Techniques

It's been a great pleasure to work with Louise Kelley and Skip George as we endeavored to help the Flagship Course of PRI, Postural Respiration, become a more digestible course. It is really the foundation of the neurology behind PRI concepts as well as the link between the other Primary PRI courses and the Secondary and Tertiary courses. The goal was to help the course attendee leave with a solid understanding of the neurology behind dynamic respiration, and how to test for, and manage, patterned airflow.

It was very rewarding to have such a diverse group of attendees. We had 10 in-person, and 36 on live stream. We had chiropractors, dental hygienists, physical therapists, athletic trainers, yoga instructors, personal trainers, and a physical therapy student. This diversity led to wonderful questions and opportunities to further explain and digest concepts. The in-person group were wonderful to work with in lab, and the live stream group had several excellent questions and comments on the lab as well.

 

Hopefully the nearly two hours of explanation and discussion surrounding the R BC pattern, scapular position, why the tests look the way they do, page 44, and Superior T4 syndrome was helpful for the attendees. We were able to spend a lot of time in lab working on manual and non-manual techniques, as well as working our way through page 50 to help organize our thoughts into an organized treatment algorithm.

My thanks to Jennifer Bell, Sharee Jedlicka, Deanna Stewart, and Ryan Esdohr for your questions and help during lab. My thanks to RJ, which again did a masterful job directing our live-stream event. It was so great to get questions from Juliana Kroese, Dave (Birthday Boy) Shamash, Alan Lee, Kimberly DelVecchio, and Ivonne Gonzales while they were on live stream. Excellent questions all around!

With this course coming right before Halloween, or as my high-school aged children call it, "Free Candy Day," my holiday wish for the course attendees is that they don't find Postural Respiration spooky or haunting, but find it friendly and enchanting!

Posted November 7, 2022 at 5:47PM
Categories: Courses Techniques Science

What was I doing in a bank vault all weekend, admiring larger-than-life action shots of Steph Curry, Lindsey Vonn, Misty Copeland, and Michael Phelps? Presenting Postural Respiration to a fantastic group of clinicians, of course!   Baltimore’s iconic Bank of America building has been refurbished and now houses FX Studios and the Under Armour Performance Center.

Half the class were newcomers to the science of PRI. The science asks these newcomers to, for a moment, put down your beveled scrapers and dry needling filaments. Pause a moment before you mobilize a joint or release fascia. Put aside any preoccupation with extremity joints and focus your attention, instead, on where movement begins: the thorax.

 

Throughout the weekend, we cited research from luminaries, such as Kapandji, Hodges, Wallden, Chaitow, and DeTroyer, to support the concepts covered in this course:  
-    Diaphragm zone of apposition (thank you Nate Taylor for reminding us of its importance).
-    Respiratory state of twist that is the precursor to habitual, reflexive patterns of movement and the musculoskeletal pain syndromes that we treat.
-    Paradoxical, inefficient breathing that impacts and reflects chest wall and pleura restrictions.
-    How to restore pelvic and rib cage position, through techniques that reinforce abdominal oblique activity and chest wall expansion.
-    How to retrain previously inhibited, inaccessible muscles to promote new, healthy patterns of movement to better sense the environment they’re in and efficiently move through it.

Lab sessions provided application of the above concepts and allowed participants to discover how the “patient-client” in front of them displayed biased sense of air flow and biased orientation of their chest wall. They learned how to coach their partner to novel positions that retrain the nervous system and promote a new, desirable sense of compression and decompression. All participants sensed freedom from habitual movement patterns.

 

I can’t help but think that the athletes adorning the walls, all of whom reached the pinnacle of their respective careers and displayed remarkable longevity, mastered the art of air flow, pressure regulation, and chest wall movement variability during both performance and during rest and recovery. This is what we should strive for in all of our patients-clients.

A huge “thank you” to the professionals of FX Physical Therapy for hosting: Matt Bordeau, Sean Jones, Christine Spurlock, Morgan Taylor, Jennifer Tola, and Mary Williams.  

Thank you also to Miranda Stauffer, Danelle Warner, Amy Morris, Kenya Lewis, Dylan Irving, Jackie De Conti, and Kenneth Scott for your willingness to be the models for tests and techniques.  

