Courses

If you have always wanted to explore Syracuse, New York...here is your chance!  Ron Hruska will be in Syracuse on July 25-26 teaching Cervical-Cranio-Mandibular Restoration.  Make a vacation out of it by attending a course while also enjoying the City of Syracuse!  This will be your last opportunity to take the Cervical-Cranio-Mandibular Restoration course this summer because it’s FULL in August.  This may also be one of the last opportunities for you to take this course before certification in December!  If you register by June 24th...we will waive the late registration fee!  To register, click here!

Posted June 19, 2009 at 7:59PM
Categories: Courses

Recently Karen Jiran, MPT, PRC taught at our one day clinical course in Crookston, Minnesota.  Karen filled us in on how the course went:

“I had a great time up in Crookston, MN!  The group was really excited and asked great questions!

  • First, we reviewed the mechanics of footwear and how correct placement of scaphoid pads can help move a patient out of a Left AIC pattern.  There was a problem with understanding the need to support the right arch and yet allow the right great toe to contact the ground to assist with weight shift to the left.
  • Second, we hit the ZOA.  We went over what the ZOA is and how we functionally need to ensure the ZOA is supported in all three planes with each integrated exercise.
  • We reviewed and performed exercises to help understand where mistakes can easily be made.
  • We discussed clues to looking at hip lift scores and when a person really is a 3 or 4 by assessing true trunk abduction.  Just because a person can lift doesn’t mean they are a true 3 to 4.  I expect to see trunk abduction as a part of the movement.  I encouraged them to be picky when evaluating the test!
  • We also reviewed progressing with right vs. left lower trap exercises and to be careful with Right Superior T4 patients.”

Here is what an attendee had to say about it:

  • “This was an open conversation course!  This was extremely helpful to address individual questions.  The small group was conducive to understanding the deeper theories.”

If you would like to learn more about our one day clinical course opportunities, contact us!

Posted June 16, 2009 at 8:05PM
Categories: Courses

The Cervical-Cranio-Mandibular Restoration course in Woodbury, Minnesota, August 8-9 is full!

Posted June 11, 2009 at 8:08PM
Categories: Courses

We are re-locating the October 3-4 Myokinematic Restoration course in Lincoln, Nebraska to Shakopee, Minnesota!  The course will not be offered in Lincoln this fall so if you were interested in taking this course in Nebraska there are still spaces available next weekend in Omaha.  If you are interested in the course in Shakopee, Minnesota you can register here!

Posted June 4, 2009 at 8:22PM
Categories: Courses

If any of you have read the book, The Last Lecture, by Randy Pausch you probably remember the section on “handwritten thank you notes”.  This note was sent to us by a course attendee of the four day Interdisciplinary Integration course.  It’s notes like these that keep us moving…

I would like to commend you on the presentation of such a wonderful course, Interdisciplinary Integration!  With each PRI course that I attend, I leave knowing that I have made such a great career choice!  I cannot even imagine what life would be like after graduation if I would not have been introduced to your work in Postural Restoration!  Thank you so much for continuing to share your knowledge.  The organization of the course and welcoming environment, in addition to the overwhelming knowledge of the presentors, made for a very educational and enjoyable four days!  Thanks!

Posted April 22, 2009 at 6:22PM
Categories: Courses

You’ll find that we’ve recently added a few more course dates to our schedule for this year: Myokinematic Restoration June 6-7 Syracuse, NY (Speaker - Mike Cantrell) June 13-14 Omaha, NE (Speaker - James Anderson) June 27-28 Sioux Falls, SD (Speaker - James Anderson) Postural Respiration October 10-11 Omaha, NE (Speaker - James Anderson)

Posted April 14, 2009 at 6:35PM
Categories: Courses

Michal Niedzielski and Gregory Parfianowicz recently returned from their trip to Poland.  On March 20th through the 23rd Michal and Gregory taught Myokinematic Restoration in both Warszawa and Olsztyn.  This year marked a new chapter for PRI as this was the first time PRI has been presented in Poland.  Michal and Gregory put in months of preparation for this course and we are honored to have both of them represent PRI!  Here are some photos from their trip…

Warszawa

PRI in Poland PRI in Poland
PRI in Poland PRI in Poland
PRI in Poland PRI in Poland
PRI in Poland PRI in Poland

