Techniques

It’s not often that I look out the window at the end of April and see snow falling, but here in beautiful Saranac Lake, NY, this is pretty typical! Matt Powers, DPT, and his team at Adirondack Regional Hospital hosted the updated version of Postural Respiration. This was the second PRI course for many, and they were eager to both expand upon and consolidate PRI concepts they learned in Myokinematics last year.

Postural Respiration Course, Saranac Lake, NY Postural Restoration Institute (PRI)

PRI is a broad science, and this course focuses on polyarticular muscular chain function of the thorax and how it contributes to patterned respiration and patterned movements, as evidenced by neck and belly breathing, rib torsions, asymmetrical abdominal oblique activity, and asymmetrical air flow patterns. Patterned activity can be a good thing. After all, it allows us to avoid an on-coming car as we cross the street, creates the beautiful music of a skilled musician, and gives the appearance of effortless movement in a professional athlete. However, the inability for the nervous system to shut off overly-patterned activity becomes a mechanism for chronic back and neck pain, shoulder and hip pathology, shortness of breath, anxiety, etc.

Postural Respiration - Postural Restoration Institute

Posterior Mediastinum Expansion reach test, Postural Restoration institute

This course has plenty of lab time devoted to assessment and treatment of compromised diaphragm position and polyarticular muscle chain overactivity. Lab time provided many “aha” moments as attendees saw in their partners, and felt in themselves, improvements in air flow patterns and tri-planar motion immediately following non-manual and manual rib cage techniques.

Hruska Adduction Drop test - Postural Restoration Institute

Ann Marenick, Sara Goldfine, and Brendon Olsen were our class demonstrators of several repositioning exercises and a few challenging lower trap, tricep, and serratus non-manual techniques. Ann was able to move her left shoulder and Sara was able to turn her neck, with greater ease and without the tension and resistance they had felt just minutes before. Brad Collins was the recipient of a 2-person manual technique. Christine Hill and I worked together to help Brad bring his rib cage on both sides into a state of more internal rotation to establish ZOAs and chest wall mobility. Upon getting up off the table, Brad smiled and said, “I feel looser all over.”

Postural Respiration Course - Postural Restoration Institute

Special thanks to Matt and Brendan, who came to the rescue following my rental car fiasco. I enjoyed the one-on-one time hearing about your families and your love of life in the Adirondacks. I’ll be teaching next at Northeastern University in Boston on June 8-9. There are a few seats available, so sign up now!

Posted May 6, 2019 at 9:06PM
Categories: Courses Techniques

Last weekend was memorable for several reasons. The first one was the new facility we were blessed to be welcomed into for the weekend. The Children's Health Andrews Institute for Orthopedics is a new facility in Plano, TX, and it is gorgeous. It's a relationship between Children's Health and Dr. James Andrews, and the facility has physical therapy, EXOS Sports Performance, and is state of the art. Thank you to Alex Lopez, Brittani Cookinham, and Stephen Laplante for their hospitality and all the set up they did for us.

Myokinematic Restoration - Plano Tx - Postural Restoration Institute

We had a great group of mostly first-timers to the science of PRI. And we had a great diverse crowd of athletic trainers, strength and conditioning specialists, and physical therapist/PTA's. We even had one Physician Assistant.

Myokinematic Restoration Course - Postural Restoration Institute (PRI)

Myokinematic Restoration provides a great foundational platform that allows us to explore the mechanical ramifications surrounding the hip and pelvis as a result of the dominant L AIC pattern. We were able to relate normal positional mechanics and normal compensatory patterns that occur as a result of the right diaphragm's influence on the L AIC pattern. After that foundation, moving into pathology and Myokinematic relationships that exist due to the pattern became an exploration of polyarticular chains of muscles. These concepts allowed us to build our assessment and treatment framework for the rest of the weekend.

Myokinematic Restoration Course - Postural Restoration Institute (PRI)

I greatly appreciate John Key and Katrina Earley for allowing us to learn from them during our demonstrations. There were so many great questions during the weekend, and I appreciate Paul Monje, Rayanne Garcia, Michael Wright, Joni Robertson, Andrew Gallucci, and Meka Venkatanaresh for their enthusiasm and re-states. And a special thank you to Kasey Aikin, PRC for her help assisting throughout the weekend! I thoroughly enjoyed my weekend in The Lone Star state, and the course attendees were a huge reason why. I am looking forward to seeing many of you in future PRI courses!

