Postural Restoration Certified (PRC)

This past weekend I travelled up to Cranston Rhode Island to teach Myokinematics of the Hip and Pelvis. Elite Physical Therapy was hosting their first PRI course! They had several clinicians in attendance and Ryan Toher, DPT was a great host. They were all new to the science of PRI as were 90% of the course attendees. This was a larger class with  45 clinicians in the room. I was joined by Miguel Aragoncillo, CSCS, PRT and Tyler Tanaka, DPT PRC as my lab assistants. They did a great job offering help during labs and comments from their experiences during lecture. The class was made up of mostly rehab professionals and strength and conditioning specialists. It was super fun meeting Tyler’s college friend Daniel Gardner, DPT aka “Gator” and helping him begin his PRI journey!

As hard as it is to be away from family and friends on the weekends and the rigors of travel, I am always excited to see the light bulbs and Ah Ha moments that new clinicians experience learning about autonomics, breathing and polyarticular chains as it relates to concepts of lateralization, habit and movement dysfunction. I enjoyed meeting my front row newly inducted PRI front row Trisha Livemore, DPT, Steve( CSCS) and Amanda Zariello,DPT, Valerie Perron, LPTA, LMT, Elizabeth Johnson, MPT, ATC and Anne Ruffus, DPT, CSCS.

A very special shout out goes to Gustavo Woff, PT who flew 15 hours from Argentina to take his first PRI course this weekend. It is so inspiring to be part of the PRI Faculty and watch it grow and spread throughout the world.  I am truly honored to be a part of the process.

Alpine Physical Therapy has been the center of advanced PRI courses for over two years. The three amigos, Chris "Murph" Murphy, DPT, PRC, Jeremiah Ferguson, DPT, PRC and Eli Zygmuntowicz, DPT, PRC hosted Cervical Revolution at their facility this past weekend and it was a pleasure seeing the guys again and having their support hosting this course. Cervical Revolution has been evolving for the past two years with course manual changes, thanks in a large part to Jason Masek, MSPT, PRC, and his diagram of the atlas and occipital bone in the left and right TMCC pattern. One of the biggest learning challenges in any PRI course is to connect a pattern to position and have a tri-planer picture in mind from a two dimension drawing from a book. Jason's description is a vital learning tool to understand position of atlas relative to occiput before the discussion of occiput on atlas in a patho-mechanical compensation called right torsion occurs.  

Postural Restoration Cervical Revolution course

In addition, several revisions to the course manual have been made with the help of Ron Hruska and Mike Cantrell to make this course flow even better.   The emphasis has become even greater on the O/A junction being the driving factor for autonomics, cranial position and especially oscillatory lateralized function. The connection with the L AIC, R BC, R TMCC and LSB cranial position, and the need to alternate and reciprocate, was integrated deeply this past weekend with ample lab time and insightful clinical discussion.

Cervical Revolution Postural Restoration

Attendees in the course included six PRC's as well as practitioners on the verge of becoming PRC's with much PRI exposure and practice.  Along with the "veterans" there were practitioners with just a few PRI courses under their belts including PT's, myofunctional speech therapists, and strength and conditioning personal with a strong emphasis on working with baseball players from little league to the pro's.  Joseph Yousefian, DDS, an orthodontist, was in attendance for his first PRI course.  He was thrown right in the middle of PRI nation and was such a valuable voice when it came to occlusion and a dentist's perspective.  In this course the discussion on occlusion is one that is interdisciplinary, and that more often than not, we need to work with a specific dentist to help with occlusion to "free up" a neck and let it revolve!

Thank you to all attendees and especially Murph, Jeremiah and Eli. I also want to thank Ron and Mike for their mentorship over the past two years. They have been so generous in their time and energy helping me understand the content and learn how to teach Cervical Revolution. This was my first solo Cervical Revolution as a faculty member and it was such a rewarding experience to be so well prepared with the help of Ron and Mike. Also, thank you to Jennifer Platt, MPT, PRC for all of your mentorship, emails and phone calls in this learning process!

