Clinicians

Recently I had the pleasure of travelling to Charlotte NC to teach my last PRI course of 2022, Pelvis Restoration! I was so happy to be joined by no other than my biggest supporter, my husband, Chris Poulin. Chris joined me to help with the lab and answer questions regarding the material presented. It is always great to have him with me, of course, but also to provide insight on application to Athletic Trainers and Strength and Conditioning Specialists. This course is one of my favorite PRI courses not only to teach but to use clinically. It is truly an integrated course when it comes to the discussions of respiration as it relates to the pelvic inlet and outlets. I had several new clinicians and almost half of the class considered themselves Pelvic therapists. I love to have conversations with new clinicians familar with the Pelvic Diaphragm, especially those that do internal work. Their contributions to a challenging patient population, do not go unnoticed. Clinicians familar with the work of Paul Hodges appreciate the integration of respiration, abdominal control and frontal plane pelvic control. PRI sheds a new and exciting missing link to some patients that are not responding to treatment! Personally, I was able to spend some time with my family in Charlotte, enjoy a nice meal at Supperland and cheer on the App State Mountaineers that upset Texas A&M on Saturday night. Teaching PRI is one of my proudest professional achievements I have accomplished in my career. I am thankful for a short fall teaching season. I can now enjoy the next several weekends cheering on my first love the NC STATE Wolfpack Go Pack!! Thank-you to all that have learned from me this year. I am truly honored to be your teacher

Posted September 22, 2022 at 7:17PM
Categories: Clinicians Courses Science

Cervical Revolution came back to Lincoln this past weekend with a large zoom audience spanning internationally from Asia to North America to Europe. I had the pleasure of teaching to a live audience as well as having the added assistance of Louise Kelley, PT to help breakdown PRI concepts including  the finer parts of technique for de-rotation of the Right TMCC as it relates to not only the cervical spine but the entire system as well. In attendance was an impressive interdisciplinary group including movement specialists, strength and conditioning professionals, massage and soft tissue professionals, chiropractors, physical therapists, an osteopath, two dentists and one RN who is also a CSCS wanting to expand his horizons!


This is a course about the cervical spine and the need for revolvement that maintains alternation side to side, brainstem oscillation, temporal bone "wobble" and a jaw that can freely move side to side to keep a neck and nervous system in balance of an asymmetrical human that can stand erect and move fully and freely. Atlas and occipital bones make up a highly neurologic articulation with a brainstem and autonomics that are intimately connected to this highly reflexive region. This course is the gateway to the cranium and the introduction to top down as well as bottom up concepts of PRI. The cervical, cranial and occlusal systems are all integrated in this course and an impressive demonstration for all, especially the dentists, was provided with a simple mouth guard that Ron made for Louise the day before the course started. I demonstrated this stomatognathic example with Louise by first testing her cervical spine with a mouth guard that gave her right molar contact and reinforced her RTMCC pattern resulting in positive tests of her cervical spine. Another mouth guard was then utilized that dis-occluded her right molar contact while giving her left molar contact sense and all of her tests became negative immediately. This demonstrated the neurologic effect of a simple mandibular appliance on not only the cervical spine but the entire neuro-respiratory-biomechanical system.

Needless to say, this was communicated to me by a student as 'mind blowing' and brought an experiential example of the power of this course. Thank you to RJ for expert facilitation of this course over the weekend, Louise Kelley for being such a great lab assistant and team mate and Ron Hruska for spending Friday before the course reviewing advanced PRI concepts. Most of all, thanks for all of the students in attendance especially from international locations that stayed up really late or got up really early and for all of the diverse professions that contributed their advanced thought and experience to the enrichment of this weekend.

Posted September 13, 2022 at 8:12PM

The skepticism I had 42 years ago, as I graduated from a Physical Therapy program, regarding models of education and health care practice remains with me today. I pursued a Masters in Public Administration to learn how cities, administrations, etc. collaborate and communicate for the benefit of the inhabitant. I learned a lot about business, how the top of the pyramid develops and what paradigms, courageously were successfully encountered and embraced.


