Techniques

It was a wonderful weekend teaching a Pelvis Restoration as a “hybrid" course. Teaching to professionals attending the course in person and through Zoom was exciting and humbling. Thank you to everyone who attended. Your desire to learn and passion for the Science of PRI is amazing. We had great questions and interaction through both forums this past weekend. We had energy. We had passion. We had a desire to learn. I felt an improved understanding of the “external” support of the pelvis with tri-planar movement (especially the frontal plane) was understood at a deeper level for improved regulation of internal pressure and airflow. I felt course attendees appreciated the PRI objective tests and how they can assist them clinically to improve PRI Non-Manual Techniques selection for patient treatment. I also felt in insight was also gained in not only “re-positioning” the pelvis but then “re-training” that pelvis for left stance and right swing with our goal to “restore” for reciprocal and alternating movement.

We were “world-wide” this past weekend with course attendees from all across the U.S. and internationally. Thank you again for all that came. It was great to teach as it makes me a better clinician.

Posted April 21, 2021 at 4:36PM

After almost a year to the day of the country shutting down, this course marked a refreshing beginning to some normalcy with teaching PRI Myokinematic Restoration again. We had at least 50 participants virtually with attendees in and outside of the U.S. ranging all the way from Canada, Slovenia, and the UK. We had 9 in person attendees that made the trek to Lincoln and served as the “models” for our myokinematic lab portion.

We began the first morning with didactic material learning all about the patterns of the L AIC. This  included non pathology and pathology discussions in relation to the compensatory demands of the femur in the acetabulum. Respiration demands, underlying neurology and asymmetry helped to shape and understand the reasoning behind the L AIC pattern.

The weekend concluded with an ample amount of lab and hands on time, learning to assess position of the hip, compensatory findings, and frontal plane performance testing with the Hruska ADDuction test and Hruska ABDuction test. The attendees then went through myokinematic techniques to restore and retrain pathomechanics of the pelvis.

We had several thought provoking questions and the enthusiasm was great from the group and could be felt even virtually!

Posted April 1, 2021 at 4:58PM
Categories: Courses Techniques Science

The Midwest started warming up to a balmy 22 degrees on the way to reaching almost above freezing on Saturday morning for the first Postural Respiration Live/Live Stream course this year. There were seven live attendees some of whom drove over 5 hours on slick and icy roads to take their first Postural Respiration course while almost 40 others from all over the country, and even internationally from Slovenia, attended this course. Ron and I had a discussion the day before I taught and it was a real inspiration to be able to emphasize to the new students the concepts of not just rib movement and diaphragm function but the importance of pressure and flow inside a chest wall and how that not only affects position and posture but every system in the human body. We spend a lot of time on the orthopedic consequences of neurologic patterns in this course but it is what is inside the chest wall in terms of how we direct air into chambers and how that affects whether ribs move up or move down, and torsos left or right as a critical element of Postural Respiration and all PRI courses. The Posterior Mediastinum has become more of an emphasis than ever before along with the role of the first rib in initiating the lifting of the rest of the ribs below it during respiration. This class really got the relationship between the right apical chest wall and the left posterior mediastinum with the role of how important inhibition to these chambers of the chest wall is.

One of the non manual techniques we focused on was the Standing Serratus Squat and the importance of learning how to perform it. This is one of PRI's more difficult positions to competently perform and that there are often precursors, especially with reaching and squatting techniques, to help facilitate this most important technique. Just because it is challenging to perform doesn't mean that students shouldn't master it and then teach their patients. This is one of many techniques that help strengthen an individual's diaphragm and give them a "sense", which was one of the key words of the weekend, of thier ribcage moving backwards!

And for forward locomotion, that is, to move forward, one most move a ribcage back! Questions came in fast and furious which is a delight for instructors since it helps to gauge where the attendees are in their understanding and to reinforce and repeat concepts that are needed to provide a good foundation to understand this course well enough to begin to apply. The students in this course were helping teach Postural Respiration by their re-states and questions with energy and enthusiasm. Shout out Meghann Vanslager and Jennifer Bacon who drove from Kansas then had a 5 hour drive home with work the next day! Thanks to Ian Katanec for being on a 9 hour time difference in Slovenia and everyone else that spent their weekend with us as over half of the attendees that were either brand new to PRI or first time attending Postural Respiration. Most of all, thanks to RJ Hruska who was my wingman performing audio and visual expertise with changing camera angles for lab and keeping things going smoothly during these virtual attendance times.

