Courses

A serendipitous encounter…

This past March, we had the honor of teaching an Occlusal Cervical Restoration live stream course to over 70 interdisciplinary professionals including several dentists. It was during that live stream course that we unexpectedly discovered that Dr. James Carlson, DDS, a giant in his profession and someone we have referenced in course material for years, was still alive! One of his good friends and colleagues put us in touch with him the following week, and this serendipitous discovery has led not only to a new friendship, but also an expanded collaborative effort on the importance of interdisciplinary team management between dentists and movement professionals. Dr. Carlson has since graced us with his presence on a Cervical Revolution and Occlusal Cervical Restoration live stream, leaving course participants with interactions and discussions that won’t soon be forgotten. In our first meeting with Dr. Carlson back in April, we knew that we had an opportunity that we couldn’t pass up. And so, despite thinking we had just finished our last Interdisciplinary Integration Symposium of its kind a few days earlier, Ron’s heart was tugged to do yet another. And it was during that first meeting, that we invited Dr. James Carlson to present as our featured speaker for our 13th Annual Interdisciplinary Integration Symposium, which is titled “The Stomatognathic System – An Interdisciplinary Approach in the Management of Spatial Navigation and Structural Strength”. The stomatognathic system is sometimes referred to as the masticatory system, however Dr. Carlson as he wrote in his book, Analyzing the Stomatognathic System, sometimes refers to it as the “cranio-maxillomandibular-cervical-dental complex”. As
a dentist, Dr. Carlson recognized early on in his career that there is a “bigger picture”, which includes caring for the components of the stomatognathic system. Collectively, we feel that it’s important that all healthcare and fitness professionals recognize this as well. And so, we invite you to join us in April, for an Interdisciplinary Integration Symposium that you won’t want to miss!

Our 2022 course brochure should be arriving to your mailboxes, doorsteps, offices and mailrooms soon, if it hasn't already!

We are so excited for the opportunities this year will bring and continuing our mission to explore and explain the science of postural adaptations, asymmetrical patterns and the influence of polyarticular chains of muscles.

Posted January 12, 2022 at 9:26PM
Categories: Courses

I honestly look forward to the Advanced Integration course every year. It offers a moment in time, at the end of the year to reflect and to resolve issues that arose in the time period between the last Advanced Integration course and the present one. It is a moment in my personal life where I can decide if I should move into areas of discussion built off of  platforms that were laid down in the recent past, or not. It is a brief period of time where I can review where we, as an Institute, are with respect to concepts that are better accepted and appreciated. This acceptance and appreciation will result in longer periods of time where application becomes a mainstream of future assessment and intervention, and more importantly, an expectation.  

Summarizing the same main concepts in 2004, at the first Advanced Integration course, offered me a moment to integrate neurological, biased, patterns of breathing with tri-planar movement and muscle through discussions on thoracic flexion and curvature of the spine, with 20 to 30 people. Who would have ever thought that there would be 80 plus people, from 8 different countries, attending a four day course with the same title, the same platforms, but advance application because of 17 other moments in time where this course, with the same title, in the same number of days, advanced the original moments in time, so exponentially.

Focusing on dextral orientation, thought processes the human uses for integrated  unilateral and contralateral anatomy and associated sense, two central diaphragm axis’s that regulate our spinal axis, and the importance of ‘left hand to right knee’ function, in today’s world of unlimited Artificial Intelligence (AI)  and limited Advanced Integration (AI), is a reflection of many, many moments in this Institute’s history, where planned periods of time, in this case 96 hours or 4 days, had a major impact on future AI.

Thank you Locatelli Rao DPT, OCS, PRC, Greer Mackie PT, DPT, OCS, Donald Ryan Hodge CSCS, LMT, and Beth Lewis for your help with live demonstration and discussion. We were so grateful. Thank you Taylor Boryca, PTA, for your Kolaches (Czech and Polish fruit pastry that I was raised on) that you served us. And most importantly, thank you Louise Kelley, DPT, PRC, Lori Thomsen, MPT, PRC, Dan Houglum, MSPT, ATC/L,PRC, Jean Masse, PT,OCS, ATC, PRC, and Lisa Mangino, PT, DPT, PCS, C/NDT, PRC for your integrative presentations and ongoing interaction. It was one of my favorite Advanced Integration courses that I have ever been a part of, or have given. Hopefully, if you haven’t been to one of these in recent years, you will consider coming in the next few.  Reach out and talk to someone who has attended this year’s AI course; and I believe you will be encouraged to attend or re-attend, regardless where you are in your PRI moments of time.

