Science

We had a huge turn-out in Minneapolis for the Postural Restoration Integration for Pilates course this weekend and attendees had fantastic questions!  We spent the morning of Day 1 nailing down breathing mechanics and  obtaining the Zone of Apposition and practicing it in lab even before lunch. We followed up by getting into the nitty gritty of the L AIC and R BC pattern and using the Reformer Supine Gait Integration Test and the Reformer Quadruped Abdominal Lateralization to test to see how well people could properly stand and shift over one leg and counter rotate the upper thorax ("legally"). We finished up day 1 with sagittal plane focused exercises.

 

On Day 2 we started with a heavy discussion on lateralized gait and understanding early-->mid stance and mid-->late stance in regards to the L AIC/R BC pattern. There may have been some dancing involved....like some sagittal pelvic tilts, frontal plane "hula hips" and transverse plane "salsa twists." Then we went through The Reformer Side lying Stance Test that really looks at the frontal plane followed by a lab of frontal plane exercises on the reformer. We finished up the day with talking about the principle of sensing, including cuing and special reference points for the hands and feet to promote L AF IR and R upper trunk rotation. The final lab added transverse plane integration including a personal favorite exercise of mine, scooter. We wrapped up the day having a frank logistical discussion on how does one start implementing these concepts without getting too overwhelmed, starting with getting a L ZOA and mastering the sagittal plane with a L hamstring. A big thank you to Kristin Procopio and Studio U, for hosting this rendition of our Pilates course at her beautiful new facility, and a shout out to Christine Peh who traveled all the way from Kuala Lumpur to be with us over the weekend!

Posted November 21, 2019 at 5:13PM
Categories: Courses Clinicians Science

In the later part of 2004 I met with Stan Babel through Karen Jiran MPT, PRC and Carrie Langer MPT, ATC, PRC. Stan who owned and managed Physical Medicine Diagnostics Rehabilitation (PD Midway) and wanted to build a pool. At that time I was really interested in hydrodynamics and had countless discussions with my brother who is an engineer regarding pump power, jet nozzles, etc. And more importantly I wanted to design a pool for patterned neuromuscular isolation and inhibition through the use of directional water to maximize specific aquatic afferentation, as well as compensatory push and pull recognized by the autonomic and central nervous systems. My first PRI Sequential Movement (PRISM) pool design was developed and constructed through Stan. All eight of the stations provide neuromuscular isolation and feed forward activation of groups of muscles to resolve postural related dysfunctional autonomic and physiologic behavior through the flow of water. With the arrival of this pool and its science, PDR Midway, became IMPACT Physical Medicine and Aquatic Center.


Presenting course material that is related to the brain’s lateralized hemispheric specialization and the autonomic nervous influence on our central nervous system’s compensatory behavior, fifteen years later, made my amygdala related emotional, sentimental and nostalgic feelings flow uncontrollably. Stan and his wonderful staff over the years has enabled me to continue to move in directions that I patiently outlined, ballooned and flowed with. I feel so indebted and grateful to him and his staffs over the years. Many of those affiliated with this integrated minded center were in this class.


This particular class also made me feel somewhat sentimental, because I have known most, if not all of them, for so many years. They were watched, observed, tested and judged by me. They were my independent, dependent and constant variables for my research effort on knowing when, how and what to deliver to get where we were on November 2nd, 2019. There were 18 Credentialed providers in the room that affectionately tolerated me being somewhat unfiltered regarding autonomic and central nervous systems and their influence on each other and our patterned behavior.  


This course is such a joy for me to teach and resonate around. Just as aquatic flow can re-balance, re-engage, and re-tense us, so can mandibular latero- molar trusive contact, sphenoid (pterygoid) and temporal (temporalis) oscillation, and palatopharyngeus  (diameter of the pharynx) and tensor veli palatine (diameter of the eustacian tube) ANS control. Before Stan, before the pools, before PRI certification, I remember a quote by Socrates that remains with me today. “I cannot teach anybody, I can only make them think” and I am grateful for those who continue to flow and follow thought processes that make them sequentially think.  