Posted March 3, 2021 at 9:07PM
Categories: Courses Techniques Science

There are four kinds of documentation that most of us use to change our behavior:  
1)  Learning oriented tutorials.
 2) Goal oriented how-to guides.
3) Understanding-orientated discussions.
4) And, information-oriented reference material.


Each of these four types of documentations usually have instances within the document that refers to related information elsewhere in the same document. This is important as it forms a network structure of relations that exist between different parts of data, dictionary-internal as well as dictionary-external. If the cross-reference mechanism is well designed, visibly or technically, the reader, and in this case, the course attendee, will be able to follow each and apply ‘cross-reference’ event, to the referenced content whether the content is presented visibly or technically.  


The last example, of the four listed above, enhances usability and application of content in each of the PRI Non-Manual Techniques. Documentation or description that identifies direct reference and referent sites of consistent interest; is required so documentation that indirectly implicates cross references from these and other discrete or unconsidered sites can provide content-strategies to meet the desired needs and expectations, from both the provider and the participant.


As the author of these techniques, and as the author of cross-referencing design associated with each technique, effort to ensure that location and content of the target of the cross-reference in each technique needs to be consistent, regardless of the aptness of the provider or the participant.  


These opportunities to provide my reasoning behind each of the techniques, that were selected by this course’s participants, are not exceeded in any other course offered in PRI. Therefore, the guidance I offer to answer questions on the ‘why’s, ‘when’s, ‘who’s and ‘what’s regarding each technique’s reference’s, referent’s, and cross-reference’s content, is an absolute unique opportunity for both the author and the attendee seeking behavior modification through documentation that is resourcefully dissected at a level that is unsurpassed in this Institute.  Each technique (documentation) dissection experience is truly one of the most rewarding things I have done in my life.  And I am grateful.

 
I want to thank Dan Houglum, Torin Berge, Dave Drummer, Jen, Hannah and RJ for their assistance in making this course so enjoyable to teach and apply to “real” life limitations and likenesses.

Posted February 4, 2021 at 4:18PM
Categories: Courses Techniques Science

What a fun experience it was to be able to connect with the 37 participants from last month’s live stream pediatrics course! With the new format, we were able to reach attendees in Japan, Canada, Poland, and India! James and I also brought the PRI science to 6 new (“VIP”) clinicians! Further, the audience was made up of yoga instructors, OT’s, personal trainers, and of course, PT’s. The participants seemed to enjoy the many videos of PRI treatment with children of all ages and all skill development levels. We were even able to do some demonstrations with kids! A special shout out to Jen Platt, Nancy Hammond, Libby Lostetter, and anyone else who let us use your children for a spotlighted kid demo! And the adult attendees who participated in demonstrations were also greatly appreciated as it brought a nice richness to the learning experience.

I’ve since been in touch with some of the attendees to see what they thought about the new format and a common comment is how nice it is to have the recording of the class for 10 days following the weekend to go back and review and refresh! It worked out so well, we are planning another Live Stream for August 28-29, 2021 with hopefully a couple in person courses as well. Check out the schedule, and tell your friends! Lastly, huge shout out to co-presenter, James Anderson, producer, RJ Hruska, as well as to Hannah Hankins and Jen Platt for all of the scheduling, manual edits and production, technical help and behind the scenes planning that putting a course like this together requires! And last but not least, thanks to Ron Hruska for the genius foundation! Hope to see you in 2021!

Teaching the Geriatrics Course via live-stream was awesome for a number of reasons. First, it was great to be in Lincoln Nebraska in person at the Postural Restoration Institute. You take something like that for granted when travel and human interaction is restricted the way it has been. I love being at the institute and associating with their staff because it reminds me of coming home to good friends and family. So good to see Hannah, Matt and Jen and to spend time getting caught up with all the fun events in their lives. It was also super great to have Jen’s expert assistance as the producer of the entire course experience. I couldn’t have done it without her and the amazing AV technology and teaching environment available at the institute. Thank you so much for ensuring that things went so well for the course attendees.

A second reason the course was awesome is that these live-stream courses give the instructor more time to discuss and practice the actual exercise techniques. The break out lab sessions to practice testing and treatments in traditional live courses become individualized learning sessions that can be taught very efficiently via live-stream. Not only are the tests and treatments taught more efficiently, but the recording of the course is available to the learner for further review at home after the course to solidify the learning experience. So I was able to teach, demonstrate and guide the course attendees through more of the actual exercise techniques with this new learning format than I am normally able to.

