Science

The "flagship" course in PRI is Postural Respiration because how and where air enters our body facilitates how the rest of the body performs. This is a very dense course with a lot of research and neurology behind the musculoskeletal ramifications of faulty airflow patterns. The huge advantage this live-stream course provided is the ability of the course attendee to go back and listen to the course material again for two weeks. We were fortunate to have a few in-person attendees as well as many on-line live streaming attendees.

I've had the pleasure of teaching via live-stream several times since March of last year. However, this was the first course I've taught that had a lab component since November 2019. It was very rewarding and refreshing to have the opportunity to interact with in-person humans again during a PRI course. I have missed the human interaction while teaching PRI. I know that all of the PRI faculty feel the exact same way; Ron probably more than any of us. It was a very enjoyable experience.

90-90 Hip Lift, Postural Restoration, Postural Respiration

We were able to dive deep into the neurological ramifications of human asymmetry, the potential role of dynamic respiration, and the potential negative affects of patterned respiration. Once we were able to fully delve into neurology of respiration, the AIC and BC patterns relative to respiration became a more fluid learning experience. The discussion around the left diaphragm's need for a team of muscles to assist in its endeavor to perform inhalation as well as the rib and sternal mechanics behind trunk rotation were topics of conversation that provided lively questions and conversation. These conversations permitted a deeper explanation into how and why Superior T4 Syndrome develops, as well as how to assess and manage it.  

The goal was to provide the attendee as much information as possible without overwhelming the new-to-PRI attendee. This opportunity is afforded to us by the live-stream event. With time to go back and listen to the information to help digest and understand topics that may be challenging or difficult, we are able to go a little deeper and a little faster into these concepts.

   

This course is different and has evolved over the last few years. If you haven't attended Postural Respiration in the past, or haven't attended in a while, I would recommend finding a way, sooner than later, doing so because of the many upgrades to this "flagship" course.

Posted May 27, 2021 at 4:10PM
Categories: Courses Science

We all know someone who experience difficulties with simple movements and at the same time can move or carry out, what appears to be more complex movements easily. This phenomenon of ‘Kinesia Paradoxa’ is one that is often seen with individuals who have been diagnosed with a basal ganglia disease called Parkinson’s Disease. However, by studying basal ganglia diseases we can learn so much about the precursors and the stages of this disease and its developmental patterns and symptomology. I believe, I have been on a journey of researching coupling and identifying similarities in people who have oscillator conflict at the caudate nucleus and putamen or dorsal striatum, at the subthalamic nucleus, at the globus pallidus, and at the substantial nigra pars reticulata, and didn’t really know it. For this is where the majority of our paradoxical function really begins, is initiated and looped. For these are the areas that make up the basal ganglia. Ganglia that reflect the parts of the brain that are not often even thought about, when sequencing steps in a “exercise”, or movement technique.

I always enjoy the amount of time, energy, thought and ideas that go into these PRI Symposiums. Ideas, that flow far in advance of the actual delivery of material and madness. I love every moment of these preparatory mental madness moments. Because that is what is exactly going on in our basal ganglia. Frenzied, chaotic, pandemonium mayhem, that can lead to periods of deranged decisions or a flow of indiscreet ideas. It’s the latter that we would never experience if we were controlled by frequencies of neuro-synapses that didn’t loop with other unfamiliar neuroreceptors, once in a while; like every 10 milliseconds.

Ron Hruska, Basal Ganglia Disease, Annual Symposium, Parkinson's Disease

Click HERE to view the full photo album.

There is a fine line between sanity and conflict. I personally need both in my life, and I am fairly certain you do too. Jennifer Smart DPT, PRC, Neal Hallinan CSCS, LMT, PRT and myself put a manual together, delivered content, and digressed into areas that reflect ideology of some of our most important ganglia we have. We enjoyed the time together in this presentation of ideas, in the preparation of ideas, and in the exchange of ideas that will hopefully strengthen the balance of movement associated with asymmetrical sanity and movement associated with symmetrical conflict. We, the speakers, learned so much from each other and the science that actually does support our zaniness and Zen-like ideas, all because of our respect for life’s paradoxes.

Here are a few of the comments we received from the class participants/attendees:

“Yes the material outlined "bigger picture" neurological influences on all humans that manifest as pathology in some. All people will benefit from this mindset of looking at human neurological function.”

“Love that these symposiums build on prior knowledge and become useful not as cookbook ways of treating patients but as ways to understand human behavior and provide frameworks to improve outcomes for all humans.”

“It brought the new perspective in how I look at Parkinsons and how big Inhibition is!”

