Josh Olinick, DPT, MS, PRC has begun writing about the pelvic-calcaneal relationships seen in PRI. CLICK HERE to read the first segment of a three part series where he discusses the sagittal plane. Josh did a great job with this article and his illustrations help differentiate what is occurring in the right foot vs. left foot in a Left AIC patterned individual. Stay tuned for part two (frontal plane) and three (transverse plane) of this pelvic-calcaneal relationship series!

For those of you who know Ron pretty well or if you saw his Twitter posting yesterday, you have realized that he likes to know “What’s your story?” He enjoyed reading these recent emails this past week! Thanks for sharing!

I can’t tell you how excited I am by the work that you’ve done (and are doing), bringing together concepts and techniques from various disciplines, and building a unique and incredibly insightful approach to physical therapy examination, evaluation and treatment.  I realize that your work (as all of our work) is built on the shoulders of others, and I am not prone to hyperbole, nor have I ever had a hero; still, I am awed by the genius of your constructions.  I am reeling a bit from all of the information I have received in taking 3 of PRI’s courses in the last month, but everything I have learned has resonated strongly.  There are many patients who I haven’t been able to help, many more who I could never take to 100%, and I’ve always been very aware that I was missing something.  Though I have treated very few patients with the PRI approach thus far, I am convinced that this is the missing link.  I am a bit of a continuing ed junkie, have taken many hundreds of hours of courses (most of them excellent) and am in the process of completing my DPT degree, but I have never encountered coursework that was this inspiring.  It seems that you are grossly under-appreciated in the physical therapy world and I just want to thank you for all you have done and all you continue to do! 
- Carrie S.

All of you guys at PRI are amazing!  I hope that you know how important each of your roles is.  PRI is really changing the lives of countless individuals each and every single day.  It is not only the lives of the patients, but the family members and also the clinicians that are using this.  I, for one, was super frustrated with being a PT and was feeling pretty much like I was wasting my time before I fell into a PRI course.  It was the first course that Jen Poulin had taught and it literally has changed my life. I know that it is easy to get bogged down in our daily lives and our work and to feel like what we are doing is just ‘work’ or doesn’t impact people, but it does. - Lori S

Posted March 1, 2013 at 2:51PM
Categories: Courses Clinicians Science

Thanks to Josh Olinick for sending us this email…

Just in case you guys don’t have this yet…(I keep realizing {and envying} the brilliance)

Vitruvius, the architect, says in his work on architecture that the measurements of the human body are distributed by Nature as follows that is that 4 fingers make 1 palm, and 4 palms make 1 foot, 6 palms make 1 cubit; 4 cubits make a man’s height. And 4 cubits make one pace and 24 palms make a man; and these measures he used in his buildings. If you open your legs so much as to decrease your height 1/14 and spread and raise your arms till your middle fingers touch the level of the top of your head you must know that the centre of the outspread limbs will be in the navel and the space between the legs will be an equilateral triangle.

The length of a man’s outspread arms is equal to his height.

From the roots of the hair to the bottom of the chin is the tenth of a man’s height; from the bottom of the chin to the top of his head is one eighth of his height; from the top of the breast to the top of his head will be one sixth of a man. From the top of the breast to the roots of the hair will be the seventh part of the whole man. From the nipples to the top of the head will be the fourth part of a man. The greatest width of the shoulders contains in itself the fourth part of the man. From the elbow to the tip of the hand will be the fifth part of a man; and from the elbow to the angle of the armpit will be the eighth part of the man. The whole hand will be the tenth part of the man; the beginning of the genitals marks the middle of the man. The foot is the seventh part of the man. From the sole of the foot to below the knee will be the fourth part of the man. From below the knee to the beginning of the genitals will be the fourth part of the man. The distance from the bottom of the chin to the nose and from the roots of the hair to the eyebrows is, in each case the same, and like the ear, a third of the face.