And the last reason the course was awesome was the actual course attendees and the things they had to contribute. We had a broad range of professionals from all parts of the US, across Asia and Europe. We were all together at the same time, irregardless of time zone, and shared in one another’s learning. There are too many of you to thank, but please know your attendance at the course and your contributions made the experience much better for all of us. The questions you asked via live discussion and via chat submission, together with the many comments shared throughout both days made the course especially fun for me. Thank you everyone and I hope the additional review days after the course proved to be a strong addition to your overall learning.

Posted July 28, 2020 at 8:43PM

We had a great time last night on our first "PRI Breathing Mechanics in COVID Times" free webinar! We had around 250 people join us, and we look forward to hopefully growing this number in the coming weeks. If you missed the live webinar last night, you can access the recording on the Webinars page on our website. A PDF handout of the PowerPoint slides is also available on the Webinars page.

Below is the 3rd (of Ron's Top 10 Chest Wall COVID Breathing Techniques that we will be discussing further on these webinars) non-manual technique clinical reasoning break down. We invite you to review and try this technique a few times over the next week, as we will be discussing this and more on next Tuesday's webinar.

Standing Supported Left Glute Push

Let’s start with the title of this PRI Non-Manual technique.

This “standing” technique requires wearing shoes that provide good heel counter support, arch support and a toe box that will allow the toes and forefoot to easily spread out in the shoe. You will also need to push a table next to a wall to prevent it from moving forward as you push it forward with your hands (or you could use a kitchen or bathroom counter in your home). This PRI technique is designed to place one in a 'Valsalva-like' maneuver position between the exhalation and the inhalation phases, without blowing up a balloon and holding the expelled air or while pinching off the nose. 
 
In this technique, the force applied by the table and floor allow the tongue and mouth to close off the airway and properly use the abdominal muscles and the diaphragm to exhale and inhale without engaging the neck or back under moderate pressure created by closing off the pharynx with the pharyngeal muscle and the larynx/trachea with the tongue muscle. This voluntary control of the abdomen is maintained during the entire technique, without having to think about how to “hold” the contraction of the abdominals during both phases of the respiration cycle. It is a wonderful way to teach someone how to inhale with good opposition to the diaphragm so that its effectiveness on opening up the mid and lower chest wall is maximized, as the subconscious effort of maintaining abdominal stabilization is minimized.

The “support” of the upper extremities, offered by the stable table or counter, also allows one to lift the right leg up and the right foot off the floor as the left glutes "push” the body forward to further stabilize the lower trunk and pelvis as the right hip is raised up. This activity co-activates more integrative assistance from the right hip flexors, the right lower trapezius and long head of the triceps and left abdominal wall. When all said and done the tension and internal pressure created by the lengthened anterior shoulder and hip flexors enables one to breathe with the diaphragm under high compliance and forgiveness of lateral and posterior chest wall tension.
 
This technique is, therefore, a good technique because the lateral, posterior, apical and base surfaces of both lungs can expand easily upon diaphragmatic contraction, secondary to chest wall compliance and the gravitational force displaced on the abdominal contents. The internal organs fall anteriorly and off the front of the thoracic and lumbar spine. It is also, an excellent postural drainage technique for the posterior lobes of the mid to lower lungs, preceding the standing positional induced coughing that more than likely will follow with those who are experiencing difficulty breathing because of fluid-filled alveolar sacs.

Here are some additional comments about the steps that follow the title and pictorial examples, along with the reasoning for the procedural step.

Stand with your feet parallel to each other and directly under both hips. While keeping both heels on the floor lean forward to place your outstretched hands on the table in front of you. Now move your feet back so that your back is close to being parallel with the surface your hands are supported by, and the floor or ground you are standing on. You should feel a gentle stretch through the back of your heels and lower legs. Maintain heel contact with the floor or ground surface, especially on the left side.

These first two steps are important because you are now in a position where anything you do from this point on will foster more uniform opening of the entire circumference of your chest walls. This position, as reflected by the person in the second photo, also indicates that the attachment sites of the latissimus muscle on the side of your chest wall is in its lengthened state, as both of its attachment sites are distracted from each other. In other words, the arms are moving away from the mid to low spine, as the spine is more rounded than “U” shaped in this position.