“Just one fun thing. I was talking to my almost 91 year old mother who now uses a Rollator and she was asking about a stand up walker the night the course ended. Her next statement was funny (no knowledge of the course) and she said that the main thing she missed in her walking was "swinging her arms". I went down and worked with her with swinging hiking sticks in her hands (except I was using 2 reachers) and progressed her to using a trowel and hand clippers and she walked about 60 feet 4 times (back and forth in her driveway) unassisted and non stop. Cannot express how much fun it was to give her some freedom (she still loves to garden). Thank you all for a fantastic event as always. It is great to be able to go back an implement changes in my patients.”

“It felt balanced between the three presenters. I felt that Jennifer utilized her time the best, she did a good job of communicating her work, her experience, research, and I am grateful for her efforts. All presenters did an excellent job. Ron helped me to appreciate the basal ganglia, I really had never thought about this part of the brain in my day to day life and now it is imprinted. Neal was very engaging and enthusiastic, His passion moved me to appreciate dance and rhythm in a whole new way.”

“This Symposium was over flowing with important information about a new way of thinking for working with all our patients or clients, not just those with Parkinson's disease.”

“This was a great course to expand my knowledge of Basal Ganglia disease and treatment options. I have been certified in the LSVT BIG program for years but would also like to branch out and have other options for my patients. This course gave me lots of ideas”

The last comment above summarizes our basal ganglia’s ability to keep us resonating with bombardment of relaying information that allow us to flow with “lots of ideas” that are recognized and required for satisfactory frontal cortex creativity. And if we don’t occasionally fulfill our dopaminergic ideas, that we create, generate and plan, we may just be laying down the framework for future unplanned kinesia paradoxa, that we want to avoid.

Posted May 5, 2021 at 3:34PM
Categories: Courses Clinicians Science

Earlier this month, I was in Fort Collins, CO teaching Pelvis Restoration after 14 months out of the faculty circuit. For many reasons that will prove impossible to come close to articulating here, this course in review proved difficult to concisely write. These past two years, objectively, I have lost a lot—a child to disease, a dear co-worker to miscommunication, contact with a dear friend and colleague to culture, contact with another dear friend and colleague to a series of business casualties...to name a few. I mention these losses because I am certain this same window has been uniquely difficult year for most everyone reading this, regardless of where you find yourself. I’m sorry for each of your losses, yet very much hopeful.

Just through that window, I take heart, because I am confident that all of these losses are temporary, and will prove to be blessings, each in their own way, though I may not understand how presently. For certain, goodness was found in Fort Collins!  It is also difficult to encapsulate how thankful I am for my good, longtime friend and colleague Craig Depperschmidt, a 2012 PRC graduate and PRI hub in Colorado, to have welcomed me back to Fort Collins with undeserving hospitality. It was tremendous working with newer friends Brian Benjamin, who served tremendously as host site coordinator, as well as Rachel Kroncke, Sara Truelsen, and Ruth Waller-Liddle in the ProActive PT Center family who welcomed PRI and me into their work home fully. Thank you each so much for your warm welcome!

Pelvis Restoration course on asymetrical pelvic influence

Pelvis Restoration course on asymetrical influences of the pelvis

The course was akin to being back on one’s favorite horse—saddle and content were true and just as they should be. Many thanks to Matthew McLaughlin for great discussion during the course and during break times. Thank you to Jason Huang, Ryan LaFountaine, Jessica Robinson, Cristi Cuellar and multiple others for your help with demonstration during lab sessions as we explored the many facets of this primary course about a pelvic inlet and outlet. Many interactions during both lecture and lab about clinical application hopefully proved beneficial to experienced veteran course participants and to the six-pack of those new to the science of PRI. This instructor enjoyed the respectful and vigorous participation from the class as we discussed optimizing neuromechanical position and triplanar control of hemipelvic inlets and outlets in order to allow alternating integrated function of synchronized ipsilateral pelvic and thoracic diaphraghms. Thank you all from ProActive PT and PRI who made this course possible once again, it really was and is good to be back!

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

January 25th was recorded as the second highest daily snowfall in Lincoln of all time, dropping 14.8 inches of snow at a record rate. Between phone calls and emails while working from home, all of us at the Institute were busy “Digging Out”, while at the same time being driven further into a pattern. This same system (of snow) hit much of the Midwest by varying degrees, and many of you, like me, may be feeling the effects after hours spent pushing and plowing our entries back to the outside world. There are many considerations to keep in mind while performing any repetitive, patterned driven activity, and in respect to clearing snow, they are heightened by the exertion and work needed to move the literal mass in front of you. Any activity occurring “in front of you” poses challenges in itself because of the linear forward movement which is often repetitive. Many of these activities and considerations are highlighted in our “Restoring Alternation in Your Daily Lives” Patient Guide which was published last year.


When it comes to pushing snow, be mindful of the following.

When pushing snow on a flat surface, consider first your hand placement and center of mass, in relation to the mass being moved in front of you and the ground below you. The most natural position will be for you to instantly lower your right arm nearest to the blade of the shovel, and your left arm closer to your body. This will lead to your COM to shift over your right leg causing you to work through Right AF IR, Left Trunk Rotation, and Left AF ER positioning, while further driving your pattern.