Olsztyn

PRI in Poland PRI in Poland
PRI in Poland PRI in Poland
PRI in Poland PRI in Poland

Posted April 8, 2009 at 6:45PM
Categories: Courses

If patient can’t maintain re-positioning…

Breathing

  • Are they diaphragmatically breathing?
  • Quality of respiration?
  • Symmetry of respiration?
  • Decreased diaphragmatic motion, increased descent of pelvic floor, altered breathing patterns associated with pelvic pain.
  • Diaphragmatic and TA muscle activity reduced with hypercapnea.
  • Pelvic floor depression associated with breath holding/Valsalva maneuver.

Abdominals

  • Can they isolate IO / TA?
  • Symmetrical or Asymmetical?

Abdominals

  • Palpate approximately 2 cm medial and inferior to ASIS.
  • Slowly & gently draw in your abdominals away from your fingers.
  • Sub maximal contraction.
  • Change positions (supine, side lying).
  • Monitor for substitutions.
  • Is IO / TA activity sustained with breathing?

Abdominals

  • Can they maintain IO / TA contraction with upright static & dynamic control?

Walking Seated Ball Pregnancy Squat

Pelvic Floor

  • Can they isolate their pelvic floor muscles?
  • Can they actively contract and relax the pelvic floor?
  • Do they feel an up & in contraction?
  • Are they substituting (glute squeeze, breath holding, adductor squeeze, bearing down)?
  • Is there symmetry?
  • Is there appropriate motor planning?
  • Voluntary contraction of the abdominal muscles stimulates pelvic floor contraction.
  • TA and IO recruited during all pelvic floor muscle contractions.
  • Relaxed abdominals resulted in only 25% of maximum pelvic floor contraction.
  • Women with stress incontinence have increased OE activity (increased OE increases IAP).
  • Back pain more common in women with incontinence , increased probability of LBP if have symptoms of incontinence.
  • Pelvic floor muscles are part of preprogrammed response to postural adjustment.
  • Decreased pelvic floor strength, endurance and thickness noted in women with incontinence.
  • Increased pelvic floor activity with postural perturbations noted with women with incontinence.
  • Pelvic floor tonic activity at rest, with cough automatic phasic response, in women incontinence unsustained tonic pattern with asymmetrical recruitment.
  • Timing deficit of muscle recruitment lost with women with incontinence.
  • Higher resting tone of pelvic floor with dysfunction, need to teach down training.
  • High resting tone does not always mean a strong pelvic floor.
  • The pelvic floor needs to relearn how to function within a neutral pelvis.
  • Feel the pelvic floor contract and relax.
  • Reported cure rate of pelvic for urinary incontinence ranges between 44-69%.
  • 30% of contractions are performed incorrectly; 50% of contraction are strong enough to increase urethral pressure.
  • Pelvic floor muscle activity alone does not predict UI, activity related to UI needs to be considered.
  • Isolated contraction of pelvic floor produces greatest displacement of pelvic floor.

Hypermobility - But Still Have Symptoms

  • Is there global hypermobility?
  • There is a high correlation of pelvic dysfunction with a reduction in tissue collegan concentration.

Abdominal Binder

Referral

  • Has there been trauma?  Consider referral early on if patient not progressing appropriately.
  • Patient can reposition but they still have symptoms- are they able to relax their pelvic floor?
  • Is there psyco-social issues?

Referral To

  • If symptoms have not subsided consider referral to OB GYN/Urologists/Primary MD
  • PT with pelvic floor specific training (biofeedback, internal evaluation, condition specific integration)
  • Podiatry (correlation of foot flexibility and SUI)
  • Dentist
  • Neuro - Optometrist
Posted April 6, 2009 at 7:16PM
Categories: Courses

Karen Jiran, MPT, PRC was the instructor last weekend for our one day clinical course called Postural Restoration.  For those of you unaware of what this course is, this course is an individualized, one day class, that covers concepts requested by the attendees.  In short, the entire day is spent reviewing concepts taught in one of our two day courses.  This course happened to be organized by PRI but we often schedule the courses on request.  Here is some feedback from the attendees:

“Great course, Karen did an excellent job!  I would recommend this class to everyone.  It was a fun, dynamic learning experience!”