This is an optimal position for the diaphragm to be in for coastal or mid to lower rib cage expansion upon contraction. It also is a great position for one to sense the abdomen lift the abdomen up against gravity and feel how one’s own body weight can serve as an element for abdominal strengthening with optimal diaphragmatic influence on the chest wall mechanics for ideal ventilation and perfusion at the anterior base of each lung’s lower lobes.
   
Shift your left hip back in Step 3 to engage your right hand as a pusher and to sense, activate, and lengthen your left outside hip muscles in preparation of using these same muscles to lift your right foot a few inches off the floor. While keeping your back parallel to the floor, in other words do not let your mid back sag toward the ground, lift your right knee up and your right foot off the floor/ground. The weight of your body should now be felt through both wrists and hands, your left hip, your abdominals especially on the left, (if you feel your right abdominals more than the left, you need to push more with your right hand into the table you are supported by) and the entire bottom of your left foot. This ‘highly integrated contracted’ position replaces the need to do this activity by blowing up a balloon correctly using PRI methodology.

Now hold this position as you take a deep breath in through your nose as you “push” with the above musculature and reference sites, outlined in Step 3. Then blow out through pursed lips or your mouth slowly by pushing slightly more with above muscles and sites. The most important consideration in Step 4 is to transition slowly from exhalation to inhalation with a “pause” (Valsalva pause) in between the exhalation and inhalation phase, without losing the “push” from your body while breathing in this reciprocal state of glossal sealing and pharyngeal closing during respective inhalation and pre-exhalation reciprocal breathing.

Stay tuned for more discussion on Ron's Top 10 Chest Wall COVID Breathing Techniques on our upcoming webinars and blog!

Posted May 7, 2020 at 12:15AM
Categories: Techniques Science

As we gear up for tonight's first webinar, below is Ron's breakdown with clinical reasoning for the second technique discussed in the free PRIVY trial video titled "Integrated Pulmonary Compliance". If you haven't yet checked out this free video, it is a great introduction to the webinar searies that begins this evening. Stay tuned, as we will be discussing more PRI non-manual techniques related to chest wall compliance in the coming weeks on our "PRI Breathing Mechanics in COVID Times" free webinar. To register for tonight's first webinar, please CLICK HERE!

Standing Wall Supported Resisted Ischial Femoral Ligamentous Stretch

Let’s begin with the title of this PRI Non-Manual Technique.

You will need to purchase approximately 5 to 7 feet of medium resistant therapeutic tubing. You can find information on the PRI Website under “Products” (and then click on "Materials") and purchase from Stretch Well, green colored medium elastic tubing. The Stretch Therapy Deluxe green tubing has hand handles included. However, you can perform this activity without band resistance, by placing your hands on the edge of a chair that easily slides forward as you reach forward. You will also need to find a book that is approximately 1 to 3 inches in height, at least 12 inches long and 7 to 10 inches deep.

When performing this activity in “standing” you will be able to use the floor as an anchor and a “wall” as “support” for distraction of your lower and upper posterior chest walls.  [This position on the floor and on the wall will allow you to primarily sense and focus on mid to low back lengthening as the accompanying posterior and lateral chest walls expand]. As you move your arms forward in performing the following outlined activity, the “ligamentous” soft tissue, including your accompanying hamstring muscle, that attaches to your “ischial” seat or sit bone and to your “femur” or thigh bone, more than likely, will feel tight. This tightness and/or “stretch” is the result of your abdominal wall of muscle contracting, as you reach forward with “resistance” from the therapeutic bands in your hands and the bands of elastic, soft tissue attached to your “ischial seats”. Therefore, the floor you are “standing” on, the “wall” your low back and hips are resting on, and the bands that are looped around the hands or the friction from the legs of the chair the hands are resting and pushing forward on, are all providing the forces needed for your left and right diaphragm leaflets, inside your two respective chest chambers, to open and expand and stretch both the inside and outside chest walls. This expansion, under the above guided resistance, allows one chest chamber to ideally open better when closure of the other chest chamber occurs, and vice versa. This PRI Chest Wall technique, minimizes pulmonary or lung static function, maximizes elastic tissue recoil of the chest walls, equalizes pressure when all four extremities are alternating or involved with lifting, and assists with optimizing immune responses.  

Here are some additional comments about the steps that follow the title and pictorial examples, along with the reasoning for the procedural step.