Click below to view full photo album,

ADVANCED INTEGRATION 2021 

Posted December 20, 2021 at 8:58PM

An Introspective Approach to the Treatment of Functional Cortical Predominance associated with forward movement of one’s body requires reliance on the observation of one’s mental state, as well as examination of one’s own conscious thoughts and feelings about physical mechanics. This course offers the PRI minded clinician an opportunity to explore the components of human cortical processing required for normal or natural, unilateral biomimicry of contralateral processes that are dominant in advancing oneself forward, into and though hemi-lateral and hemispheric forces, that may or may not be perceived or recognized.


Most individuals that do not have natural use, or flow of the four hemispheric components outlined in the Forward Locomotor Movement course, will express forward movement with suppression of one or more of the four components, for unilateral functional dominance, associated with ‘unnatural’ forward advancement of their body, and non-biomimetic formation and function.


Biomimetics is the study and development of synthetic or artificial systems that mimic the formation, function or structure of biologically produced substances and materials, or biological mechanisms and processes that are reproduced from unnatural behaviors. In the case of forward locomotor function, humans often ‘synthesize’ artificial mechanisms of movement by mimicking unnatural homolateral movement, which often results in similar bilateral patterns, that were established through biomimetic cortical processing.


When the contralateral function of the human body, produced by unnatural or compensatory function, that may or may not mimic the ipsilateral function, occurs, the human will rely on biomimetics to synthesize, fabricate or re-produce an acceptable ‘unnatural’ function, for the compensatory form required for safe, effortless, forward advancement of itself.   

 
This unnatural biomimetic behavior often becomes cortically represented and patterned with “natural” contralateral or unilateral function that is recognized, strengthened and patterned by existing functional cortical sites of respective human cortical dominance. This novel integrated patterned functional cortical dominance, along with the associated replacement of biomimetic components of novel, unnatural function, become embedded and accepted as natural neurologic function and flow, for future forward kinetic movement challenge and recognition.


By breaking down the four hemispheric biomimetic components humans use to move themselves forward, the attendee can gain a deep appreciation for the need to consider the influences the hemi-chests, arms, and the eyes can have on flow, effort and trajectory, when designing or outlining a program for the challenged forward mover of his or her body and legs.


Conversation like this, in a tertiary PRI course, is so easy for me to engage into with people who are willing to interact, acknowledge their confusion, share their opinions and provide clinical insight. I greatly appreciated the open dialogue with the live stream individuals who did just that. Laura Kompkoff OD, Ginger Mandy PT, Stephanie Ritter PT, and Kris Zeller-Hack MD, thank you so much for the interaction.


 I also want to thank Masa Abe, ATC, CSCS, Chad Beckman SCCC, PRT, CSCS, Heather Jenny PT, PRC, WCS, Yoshi Mitsuyama MS, ATC/L, PES, PRT, and Stuart Nichols, ATC who helped so much in demonstration, discussion and dialogue on topics that were made easier to discuss because of their actual presence. Actually, I appreciate all those who are here, in-person. Your travel, lodging and overall expense to be here is not overlooked, and I appreciate all of you who come to Lincoln, for any of our PRI courses. It is such an invaluable opportunity for any speaker. Thank you.

Posted November 30, 2021 at 10:37PM
Categories: Courses Science

Postural Respiration was presented at Thrive Proactive Health to an enthusiastic group of diverse healthcare practitioners including PT's, PTA's, a DC, personal trainers, a massage therapist and a physician assistant  .  More than half of the attendees were brand new to PRI as this was their first primary course.

