Science is all about expanding the realm of human perception and human sense. Life is both. This tertiary course allows me to discuss how a change in perception and sense of the visuo-spatial cortex, hemi-chest compression, upper extremity reciprocation and lower extremity alternation of mass management can influence dominance or patterned design outcomes.  A change in perception related to any one of these components, changes perception associated with the other three. This predominant component patterning, precedes our cortical and associated physical, physiologic and psychologic dominance in moving ourselves forward.   I asked two individuals who attended this course to provide some honest, visceral feedback about the material that relates to the assessment and treatment of functional cortical dominance. Thank you Andrew Hauser ATC, CSCS, RSCC, PRT and Robert George DC, PRC for the following insights.

"I feel like I could write quite a bit about this subject as everything I felt like I learned in Vision& conversations from both you (Ron) & Heidi all came flooding back, and then some. It integrated all of it, and I appreciated how good of a job you did regarding bringing up what was backed by research. Simple, complex and everything in between. It's tertiary for a reason, there is no doubt, but it felt like I could finally share what I had learned from you that others hadn't yet experienced. It put it into words. I'm sure each course will be different, yet the golden thread will remain.

Where to begin?! The FLM course brought concepts from the previous vision courses, advanced integration and the primary courses and truly integrated them into what is driving the show on a daily basis. Being able to take all the phases of gait and break them down through our visual processes, hemi-chest airflow, upward limb alternation and how the lower half is responding & supporting these components of forward locomotor movement was a revelation. Understanding the biased-cortical / hemispheric "need for speed" and our abilities, as practitioners, to slow everything down may have turned this into a course on psychology, that wasn't a course on psychology. I think they just took the lid off of Pandora's box." - Andrew Hauser

"Last weekend Ron presented FLM and for this faculty member it was an experience that opened the door wider to PRI tertiary principles.  Integrating Hruska hemispheric components of vision, hemi-chest wall airflow and upper limb alternation first, then considering lower limb alternation, really cemented the basics of forward locomotor movement.  The course also opened the door to more questions for me especially when Ron was talking about the “trombone” effect of near and far vision for FLM.

I called Ron after this course today with not only questions but a realization that this last weekend so many light bulbs went on in my head that opened a gateway to somatosensory topics.  I must confess when I took the vision course several years ago, I didn’t understand much after words!  I was just learning to teach the basic mechanics of primary course work and was overwhelmed by what seemed to be a really complex subject.  After this past weekend, not only did the vision course make more sense, but tertiary course concepts from Cranial Resolution and Occlusal Cervical Restoration became more clear as the sensory and motor components of coordinated and balanced movement were revealed.

One of my questions for Ron was regarding Functional Cortical Dominance.  In our talk today, Ron was discriminating between cortical dominance as well as individual pre-dominance developed over time.  In Postural Respiration, we present the very basics of the left half of brain contributing to right sided dominance.  But the discussion is much more complex including what we see, hear, feel, sense from the ground, temperature, where sound is coming from and the visual kinesthetic sense of movement and flow of things going past us.  This is a short list of sensory input in addition to a psychological component of how we respond to the mystery of being alive for a sense of well being!

In a recent walk I had in nature with Ron and Robin, the topic of discussion was the very human hunger and need of having a sensual experience in nature for our mental and emotional wellbeing.  Filling our senses the sight of waterfalls, rivers flowing into pristine lakes, seeing  the varieties of color, wildlife and trees  all fill a need for a sensual experience.  Ancient natural sound that we have heard as humans for thousands of years like the sound of wind in tall trees, flowing water falls, a thunderstorm and the sound of wildlife including birds and a coyote call are all in our DNA.  The mille-second processing of natural sounds orient us in time and space and even feeling the wind on one side of our face gives us a sense of direction and orientation as well.  Becoming conscious of and feeding all of our senses we all hunger for but have become unconscious or disconnected from in a converged modern world.  These somatosensory experiences expand our awareness, feed our mind and emotions beauty and inspiration and allow for the joy and freedom of movement that is rare in a paved over, domesticated and confined modern experience we just assume is “life”.

 Sensory processing though our five senses is a complex, multilayered experience affecting all parts of our brain all at once with horizontal and vertical movement, flow and forward motion and a mental and emotional response that is processed unconsciously and consciously instantaneously.

Ron asked be for a brief recap of my brief discussion today and as I see it as movement specialists in PRI, expanding and becoming more conscious of our own sensual acuity with the purpose of understanding not just human movement, but providing a path to more sensory awareness, internal mental and emotional fulfillment and well being for our patients and ourselves is a worthy endeavor." - Skip George

The clinicians of Lancaster General Hospital are pros at hosting PRI courses. Last weekend’s Postural Respiration course was their seventh. This instructor had moments of déjà vu, since LGH was the location of the first PRI course I attended, back in 2007. Two participants, Deborah Schrodi, PT, and Cathy Ingram, PT, were also in attendance at that very course 15 years ago! The surrounding Amish community, who eschew automation, provided an interesting contrast to our modern way of life and its epidemics of myopia, asthma, and loss of movement variability. These modern ills can be traced, by-and-large, to technological “advancements”.   