I hope all attendees left the course feeling empowered to immediately apply the tests and techniques and begin to weave this new, powerful paradigm, one patient-client at a time, into your approach to care. And to the Newbies:  Welcome to PRI Nation!

Posted October 4, 2022 at 6:38PM
Categories: Courses Techniques Science

The weekend in Valencia, Ca teaching Myokinematic Restoration was one for the books. The majority of the class were first timers to PRI which is always rewarding to be able to introduce PRI concepts such as inhibition, neutrality, and acetabulum on femur movement. Getting to teach with Jason Miller PT, PRC was a joy as well and having 2 clinical perspectives added great benefit. Locatelli Rao PT, PRC was an asset to have as a lab assistant and he brought tremendous value by helping the attendees hone in on their assessment skills. They learned the interpretation of the Hruska Adduction Drop test and spent time with the Hruska ADD and ABD Lift tests during lab. We discussed the “money muscles” to help inhibit the left Anterior Interior Chain (L AIC). The staff at Henry Mayo is nothing short of amazing and the facility is top notch!

Posted October 3, 2022 at 4:03PM
Categories: Courses Techniques Science

Cervical Revolution came back to Lincoln this past weekend with a large zoom audience spanning internationally from Asia to North America to Europe. I had the pleasure of teaching to a live audience as well as having the added assistance of Louise Kelley, PT to help breakdown PRI concepts including  the finer parts of technique for de-rotation of the Right TMCC as it relates to not only the cervical spine but the entire system as well. In attendance was an impressive interdisciplinary group including movement specialists, strength and conditioning professionals, massage and soft tissue professionals, chiropractors, physical therapists, an osteopath, two dentists and one RN who is also a CSCS wanting to expand his horizons!


This is a course about the cervical spine and the need for revolvement that maintains alternation side to side, brainstem oscillation, temporal bone "wobble" and a jaw that can freely move side to side to keep a neck and nervous system in balance of an asymmetrical human that can stand erect and move fully and freely. Atlas and occipital bones make up a highly neurologic articulation with a brainstem and autonomics that are intimately connected to this highly reflexive region. This course is the gateway to the cranium and the introduction to top down as well as bottom up concepts of PRI. The cervical, cranial and occlusal systems are all integrated in this course and an impressive demonstration for all, especially the dentists, was provided with a simple mouth guard that Ron made for Louise the day before the course started. I demonstrated this stomatognathic example with Louise by first testing her cervical spine with a mouth guard that gave her right molar contact and reinforced her RTMCC pattern resulting in positive tests of her cervical spine. Another mouth guard was then utilized that dis-occluded her right molar contact while giving her left molar contact sense and all of her tests became negative immediately. This demonstrated the neurologic effect of a simple mandibular appliance on not only the cervical spine but the entire neuro-respiratory-biomechanical system.

Needless to say, this was communicated to me by a student as 'mind blowing' and brought an experiential example of the power of this course. Thank you to RJ for expert facilitation of this course over the weekend, Louise Kelley for being such a great lab assistant and team mate and Ron Hruska for spending Friday before the course reviewing advanced PRI concepts. Most of all, thanks for all of the students in attendance especially from international locations that stayed up really late or got up really early and for all of the diverse professions that contributed their advanced thought and experience to the enrichment of this weekend.

Posted September 13, 2022 at 8:12PM

As always, I enjoyed my weekend at the home of PRI in Lincoln, NE to present Postural Respiration to an in-person and virtual group with my friend and colleague Jen Platt, PT, PRC. Although virtual learning can be a challenging format to gauge the interest and energy of attendees, such was not the case with this group, who offered many questions, insightful comments, and thumbs-up to relay to this instructor “Yes, we got this concept.” Our in-person squad was instrumental in helping illustrate concepts, serving as models for the PRI tests and non-manual and manual techniques. A huge thank you to our models Hailey Beasley, PTA, Jason Bushie, ATC, Ellen Kindelsperger, DC, and Tasuku Kurane, ATC, for your willingness to express what you sensed during and following each technique.