 
A student's first introduction to a PRI primary course can seem exciting, daunting and often like a quantum paradigm shift with an introduction to asymmetries, lateralization and neuro-respiratory driven biomechanics!  Understanding respiration is the key that has the potential to unlock the mystery of how we position a pelvis with a diaphragm, which leg we favor for stance, how we regulate airflow into chambers of the thorax and especially what drives "sense" position and pressure neurologically. Understanding and defining the multi-dimensional neuro-respiratory components of posture as it relates to the asymmetries that exist in the human body, what position we typically live in as humans and then learning how to test and treat objectively and effectively is a major shift in thinking about patient care as well as living in our own body.


It is safe for this faculty member to say that every time a faculty member teaches a course, in some small or large way, we all remember what our first PRI course was like and how new PRI concepts are to the first time student. That is the challenge and fun of teaching, watching "light bulbs" of awareness and discovery come alive in new students and new insights and skills being developed in returning veterans that keep coming back for more PRI as they build their skills and knowledge!

 
Thrive Proactive Health is an ideal location to provide courses and many thanks to Julie Blandin, PT for providing this state-of-the-art facility, enrolling her staff and especially being an experienced veteran of PRI, first rate lab assistant and sharing her clinical experience and competence with all attendees.  Many thanks to her staff for set-up and clean-up including Matt, Dante, Taylor, Karyn, Brittany and Kate!   

Posted November 22, 2021 at 9:58PM
Categories: Courses Science

Timing is a tricky thing, isn't it? Difficult to measure. Tough to describe. Hard to master. But once you find timing, or timing finds you, it can dramatically change any outcome. Aren't we all searching for that nebulous and elusive thing called "timing"? One of the main overall goals of PRI is to improve neuromuscular timing to reduce patterned behavior. Timing is kind of like a unicorn with a majestic, golden mane; you know it when you see it.   

Last weekend it was my distinct pleasure to teach Myokinematic Restoration to 68 movement specialists, 45 of which were new to the science of PRI. We had 10 individuals in person, and two of them were my good friends Craig Depperschmidt, DPT, PRC and Jason Miller, PT, PRC, both of whom are new additions to our PRI faculty. We are lucky to have them. We had a group of 18 co-workers attending the live-stream together. It was daylight savings, which means we got an extra hour of sleep Saturday night. And we had a unicorn in our midst. We were fortunate to have had several unique events occur this weekend that I feel blessed to have all been able to share the experience with 68 friends, old and new.

One of our objectives in this course is to learn how to correctly interpret the tests and let them lead us into our treatment approach. Another objective is to understand how and when to use ligamentous muscle to stabilize an unstable hip capsule. For those of you who have taken this course before, you've experienced the lab portion on the second day, and we usually are able to get to around 7 or so PRI non-manual techniques. On this unique weekend, we were able to get to 15 techniques in lab. Part of it was the small class size during lab, but Craig and Jason were an enormous reason we were able to get to so many activities. It was just a unique experience afforded to those in attendance in-person and on the live stream. This extensive lab time allowed us to dive into the algorithms on pages 49 and 52, as well as the inhibition section of the appendix.  We used page 48 as a treatment flow chart, and proceeded through that page as a decision-making tree to help the attendees solidify examples of how to apply the science of PRI upon returning to their clients and patients. Do what the tests tell you to do. Reposition. Do page 39. Retest. Do what the tests tell you to do.

One of the best teaching examples for this course is an example of someone who fits the description of the algorithm on page 49, and the algorithm on page 52. Ron did this for me in my very first Myokin class in 2004, and it helped me remember how different these patients can present. It is pretty easy to find someone in the course during lab who presents with testing representative of page 52; however, finding someone who fits the description on page 49 is kind of like finding a majestic unicorn with a flowing golden mane. In 6 years of teaching this course I had only met one unicorn, until this weekend. Our unicorn's name was Brett, and he provided us with an exceptional example of how and why testing matters, and how testing helps drive the treatment decision-making tree on page 48.  

My thanks to all of those who attended on live-stream. Your questions clearly indicate you were engaged and were thinking ahead to future courses. Your questions were spot-on and I am looking forward to seeing many, many of you in future PRI courses.
 
