Please check out this 6 minute video and accompanying blog article to learn a PRI based technique to help improve lung health amidst COVID-19.
Please check out this 6 minute video and accompanying blog article to learn a PRI based technique to help improve lung health amidst COVID-19.
Enjoyed a great weekend at the University of Missouri teaching the primary course classic Myokinematic Restoration. This course is essentially an expanded and updated version of my very first PRI course, its the first course I learned to teach as a new Faculty member 20 years ago, with material that continues to mean a lot to the work I do on a daily basis. Thank you to Joe Pope, DPT, PRC for assisting me with the course and helping give all the attendees a great overall experience. Your additional comments from your own experience learning the science of PRI were very valuable and I could tell were much appreciated by course attendees.
The course was taught at the Missouri Orthopedic Institute on South Stadium Drive across the street from the Hearness Center Basketball Arena and diagonally within view of the neighboring Faurot Football Field. Seeing this field brought back a memory from my college days that I may share just because its nice to reflect on the glory days, when Nebraska Football was dominant and we expected to win the National Championship every year. I'm also sharing this memory for those of you reading this who are not old enough to remember what I'm talking about, because its something you should know about.
The #1 ranked Nebraska Cornhuskers rolled into Columbia back in 1997 expecting an easy win and they ended up pulling out a squeaker that has come to be known as "The Miracle in Missouri". If you don't know what I am talking about (or even if you do), you should do an internet search and watch the spectacular (and very lucky) play called the "Flea Kicker". It's a signature memory for Nebraska Football fans in the 1990's and a pivotal reflection point for current fans hoping current Head Coach (and Flea Kicker Quarterback) Scott Frost will take the program back to its glory days. I think Matt Davidson still gets paid to retell the story of that play to anyone who will listen.
Another reason I tell that story is that 1997 was the year I met Ron Hruska. I was a student at the University of Nebraska Medical Center and we had a guest speaker come in one day to teach our physical therapy class about temporomandibular dysfunction. I had no idea at the time that I was listening to a man who would in time have a more dramatic impact on my career than any of the good professors I was being taught by in my current course of study. These professors gave me the fundamentals of joint structure and function, muscle function and general rehabilitation, but I remember wanting so much more in terms of "real-life biomechanics". And it wasn't until Ron presented courses on lumbopelvic and hip dysfunction that I started to feel satisfied thinking through what I thought was really going on.
This Myokinematic Restoration course was my first hook, because it answered questions about biomechanics and human movement that I hadn't even asked myself before meeting Ron. Questions like, "What is the position of the acetabulum relative to the femur on each side and why does it matter?", "What is ligamentous muscle and why is it necessary?", "What is the performance strength of the acetabulum in early stance on the left and in late stance on the right?", "How does the performance strength of the femur relate to the performance strength of the acetabulum?", "What actually is acetabular hole control?", and my favorite,..."What is the function of the obturator internus and what is its role in upright human function?"
All of these questions and more are answered in the current version of the Myokinematic Restoration course. How grateful I am that I was able to consider such important questions so early on in my career and that I, like Matt Davidson, so much later in our careers, still get paid to tell my version of the story to anyone who will listen.
Beautiful weekend in Oakland California talking PRI for the frail, the immobile and the chronic with a super group of medical professionals at the Alta Bates Summit Medical Center. A huge thanks to our host site coordinator Shaun Buchanan for thinking of everything and making sure we had a wonderful weekend. Your hosting was amazing Shaun. Also thank you to Tim Dempsey, CSCS, CPT, PRT who assisting me this weekend as a lab instructor and made sure the group had a good experience.
The night before the course was fun and relaxing for me because I got to attend a Golden State Warriors basketball game in the new Chase Center arena. I have been to several games in the historic Oracle Arena in Oakland, but getting to attend a game in their newly completed arena across the bay in San Francisco was an awesome experience. After the game, I picked up a souvenir that helped me teach the course the next day. It was a Matryoshka or nesting doll painted as one of my favorite players, Klay Thompson. Klay turned out to be great asset for giving the class context for rotational diaphragm performance, lumbopelvic rotation and contralateral respiratory rotation through the rib cage during transitional activities and gait. Who knew?
This PRI Integration for Geriatrics course does a great job assessing and making treatment recommendations for different aspects of the human gait cycle. The design of the Seated Gait Integration Test is to determine early to mid stance performance and the design of the Seated Eversion with Abduction Test is to determine late stance/pre-swing performance for the geriatric athlete. These components of upright performance are essential for dynamic upright balance activities, transfers in and out of the standing position and delivering efficient gait mechanics. Seeing the L AIC/R BC pattern in context with different components of gait allows the practitioner to make meaningful changes to gait deficiencies and upright balance and transfer problems. Preventing falls in these populations is by far the most meaningful thing you can do to preserve upright function.