On page 16 of the Cranial Resolution manual, there is a bullet I wrote that states ‘If we don’t balance rotational events through hemispheric oscillation, occipital alternation or lateralized rhythm, we remain resolved to compensate for our rewarded over-reaction and autonomic drive to repeat.’ 

Yet there were 14 PRCs, 1 PRT and the rest of the class who have taken a minimum of 7 PRI courses. Needless to say, they were “repeaters”. Their drive to continue to learn how to balance rotation with frontal oscillation is on a continuum. The host couple emulates this drive. Thank you Josh and Katie Olinick for hosting another PRI course in the manner you did. (The coffee was just a tad bit cold. Just kidding. I did not need the sugar. Your sweetness diffused into my body before my first sip.) Your hospitality and reception is truly reflective of “home”. Sangini Rane PT, PRC thank you for bringing a patient for all of us to evaluate and make suggestions reflecting autonomics and the course material. Everything about this course I love. The material has been strengthened over my last 30 years of clinical practice. And the messages are being delivered to a body of people who now can appreciate what my autonomic and somatic nervous systems were integrating 30 years ago, with a platform, called ‘PRI’. Any time I get a hug from Susan Henning PT, PRC I feel better than a cold cup of coffee. 

Jason Miller, PT, PRC, was our host for Myokinematic Restoration last weekend in Missoula, MT.  Jason has been using PRI for quite a while, and this was a great opportunity for Jason's co-workers to get exposed to the science of PRI.  Nearly half the audience were from Jason's facility, which will really assist those new to PRI in their journey.  It's always easier to have co-workers along side for the ride.  My thanks to Marla, Seth, Samantha, Kristina, Kailey, Erika, Jessica, and Sydney, as well as Jason's wife, Jill,  for their willingness to learn and ask great questions.  

Dan Houglum, Myokinematic Restoration, Postural Restoration Institute, Primary Course

It was a great group of movement professionals, and a nice mix of those new to PRI, and those who had been exposed to PRI previously.  We started the weekend talking about positional influences on femur position and performance, as well as why and how AF position directs FA performance. We proceeded into which muscles are available and unavailable while in the L AIC pattern. This introductory 5.5 hours of didactic information is the foundation upon which the rest of our weekend was built. And it will provide a solid foundation for those new to PRI to build from as well.  

Myokinematic Restoration - Postural Restoration Primary Course

Once the groundwork had been laid, then we can start getting into the real value of PRI: getting off the right leg and onto the left leg correctly without compensation. The role the Hruska ADD and ABD tests play in that endeavor cannot be overstated. We were fortunate to have a lot of time to dedicate to these valuable tests. Additionally, we were able to experience, find, and feel inhibitory and faciliatory techniques, which allowed us to bring together both days of learning into a great time of lab.

Myokinematic Restoration - PRI Primary Course

We had a great crew of attendees. In addition to Missoula Bone & Joint group, I greatly appreciated Tim Cordial's questions, Amy Downing's help in lab, and Mandi Nystrom's willingness to be our volunteer during demonstration.

Again, my thanks to Jason and his crew for a great weekend. Looking forward to the next trip to Missoula!

As all the PRI Faculty will tell you, having the opportunity to teach a PRI course in Lincoln at the Postural Restoration Institute is kind of like a homecoming. Even though it isn't really our "home court," it does feel like it. That's a testament to Hannah, RJ, Sage, and, of course, Ron and Jen. As I said in our introduction at the beginning of the course, those new to PRI couldn't have picked a better course than this one for their first dive into the science of PRI.

Myokinematic Restoration, Lincoln NE, Postural Restoration Institute

It was such a great experience to teach with Kasey Aikin, our newest PRI faculty member. She did an awesome job, and I'm eager to watch her develop and grow into her new role. We had two other PRC's in attendance as well this weekend: Lisa Bartels and Jason Masek. They have been integrated in PRI for many years, and it was so beneficial to the attendees to have them in class and during lab. Additionally, we had five other attendees who had attended multiple PRI courses prior to this one.

