, secondary to the compression or lack of compression on these three nerves. The glossopharyngeal nerve innervates the stylopharyngeus muscles, the vagus nerve innervates the levator veli palatini, the salingopharyngeus, the palatoglossus, the palatopharyngeus, and the pharyngeal constrictor muscles, and the accessory nerve innervates the trapezius and the sternocleidomastoid muscles. I will not go over these three nerves sensory innervation, but these nerves are instrumental in how we physically, physiologically and psychologically behave and operate. Cranial mal-guidance provided by the calvaria, temporal and occiput bones and their associated torsional patterns of function can be resolved through PRI based sacral cranial repositioning and through PRI based thoracic cranial resolution, that incorporates cranial oscillatory alternation. Having the opportunity to outline and teach the reasoning behind these PRI techniques and considerations, offered by this unique course, through the involvement of the sinus cavities, the palatine bones, and the pharynx, is as fulfilling for me as any course I have ever written, designed or taught.

 

I would like to thank Amy Goddard PT, DPT, OCS, CSC, PRC and her staff, once again, for hosting another PRI course at her expansive and accommodating facility. Gail Kaiser PT, OCS, thank you for your willingness to participate in my demonstration autonomic orthotics. And Stephanie Irizarry Pt, CLT-LANA, PRC your presence is always welcomed because of your love for Pantone 269 C (purple), your predictable body performance through autonomic filtering, and your on-going smile. Jennifer Bullock PT, DPT, OCS, PRC your input, discussion and feedback was so invaluable. I honestly believe, this is ‘your course’ if there ever was one offered by PRI. I truly love everything you stand for and represent.  

    

Posted March 4, 2020 at 10:08PM

PRI nation, it’s good to be back!  

I returned this week from my first opportunity to visit the great state of Louisiana.  What a fantastic welcome this instructor received!  I had the pleasure of introducing nearly the entire class to the science of Pelvis Restoration thanks to the host and hostess Chris and Karlie McDougall at Renew Physical Therapy. Chris, Karlie and the whole team at Renew were kind and gracious, and provided King Cake, and other local delicacies…and I got the baby, so I’ll be back!  

The course involved great conversation and discussion about the theory, science and specifics of inhibiting, facilitating and integrating alternating function of a pelvis into our neuromechanical system. Thank you to PRC, Kyle Babin for your time and energy serving as the lab assistant during our many lab breakouts, you were excellent! This instructor enjoyed the discussion of how to implement PRI objective tests into a comprehensive triplanar picture of the position and tendency of a pelvis as part of the individual human system we assess. Many thanks to Payton Spell, Shaun Lopez, Jessica Lamothe, Lonnie Arroyo, David Giardina (even in the short time!) and more for your help with lab demonstrations and observation of objective tests and treatment techniques.

 

This group had an exceptional array of patterned movement strategies that made this an enjoyable cross-section overview of the greater population and a great venue for learning first hand. I did my part to eat Covington out of Gumbo and I very much appreciated being welcomed to enjoy an evening with the McDougall family for my very first Marti Gras parade. What an enjoyable spectacle!

Thank you again, my fine Louisiana friends, for an enjoyable learning experience in The Bayou, my best to each of you!

Posted February 26, 2020 at 5:29PM
Categories: Courses Clinicians Science

 PRI Integration for Pilates kicked off first course of 2020 at its home base at Pilates Central in Wilmette, IL with fantastic group of Pilates teachers, PT’s, massage therapists, a chiropractor and other fitness professionals. We started the day with introductions and then introduced PRI and Pilates principles. There so many commonalities with Postural Restoration and Pilates, especially that Joseph Pilates and Ron Hruska were both 50 years ahead of their time.

Sarah Petrich introduced the concepts of ZOA and the asymmetrical human body and soon we were all fully exhaling to inflate purple balloons. Day one morning ended with a mat and breathing lab.

