Science

Advanced Integration and specifically the Integration symbol itself, represent one’s ability to integrate not only the Primary Course concepts, but also one’s ability to recognize the asymmetrical patterns of behavior themselves. In fact your predisposition, perspectives and past experiences will all dictate how you perceive this symbol and consequentially appreciate this 4 day course. Advanced Integration allows us to come together once a year, for a detailed, didactic and sometimes difficult discussion of the most advanced considerations covered in Myokinematic Restoration, Postural Respiration and Pelvis Restoration throughout the year. It allows us to welcome individuals with various degrees of professional practice, differing levels of clinical understanding and multiple locations of living across the globe. This year we were joined by our PRI Family from 26 states, as well as the countries of Malaysia, Australia, Iceland, Germany and Japan. With Valerie Chai (PRC Class of 2019) traveling 35 hours to attend, the dedication of these individuals is something that is continually humbling, and appreciated beyond our measure.


Our Japanese family continues to grow and integrate their own understanding of these concepts as they are now offering all three Primary Courses, and working to present Impingement & Instability in the year ahead. We are also excited to announce the creation of the PRP, (Postural Restoration Provider ™ ) credentialing program that will be offered in Japan in the years ahead. Following these four days we were able to spend an additional two days with the PRC class of 2019, and welcomed 14 new providers from these countries.


The four days of Advanced Integration included some of the best presentations we have seen from Lori Thomsen, Jennifer Poulin and a special appearance by James Anderson representing the concepts they teach throughout the year in the Myokinematic, Pelvis, and Postural course work. If you have not heard these individuals teach this material I highly encourage you to attend one of their courses in 2020, as well as any other Faculty Member that may challenge your current understanding by receiving a different perspective from a different presenter.


The fourth day in particular allows us to reflect solely on Curvatures of the Spine and the effects that Torsion, Torticollis, and too much Torque can have on our already twisted systems. Lisa Mangino, Jean Masse, and Susan Henning have truly spent the better part of their collective careers to understand these concepts and the chance to learn from their intervention strategies was truly a gift to us all.


It is hard to wrap up an entire year of PRI course work through this one four day event. However the opportunity it gives us to come together as a family and challenge each other in a positive manner is one that we never take for granted. As you reach towards the year ahead, may you all appreciate the journey this past year has been for you as we do each December. May you reflect on those that mean the most to you along that journey, and welcome the challenges that will continue in the year ahead.

Our PRI Family starts with our Faculty and Staff and extends from there to all of you. I wish you and your Families a Happy Holiday Season and an Integrative year ahead!   

Posted December 18, 2019 at 5:57PM
Categories: Clinicians Courses Science

 We had a super group of performance professionals come together for this year’s PRI Integration for Baseball course at Salt River Fields in beautiful Scottsdale Arizona. Awesome to have course attendees representing high school, collegiate and professional baseball performance from all parts of the United States, the Dominican Republic and Japan. A big thank you to the Arizona Diamondbacks for the warm hospitality and professionalism in hosting the course. We couldn’t have been treated any better.

PRI Integration for Baseball - Arizona Diamondbacks

I started the first day introducing key PRI principles and concepts for first time attendees and others who are new to the science. Fundamental concepts of performance breathing like Zone of Apposition (ZOA), diaphragm function, abdominal integration and abdominal regulation for breathing and movement were discussed. The Left AIC/Right BC pattern of developmental asymmetry was also introduced and explained, including objective tests used to identify this pattern clinically. We then demonstrated the respiratory changes and the positional orthopedic changes that occur when a Zone of Apposition is restored.

PRI Integration for Baseball - Arizona Diamondbacks

Ben Hagar, DPT, PRC took over on the second half of day one to take us through the mechanics of throwing and hitting. Wind Up, Stride, Cocking, Acceleration and Decceleration/Follow-Through were all discussed, including analysis of slow motion video to break down the movement into functional pieces that were easier to digest. Tendencies in each phase of throwing and hitting were discussed, including the patterned tendencies for a baseball player as a result of their inherent Left AIC/R BC pattern. This understanding of the pattern included the specific early and late phase tendencies for both right and left handed throwers and hitters.  

Positional and rotational performance tests for baseball athletes were provided in the seated position, the quadruped position and upright in standing to help guide diagnosis and treatment. Specific treatments for R BC, Superior T4 Syndrome and Repetitive Rotation Superior T8 patterns were discussed, with the majority of our time and attention being spent on Superior T4 Syndrome, because of its high prevalence in baseball. Ben went on to provide training activities for performance deficits at different phases of throwing and hitting for both right and left handers.

PRI Integration for Baseball - Arizona Diamondbacks

It was an honor to be there with such a super group and again to be able to partner with someone as dynamic as Ben Hagar. He continues to impress me with his understanding of rotational performance and his ability to orchestrate learning and to clarify challenging concepts for large groups in a classroom setting like this. Well done Ben and thank you to everyone in attendance. Your attendance made each one of us a little better.