Instead, consciously start by reversing the above position, lowering your left arm further down the shovel and placing your right arm nearest your body. This will allow your COM to shift to the left, leading to Left AF IR, Right Trunk Rotation, and Right AF ER positioning, while helping to minimize the above pattern. Over time it is likely that you will naturally re-adjust back to the first position as it is what your body is asymmetrically driven to. When possible alternate between these positions as much as possible to minimize some of the common aches and pains that occur from pushing snow in a patterned position!

Posted January 27, 2021 at 6:37PM
Categories: Science

"The new normal."  That's a phrase we all have heard many times during the last 10 months. As we are all adjusting to what that phrase means to us individually on a personal level, all of us are adjusting to what that means with regards to our relationships with each other as well. We are all finding new boundaries, and freedoms, associated with this "new normal."  

PRI opened the 2021 year with the newly revamped Impingement and Instability course, which introduces the concept that impingement and instability are both necessary and vital for optimal human performance. They provide new boundaries and freedoms that allow us to be able to oscillate between our two hemispheres of our body and brain. Our body needs to find a "new normal" with these new parameters in order to appreciate the left side of our body and the right hemisphere of our brain. As I reminded the course attendees, the question isn't "are you going to get onto your left leg?", the question is "how are you going to get onto your left leg?"  

This upgraded course introduces the neuromechanical concepts to answer the question of "how", as this course serves as a gateway into the other PRI Secondary and Tertiary courses, such as Forward Locomotor Movement. This is the material Ron was looking to introduce 20 years ago, and it is my honor to be able to help provide the neurological answers to the question "how are you going to get onto your left leg?" As we discussed during the entirety of the weekend, the how is rooted in one's ability to compress, or impinge, certain areas of the body, and decompress, or destabilize, other areas of the body. In order for the brain to appreciate these novel concepts, we need to provide the cortex of the brain with novel reference centers for proper inhibition of functional cortical dominance.

As we embarked on our "new normal, " not only in 2021, but in our cerebral cortical function, this course has now become much less of the orthopedic course it had to be several years ago, but has progressed into the neuromechanical blueprint for behavior modification that Ron had intended from Day 1 of the Institute. This course has always been my personal favorite of all the PRI courses offered because it is a clinician's course as it provided me a more integrated manner to apply the information I had learned in the three PRI introductory courses. My appreciation for this course has grown dramatically due to the necessary evolution from an orthopedic delivery to a neuromechanical, cohesive, and expansive delivery of PRI concepts. As the attendees of the course can attest to, Impingement and Instability helps our body's ability to appreciate the "new normal" from the inside out.

Posted January 21, 2021 at 5:31PM
Categories: Clinicians Courses Science

Happy New Year!

As we approached this New Year, I reflected on the the year that was 2020. As I transitioned into this new role of Executive Director at the beginning of this year, I could have never imagined the challenges we would be facing in just a few short months. I think most people would agree that 2020 was a year that none of us could have ever predicted, but even with the challenges presented from COVID 19, we were determined to make the best of it. And that’s just what we did! The events of 2020 really encouraged us to explore new ways to expand our ‘reach’. Although we already had our primary courses available online, we transitioned quickly to live stream virtual courses for our secondary, tertiary and affiliate courses, and this allowed us to reach interdisciplinary professionals from all over the world. Several live stream courses were sold out with 100 attendees, and many had at least a dozen countries represented. We are grateful that we were able to continue to reach you through PRIVY and podcasts, in addition to some new projects geared towards expanding our reach to the general public, including the ‘Restoring Alternation’ Patient Daily Living Guide. We also took advantage of the circumstances and reached thousands with our ‘PRI Breathing in COVID Times’ 9-week webinar series, which was (and still is) available online for both the general public and healthcare & fitness professionals. The word ‘reach’ has always been a staple of our Institute, and for those of you who are familiar with the PRI non-manual techniques, you have undoubtedly experienced the power of a reach. While our ability to reach you over this past year has been primarily through digital formats, we are excited to get back to reaching (with) you at our live in-person courses. We will be forever grateful for all of you who allowed us to continue to reach you during this crazy, uncertain past year that was 2020. It’s a year that we will never forget, but due to the circumstances that were presented, we now have many new means in which we plan to continue to reach you in 2021 and beyond.

Although we didn't print a brochure this year, you can see that 'reach' would have been the theme carried out within the pages of our Programs and Courses brochure. Please visit our website over the coming year for the most up to date schedule of our programs and courses. In addition to returning to hosting courses across the country this Spring, we are excited to be offerering over 20 live stream courses this year, and we will also have limited in-person attendance available for each of the live stream courses held in Lincoln, Nebraska.

We hope we have the opportunity to reach you, in one way or another, in this New Year!

Posted January 5, 2021 at 9:52PM
Categories: Courses Science
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