Stand with your feet parallel to each other and with your hips directly over your feet. Place a book that is 7 to 10 inches deep between the door and the back of your heels.  The back of your heels will help you sense the wall you are about to touch with your low back and hips. This heel sense, together with the sense of the floor you are standing on, will provide the anchoring your abdominal wall will require for upon contracting as you reach forward with your hands to relax and open your posterior chest wall and or back muscles.   

By also anchoring therapeutic tubing in the door at a height slightly above shoulder level, and around both of your hands, you will begin to sense the need to engage your abs, lower your head and shoulders and move your upper chest walls forward as your mid back and chest walls simultaneously move back. The same type of activity will occur if you place your hands on the top of a chair or stool on wheels.  

If you have difficulty sensing your abdomen muscles contract and it is difficult to round out your middle to lower part of your back, your anterior chest wall is too elevated.  Place a rolled-up towel between the upper part of your thighs, as high as you can get it. This rolled-up towel should be wide enough so that when you bring your knees together your knees will not touch. By placing this bolster between your upper thighs and squeezing your knees toward each other, your back muscles will relax and your ligaments at the back of your hips will be more easily stretched out as you lower your body with your muscles that attach to the two ischial seats. These muscles are called your hamstrings and will enable you to maximize your diaphragm’s influence on chest wall mechanical activity that will enable better upright perfusion of oxygen into posterior and lateral lobes of the lungs, that may be ‘locked up’ because of over contracting back muscles used for postural stabilization. Therefore, by pulling your two hips apart with the bolster between the knees, that are moving toward each other, you are essentially decompressing not only the pelvis that lies between the hips, but also the spine that lies between both chest walls. This decompression of the ‘chest wall’ spine decongests the lung tissue associated with congestion of lung tissue (alveola) that is incapable of opening because of spinal compression. By squeezing the bolster between your thighs, as you are doing with this PRI technique, you are essentially reducing the ‘squeeze’ on the posterior lungs.  

To place as much low back on the wall that you can, in Step 4, you may want to slowly and carefully bring your knees slightly forward as you are exhaling through your pursed lips. Try to keep your heels and feet flat on the floor as you are reaching forward with your outstretched hands and arms. Many of you will not be able to place your low back on the wall, and may only be able to sense your rear on the wall, as you attempt to round your back while reaching forward with your arms and knees as your body gently lowers. The most important thing about Step 4, is to reach with your hands and arms, resisted or unresisted, while you “round” your mid to low back, during this exhalation phase of movement.

Step 5, is where the magic happens. The magic is when your inhalation effort through your nose, after performing Step 4, continues to open up the entire chest wall cavities on both sides, along with all the underlying alveolar tissue in your lungs. The position you worked so hard in achieving is now serving as a platform for diaphragmatic inhalation without resorting to muscles that over compress the posterior lung tissue. Those muscles lie both directly in front of your neck and in the back of your chest walls.  
As you continue to breathe in through your nose and out through your mouth, or through pursed lips, let the air move your chest. Assist this chest movement by drawing in the air (Step 7) and compressing it out by reaching further forward with your arms, as the weight of your anterior body opens up the posterior body (Step 8).

The resistance provided by the forces through the arms, the wall and the floor allow you to receive the floor, the wall and the space in front of your arms as the space inside of your chest walls expand and elevate your body; as it is being lowered gently, softly and peacefully to the ground. When you stand up, in Step 10, focus on maintaining “push” through the heels, the hands and the inner thighs as your entire chest remains opened, relaxed and uncoiled. Breathing should be effortless at this stage, because of true postural support offered by muscles that keep the posterior chest walls elevated, and the anterior chest wall opened and lowered, for maximum lung perfusion and ventilation.

Posted May 5, 2020 at 2:01PM
Categories: Techniques Science

As an introduction to our free "PRI Breathing Mechanics in COVID Times" webinar series that is debuting tomorrow, we invite you to view a free trial privy episode titled "Integrated Pulomonary Compliance". During this privy episode, Ron and I discuss lung compliance and two techniques that are incredibly valuable for maximizing pulmonary compliance during this COVID-19 pandemic. As promised, Ron has broken down this technique and provided further reasoning behind the title and each step of the technique below. Stay tuned for the second technique, which will be posted to our website tomorrow. And, don't forget to REGISTER for week one of our free webinar series, which debuts tomorrow at 6pm CT.