Posted May 3, 2019 at 5:40PM
Categories: Courses Techniques

PRI for Pilates took the show on the road to Webster Groves, Missouri last weekend. The iconic St. Louis arch was a perfect example of  a beautifully domed diaphragm.  Participants included PT’s, Personal Trainers, Pilates Instructors and an OT. The Pilates newbies to PRI were very receptive to the new concepts and how to incorporate PRI into their Pilates practice. There was great group participation, questions and comments especially from the Laurens, Leah, Tara and Cory. 

PRI Integration for Pilates - Postural Restoration Institute

PRI Integration for Pilates - Postural Restoration Institute

PRI Integration for Pilates - Postural Restoration Institute

James did a stellar job explaining appropriate diaphragmatic breathing and the the roles of the IO’s, EO’s TA’s and serratus to this group whose primary focus is the “core”. Sarah had everyone  learning to drive in the left and make legal right turns. Donna led the lab integrating Pilates and PRI techniques on the Pilates reformer. We were honored to have Jen Poulin  join us to learn how to begin to use Pilates equipment to further enhance her pelvic restoration expertise.  Shout out to our host Kelly Ruesing who jumped through many hoops to be present even though she had a music gig in Indiana the same weekend. Special thanks to Nancy Hammond PRC for igniting the interest and bring PRI Pilates to St. Louis.

PRI Integration for Pilates - Postural Restoration Institute

PRI Integration for Pilates - Postural Restoration Institute

PRI Integration for Pilates - Postural Restoration Institute

 

Paula Webster, PT, invited us into her Canton, CT, clinic for the weekend to host Postural Respiration. This was one of the most unique clinics I’ve seen: a renovated 1812 home, with its original bee hive fireplace, whose previous owner was involved in the abolitionist movement.

Postural Respiration - Canton, CT

 This was the first PRI exposure for close to half of the participants. It was also a first for me to have a gastroenterologist in attendance, Dr. Kiran Sachdev, who provided insights into the connection between GI issues and patterned respiratory mechanics.

 Discussion opened with the asymmetrical diaphragm and its role in patterned lumbo-sacral-pelvic mechanics below and rib and humeral-glenoid mechanics above, driving us into L AIC and R BC patterns that direct air flow patterns and influence every physiologic system in the body.

As always, the concept of the Zone of Apposition, as needed on the left, was thoroughly defined. This left ZOA indicates left lower ribs that are held down, in, and back to lateralize the body to the left and enable healthy air flow directed into the left posterior mediastinum and right apical areas. With a sufficient ZOA, the left hemi-diaphragm is able to regulate and balance thoracic pressure and abdominal pressure so that its dual roles of respiration and stabilization are preserved.

 We emphasized the three-dimensional function of the abdominal-pelvic and thoracic cavities, and discussed numerous examples of “deflated, converged” cages and thoracic flat back posture, presentations that require over-activity of necks, bellies, and backs to breathe.

Then it was off to the gym for lab time, to practice PRI’s objective tests, including the new "posterior mediastinum respiratory reach test", along non-manual and manual techniques. Attendees put their hands and minds to work to facilitate and experience the powerful sense of rib cage expansion and freedom. How apropos to sense this freedom within a former abolitionist’s home!

PRI - Postural Respiration Subclavius Technique

Thank you to Paula’s Canton PT colleagues, Jeanne Daubert, DPT, Heather Mogielnicki, OT, and Shanya Stearns, DPT, for welcoming us into your clinic and tending to the nitty-gritty to help the course run smoothly. Thank you to Robert Barksdale, DScPT, FAAOMT, for your crucial A-V assistance. I also appreciate the willingness of everyone to act as models for various demonstrations. You were a fun group to hang out with all weekend!