I then introduced the supine reformer gait integration assessment test followed by lab so everyone had a chance to observe and experience the tests. Sarah got us all dancing the hula and salsa to illustrate triplanar motion.

Followed by a conversation in which I covered quadruped abdominal assessment and the sidelying stance tests which drive the programming labs. Speaking of driving, Sarah taught us all how to get in the left lane and make legal right turns while discussing lateralized gait. Attendees practiced hand and foot references to “layer “ on to the “choreography “.

So many wonderful attendees to mention: shout out to Chad Moreau, PRC and Whitney from Southern California for braving the Chicago winter; Wanda, who works with wounded warriors in Atlanta and Beth from Houston. Honored that Donna Olivero PT PRC was there to learn how to incorporate more Pilates into her chronic pain practice, especially because she completes the trio of Donna’s in the PRC class of 2012. Thank you to Stephanie (her 3rd PRI Pilates course!) Holly, Petra and Amanda from corepilates Chicago who have embraced PRI Pilates at their studio. Last but not least thank you to my wonderful instructors , Elizabeth, Charmaine, Deb, and Laura for their help in lab, for asking great questions and for help getting the studio back together for Monday morning Pilates.

“Thanks for hosting such a wonderful class! It gave me so much inspiration to continue down the PRI path and incorporate more Pilates into my practice”  -Karolyn

Posted February 24, 2020 at 10:29PM
Categories: Courses Techniques Science

Do you have an interest in learning Postural Restoration but are not sure where to start? Would you like to be more efficient at using the PRI framework to evaluate your clients or patients? If you said yes to either of those, then the Affiliate course for Fitness and Movement is a perfect course for you!

This past weekend, James Anderson and I traveled up the west edge of Illinois to present at Advance Physical Therapy in Quincy. We had a large group with a mix of personal trainers, strength coaches, athletic trainers, football coaches, and physical therapists. For some attendees, this was their first course and then others had attended several previous PRI courses.... And that is the beauty of this course, it has something for everyone and is a good introduction or review of invaluable principles that can transform how we work with our clients, athletes, and patients.

Thank you to PRC Eric Ley, Natalie Stratton and the other Advanced PT owners for supporting their staff’s continuing education. It was a great opportunity to have so many team members at one course all together!

PRI Integration for Fitness and Movement is an advanced course that focuses on helping us look at movement and posture differently while integrating key Postural Restoration principles that promote symmetrical form and balance between the two halves of our axial frame. We are looking at how the ribs, thorax, pelvis and hips work together to empower the diaphragmatic mechanical advantage, optimize spinal relationships and the range of motion of our proximal ball and socket joints.

Here are some comments from this past weekends attendees:

“Great experience for my first PRI course. I feel like I can start looking at my clients posture differently while performing exercises and give more beneficial cues to prevent injury and improve overall function.”

“Absolutely the best explanation of ZOA that I have ever heard”

“I learned so much! The speakers were great and personal”

“Good course. I really took home more than other PRI courses I’ve attended. Speakers broke things down to understand ZOA effectively. I plan to incorporate this course in my current patient’s plan of care.”  

Thanks again to Advance Physical Therapy in Quincy for hosting and coordinating with PRI to have us come out there! Check out the Affiliate course schedule to learn more and get to one of our affiliate courses this year! We have courses coming up in Richmond, VA and Fort Worth TX.