The staff at IMPACT are always such wonderful hosts. The morning breakfast, break food and afternoon warm cookies (thank you Stan) are so appreciated. Christie Amundson PT, DPT, HFS,PRC and Mara Brandsoy OTR/L, PRC have a system in place for courses like this. Their and their fellow team-mate’s effort does not go unnoticed.  I also want to thank Amy Pennaz PT and Catherine Shelton PT for their willingness to work with me in demonstrating how to resolve postural related dysfunctional autonomic behavior.

Posted November 19, 2019 at 10:03PM
Categories: Clinicians Courses Science

This was the last offering of Myokinematic Restoration for 2019. And what a way to end the year! We had a great group of chiropractors, athletic trainers, physical therapists and PT assistants,  strength coaches, personal trainers, and cranial therapists.  I was very excited to get to sunny northern California, as the we got 4-6 inches of snow the day before I left. Which made for a miserable Halloween.  

Fortunately, only treats and no tricks with PRI! This course affords us the luxury of spending a lot of time in lab.  Nearly 40% of the class is spent in lab, which provides the attendee ample opportunity to find, feel, and experience the science of PRI. This course also provides ample time for us to discuss, explain, and digest the Hruska Adduction and Abduction Lift Tests as a means of determining one's ability to walk and breathe. If walking and breathing require compensation, everything will require compensation.  

We had a great discussion about sympathetic vs. parasympathetic nervous system activity related to pelvic positioning, foot and ankle performance, and how the acetabulum position dictates femoral activity.  

My thanks to Shaun Buchanan and Joan Shepherd Mellows for hosting us and all the logistical work that goes into a successful weekend.  My thanks to Jenn Gaskin, Brian Schulman, John Garland, Cody Gilliss, Michael Serrano, and Tracy Henry for all of their great questions and help during demonstrations.  

But this weekend wouldn't have worked nearly as well if it weren't for Will Waterman, PRC, and Tim Dempsey, PRT. They were fantastic lab assistants and were a great help during the entire course. Without a doubt, they were instrumental to helping this diverse group digest this information. Looking forward to 2020!

Posted November 11, 2019 at 5:04PM
Categories: Clinicians Courses Science

Lima, Ohio. Home of the KewPee Burger!

This weekend I travelled to Lima Ohio to teach my last course of 2019. It is not the easiest site to get to, but it was so worth the effort. This course had 18 attendees of varying backgrounds. It’s nice to teach to a group of professionals with different perspectives. There were PT’s, PTA’s, Chiropractic Physicians, Athletic Trainers, Strength Coaches and a Pilates Instructor.  


We spent the weekend discussing optimizing patterns, breathing and compensations of the Pelvic girdle as they relate to frontal plane control of Inlets and Outlets. Most of the attendees were new to the science so teaching this integrated introductory course allows us to explore the integration of thoracic diaphragmatic breathing with Pelvis respiration to balance posture and gait.  Pelvis Restoration is known for its complex acronyms. I tried to move away from overuse of acronyms, and discussed proper position of inlets and outlets during upright function. I think this helped the new learner shift their perspective from orthopeadic thinking to the neurologic ANS control of patterns.

On Sunday, “Treatment Day!”, we discussed a pathway for treatment of the L AIC, PEC and the  Patho PEC patterned individual. We explored the triplanar position of the iliacus as it relates to swing and stance and sacro-iliac dysfunction. This is always an awesome opportunity to bring concepts of inhibition and activation of the same muscle in different planes of movement. This course allows me to dive deep into rabbit roles of pelvic respiration and thoracic diaphragm position. We had a great time integrating breathing throughout the weekend. By Sunday afternoon, the light bulbs were going off as were the “Ah-Ha” moments.

I enjoyed the banter with both Jason Russell, DC and Nick Goins, DC throughout the weekend. They were my Glut Gait guys! Jason, be nicer to Nick!
Carri Baumback, PT took her first course 10 years ago with Ron and brought her co-worker and friend Cynthia Nieberding, PT. It was great having them in the front row, not afraid to ask questions! Next time we have dinner ladies!