As anyone who has taken Postural Respiration knows, there is a great deal of research and conceptual material to sift through, contemplate, and consider. What is quickly understood, by practitioners both new to the science and with numerous courses under their belt, is that the PRI approach can be applied to any and all patients/clients. Its techniques offer a game-changing approach to care. The many lab sessions provide experiential learning and an opportunity to practice how to present and explain the how and why of assessment and treatment with the “patient” in front of you.

It is not enough to simply move air in and out of the thorax. All humans accomplish this, one way or another, to stay alive. It is the ability to direct that bolus of air into different regions of the thorax that determines how variable and efficient our movements may be, how we experience the environment around us, and how well we rest at night. This ability becomes compromised the longer we are constrained by the human’s natural asymmetries that become reinforced by static postures and repetitive activities of daily life. Ensuring the balanced roles of the left and right hemi-diaphragm, that of both posture and respiration, requires an understanding of how to maintain each diaphragm’s zone of apposition, inhibit deleterious muscle over-activity, and re-establish a sense of expansion of the posterior mediastinum from which new, healthier patterns of movement can emerge. These foundational concepts are what Postural Respiration is all about.

Thank you to all attendees for taking time out of your summer to challenge your thinking and grow professionally. It was nice to see many newcomers to the science as well as veterans such as Brittany LaFountaine, DPT, PRC, and Joe Siracusano, DPT. I encourage all of you to keep asking questions and seeking answers, through the PRI website resources, dialogue with fellow clinicians, PRIVY, and the many courses that PRI has to offer

Posted August 24, 2022 at 8:51PM
Categories: Courses Techniques Science

Every PRI course has its own unique flavor, and the major reason for that is the attendees. We had a unique blend of movement specialists for this recent Myokinemtatic Restoration course. Many times, upwards of 80-90% of the attendees have not taken a PRI course before, and usually the remaining attendees may have had a prior PRI course, but not Myokin. What made this course unique was most of the attendees had taken a PRI course prior to this one, and for a few folks, they had taken many PRI courses. It was a treat to have Skip George, DC, PRC, PRI Faculty in attendance. Skip's point of view was exceptionally helpful, as he is able lend a chiropractor's perspective to PRI since we had another chiropractor in attendance. It was an honor to have Lucy Yu, DPT, LMT, in attendance.

Lucy wrote a fantastic article regarding PRI and evidence based practice (EPB), and it is in the back pocket of every Myokin manual. I have seen her name many, many times, and read her paper many times as well. She was kind enough to spend a few minutes discussing her paper and how, by any criteria, PRI meets the standard of EBP. It was a wonderful conversation, and further strengthens the science of PRI by demonstrating its absolute support by research.

Craig Depperschmidt, DPT, PRC, and Jason Miller PT, PRC, are training to teach Myokin, and they did an incredible job. When learning a new concept, it is helpful to hear several different perspectives surrounding the topic, as different perspectives often allow the material to resonate more easily with more people. We were blessed to have three speakers for this course, lending clinical experience, as well as personal perspective to the material. It's not often that the live attendees receive almost one-on-one attention during our labs, but that's essentially what we had with three instructors and four live attendees. Myokin is roughly one-third lab time, so our in-person attendees were able to experience all of the tests and non-manual techniques on themselves several times during lab.

My thanks to our live attendees, and their willingness to learn, ask questions, and allow us to use them for demonstration. Their attendance helped the learning process for the live stream attendees, in lab as well as in demonstration. We are very thankful to Angela Marchant, JJ Miranda, Paul McMahon, and Gabrielle Williams-Hubbard. We know you all came a long distance to be with us, and we greatly appreciate your attendance.

And it was Jason Miller's birthday! It was an honor that Jason was willing to spend his birthday weekend helping to teach the science of PRI. It was probably a wise decision on his part to not let any of us know that it was his birthday during the course. There is a small chance we would have called him Birthday Boy the entire weekend. Despite that lost opportunity, this was a very unique and memorable course.