Another powerful aspect of this course if the time spent on Functional Routines in the Home from both a patterned and a preferred standpoint. Thank you John Maynarich, OT for helping our class stay functionally minded throughout the course and for representing the profession of Occupational Therapy so well. You were right, this material is well designed for OT practitioners and should be an important part of all geriatric care. Our ability to make positive changes in daily functional routines really is the whole point, isn't it?
Lastly, I wanted to give a shout out to our 3 first-time course attendees in the class. Thank you Tom Borremeo, Christina Cherg and Fabrice Rockich. You guys were amazing. And thank you Carol Cahn, PT, PRC for personally bringing your friend and co-worker Tom to the course. As I said, you 3 newbies are VIPs from my perspective and it was an honor to cater the content of the presentation to your level of understanding as we went along. Thank you for being willing to ask questions and for the great class discussions you helped to generate. You literally are the reason the Affiliate program exists and we thank you for being there.
The New Year for PRI was kicked off with the first Cervical Revolution course hosted by Advance Physical Therapy January 18-19th. This host site is a Postural Restoration Center with some of the most experienced and professional clinicians I have ever met. Their experience and knowledge of PRI, Schroth Method for Scoliosis, pediatrics and working with dental professionals for occlusal reference is truly interdisciplinary and artful in approach.
Cervical Revolution has had a lot of "evolution" this past year with a refined, step-by-step description of atlas on occipital bone position that is clear cut and more easy to understand in the Right vs. Left TMCC. This weekend students learned to appreciate and understand what seems to be at first the challenging subtleties of atlas on occipital function. Visualizing how "A" on "O" drives the sphenoid and how the sphenoid positions temporal bones and ultimately the jaw for a tri-planer picture of how the neck, cranium and TMJ complex affects the entire postural system seems daunting to everyone at first. In this course, autonomics is a prime focus as the neck is the neurologic appendage that drives the rest of the body.
This high level PRI group of practitioners was engaged from the first minute on Saturday to the last minute on Sunday actively asking questions, contributing to the professional dialogue and just working really hard to take in the detailed insights of an advanced PRI course. And then, be enthusiastic about how to apply the basic concepts of this course on Monday morning. This weekend there was a strong emphasis on the basics with a straight forward path to application of course principles.
This was a dream course for any faculty member with this kind of energy and participation from students. What made this course rewarding for me was the staff at Advance Physical Therapy. It was such a comfort to be with physical therapists and PRC's Lisa Mangino, Jean Masse, Joe Belding, Susan Henning, Josh Olinick from STEPS for Recovery, Sangini Rane and of course Jennifer Smart in attendance. Jennifer Smart will be presenting at the next Interdisciplinary Symposium in April and her presentation is not to be missed! In addition, this group of veteran PRC's offered clinical discussion and were all lab assistants in one way or another to lighten the load for the entire class and elevate everyone's experience. Shout out to Angela Ellis, DDS who works with Advance Physical Therapy. She is a dentist and was a first time attendee to a PRI course and she could not have been more delightful and engaged! Thank you again Advance Physical Therapy for hosting Cervical Revolution and supporting PRI.
We are excited to announce and congratulate the Postural Restoration Certified (PRC) Class of 2019! PRC credentialing is the result of completing multiple advanced PRI courses, demonstrating a thorough understanding of the science through completion of the PRC application, and successfully participating in practical and analytical testing. This week, 14 clinicians earned the designation of Postural Restoration Certified (PRC) under the direction of Ron Hruska, Lori Thomsen, Jennifer Poulin, and Jennifer Platt earlier this week.
The Postural Restoration Institute established a certification process in 2004 as a way to recognize and identify those individuals with advanced training, extraordinary interest and devotion to the science of postural adaptations, asymmetrical patterns and the influence of polyarticular chains of muscles on the human body as defined by the Postural Restoration Institute. The PRC credentialing program is available to physical therapists, physical therapist assistants, occupational therapists, and chiropractors who have attended PRI courses, demonstrated a thorough understanding of the science through completion of the PRC application, and successfully participate in both clinical and analytical testing. To date, 215 professionals have earned the designation of Postural Restoration Certified (PRC).
To view/download the photos click here.
Back Row (from L to R): Jennifer Poulin, Eric Ley, Craig Stasio, Brian Coleman, Samantha Red Anderson, Laura Mills, Noelle Ekonomou, Brent Henderly
Front Row (from L to R): Ron Hruska, Maureen Moore, Rachel Rand Smith, Valerie Chai, Lisa Simmons, Carol Jacobs, Kazufumi Nishimura, Michelin Carroll, Jennifer Platt, Lori Thomsen
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.
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.
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.
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.
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.
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.
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.
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.
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.