Underscoring the Institute’s interdisciplinary mindset, the class was comprised of a mix of clinicians, including physical therapists, physical therapy assistants, athletic trainers, massage therapists, and personal trainers. Many were new to the science, while others had multiple PRI courses under their belt.

The Institute continually works to update course material, adding research articles and patient photos and videos to illustrate and support course concepts. Our left and right hemi-diaphragms are different in size and have differences in abdominal support.  This “static asymmetry” creates a teeter-totter effect within our body, keeping us reflexively alive and providing a starting point from which to move. When this teeter-totter situation reaches a tipping point, we have only a “totter”. The right side remains pinned-down, grounded, and compressed. The left side is held aloft, remaining ungrounded and decompressed. We cannot thrive in this state.

Our patterned, maladaptive hemi-diaphragm position and activity has consequences on movement, physiology, and behavior. Humans require oscillating compression and decompression of our lungs and rib cage to provide movement and ensure the health of our tissues, most notably the nervous system. An outward sign of this lack of oscillation is breathing pattern dysfunction, such as belly breathing, chest wall elevation, and superior T4 syndrome, the underpinnings of many of the syndromes that we treat.

Postural Respiration is a lab-heavy, hands-on course, better taken live, if possible. Participants came away proficient in performing and interpreting PRI’s objective tests to identify overactive left IAC, right BC, and B PEC chains of muscles and the pesky superior T4 syndrome. These patterns need to be inhibited so that we can efficiently and effectively inhabit the environment around us, without deleterious effects on our neuromusculoskeletal system.

A huge shout out to Frank Mallon, DPT, PRC, owner of Renaissance Physical Therapy in near-by Philly. Your expertise and instruction on the nuances of the Institute’s non-manual and manual techniques was invaluable!

Thank you to all who asked questions and provided clinical comments, keeping the energy level high. Thank you to our models, who enhanced the learning experience: Kirsten Ditzler, DPT; Kelly Faller, PTA; Eileen Herman, PT; Isha Mody, PT; Joesph Newton-Pretko, DPT; Kyle Price, PT; Lori Shearer, PTA and Michael Polejav, PT who all helped facilitate our learning.

Thank you to the LGH clinicians for your efforts in set-up and clean-up. I appreciated the opportunity to present this material at the place where my PRI journey started.

Pro-Active Physical Therapy in beautiful Fort Collins, CO hosted Cervical Revolution this past weekend. This was a unique gathering of not only first timers to Cervical Revolution but seasoned veterans of PRI including a total of four faculty members and four PRC/PRT's. Included in the group was a local dentist, Dr. Behar Esmaili, who brought an enthusiastic perspective on how occlusion affects the entire physiologic and postural system. The subject of a stomatognathic consideration to the cervical, cranial and occlusal system with the cervical spine as the primary driver of the system was reinforced this weekend.

Postural Restoration is an interdisciplinary institute and that was reflected in the backgrounds of the attendees. Cervical Revolution bridges a gap, as does PRI, with many professions with respiration sacred to physical therapists, the atlas/spine with chiropractors, the cranium with osteopaths and occlusion with dentists. Mix in ATC's and fitness professionals for performance and this course, as well as every other PRI course, has a wide appeal and utilization for many health care disciplines.

Having four faculty members in attendance is rare unless a course is given in Lincoln and the energy with vast clinical expertise of Louise Kelley, DPT, Jason Miller, DPT and Craig Deperschmidt, DPT was appreciated by all. Louise Kelley, DPT will soon be ready to teach Cervical Revolution and her ability to describe testing and non-manual techniques, especially the Standing Stomatognathic Squat, was a "bonus" contribution to the weekend and was also greatly appreciated. The discussion of the A/O articulation being highly neurologic/autonomic went from a theoretical consideration in opening remarks to real lab experience when several "extension driven" students, with PRI Cervical repositioning non-manual techniques, got to experience first hand what neutral feels like. Thanks to all of the Pro-Active Staff for hosting this past weekend and this entire group of professionals that took time out of their schedules to "revolve" with us!

I had a wonderful time teaching Pelvis Restoration in Bradenton Florida!  Thank you IMG Academy for hosting , Megan for being my lab assistant, and the course attendees for learning with me for the weekend.  

As always, we went into detail of the pelvis position anteriorly and posteriorly and left and right in the pelvis inlet and outlet.  How this position influences compression and decompression of the pelvic inlet and outlet and how the respiratory and pelvic diaphragms assist in treating the L AIC and PEC patterns to allow for lateralization to the left and right.  The course attendees stated that understanding PRI objective tests to assist with inhibition/facilitation of the L AIC and PEC polyarticular chain of muscles to assist with treatment to restore reciprocal and alternating movement was helpful.

It was a great class with great energy!  Thank you for spending your weekend with me.