My sincere thanks to Brett Shulte, Alison Janky, Savannah DeVault, and Angie Nixon. Your willingness to be our models for demonstration provided all of us with an exceptional learning experience. My thanks to RJ for his excellent production of our live stream, and to Jason and Craig for keeping me honest and helping us get through as much lab as we did.  

So, to recap......
Fantastic in-person and live stream audience. Excellent questions all around. Unbelievable lab. A splendid unicorn. An extra hour of sleep.
Timing is everything.  

Posted November 18, 2021 at 6:50PM

Thank you to Impact Physical Medicine and Aquatic Center for hosting Pelvis Restoration this past weekend. It was a wonderful weekend of integration and learning with fellow colleagues as we dissected the pelvic inlet and outlet. Our goals were to Reposition (inhibit), Re-train (facilitate) and Restore (alternate, oscillate, resonate, vibrate).  Participants were energized with open minds with 7 new course attendees to PRI, 3 PRC’s, and the rest attending another PRI course with various backgrounds. I feel the attendees gained a better understanding with the Pelvic Ascension Drop Test (frontal plane stance phase) and Passive Abduction Raise Test (frontal plane swing phase) with application of the Hruska Abduction Lift test to assist with the pelvic inlet or outlet restoration. From Shirley’s purple highlighted hair reminding of us of internal rotation/inhalation, to Lindsey’s awesome questions, to Mylan’s “light bulb” moments—it gave me energy and found me grateful. Mike, Mara and Christie (PRC’s and lab assistancts) thank you for supporting the Institute and for your passion for the science of PRI.

Essex Physical Therapy near Burlington provided a warm welcome to students and PRI faculty that matched the fall colors of a Vermont fall season. This facility is a dream location for learning PRI principles and provided a perfect learning environment for all of the students in attendance.

Cervical Revolution is the secondary course that introduces "top-down" and autonomic function guiding movement that is reciprocal and alternating. The heart and soul of this course is the atlas and occipital articulation which is autonomic in nature given the location to the brainstem anatomically. From that articulation the course builds into normal cervical spine coupling, compensatory coupling, occipital influences on a sphenoid, sphenoid to temporal bone, temporal bone influences on the entire system including mandibular/occlusal position and finally to right torsion as a pathologic compensation of the cranium that originates at the O/A joint.  This course integrates sense from top down and ground up including pressure sense generated by respiration, autonomic nervous system regulation of balance, sight, occlusion and especially alignment, position and dynamic tone and tension of the cervical spine.

In addition to PT's in attendance, there were athletic trainers, strength professionals, massage therapists and two doctors of chiropractic in attendance with one of them also being a PT. Our discussion on Saturday morning included speaking of the atlas and that chiropractors have always held this articulation with high reverence observing it's role in overall wellbeing and neurologic function. Ron Hruska also has seen this relationship for years, and as a chiropractic physician, I appreciate Cervical Revolution so much as it brings our knowledge of the cervical spine, and how it specifically relates to overall function of every system in the human body, to a practical clinical application combining objective testing with powerful and effective treatment.

Fellow PRI faculty member Louise Kelly, DPT, who is training to teach this course, was our lab assistant and my sidekick during the weekend and courses always are easier to teach with her energetic input, insights as a masterful clinician and ability to break down PRI Non-manual techniques. Many thanks to her and many, many thanks to Estelle La Clair and the entire Essex Physical Therapy staff for their support, organization, food, set-up, clean-up and overall spirit of learning this past weekend!

 

Posted November 10, 2021 at 10:31PM
Categories: Courses Science

One of the main objectives of this inaugural course was to help the participant gain an understanding on how the development of the human vocal tract resonance and articulation of speech is influenced by air pressure, and controlled through entrained exhalatory patterned function. Patterned exhalatory function, or voice, is most influenced by the position of the larynx, the trachea, and the esophagus, and through the available freedom the hypopharyngeal region of the neck offers.


Over adduction of the vocal cords severely impedes normal modes of vocal cord vibration and accentuates cervical tension from the accessory muscles of respiration, from the “lifting” muscles of the larynx and neck, and smooth muscles of the airway. Two of the most visible outward signs of over adduction of the vocal cords, is a prominent right sternocleidomastoid (extended, posteriorly rotated, and internally rotated right temporal bone) and a protruding left ear (flexed, anteriorly rotated, and externally rotated left temporal bone).