Myokinematic Restoration, Lincoln NE, Postural Restoration Institute

Myokinematic Restoration, Lincoln NE, Postural Restoration Institute

With all the experience in the room, with Ron and Jen providing context during the course and lab, and with the interest and energy from the attendees, the course proved to be a very fertile environment for those new to the science of PRI. Kasey presented an excellent opening and really set the table for the rest of the weekend. We opened the course with discussing osteokinematics and myokinematics surrounding the relationship between the pelvis and femur. And we finished the day with a great repositioning wrap up, which lead us right into Day 2. Kasey again set the table with another stellar opening session, and the table was set for our day of lab.

Dan Houglum, Postural Restoration Institute

Our lab times were very productive and engaging. And a lot of it was due to where we were, and the expertise in the room. I have to thank Lisa, Jason, and Jen for their help during our labs. Kasey ran a great lab session on Sunday afternoon, as well. We were fortunate to have nearly 7 hours of lab during this course. We had a 4.5:1 ratio of student to PRC in the lab. I'm not sure the first time attendees realized how valuable the lab time was, and how much we were able to get out of the time we had.

My thanks to Jennifer Bacon, Meghann Vanslager, Kelli Reilly, Kellen Goertzen, Joe Siracusano, Kristen Wassung, and Benjamin Sandman for their wonderful questions. Honestly, we had great questions from nearly everyone in the room. I think every course attendee asked a question at some point during the weekend, which just shows how great a group we were fortunate to have. For many reasons, this particular Myokinematic Restoration course was unique, and Kasey and I feel very fortunate to have been a part of it.

Austin! The Texas state capital. I traveled there to visit with the best little PT house in Texas! Star Physical Therapy. I was there to teach Impingement & Instability.  Jon Hupp PT, PRC is the owner of Star and he is a dang good clinician and a good man.  Many of you may know Jon but did you know that his daughter Skylar is an elite gymnast? She will likely get a nice scholarship as a result of her gymnastic skills. His son Sterling just started his senior year in high school football and has been doing some good playing so far! Jon’s wife’s name is Bear. Yes! Bear! I LOVE that! I met her and the minute I did I knew she was a nice lady and a kind person. She spends her time taking care of the kids and doing a ton of administrative work for Star. 

Speaking of a ton, this I&I class had a TON of participants!  Around 40. That’s a big class size for a secondary course but...well...Texas.  A dentist named Alice Lam dropped by the first morning to visit. I do some work with Dr. Lam in Houston and she is fascinated with PRI.  I&I is a complex course that explores WHY your patients have Impingement phenomena.  Did you know that they WANT to impinge? It’s neurological. That’s probably why so many veteran PRI clinicians were there. There were 5 PRC’s there: Jon Hupp, Steve Cuddy, James Guzman, Sarah Luin and Josh Elrod as well as PRT, Josh Ogden.  At the other end of the spectrum we had two PT students there. Both of them are my friends: Steven Blair and Phillip Wuellner. 

I&I explores calcaneal, patellar, hip and scapular Instability and the varied impingements that can and do occur as a result. Be prepared for multiple surprises when you take this class.  Some comments from this past weekend: “This changed how I look at the Hruska Adduction Lift Test!” “It changed how I consider the position of the heel as I address my scapular programs to decrease humeral glenoid mechanics.” Oh, and did I mention the ribcage? The deep-dive into detailed mechanics of the existing respiratory variations puts a massive neurological spin on ribcage-scapular function. Whew! I got a little crazy there for a second. Thanks Ron Hruska, for my mild derangement. I cannot WAIT to see all of you in this most fascinating course.

"Wow" was the word of the weekend at Cantrell Center for Physical Therapy, Sports Medicine and Wellness. This was one of the most enthusiastic groups this faculty member has observed with half of the attendees being new to PRI. In addition, The Cantrell Center had half of the total number of students in attendance which made this a real team effort for their facility and created a stronger culture of PRI for their facility. What I loved about this group was the balance of great questions and re-states from every one of the new students as well as the "veterans". There were two PRC's, including lab assistant Ken Smith, who stated what we all experience attending a PRI course-no matter how many courses we have had is that there is always more to absorb and learn!