Posted July 21, 2022 at 3:03PM
Categories: Courses Techniques 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

A few days before I was to present Postural Restoration, I reflected back to the number of times I had taken this course during my 17 year journey in PRI. We were fortunate to have nine movement specialists taking their first PRI course, and with the exception of two attendees, no one else attending the course had attended Postural Respiration previously. Since it was almost everyone's first voyage into this course material, I wanted to really focus on two topics that had escaped me in my previous attendance of this course: what/why/how surrounding Superior T4 Syndrome, and why do the R low trap/tricep and L serratus anterior/low trap hold such high significance in PRI for management of the BC pattern.  

We had lively discussion surrounding human asymmetry and how that asymmetry feeds into patterned respiratory mechanics, as well as the potential detriments of patterned breathing. Once we had the foundational concepts secured, we could move into the prevalence of the R BC pattern and what tests we could use to determine if the R BC pattern was overactive. Using the algorithm found on page 48, we were able to walk through manual and non-manual treatments, as well as spend a lot of time defining why and how Superior T4 Syndrome presents itself, and how to uncover the presence of Superior T4 Syndrome as a pathological, or "phony", respiration strategy.   

Algorithms are used frequently in PRI as a means to learn and improve ones ability to apply PRI concepts, particularly if the learner is new to PRI and the science behind it. Again, using page 48 as a backdrop, we were able to progress through why the R low trap/triceps is a necessary piece of R BC inhibition, but also why the L serratus anterior/low trap are necessary for security after proper management of Superior T4 Syndrome. We were also able to spend time in lab going through several of the non-manual techniques that support the manual techniques presented in this course. Since inhibition is such a huge part of PRI, we were able to focus on several non-manual inhibition techniques surrounding those individual who present with B PEC or B BC findings.

Being able to present this course in the clinic I work in with fellow PRC, Donna Parise-Byrne, was great. It was also rewarding to have fellow PRC, Jill Maida, in attendance as well. My thanks to Gail Trubow, Brock Mitchell, Anne Farkas, and Heather Pappas for their help during labs and asking great questions. We really had many great questions and dialogues over the course of the weekend. Thank you to all who attended the course as we took every precaution possible to ensure everyone felt safe, while still receiving the course content at a level that each individual needed.

Posted September 14, 2021 at 3:36PM
Categories: Courses Techniques Science

For many of us who have taken PRI courses over the years, Lincoln, Nebraska, often becomes a home-away-from-home. This has been particularly true in the last two years with the inception of PRI live-stream courses. It has been such a blessing for PRI to reach so many people via live-stream. In total, we had 78 people attend Impingement and Instability, with 20 of those having attended the course in previous years. However, only 5 individuals had attended the new and upgraded version of I&I before this weekend. Having six people live and in person was such a gift. It was an honor to have 11 PRC's and PRT's in the audience as well.

This course is a clinician's course, and we are able to make a lot of connections and links between several PRI courses in one weekend. Yes, this is a dense course with a lot of great information. The advantage of the live-stream is that all the attendees received the recording of the course for two weeks to listen to the material again. The ironic part of the "new" version of I&I is that a lot of the material is unchanged; the context and neurological links between the floor on the ground and the "floor" under the scapulae are significantly changed. This allows the attendee to further appreciate the "why" and "how" behind non-manual activity application and selection.

   

This course is dripping with neurology and is a gateway for the attendee to attend the PRI Forward Locomotion Movement, Cranial Resolution, Occlusal Cervical Restoration, and the new Voice Box course. We build off the three PRI primary courses to delve into how to apply those basic concepts using a higher level of decision making based on a neurological sensory framework. Hopefully, we were able to provide the attendees with that appreciation and help prepare them for future PRI courses.

My thanks to RJ Hruska for orchestrating the entire weekend. He was very helpful to me, and made my job much easier. We got so many great questions over the weekend, and we were able to answer most, if not all, of them.  And having six people live in the building provided an additional layer of questions and feedback. My thanks to Benjamin Sandman for his help with our calcaneal sensorium demonstration. He said it perfect when he said he was surprised at how much better he could sense the ground under his L calcaneus even after the demonstration was over.  