Posted December 16, 2019 at 9:19PM
Categories: Athletics Courses Science

It was a great weekend in New York teaching Pelvis Restoration. We had 48 clinicians attending the course and 13 were attending their first PRI Course….they made it! Pelvis entails positioning of the pelvic inlet and outlet coupled with muscles facilitation and inhibition with respiration. It’s a lot. I felt the class did an amazing job absorbing the material and asking wonderful questions. Edmund, Sebastian, and Romina your thinking and questioning benefiting the entire class, thank you. Frontal plane appreciation with synchronization of the respiratory and pelvic diaphragm were emphasized with demonstration. Nicole is your left ischial condylar adductor still burning? Geri, I hope you appreciated frontal plane of the left inlet and outlet to re-direct airflow into the right apical chest wall and left posterior mediastinum. Physical appreciation of PRI is powerful, thank you both for letting me teach throught you to the class. The weekend went way too fast, I appreciated everyone and their willingness to come and learn. Thank you Dave, Cuyler, and Brendan and Finish Line for hosting. Neal and Sean thank you for lab assisting! I was able to see the Rockettes in their annual Christmas show,  it was specatular!  Bucket List for me since I was young. Thank You again!

Posted November 27, 2019 at 5:41PM
Categories: Courses Techniques 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

Getting to visit the beautiful state of Alaska is always a gift and if you haven’t been there before, you get a taste of the rugged and majestic way of life the minute you step off your plane at the airport. A beautiful bull moose graces the main hallway and a world record 459 lb. halibut graces the wall as you head down to get your luggage. Both of these beautiful creatures instantly remind me of trips I have taken to Alaska with my Dad and my son to catch salmon and halibut and to enjoy the great big Alaska outdoors. Great memories for me indeed.

Historically, my trips to Alaska began in 2011 when I traveled up to speak at the Alaska Physical Therapy Association annual conference at the Alyeska Ski Resort. Over 100 people listened to Myokinematic Restoration that day and the group struggled to appreciate the value of the science and to understand how the principles of PRI fit into what they “knew”. To be honest, we may not have had continued opportunities to grow PRI in Alaska were it not for one innovative pioneer who quietly sat in that class named Joy Backstrum, PT, PRC. Thank you Joy. Thank you for your patient, thoughtful, open-mindedness and for your commitment to be a mentor to your peers. Thank you for the difference your drive and persistence has made in so many lives from that first course until today. It was special to see the members of this Impingement and Instability class recognize that you are the reason they are able to be so far along in their PRI journey.

And thank you to the entire team at The Physical Therapy Place for being such great great hosts this weekend. You guys went out of your way to make sure I felt welcome and appreciated in every way. From making sure I had everything I needed to taking me to awesome Anchorage restaurants like Hearth Artisan Pizza and The Moose’s Tooth, you guys did it all.

This Impingement and Instability course went off quite well. We started the first day explaining how impingement and instability are actually good things, when seen in the proper context. Instability where you have previously experienced impingement and impingement where you have previously experienced instability are essential for the alternating reciprocal rhythm your autonomic nervous system seeks. Your sense of the floor and your sense of the PRI Reference Centers on both sides of your body help your autonomic nervous system appreciate this desirable rhythm.

Calcaneal instability, femoral instability, Ilial instability and scapular instability were all discussed in context with this desirable rhythm and variable autonomic function. When the body starts to look like a system where regions of the body rely on other regions of the body for what they need, then you can begin to move past introductory level PRI thinking into secondary and even advanced PRI thinking. This class is really fun to teach because it does such a good job bringing concepts together and it helps the course attendees advance to the next level without losing any fundamental components. If you haven’t taken Impingement and Instability in a while or at all, I hope you can join us for this innovative course in 2020. You’ll be glad you did.

Posted November 20, 2019 at 5:19PM
Categories: Clinicians Courses 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

Phoenix Arizona is a beautiful place to visit just about any time of the year, but early November in the Valley of the Sun is just about perfect. A big thank you to Jimmy Southard and the amazing staff of the LA Dodgers for hosting Postural Respiration, our flagship course. Also thank you to all of our wonderful course attendees and a special thanks to Aaron DeBord and Jim Wittekind for assisting me as lab instructors.

Postural Respiration hosted by the LA Dodgers, James Anderson, Postural Restoration Institute

The recently updated Postural Respiration course is fun to teach for many reasons. First of all, the research associated with the presentation on day one is comprehensive and clarifies concepts that have been fundamental to this institute since its onset. Emphasis on powerful PRI principles like Left Posterior Mediastinal Expansion, Right Apical Chest Wall Expansion, Autonomic Sense and Limited Functional Patterns take on new meaning in context with these newly included research articles.

Postural Respiration Primary Course, Postural Restoration Institute

Postural Respiration Manual Technique, Postural Restoration Institute

Another highlight is a new test to assess Standing Posterior Mediastinum Expansion. This group took the time to appreciate the the critical nature of this concept and to experiment with this new test and it really paid off. Many new ideas for utilization in a variety of settings were discussed and shared. Many eyes were opened up to what this institute has always been able to offer upright rotational performance and the autonomic variability for athletic performance and standing upright training activities. Fun to see and experience.

Standing Posterior Mediastinum Reach Test, Postural Restoration Institute

Thank you Jimmy Southard and thank you LA Dodgers! Always a world class organization with world class hospitality.

Posted November 13, 2019 at 4:27PM

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
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