Standing Supported Right Step Around with Right Quadratus Lumborum Stretch and Right Apical Expansion

Let’s start with the title of this PRI Non-Manual technique.  

You need to be in a “standing” upright state, preferably with good arch and heel cup supporting shoes on, as you hold on to a “supporting” dowel, pool stick or some type of rod in your right hand. The right hand needs to be in a position where the palm is down and the thumb is up, as your hand is wrapped around the stick. [This will position and assist your “right apical” or upper chest wall into an “expansion” state, or more open state, which is one of the desired area that this activity will focus on.] The right foot will “step around” the left foot to assist in lengthening, or “stretch”, a muscle that is connected to the top of your iliac crest or hip bone, the last rib of your rib cage and the first four vertebrate of your lower back. This muscle, the “right Quadratus Lumborum”, often becomes very short, tight and restrictive when your upper chest doesn’t turn or rotate to the right as your lower chest turns or rotates to the left. This muscle also can limit lower trunk and hip turning or rotation and forward movement to the left at the low back; as a result of the backside of the last right rib being held down by this muscle. [This right low back area will be the other desired area you will be focusing on.]

Here are some additional comments about the steps that follow the title and pictorial examples, along with the reasoning for the procedural step.

Stand with your feet parallel to each other and with your hips directly over your feet. Place your right hand on the dowel or stick at right shoulder level.  Place the dowel’s or stick’s other end on the floor at approximately arm reach in front of the right foot. This step is important because it begins to put your right shoulder and chest in a position where your air flow can begin to move more easily into your right upper lobe of your right lung under your right anterior and lateral chest walls.  

As you try to cross your right foot in front of your left foot, you may notice that you can not make a perfect “T” with your right foot perpendicular to your left. If you can not make a “perfect T”, do the best you can. Both feet need to be, however, flat on the floor. This means you should feel your inside arches of your feet hit the bottom of the shoe as you put weight through each foot. Step 2 provides the anchor needed for your right lateral and back side of the chest to open up as you stand in the final position as outlined in Step 5, and as you breathe in when in step 6.  

By slightly bending your knees, in Step 3 your low back will relax and your mid to upper back of your chest, on both sides of your back, will expand and gently begin to open up during normal breathing. By “shifting” or moving your left hip back, your body weight will be directed and moved over to the left foot, more than the right. Try very hard to keep your right arch and foot on the floor as you do this. Your entire lower body and lower chest will be turning to the left as your upper chest is essentially turning to the right, simultaneously. As your left lower posterior chest wall is lengthening, decompressing and beginning to open, your right lateral chest wall is simultaneously opening.

Begin to “round our your trunk” in Step 4 by slowly lowering your left arm, as your right arm is held up the dowel, that is secured by your right hand.  Slowly breathe in through your nose and out of your mouth, as you lower your left shoulder. Simultaneously place emphasis on rounding your back to open the back of your chest walls on both sides of your back. Take a few seconds and pause after each ‘breathe out’ through your mouth, before you take a new one in through your nose. This pause allow your mid back to expand, open, and loosen any “mucous” in the posterior regions of your lower and mid lobes of your right lung and your lower lobe of your left.

As you continue to breathe in and out, begin to “reach for your right toes with your left hand” during the exhale phase of this slow, methodical breathing cycle you are in. You may not be able to touch your left toes. This is OK. Over time as your chest wall becomes more flexible, you may get close to your toes, or you may actually touch them. Let the back side of your right leg or hamstring area dictate on how far to reach with your left hand as you exhale. This is not a right hamstring stretch activity, although you will feel that area being pulled. More importantly, let your right hamstring region hold, stretch and anchor you as you breathe in slowly to fill and expand the back side of your left lower chest. This will allow your left posterior lower lung lobe and right anterior upper lung lobe to open, drain and exchange air more efficiently.

After you have arrived at a comfortable state of reaching with your left hand toward your right toes, concentrate on filling your right upper lung and stretching open your right upper anterior chest wall, as you slowly take deep breaths in, after each long breath out. Try very hard to “maintain” your hand and foot positions as indicated in Step 6. This ensures good respiratory mechanics for ventilation of lung surfaces in the upper lobe under your right, upper, anterior and lateral chest wall; a region of our body that is often compressed and restricted because of handedness and our human asymmetrical bias toward managing posture through our right body activity.