The preceding is the complete translation of the text accompanying Leonardo DaVinci’s Vitruvian Man. It is actually a translation of Vitruvius, as Leonardo’s drawing was originally an illustration for a book on the works of Vitruvius.

A while back we received a great question from Joyce Wasserman, PT, PRC on Tinnitus.  Read her question and Ron Hruska’s response…

“I am looking for references that link tinnitus to suboptimal dental occlusion or absence of centric occlusion. I’d appreciate any leads, names of journals or websites, that I should be looking at. Has any of the PRC therapists been able to help people with tinnitus, alone or in collaboration with a dentist?”

Tinnitus, or ringing in the ears, can be a very confusing and often poorly understood symptom.  Tinnitus and dizziness are the two most frequently asked about symptoms, both here in the clinic and through the internet.  From the reading that I have done, it is thought to occur when the brain areas involved in hearing spontaneously increase their activity.  Therefore, it is associated with virtually all disorders of the auditory system.  It is not limited to ringing of the ears, but may be perceived as whistling, buzzing, humming, hissing, roaring, chirping or other related sounds. 

There appears to be three forms of tinnitus.  The last is more of an osteopathic thought process approach.  Nonetheless, I’d like to cover all three briefly in this response to a question received by a PRC therapist about the relationship between tinnitus and dental occlusion.  The first most common form of tinnitus according to James B. Snow Jr., a physician at the University of Pennsylvania, and former director of the National Institute on Deafness and other communication disorders, arises from damage to the inner ear, or cochlea, caused by exposure to high volumes of sound.  Dr. Snow also states that drugs such as aspirin, quinine and aminoglycoside antibiotics, cancer chemotherapeutics and other ototoxic agents, and infections and head injuries.  He goes on to state that if the inner ear is damaged, input decreases from the cochlea to the auditory centers of the brainstem, such as the dorso cochlear nucleus.  This input loss may lead to increased spontaneous activity in the nucleus neurons as a result of inhibition that has spontaneously been removed. 

The second most common form or theory of tinnitus is autonomic nervous system stimulation from increased neuromuscular tension.  Retraining therapy, a process that can take a long time, often two years or more, can help reduce this tension from the autonomic nervous system.  This process is called habituation of reaction.  Tinnitus then becomes quieter for longer periods of time and eventually or hopefully will disappear or become a natural part of the background noise or “sound of silence”.  This is sometimes referred to as habituation of perception.  This won’t happen if or while the tinnitus is still classified by the person experiencing it as a threat, negative experience, an undiagnosed symptom, or while the individual is under a lot of emotional stress.  Many tinnitus patients have hyperacousis or high degrees of sensitivity to external noise and therefore they seek and search for quiet environments to work in.  In this respect, according to information from, they are their own worst enemy.  Supposedly, if strong beliefs about the threatening nature of tinnitus are maintained, the survival style or condition response mechanisms in the subconscious brain insure that it is continuously monitored and therefore the condition itself will not improve.  Imaging studies confirm increased neural activity in the auditory cortices of those experiencing tinnitus.  Their brains also show increased activity in the limbic structures associated with emotional processing.  Other symptoms that sometimes appear alongside tinnitus, such as emotional distress, depression, dizziness, and insomnia, may have a common basis in some limbic structure such as a nucleus accumbens. 

In addition to the two most common forms of Tinnitus, that is damage to the inner ear and increased tension from the autonomic nervous system stimulation, I find that there is a very strong relationship between tinnitus and those who are experiencing temporal bone disorganization or temporalis overuse.  Clenchers, grinders, and trismus oriented individuals often experience tinnitus associated with hyperactivity of musculature that is attached directly to the temporal bone which houses the inner ear.  There does not appear to be a relationship between tinnitus and externally or internally rotated temporal bones at this time according to the literature, however, it does stand to reason that this third reason for tinnitus is strongly related to the position and orientation of a muscle called the tensor tympani muscle that inserts on the manubrium of the malleus bone and originates or attaches directly to the sphenoid bone and the temporal bone.  It lies in our auditory tube and its main action is to tense the tympanic membrane along with the stapedius muscle of the ear.  It also contains cerebellar input related to the ability to adapt to vision as well as hearing.  Since this muscle makes the tympanic membrane taught if it is put in a position where it is lengthened it can also influence its own innervation by the mandibular division of the trigeminal nerve.  It can have a direct impact on the external surface of the tympanic membrane. 