Posted March 25, 2019 at 4:34PM

I had a great time this weekend teaching Myokinematics of the Hip and Pelvis at Body Dynamics in Falls Church, VA. I grew up not far from Falls Church and my college roommate lives in Rockville MD. I got to spend some time with an old friend and teach a course that I consider an old friend. Myokin is a great course to start a PRI journey and that is exactly what 90% of my course attendees were experiencing. We took an OBER and Thomas Test and turned them from orthopedic soft tissue tests to the neuro respiratory positional tests as they provide clinical evidence of an asymmetrical pattern.

PRI Myokinematic Restoration Course Demonstration

There was as much fog in the room at 4:00pm on Saturday as there was on my drive up to VA on Friday night! But… by Sunday at 5pm the sun was out and the connections in their new PRI minds were clear as the weather outside!

PRI is an integrated science and Myokin of the hip and pelvis is just one piece of an integrated system. But what would a Diaphragm be without a solid pelvic base and a good appreciation of AFIR in stance and AFER in swing!

I was honored to have Dr. Felix Liao, DDS author of “6 foot Tiger in a 3-foot cage”! Dr. Liao considers himself an airway mouth dentist. He was in attendance to understand the perspective of the PRI therapist, so he can better understand the neuro mechanics of PRI and how he can better help patients integrate!

Jennifer Gamboa, Lisa Clarkson and the entire staff of Body Dynamics welcomed all of us to their clinic. These professionals all work well together and it was so fun to watch how they picked right up on PRI methods. Lisa had been exposed to PRI out in Seattle as a student. She did a great job hosting us this weekend!

This class kept me on my toes and asked awesome questions to better understands how to integrate PRI into the current practice. I always enjoy teach Myokinematics of the Hip and Pelvis. It helps further stabilize my own clinical practice and reinforce the importance of sound PRI fundamentals in my treatment plan.

Posted March 13, 2019 at 5:01PM
Categories: Courses Techniques Science

A great weekend in Chicago at Pilates Central with Donna Byrne, PRC and her awesome team of Physical Therapists, Athletic Trainers, and Pilates/Yoga Instructors. Dan Houglum, PRC served as a capable lab assistant and the entire Pilates Central Team were warm and welcome hosts. Besides Donna and Dan, we were grateful to have 3 other PRCs in the course: Jesse Ham, PRC, Alex Maag, PRC and Jill Maida, PRC.

Pilates Central - PRI Integration for Geriatrics Course

Of the 32 people in attendance, 4 of them were first time attendees, and we had fun getting to know them. When you attend an Affiliate Course as your first PRI course, you are an instant VIP and we make sure you feel welcome and that you are not left behind on any of the new concepts. We checked in regularly with the first timers and we were able to stay on track for them throughout both days. In fact, as it turned out, these 4 VIPs ended up having some of the best questions and concept summaries of the entire group. Yes, I'm talking about you Candis. You made Rapid City, South Dakota proud (even though I know you are a transplant). Beyond tailoring the course to first timers, it was great to also expand on some interesting principles for those with more PRI experience. Always fun to keep it simple and also strengthen the experienced.

James Anderson, PRC Instructing a PRI non-manual technique, PRI Integration for Geriatrics course

 The group was grateful for the simplified explanation of AIC patterned development, ZOA acquisition, lateralized frontal plane performance, integrated upright standing dynamics, and gait performance. The use of the PRI Integration for Geriatrics Tests in sidelying and sitting provided some great assessment options for the immobile, frail and chronic, while keeping our focus on gait deficits specific to each side of the body. The Positioning Techniques, the Group Exercise Techniques, the Functional Routines Handout and the appendix full of useful Geriatric exercises were a big hit. The functional bed, recliner, seated, transfer and standing sections in the appendix were a great resource for clinicians working with this type of patient.

James Anderson, PRI Integration for Geriatrics Course

Besides there being 6 PRCs in the room throughout the weekend, there were many in attendance who had been to several PRI classes and had lots of experience using traditional PRI tests and techniques. One of my favorite things about the Affiliate Courses is that they provide a fresh approach and innovative ideas, even for seasoned PRI practitioners. I was reminded of this fact when I received the following message from a fellow PRI Faculty Member and PRC and good friend Jesse Ham: "James, clinically, I am loving the ability to achieve left laterality into the back seat with the posterior mediastinal feel/sensation in seated and being able to reposition a pelvis in hook-lying with alternating respiration. Thank you for adding layers of understanding to what I already knew and appreciated about PRI." You're welcome.