It was truly and honor to have attendees from 14 countries. It is amazing to think that this technology exists, and I am very thankful that fellow movement specialists were willing to spend time with us, even from the other side of the world. Even though most, if not all, of the 72 of the live-stream attendees were in their homes, it was comfortable for me as well to be in my home-away-from-home and spend some quality I&I time with so many like-minded peers. 

Posted August 26, 2021 at 4:19PM
Categories: Courses Techniques Science

This workshop was a first for Jen Platt and I. Opening the workshop with discussion on corollary consequence, correspondence and compensation allowed us to “look” at the top-down influences of PRI Corollary Movement in each of the 12 secondary and tertiary techniques that Jen chose for us to cover. She did a great job in organizing these techniques, laying them out and selecting techniques that offered the attendee a wide perspective of application. Normally, we do not list testimonials after a course.  (You can find testimonials by courses by going to the ‘Programs and Courses’ site on our website).  However, after reading the feedback that Hannah compiled, I felt it would be helpful for those who may be interested in taking this course in the future, as well as to read what the ‘first-time’ attendees had to say about it.

 “I have already listened to at least 60% of the course material. I cannot tell you how much it helps to have the content available to go over again. This course put so many things together in regard to patterning. There were so many lightbulb moments into why things may fall apart for the patient at home with their exercise program because of the brain influence in regard to patterning. The word sense is so different than finding and feeling. Sensing something different in the body especially when sensing one thing can help the patient sense another area is HUGE in regard to making a program successful. Walking away from this course has had one of the most dramatic effects on putting the whole picture together, especially with the ability to go back and review it again. I hope that you can continue to offer the courses on zoom. I also wonder if any of the other recorded courses that were offered through zoom could ever be available as a take home course. It is nice to have that available as an option. Also wondering if Ron was ever going to put all the 33 corollary exercises together now that we understand the corollaries. I know that the other exercises are from other courses but we never had the corollaries with them. Thank you again for everything you all do!!!!”

“This course will allow me to progress all of my clients over the coming months and was a fantastic guide in sensory integration that I felt was a missing puzzle piece.”

“I have learned it in neuroanatomy but only in an abstract manner - now it becomes more meaningful for my work. Thanks!”

“I've always known the importance of multi sensory "sense", but this took my understanding a step further for sure”

“It feels like this course was a missing puzzle piece in my application. This made it much more straightforward to progress and cue clients”

“1. Greater confidence with technique selection 2. Deeper understanding & appreciation re: critiquing and cueing for a clients understanding of both positional and integrative sense”

“This course material will likely allow me help clients move to a higher level of motor learning much more efficiently and with less cognitive load (corollaries > references) especially in a fitness setting, but obviously also with rehab clients.”

“This is one of the MOST relevant courses offered by PRI to my area of practice in my opinion, moving away from more "attention intensive" movement practices towards integrated sense of corollaries will allow all of my clients, from pro athlete to rehab, to experience and sense the task at hand rather than trying to juggle a more cueing intensive task.”

“Thank you again for supporting the growth of PRI nation. We love you and this course was fantastic. When entering a black hole, one needs a guide named Ron Hruska. I can feel the effort, the labor of love, the hard work that has been put into this course (and all other courses). Thank you PRI team for continuing to lead the way. You inspire me to be better. Much love from Alpine PT in Seattle.”

I could not give this course, the way it was presented, without the direct input, production, and guidance that Jen provide both me and the audience. So grateful for her many roles she plays in this Institute, but now, because we know each other so well and the overall intent so well, the delivery and message is seamless, sincere and solid. This truly was the Institute’s first multisensory movement workshop that reflected the strength of the corollary movement sense needed for natural cognitive processing built around vestibular-ocular reflexive correlations. We also could not have made this workshop the ‘virtual reality’ workshop it was without the live presence of Amy Morris, PT, Phil DeNigris, CSCS, Rua Gilna, CPT, SFG1, PN1, and Dave Drummer, DPT, PRC. Their patience with my Socratic style of teaching and their willingness to objectively communicate what they felt, sensed, experienced and struggled with made multi-dimensional processing understandable and appreciable.

Thank you again for coming to Lincoln and participate in the manner in which each and every one of you did.  

Posted June 22, 2021 at 8:31PM
Categories: Courses Techniques Science
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