These two outward signs reflect the ongoing entrainment of deteriorative phonatory pitch effort (more than likely from the left temporal orientation) and disturbing auditory high pitch continuum (more than likely from the right temporal bone orientation). This intrinsic stricture, influencing both how we speak and hear ourselves speak, is the reflection of air pressure production, that is incapable of unrestricting temporal resonance entrained patterned function, that we have become accustomed to and rely on for identification of who we are as a physiologic, psychologic, and physical machine.


I feel honored to have had the emphatic opportunity to present to so many PRTs and PRCs. Thank you for showing interest and for your attendance.


Out of all the courses that I have written, out of all of the objectives in those courses that have been written and out of all the corollaries made, I feel so grateful to have had this opportunity to share this written work, for the first time. One of the most important attributes, that reflect most my course and objective effort, is that ‘brainwave entrainment revolves around patterned exhalatory function’, and this course allowed me to emphasis this concept through a review of research and literature from the world of “voice”, through a reflection of this Institute’s respect for pressure management, and through a strong case presentation.


I especially want to thank Ruth Hennessy, Hennessy Breath and BodyWork, and Ann Marie Pollard, Voice Realized, for sharing their insights and thoughts on subject matter that is dear to their heart and soul. They helped me discuss the role of the hypopharynx, that is not often associated with the inhibition effort of a right femoral adductor magnus, right internal and external obliques, left gluteus maximus, left psoas major, left pectoralis major, left anterior temporalis, and most important a right sternocleidomastoid muscle.


So much of my clinical and academic life has been centered around our need to express, explain, and explode alternation, through the regulation of intrinsic, biased patterned pressure, for the improvement of outward, unbiased positional performance. Our exploration in and of life depends on the re-reference and re-interference, offered through this plosive vocal ‘sounding’ and explosive plantar ‘pounding’.

Posted November 4, 2021 at 9:21PM
Categories: Courses Science

My maternal grandmother, Lucy, raised pedigree Saint Bernard dogs. Some of my best memories were traveling with her and her prized show dogs to “dog shows”. My brother and I would ‘dog-sit’ the dogs she was not showing on the runway. They were big dogs, with big mouths, to her 8 and 9  year old grandsons. But they were so lovable, slobbery, tongue friendly and gentle. They also had the cleanest teeth of any of the other dogs being shown. Grandma Lucy would say that clean, healthy, teeth on her Saint Bernards were one of the secrets to keeping their coats of hair beautiful and shiny, their overall social disposition, and their extended longevity.  She would often tell us that she believed a dog that could “keep” all its teeth, for as long as possible, would be a happy dog, and “to some degree” would generate better “pedigrees”.  I am not sure I believed her then, especially when I was given the responsibility of brushing slobbery dog teeth before they walked on a runway. None the less, I will always appreciate her for so many reasons, including responsibilities she gave me, like brushing canine teeth. She introduced the concept of  ‘epigenetics’ without ever talking to people like Dr. Singh. I will always be reminded of her phrase,  “to some degree”, when tying to make a point about something she believed had a corollary; which to grandma Lucy, was everything in life.

After many years of discussing material, presenting my thoughts, teaching concepts and writing on occlusal-cervical  and cervical-occlusal corollaries, I am beginning to see, hear and read inter-disciplinary discussion on patterned airway and occlusal cervical malfunction relationships, that contribute to and lead to pathology. It is exciting for me to watch and nurture these pedagogical moments, on many disciplinary fronts and confronts.

After presenting the Occlusal Cervical Restoration course on October 8th and 9th, I have received many emails and notes from course attendees, including dentists, who were so appreciative. The course was strengthened by Dr. James Carlson, a dentist who has written so much on the stomatognathic system, physiologic occlusion and orthocranial force, presence, input and confirmation. One dentist wrote, “to see your interactions with Dr. Carlson will never be forgotten”. This comment, followed by other comments from other participants, reinforce our mission, our intent and our desire to help create and foster communities of interdisciplinary minded providers. A community that appreciates the health of occlusion and oral alignment.