Cantrell Center Exercise Physiologist "Gentle" Giant Jalen Lawrence asked some great questions on how to apply PRI to power lifting and being able to learn how to better "axial load" when lifting. This was one of the most important questions for his athletes. In addition, we discussed that PRI loves extension for performance. We just don't want to live there all the time and that flexing and internally rotating ribs is needed to down-regulate a system and help restore autonomic balance. HRV or heart rate variability was discussed in the context of Postural Respiration concepts. Autonomic function with parasympathetic inhibition upon inhalation vs. parasympathetic facilitation upon exhalation was discussed as a needed balance for HRV. Since breathing is such a common dysfunction, considering most of our patients present in a hyper-inflated, neurologically extended state, understanding diaphragm function and airflow management is a critical issue. This is not only an issue with people that come into our clinics with pain and dysfunction. It is a performance/recovery issue as well. Shout out to Mehmet, Marion and Michael from Florida who asked great questions and brought great energy. Thank you to all in attendance for making my weekend flow so well with all of you especially the "Cantrell Gang" who can collaborate and apply PRI in a supportive setting. Ken Smith, PTA, PRC was golden as our lab assistant and his energy helped move all of us along. Finally, thank you Tassie Cantrell for such a beautiful facility, great food and wonderful staff that attended and helped all weekend with set-up and clean-up duties.

This image popped up on my "Facebook Memories" this morning, and it was perfect timing because I was planning to do a post this week with some tips for preparing your application for PRC or PRT credentialing. Eight years ago, I was practicing full time as a PT at the Hruska Clinic. I began taking courses when I was still in PT school, had an awesome clinical instructor Lori Thomsen for one of my final clinical rotations, and landed my dream job after graduation at the Hruska Clinic. I was surrounded by the best mentors ever, yet I must admit that I was a little scared at the thought of completing the PRC application and testing. However, having been on both sides (a scared and nervous applicant 8 years ago, and now the Director of Education and Credentialing running the show), I want to take a moment to share some tips and more information to ease your anxiety about the process.

Top 3 tips for preparing your PRC or PRT application:


1. Set aside larger chunks of time to work on your application.
When I first started my application, I was working on it for a couple hours at a time in the evening, or when I had a patient cancellation during the day. But, I found that by the time I would get my stuff out (all of my course binders, my case study patient charts, stacks of research articles, etc), and I mentally prepared myself to get started, I didn't have much time to get actual work done on my application. Therefore, I found my groove when I set aside a full Saturday (which is what this picture is representing from 8 years ago). I set up a table to work, had all of my course manuals accessible and I got major work done! I did this a couple more days over the next couple months and finished the application. It isn't too late to start on your application for this year, if you are able to dedicate a couple weekends to the process.

2. The review committee isn't looking for perfection.

The application review is a peer-reviewed process (PRCs and PRTs). Each application is reviewed by two members of the review committee for which you are applying (either PRC or PRT), and their recommendations are provided for review by Ron and myself. Based on their feedback, we then determine if the applicant is prepared for testing, and the applicant then receives the reviewer's feedback. None of us are perfect in what we do, and thus the review committee is not looking for perfection. Rather, they want to see your 'thought process' and 'decision-making' with the PRI concepts from the four pre-requisite courses displayed on paper throughout your application. Therefore, I would recommend that even if you look back at a case study or client program that you put together and think "wow, I would have totally not selected that technique now that I know more...." (that is fine), you can still use that case study, and at the end of your case study discussion, reflect on what you would do different now (and why....knowing what you know now, that you didn't know then).

3. The application in itself is an educational experience.

I hear this often when people are here for PRC and PRT testing, and I felt the same way myself. I learned SO much when I was preparing my application. It forced me to review content from the courses and find answers to questions that I still had myself. I vividly remember that I didn't fully understand the Superior T4 Syndrome until this day 8 years ago, when I went back and studied my manual, watched the home study course again and reviewed the manual techniques. I had an 'ah-ha' moment in preparing my application that day. The application made me reflect on my decision making process, consider what I might do different now, identify favorite techniques (which is difficult when there are so many), and it allowed me to realize how much I did know (even though there was still a lot I didn't know). This last one is important. Preparing your application is not an easy task, and it takes a lot of time, but it should give you a little boost of confidence (you are studying for the exam while you prepare your application), and that is the hidden gem. Last but not least, the feedback from the reviewer's is so incredibly helpful!