The external surface of the tympanic membrane is innervated by the oriculo temporal branch of the mandibular nerve and the oricular branch of the vagus nerve.  The internal surface of the membrane is supplied by the tympanic branch of the glossopharyngeal nerve.  Temporal and sphenoid orientation, therefore, can have a both direct and indirect impact on the autonomic nervous system, trigeminal innervation, and vagal activity.  Clinically, keeping the temporal innominates aligned, stable, and functioning in a reciprocal manner with respiration and mandibular activity is important to keep the tympanic membrane, tympanic cavity, and septum of the auditory muscular canal aligned.  Through manual or non-manual techniques using PRI principles and philosophy, I have been able to change the frequency and intensity of this irritant.  Many of these same patients also need to be evaluated by a dentist with a strong background in TMD and occlusion and it’s always helpful to work with a dentist who has a cranial-gnathic orthopedic mind.  Being familiar with the different lesions of the cranium that can occur with malocclusion is always helpful in restoring proper cranial symmetry with a bite. 

In addition to this I’ve also had success in working with optometrists, specifically COVD trained optometrists, who presently understands the autonomic nervous systems influence on accommodation and tension across the cranium as a result of vestibular constraint secondary to visual and spatial lack of integration.  Hopefully, this overview will help anyone working with a patient experiencing tinnitus.  Obviously, we’re excited that the physical and physiological implications associated with tinnitus, can be corrected or reduced using methodology that diminishes the asymmetrical issues at the temporal region as well as the hypersensitivity associated with torque placed on the temporal bone itself. 

Posted March 17, 2011 at 6:35PM
Categories: Science

We recently had a course attendee ask some great questions following the Myokinematic Restoration course.  Please check out Recent Emails to see the questions and answers!

Posted July 1, 2010 at 2:32PM
Categories: Science

We received a great email regarding treatment of an anterior class I and posterior class III bite.  To read about it go to Recent Emails!

Posted September 21, 2009 at 4:13PM
Categories: Science

Look at all the asymmetry going on in this x-ray!  Notice the size difference in the obturator foramens, the asymmetry in the pelvic floor opening and the difference between the left and right head of the femurs.  This is a classic example of a Left AIC pelvis!

Posted August 7, 2009 at 2:45PM
Categories: Science

Take a look at the most recent picture we have taken of a classic Right TMCC pattern!  Do you see what we see?

  • Fullness and bulging of the right lateral face (zygoma region) secondary to increase of frontozygomatic angle.
  • Right temporal indentation compared to the left (right temporal internal rotation, left temporal external rotation)
  • Forward, opened, wider, larger right orbit
  • More visible left flared ear
  • Larger and more opened right nostril (especially seen with right torsion)
  • Increased distance between side of face and lateral ocular angle on the right side
  • Elevated right eyebrow

If you are interested to learn more about this, register for a Cervical Cranio Mandibular Restoration course here!

Posted June 29, 2009 at 7:48PM
Categories: Science

For those of you familiar with PRI, we thought you would find this intriguing.  This diagram was presented in the first course given by Ron Hruska.  The course was given in September of 1995 and was called “Postural Reconstruction - An Integrated Approach to Treatment of Upper Half Musculoskeletal and Respiratory Dysfunction”.  This is literally, the first sketch of the Left AIC, Right BC and PEC chain! 

Posted May 19, 2009 at 7:36PM
Categories: Science
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