Coming from the Polar Vortex, it was a refreshing respite to be in sunny Arizona for the first Myokinematic Restoration course of 2019. We were fortunate enough to have a very diverse class of attendees ranging from chiropractors, to strength coaches, to physical therapists working in various settings, to certified athletic trainers working with professional athletes.

Myokinematic Restoration is a fantastic course to kick-start one's PRI journey. This was the rare introductory course where over half of the attendees had been to previous PRI courses. This provided us a unique opportunity to delve into other material that we wouldn't otherwise be able to cover. We had excellent questions and excellent lab time as a result.

Lab Demonstration of PRI Testing, Myokinematic Restoration, Chandler, AZ

One of the topics that we were able to cover in this course that previous attendees appreciated was the Hruska Abduction Lift Test. This test is taught in depth in Pelvis Restoration as well, but for those who had attended Myokin previously, this was a new topic for them. Additionally, it provided the newcomers a chance to be able to appreciate how PRI integrates the gait cycle and breathing into treatment from beginning to end. We were also able to briefly touch on other topics, such as PEC management and rib cage IR, because of the previous experience of many of the attendees. However, we were also able to stay very on point and keep the course on track for those who were attending for the first time.

Dan Houglum demonstrating the Hruska Abduction Lift Test, Myokinematic Restoration Course

My thanks to Jim Wittekind, PT, PRC, for his help during lab and insightful discussion. The staff from 360 Physical Therapy, Becky Fox, Jennifer Peters, Krystina Leal, Caleb Walls, and Jason Roe, were perfect hosts. My thanks to Nathan Whitney, Ginsie Huntley, Liz Cash, Chris Burke, and Garrett Chin for their questions and discussion.

Lab Demonstration, Myokinematic Restoration course, Chandler, AZ

At the end of the day, we all need to be a little more like Bruce Wayne, and less like Batman. And we need to use our "good boy band" of muscles, instead of the "bad boy band" that the L AIC often puts us into. As a result of our conversation around normal mechanics vs. compensatory mechanics relative to the L AIC pattern, we were able to delve into how these analogies applied to our assessments and treatment approach. We were able to spend a lot of time on muscle activity as well as how to apply the Hruska Abduction and Adduction Lift tests into assessment and PRI non-manual activity selection.

Hruska Abduction Lift Test, Myokinematic Restoration Tweet

We were blessed with a great group of movement professionals, and I was fortunate to be able to help them either continue or start their PRI journey. Thanks for a great weekend!

Posted February 14, 2019 at 5:29PM
Categories: Courses Techniques Science

What a great way to start off teaching my first course of my 2019 schedule at my own clinic here in Southern Pines! Nothing like sleeping in your own bed and walking your dogs at lunch time! I had the help of Sarah Ratti PTA, PRC! Sarah was a member of the 2018 PRC class and I was lucky enough to get to know her in December and have her help during lab!

Sarah Ratti and Jennifer Poulin at the Pelvis Restoration Course

 I was so excited to teach Pelvis Restoration following attending Ron's Non-manual technique workshop last weekend in Lincoln, NE. I learned so much and it certainly help energize my teaching and deeper understanding of the Non-manual techniques! I was able to really help my course attendees with choosing techniques and following a frontal plane progress as it relates to the Pelvis.

Jennifer Poulin Instructing a PRI Non Manual Technique

Every time I teach this course, I learn more and grow not only as a faculty member, but also as a clinician. I am hopeful my course attendees would feel the same. My class was interdisciplinary! We had PT's, PTAs, massage therapist, kinesiologist, strength and conditioning coaches, Yoga Instructors and massage therapists! It was a 50/50 split of newbies and experienced PRI clinicians. Maude and Brenda were my Pure Newbies, meaning they really didn't know what PRI was all about. But they left excited that they had been exposed to the science and couldn't wait to integrate what they learned into their current practice. I was happy to have Malynda Kerksick in my class. Malynda was a former patient of mine and now a PRI enthusiast!