If you are considering applying for PRC or PRT, and you have any questions, please do not hesitate to reach out to me! The PRC application deadline (for testing in December) is September 15th and the PRT application deadline (for testing in January) is October 15th. 

I also plan to share more information and answer questions throughout the week on social media, so if you are on Instagram or Facebook, follow PRI and ask away!

Lastly, in case anyone was wondering how that triathalon went the next day (8 years ago), it was an experience that I have chosen not to do again, but I must admit I was not fully prepared for what I signed up for (it was a last minute decision and challenge with some friends)...but we survived!

Jen and I recently returned to the NATA National Convention in Las Vegas for their 70th Annual Meeting! This year we were joined by Hruska Clinic Physical Therapist and PRC, Jason Masek as he presented and contributed to a break out session on the first day of this Conference. We are always humbled by the unique interest voiced by the Athletic Training community and this year in particular, Universities throughout the country. As more and more Student Athletic Trainers, Graduate Assistants, Administrators and Professional Athletic Trainers introduce Postural Restoration concepts to their athletes, the desire to learn more continues to grow within these populations. Many attendees looked forward to taking further course work through the Institute or hosting courses themselves within their programs. Our PRI Japan Faculty was continuously mentioned by the Japanese Athletic Trainers in attendance and the impact that Kenny, Sy, and Takashi had on their peers not only during their time here in the States throughout their foundational years, but also through their Faculty roles as they currently grow PRI Japan, was voiced with high praise.

Jason intorduced our science through the "Prevention of Movement Patterned Conditions Beyond Competitive Years: Asymmetrical Movement Pattern Considerations". He and Jen fielded many questions by those who attended this talk, and led these individuals through a break out session of performing several PRI objective tests and Non-Manual Technique interventions addressing these findings. A special thank you to Mark Cairns, ATC, PRT and Jessica Tidswell, PT, ATC, PRT for their contribution in helping to guide and assist these techniques during this session. This introduction led even more traffic to our booth and many of those who received these concepts for the first time were eager to attend their first course. 

For those of you who were unable to attend but are interested in viewing the concepts Jason presented, his full Handout can be VIEWED HERE. We look forward to the continued growth of #PRINATION within the Athletic Training community and would love to answer any questions you may have!

The seeds of PRI science have been planted in the birthplace of philosophy. We have all seen the beneficiaries of Ron Hruska’s Socratic style of teaching. Sharing PRI wisdom in Athens was a natural fit.  
 
Praxis Physical Therapy in Athens graciously hosted this Intro to PRI seminar. Mimi Marsellou PT/ Μιμή Μαρσέλλου PT, M.Sc. and Foteni Largari PT / Φωτεινή Λάγαρη PT have owned and run a women’s health and general PT practice for over 20 years.   
 
How did this come about? A unique professional connection to Greece:
Having had the great fortune to have lived in Greece for 6 years, working in Athens as a PT from 2000 to 2004, including being a PT for the Greek Olympic Committee/Athens summer Olympic and Paralympic games in 2004. When I returned to the US, and discovered PRI in 2008, obtained a PRC certification in 2011 with the culmination of opening my own PRI Center in 2014. Like Odysseus traveling so far only to return home again; this summer presented the opportunity of introducing PRI to rehab professionals in Athens. It is no surprise that they are eager for more.
 
Now that they have been exposed to PRI concepts, there are plans for the home study courses in the near future.   
Who knows, perhaps hosting a course as well. “OPA” PRI!

Karen Taylor Soiles PRI Inservice Athens Greece Praxis Physical Therapy

Karen Taylor Soiles PRI Inservice Athens Greece Praxis Physical Therapy

Karen Taylor Soiles PRI Inservice Athens Greece Praxis Physical Therapy

Karen Taylor Soiles PRI Inservice Athens Greece Praxis Physical Therapy

Karen Taylor Soiles PRI Inservice Athens Greece Praxis Physical Therapy

Karen Taylor Soiles PRI Inservice Athens Greece Praxis Physical Therapy

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