Step 7 reminds you to accept the “stretch” you should feel through your “hips, back and right chest wall”. This stretch sense is especially desirable upon exhalation. So exhale, and pause, to experience this wonderful “lung” related stretch sense. Your diaphragm will work so much more effectively, after this final step. Your chest walls, in general, will expand so much more efficiently and your ventilatory gas exchange will enhance your mood, behavior and decision making.
   
By continuing the sequence recommended, in Step 8, your chest wall reciprocal movement associated with inhalation and exhalation mechanics, will allow better alternation of chest wall movement when you walk and swing your arms and legs and when you sit and turn to one side and then the other, or when you lie down and turn one direction followed by another. This PRI technique fosters more desirable, unrestricted chest wall mechanics, lung drainage and diaphragmatic productivity both at rest and with upright bilateral extremity movement.

Posted May 4, 2020 at 8:09PM
Categories: Techniques Science

We are excited to announce a Free “PRI Breathing Mechanics in COVID Times” Webinar Series beginning next week. We have been receiving phone calls and emails with questions on how the science and techniques of PRI can be applied to COVID-19 patients. What do we recommend, and why? Well, if you have been wondering the same, we will discuss all of this and more over the next several weeks on this webinar series.

As Ron discussed earlier this week in our Zoom Director’s Meeting, he feels like he has come full circle, that is 360 degrees from where he started almost 40 years ago; and where the profession of physical therapy started. Many of the first non-military patients that were treated in 1918, when the Women’s Physical Therapeutic Association was started, were children who were having difficulty breathing because of the Polio epidemic that ramped up in the United States in 1910. Chest physical therapy was well recognized by 1948 and physical therapists and physiotherapists around the world were taking responsible measures and opportunities to ‘restore lung function’ after acquiring an illness or after surgery.

In more recent years, several studies have questioned the use of intermittent positive pressure breathing (IPPB) machines and have caused many respiratory therapy departments to look to chest physical therapy as a replacement for IPPB. Respiration, ventilation and breathing are all influenced by our postural positions and patterns we are in at the time we are exchanging gas. Therefore, breathing mechanics are postural mechanics. The Postural Restoration Institute’s (PRI) concepts and scientific applications, are today used by many health care providers who collaborate with other disciplines that are mindful of the importance of keeping oral airway and lung airways open. This interdisciplinary practice reflects our early colleague’s effort in taking responsibility for the restoration of lung function through human mechanical intervention, prior to or following events that challenged lung airway position and drainage.  

Postural positioning is necessary for postural drainage, and the importance of coupling proper breathing mechanics with positioning enhances lung perfusion, expansion, and compliance to help fight off respiratory illnesses such as COVID-19 and to help acquire lung and chest wall function that speed up recovery following COVID or other viral acquisitions. This is why we are so excited to share PRI concepts, considerations and advice on how to keep your chest and lungs mechanically efficient and physiologically effective.

Just yesterday, a good friend and colleague, Cheryl Chase, PT, PRC emailed us and shared an old book that she pulled out of her desk titled “Postural Drainage and Respiratory Control, 3rd Ed”, which was published in 1971. Her colleague is going to provide an in-service on postural drainage, something that all physical therapy education programs cover, yet many PT’s have never clinically used. In the direct words of Cheryl, “I am so saddened by our current pandemic crisis, but also delighted that this current situation creates opportunities for new dialogues. It seems strangely serendipitous to coincide with the 20th anniversary of the Institute.” This message truly hit home. This is not how we imagined we would be celebrating our 20th anniversary. Yet, in some ways, it is blessing because with all of the messages and questions we have been receiving, we know that we can contribute to this opportunity for new dialogues amongst the general public and across multiple disciplines.

So, we invite you, and your friends and family to join us for this free webinar series, happening every Tuesday at 6pm CT (starting May 5th). Invite someone who has always wanted to know more about PRI, or maybe those who have questioned the “why” behind your use of Postural Restoration®. During this pandemic, we have witnessed humanity helping each other more than ever, and we are hopeful that the dialogues we can spread through this webinar will help thousands across the world.

*If you miss any of the weekly live webinars, they will also be posted to our website, so you can go back and view them later.

PRI Breathing Mechanics in COVID Times
Tuesdays at 6pm CT
CLICK HERE to register to join the webinar

*Pre-registration with your name and email will be required each week

Posted May 1, 2020 at 3:22PM
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