Alex Maag and his staff took very good care of me and our class. The interest in PRI in that great state of Ohio is growing. I look forward to seeing these clinicians grow and develop their PRI knowledge.


“When you go to Lima, you eat a KewPee Burger and rub the babies belly” - James Anderson
Well, I ate the burger but couldn’t reach the belly. Next time…..

Posted November 6, 2019 at 4:42PM
Categories: Clinicians Courses Science

Robert Newhelfen, DC, founder of Motus Integrative Health, describes his clinic as “a full integrative health clinic bringing new and unique treatment options to the people of Northwest Indiana.” In keeping with this vision, his clinic hosted Postural Respiration, a unique and integrative approach to addressing postural influences of rib torsion, inconsistent breathing patterns, habitual use of accessory respiratory musculature, and a positionally-restricted diaphragm. As in most PRI courses, we had an interdisciplinary group of course attendees, comprised of PTs, chiropractors, ATCs, and strength and conditioning experts in professional baseball and soccer. Also in attendance was Ruth Hennessey, MM, a vocal specialist well-known in the world of singing. Thank you, Ruth, for your insights into how singers develop faulty breathing strategies and retain undesirable tension that can affect their voice.

   

From the get-go, we discussed human asymmetry, most notably of the right and left hemi-diaphragms, leading to predictable patterns of muscle activity and movement. Our inherent asymmetry gives us a starting point from which we  shift our bodies and rotate. It is what an infant relies on to make its way from the womb to the external world. This applies to every developmental milestone, from crawling to running. However, when patterned muscle activity "goes rogue", from too much sitting or engaging in the same, repetitive activities, day in and day out, the results are patterned restrictions, injury, and fatigue.  

Course attendees served as one another’s case studies as they compiled PRI objective data to assess for both lower and upper body neuromuscular dys-synchrony and to guide treatment. Thank you to Rebecca Custer, DPT, and Wynne Conklin, CPT, our templates for the entire class for right BC over-activity and its pathological sibling, superior T4 syndrome. We discussed how this syndrome limits first rib mobility. The first rib is the driver behind the mechanics of the entire thorax and, therefore, must remain mobile! This course was updated a year ago. It includes a new test for the brachial chain as well as where, when, and what inhibition techniques fit into the treatment scheme. If you haven’t taken Postural Respiration in a while, it’s time for a refresher!


 
Thank you everyone for your thoughtful questions. Nate Kloosterman, DPT, OCS, gets the prize for most questions asked, keeping this instructor on her toes. A special thank you goes to Adrian Gutierrez, DC, for handling the set-up, food, sign-in, etc.   You were a gracious host and helped make this weekend an enjoyable experience.

Posted November 5, 2019 at 4:16PM
Categories: Clinicians Courses Science

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!

If you have attended Myokinematic Restoration in the past, but not since the course received a make-over in 2016, I suggest you strongly consider attending. If you haven't started your PRI journey, this course is one of the PRI introductory courses, and is a great way to begin that journey. A couple of changes that were made in 2016 that I appreciate compared to the version I first took in 2004 are that now we have a lot more time for lab, we are able to discuss and spend time in lab on both of the Hruska Lift tests, and we are discussing some ankle mechanics related to the L AIC pattern.

 

This most recent Myokin class is an excellent representative sample of these changes.  This class was nearly 40% lab.  So everyone was able to find, feel, and experience the muscles required to inhibit the L AIC pattern.  We were able to spend a solid amount of time on the Hruska ABD and ADD Lift tests with lab and explanation of both tests.  And we had a lively discussion about how calcaneal position and mechanics influence and are influenced by the L AIC pattern.

This class had a lot of great participation, as every single participant asked a question, which helps everyone learn. My thanks to Ken Guzzardo for hosting our course. My thanks to Amy Corbin, Amanda McDevitt, Jaclyn Marino, Ivan Salazar, Kristian Flores, Aidan Scotland, and Jamil Skakoor for their excellent questions and re-states. Really, my thanks to all the course attendees for their interest and many awesome questions.  