I have had the pleasure of watching her grow as a Yoga instructor and her questions were much appreciated. She also did a great job photographing moments throughout the weekend. She gets photo cred for capturing my pure joy while teaching this weekend. I am so proud to be a part of the growth of Postural Restoration. We get asked all the time which course should I take next? What is the best first course to take? I made sure to emphasize the true nature of feed-forward neurology. You treat a pelvis, you influence the thorax, neck, head and big toe! I hope to see these faces again in a future PRI course! The #PRINation is now stronger than ever before!

Pelvis Restoration Course, Non Manual Technique Demonstration

Pelvis Restoration Lab Demonstration

Posted February 13, 2019 at 5:33PM
Categories: Courses Techniques Science

A few days before this course, I was reviewing the material and made a remark to Jen Platt on how much “good” stuff is in this course, that I forget about from year to year. It is so enjoyable to have an opportunity to discuss the reasoning one might use before selecting a position to place a client or patient in, before selecting a non-manual technique. What went into the thought processing regarding reference centers and concepts and why is it important to select an appropriate primary reference for desirable “referent” behavioral outcomes? 

Ron Hruska demonstrating a Non-manual Technique with Neil Rampe

Results are based on preparation. Preparing the patient on what to be mindful of, sense, possibly expect, experience, etc. are all more important than making sure they are doing the technique “correctly”. Processing information can be difficult if individual centers of tactility are not explored first. Words matter, word placement matters, word meaning matters, word correlates matter, word integration matters and word synchrony matters. 

Ron Hruska Non Manual Techniques Workshop

This course allows me to review this communication process, inhibitory intensity and neurologic effort for those who have unique limitations but very similar outcome needs, relating to pattern development around asymmetrical design. Over twenty different non-manual techniques, many of which were selected by the attendees, were reviewed, torn apart, discussed, re-designed and then re-designed again, to recognize reliability of approach and validity of use. It is personal for me. And therefore, an opportunity for those who share their transparencies to reap “good” stuff.

Ron Hruska Non-Manual Technique

Posted February 12, 2019 at 5:10PM
Categories: Courses Techniques Science

Santa Barbara is one of California's beautiful towns and would be considered one of our seaside gems. Prevail Conditioning and Performance Center was the location of Postural Respiration this past weekend. Owner and operator, Peter Blumert, provided a superior training facility for this weekend which followed his hosting Myokinematic Restoration last November. This weekend was a first for PRI! We introduced our latest revision of Postural Respiration. This course is packed with new material including a new test for posterior mediastinum inhibition called the posterior mediastinum reach test. There have been new documents added to support PRI concepts with loads of references for this course. In addition, case studies have been added and were a big hit with our students!

This was a course loaded with professionals in not only physical therapy, athletic training and sports performance but included an osteopath as well. Postural Respiration really describes how the diaphragm affects every system in the body. This course connects pelvis position to the ribcage and illustrates that breathing can be viewed as the gait cycle allowing ribcages to actually walk! That seems like such a far-fetched concept to those new to PRI on day one of the course and seems like such a bold statement. By the end of the weekend, every student could see that breathing is walking and the diaphragm and ribcage position and posture is key to tri-planer, dynamic, balanced gait.

We also had a chance to introduce the effects of the diaphragm and the ribcage to the cervical spine and jaw as well. The connection with Postural Respiration and the neck and jaw was experienced by a student when testing HGIR, or internal rotation of a Humerus in a glenoid fossa. She experienced jaw pain during HGIR testing and learned there was a connection of the Omohyoid with shoulder blade, neck and jaw. This was reinforced when the manual technique to release her subclavius muscle was demonstrated. Not only did this technique make her tests neutral but her jaw pain was gone. She also understood that with any manual technique, a non-manual technique and progression via treatment guidelines will be needed. Needless to say she was enthusiastic about continuing her PRI journey! Thank you to Aimee Miyazawa, ATC, PRT for being a seasoned veteran of PRI and a wonderful lab assistant. Thanks again to Peter Blumert for hosting this course as he welcomes Pelvis Restoration later this year.

Posted January 24, 2019 at 9:00PM
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