“Excellent course, please offer more of them!  It’s nice to have a small class size to have practice time!”

“Very, very good!  The case studies and small group discussion made the problem solving effective!”

“It’s nice to have a source to get questions answered.”

If you are interested in having a one day clinical course at your office, please contact us! This is a great opportunity for more advanced, hands on clinical application for you and your colleagues!

Posted April 3, 2009 at 7:34PM
Categories: Courses

to our first Interdisciplinary Integration course, you missed out on a fantastic weekend!  Let me give you a quick overview on each day…

Day one which covered Podiatric Integration started out with information covering gait analysis and it’s relevance to PRI related treatment.  It was a great overview of the reciprocal process that takes place as our body moves through the motion of gait and what PRI considerations we should keep in mind as we are treating different phases of gait.  The afternoon carried on with information regarding orthotics and what purpose a PRI orthotic serves in reducing neuromotor pathomechanics provided by Dr. Paul Coffin.  The day couldn’t have ended better than with Ann Ringlein, from the Lincoln Running Company, covering proper shoe wear.  Here are some comments from attendees of day one:

“Excellent clinical application I can use immediately.”

“Fantastic, fascinating guy; we could learn a lot more from him!”

“Excellent information and application for our clinic.”

“The videos and pictures of those walking was so helpful!”

Day two was devoted to Dental Integration provided by Dr. Mike Hoefs.  The entire day was spent by a passionate, enthusiastic dentist talking about the importance of position and maintaining cranial symmetry.  Dr. Hoefs is one of the few dentists in our country treating craniofacial pain and dental discrepancies through gnathic orthopedic positioning.  The highlight of the day was when he took our very own, Lisa Bartels, DPT, PRC, and placed a twin block ALF appliance in her mouth in front of the whole class.  It was incredible to see the postural changes that took place immediately following the application of this appliance!  Here is what others had to say about the day…

“Interesting, informative and very helpful for understanding when and how to refer to an appropriate dentist!”

“This was such an eye opener; I really appreciate all the information given!”

“The demonstrations used during this course were very applicable for use in the clinic.”

“Wow, Dr. Hoefs is the Ron Hruska of dentistry!  He is such an innovator!”

Day three was spent on Vision Vestibular Integration.  The first part of the day covered optokinetic learning taught by Ron Hruska, MPT, PT.  We learned all about vision and its influence on balance and the vestibular system. The morning provided an excellent overview on how to integrate and communicate with optometrists.  Dr. James Nedrow discussed his expertise in neuro-optometry and the treatment of visual midline shift and post traumatic visual dysfunction.  Here is what others had to say:

“I have a better idea of when to request optometry and neuro optometry.”

“Both the morning and the afternoon came together for me and showed me where to look to study and begin tying things together.  The whole day was fascinating!”

“This course opened my eyes to the importance of treating the entire system.”

“Wow, this course definitely helped clarify the relationship of the vision-vestibular system and posture.  Ron and Dr. Nedrow did a great job of presenting this information and demonstrating the importance of interdisciplinary integration.”

And finally, day four!  Pelvic Floor Dysfunction was the topic of this day given by Heather Engelbert, PT, PRC and Lori Thomsen, PT, PRC.  What an incredible day covering the importance of establishing a positioned pelvic floor, before addressing pelvic floor dysfunction.  Not only was pelvic asymmetry discussed but also covered was the importance of the respiratory system and its influences on the pelvic floor!  The afternoon was spent on treatment techniques for pelvic floor dysfunction and we were given several new activities to use with our patients.  Here is what other attendees had to say about it…

“Great explanation of the Left AIC pattern and how it affects pelvic floor dysfunction.  I loved the “egg”, pelvic floor and diaphragm diagrams; it helped me to understand position of the pelvic floor and the pelvic diaphragm.”

“The clinical application with treatment strategy and reasoning behind these strategies was one of the best discussions I have ever heard!”

“This was a wonderful way of improving my understanding of how to fit the pelvic floor in the PRI picture.”

“This course exceeded my expectations; I now know what is going on at the bottom of the egg and what to do about it!”

Interdisciplinary Integration

Posted April 1, 2009 at 7:42PM
Categories: Courses
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