It was a true pleasure to have Neal Hallinan as the lab assistant. He's a PRI Black Belt, and he's speaking at Interdisciplinary Integration in April 2020. He's going to kill it! 

Posted October 28, 2019 at 4:48PM
Categories: Clinicians Courses Science

As one attends conferences organized by various boards and professional groups of education, it becomes apparent that many of them, no matter which organization is of the primary focus, are alike. This is now our second time attending the AAPMD Airway Summit, and it again was distinguishable from any other conference in the past. I believe it is important to understand the truly collaborative effort of all the organizations involved as the level of discussion was already set high because of the many disciplines present during these four days.


We were proud to join a long list of sponsors which included; The American College for Advancement in Medicine, The American Academy of Physiological Medicine & Dentistry, The Academy of Applied Myofunctional Sciences, The American Academy for Oral Systemic Health, The Institute of Physical Art, The Foundation for Airway Health, The North American Association of Facial Orthotropics, The International Academy of Oral Medicine & Toxicology and the American Academy of Craniofacial Pain.If you made it through the list above, it may be easier to understand the vastness of conversations had, professions in attendance, speaker topics presented and overall interest in integration. As I spent four days discussing and fielding various questions related to the relevance and strong presence of our Institute at this event, we immediately became aware of the potential and power that this science of Postural Restoration can have on a collaborative group of minds which we were surrounded by. After having these conversations between various Dentists, Oral Facial Myologists, Hygienists, Speech & Language Pathologists, Craniofacial Pain Physicians, and many other systemic health and physiology professionals, their desire for integrative and collaborative care was at an all-time high.


Many of them however were curious and sometimes cautious about where to begin, who to reach out to, and how those other professionals may benefit their patients overall plan of care and most importantly their treatment outcomes. Then comes “The Important Collaborative Role of PT and Airway Health” which was presented by Ron Hruska, Gregg Johnson and Brad Gilden. Which in and of itself was a milestone in the collaborative effort to introduce the important role PT’s have in viewing and treating airway and all other forms of dysfunction. Not only is the role of the physical therapist becoming more apparent but the roles of ALL individual professionals involved are becoming more appreciated. We were fortunate to have the presence of PRC, Steve Cuddy who has been practicing PRI and integrating with other disciplines in the Austin area for many years. Steve, it was truly an absolute gift to have you there as a representative of our credentialed providers across the country and abroad as these other professions look to you and others like you, who have become a PRI provider. The professionals mentioned above will be reaching out to all of you in the days, months and years to come, as a resource for integration of the science of PRI within their approaches of treating Airway Dysfunction and overall health!

“Attending the Collaboration Cures Airway Conference was an eye-opening, yet reassuring experience.  Eye-opening in the sense that the collection of airway-related issues is more complex and prevalent than, I believe, anyone truly understands.  Reassuring because I’m more confident than ever that we as PRI practitioners are uniquely positioned to play an integral role in the detection and treatment of obstructive airway conditions. Returning back to our homes, I’m sure that all attendees are more hopeful after listening to and meeting a wide range of passionate practitioners. This would include Ron who gave a few very insightful presentations.  I’m here to tell everyone in PRI Land that airway obstruction and the anterior neck are areas that we understand, thanks in very large part to the information that Ron has put together for us. My hope is that we make that clear to all allied airway health professions in our communities as we continue our own Postural Restoration journeys.”
Steve Cuddy

A huge thank you to Dr. Howard Hindin, and the AAPMD Organization for once again including us in this effort. Dr. Hindin was awarded the “Howard G. Hindin, Breath of Life Award” for his dedication and role in this collaborative movement and because of his efforts Airway Health has been brought to the forefront of Healthcare. Thank you again and we look forward to continuing our involvement with and alongside you all. Next year’s Collaboration Cures conference will be held in Seattle, on November 12-14th! See you there.

Posted October 23, 2019 at 4:44PM
Categories: Website Clinicians Science

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. 

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