Posted February 21, 2020 at 9:48PM

Pasadena Physical Therapy was the location of last weekend's Cervical Revolution. Locatelli Rao, P.T. hosted this course and it is always a pleasure to share time and knowledge with "Loc" on this PRI journey. I first met Loc two years ago in L.A. when I taught Postural Respiration and the questions he was asking then and now are some of the best. What is really gratifying is when a student can take a complex subject, like Cervical Rev, and break it down into component parts to provide a simple, sequential and detailed description of the concepts of the course. This has been a goal in Cervical Revolution to have students take a course and "get" the primary concepts with motivation to go back into the course manual and absorb more completely the material. Application on Monday morning means just getting the most important concepts, start to practice examinations of the cervical spine/neck, know the basics of what they mean and then experiment and provide PRI techniques! Yes PRI courses make our brains hurt a little as most students will attest while their enthusiasm for more expands with their craniums! One of the most powerful PRI techniques and taught in this course is the Active Left Lateral Pterygoid in Protrusion. After testing a student in lab with bi-lateral positive findings, this technique with just a few breathes demonstrated how powerful inhibiting a Right TMCC can be with a left lateral pterygoid. Not only was the R TMCC inhibited, but so were the BC and AIC chains bilaterally.

PRI Cervical Revolution Course - Skip George

PRI Cervical Revolution - Skip George
Follow up recommendations included Standing Cervical Cranial Repositioning with a Supine Active Sacro-Spheno Flexion which were demonstrated in lab with other students all producing immediate neutrality.  A manual technique was provided on another student in lab called the Frontal Occipital Hold who was also bilaterally positive in testing. After this technique, he was neutral upon testing. That was astounding to all, especially this instructor! This course is really about autonomics and reflexive oscillatory function of a neck that has to be free to turn. Cervical Revolution is so fun to teach because of the power in it's application just like all the courses in PRI. Big Shout Out to Chad Moreau, D.C., CCSP, PRC for being our lab assistant again. Your support and presence always brings a positive force to the room. Thanks again Loc for you support, questions, restates, hosting and always expanding your knowledge. 

 

Posted February 18, 2020 at 5:28PM

Dominant cortical behavior and function as related to human bias and behavior has always been a strong interest, and passion of mine. In 2007 I wrote and compiled a course entitled ‘Impingement and Instability’ to begin a journey with those who have interest in the gifts of contact and oscillation. Four tabs were selected based on their importance in corporeal-sense, hemispheric influence, and biased lateralized behavior. Interaction of calcaneus, femur, hip/pelvis, and scapula anatomy through our extrapyramidal system is critical for reflexes, forward locomotor motion, complex dominant driven function and postural control. This has always been an ‘extrapyramidal’ based course. However, after thirteen years of presentation, I feel the Institute is at a great place to incorporate the significance of pressure, pronation, and push as it relates to these sites of interactive referenced modulated motor activity.

 

The extent of our creativity and capriciousness depends on both our soul and the soles we use to develop behavioral patterns associated with confidence built off of integrating contralateral, hemispheric and bio-tensegrity input. I was so excited this last weekend to discuss how we are regulated by self-regulating pressure of the scapula to capitalize on our ability to perform with things that push, propel and please us. The ground developed, directed and designed our anatomical behavior, while the earth’s gravity gave us the security to defend, offend and create without loss of life. This updated course has not really taken on a new course of direction, but definitely will take those, who attend, into dimensions never before looked at or addressed in the manner they are now presented and applied, with evidence that was not considered when addressing the reasoning for symptomology related to feet and hand haptics.

   

The re-assurance from the wonderful feedback I received after this course, re-assured me that the PRI nation is ready for the importance of variable femoral and scapula instability, and associated counterpart contralateral stability, as related to the metric embracement of calcaneal and pelvis impingement that directs and orchestrates the possible disharmony and dysfunction associated with pre-patterned forward locomotor movement. Thank you One on One Physical Therapy for hosting another PRI course. You all were so gracious with your time, support and assistance. Karen Warren PT, MPT, OCS, ATC the coffee was great from both cups, even when you lifted the left hand with the cup in it and your body’s mass moved to the right, (LAIC, RBC coffee). Dan Houglum MSPT, ATC/L, PRC, Jennifer Smart DPT,PRC and Michael DuBois DPT, OCS, TDN, CS USPHS/HIS provided so much insight and instructional feedback, thank you.

Posted February 12, 2020 at 2:44PM
Categories: Courses Clinicians Science
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