Dr. Carlson, in his 2005 publication on Physiologic Occlusion (a book that is now titled “Orthocranial Occlusion and Dentition Design”) wrote, “With the advancement of integrated health care it is becoming apparent that dentistry, osteopathy, chiropractic, medicine, optometry, physical therapy, massage therapy, and craniopathy have overlapping areas of concern: the head, neck, and face. The concept that the structural alignment of the maxilla, the position of the mandible, and dental occlusion affect the craniosacral mechanism, orbital bones of the skull, neuromuscular system, and the position of the cervical vertebra may be new to many dentists. However, with more dentists cognizant of the interdisciplinary approach to treating patients, the awareness of the concept is growing.” His presence at this course was such a gift, a privilege for all of those in attendance, including the 14 dentists and the other health care providers, that were also in attendance, some of whom work directly together. We will again be honored with his presence and presentations at next Springs PRI Interdisciplinary Integration Symposium (The Stomatognathic System: An Interdisciplinary Approach In The Management of Spatial Navigation and Structural Strength) next year on April 21-22nd. Because of his, and my, strong belief in integrating different disciplines, the health and happiness of the patients being served by an integrative team, should improve; ‘to some degree’.

Posted October 21, 2021 at 8:52PM
Categories: Courses Science

Malta, New York’s colorful foliage and Capital Area Physical Therapy and Wellness welcomed Postural Respiration into its PT-owned clinic. Course attendees had expertise across multiple disciplines -- physical therapy, strength and conditioning, internal medicine -- and patient populations, from pediatrics, geriatrics, basal ganglia and other movement disorders, and high school through professional athletics. Most expressed gratitude and satisfaction with getting back to a live course following the covid sequester. With so much of the weekend devoted to hands-on lab time, Postural Respiration is better experienced live.

Postural Respiration, Postural Restoration, Primary Course, Diaphragmatic Breathing, Zone of Apposition

Postural Respiration

Abundant research exists that describes the role of the diaphragm in facilitating physiologic processes and homeostasis. Less understood and studied is its role in regulating pressure within the chambers of the body to produce integrated and coordinated movement. When the diaphragm’s shape is altered from patterned postural positions, movements, and behavior, the result is asymmetrical air flow patterns that become ever more patterned. Practitioners encounter this phenomenon every day in our patients/clients and witness its influence on autonomic variability, a concept fundamental to the Postural Restoration Institute.  

Throughout the weekend, we considered questions such as:  
-    How do the left and right diaphragm position and function influence rest, recovery, and performance?  
-     Why are the right triceps, left internal obliques and transverse abdominus, and bilateral low traps and serratus anterior so crucial in establishing and maintaining effective length-tension properties of the thoracic diaphragm? And how do they influence new, unfamiliar, yet optimal, patterns of movement in our patients’/clients’ day-to-day lives?
-      When and why do the scalenes, notably on the right, conspire with the subclavius and pec minor, to produce unrelenting activity and the pathological respiratory syndrome known as superior T4?
-     How does the PRI paradigm fit within a clinician’s current approach to evaluation and treatment?  
-      If you have only thirty minutes with a patient, how do you prioritize?  
-     Why/how do patients/clients benefit from reaching activities? Balloon blowing?

It was a treat to be reunited with Kathy Metzger, PT, PRC, a fellow member of the PRC squad of 2011. Kathy applied her experienced hands on many rib cages to teach the nuances of objective tests and treatment techniques.  Thank you for all your help!  

We greatly appreciate our models:  Christopher Denio, DPT, Mike DeMille, DPT, PRC, Andrew Gaetano, DPT, Ken Jin, DPT, and Trisha Livermore, DPT.  Your willingness to participate allowed all of us to gain a deeper understanding of the tests, interpretations, and techniques.

    

A special thank you to Evan Marsh, DPT, and Andrew Gaetano, of Capital Area Physical Therapy and Wellness, for opening your doors and welcoming this wonderful group of clinicians! 

Posted October 20, 2021 at 1:30PM
Categories: Clinicians Courses Science
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