When I read the forward of Dr. James Calson’s book ‘ Physiologic Occlusion’ I remember thinking about his comments about “societies” and how much I agreed with his philosophies. He wrote, “Dental societies, associations, foundations, and academies sponsor journals and other publications for the dissemination of scientific articles to the dental community. It is interesting to me that all are accompanied by length bibliographies. I wonder who wrote the first dental paper and what the bibliography included.  Sometimes it seems that authors are compelled to have large bibliographies to satisfy the critics and skeptics of new and compelling information. Could it be that they are afraid to ‘stand alone’? Afraid that they won’t be accepted on the merits of their own work? Afraid to say anything that is not based upon the work of others who are already accepted and respected in the dental community? I may be wrong in that assumption, but I don’t think so. Copernicus, Einstein, Columbus, Leonardo da Vinci, and many others challenged the current thinking of their age, and today we live with the benefits of their Paradigm Shift.”


Having the opportunity to share and discuss my thinking regarding the Stomatognathic System with someone whom I have always considered a silent mentor, for so many reasons, is truly an honor. This opportunity, probably will not come again in our lifetimes, and for that reason alone, I am so grateful. Dr. Carlson is a giant when it comes to education and paradigm shifts.

 
“Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is – His good, pleasing, and perfect will.” (Romans 12:2)

- Ron Hruska

Someone once said, “you don’t know what you don’t know.” So, it is with those of us who are “students” including me. For almost 30 years I have been traveling from home, both here and abroad, to many countries around the earth to share what I have learned to be true. In so doing, I have met several hundreds of people most of whom have been kind and hospitable including everyone at PRI with Ron, Jason, Jennifer, and RJ being tops on my list.

I was also most impressed by the level of the content of all the information that Ron and Jason presented.
My “world of dentistry” would be wise to listen to the knowledge and information that is being presented in all of your programs.
That might just make a difference between “knowing and guessing.”

- Dr. James Carlson

CLICK HERE to view the full photo album.

Posted May 25, 2022 at 9:07PM
Categories: Courses Clinicians Science

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.

Posted May 5, 2022 at 9:06PM
Categories: Clinicians Courses Science

Last week, at our Annual Interdisciplinary Integration Symposium, we presented the PRI Director’s Dedication Award to two very deserving individuals who have had such a positive impact on our Institute; Joan Hanson and Robert "Skip" George. Although they were unable to join us in-person for the symposium this year, we knew we didn't want to wait to present them with this award, and so we did so virtually, with 40 in-person attendees and approximately 90 others watching on the live stream feed. The PRI Director’s Dedication Award was established by the Board of Directors (Ron Hruska, Janie Ebmeier, Jennifer Platt and Bobbie Rappl) in 2012 to recognize individuals’ ongoing dedication to their advancement in PRI. To date, we have presented this award to 18 individuals and an award recognition plaque, which is pictured above, is displayed at the Postural Restoration Institute® in Lincoln, Nebraska, recognizing each of the PRI Directors Dedication Award recipients.

Joan Hanson is a Physical Therapist in Sioux Falls, South Dakota. Joan began her PRI journey 22 years ago, with a Protonics course, and since then has taken 32 PRI courses. She completed PRC credentialing in 2005, as part of the 2nd class to complete PRC credentialing. Joan owned an outpatient clinic, Physical Therapy Solutions in Sioux Falls, prior to merging with Sanford Health; now operating as Sanford Physical Therapy Solutions. Joan continues to make her presence felt in the PRI community, by attending courses in Lincoln on a regular basis, contributing questions and responses to peers in the PRI Google group, mentoring the colleagues at her clinic, and being an avid PRIVY fan, who regularly asks questions that prompt further PRIVY discussions. I have no doubt that Joan has watched every PRIVY, and many of them more than once. Joan is a life-long learner, and that includes merging other approaches with PRI for the best patient outcomes. She recently completed a week long Schroth training, and looks forward to integrating this approach within her practice. We feel like this award is long overdue, and we were so honored to present the PRI Directors Award to Joan Hanson.

Robert "Skip" George is a Chiropractor, who now resides in Logan, Utah. However, Skip spent much of his life and career in La Jolla, California, before moving to Utah this past year. He traded in surfing for weekly skiing or hiking, depending on the season in Utah. Skip took his first PRI course in 2012 and he completed PRC credentialing in 2014, becoming the first chiropractor to complete PRC credentialing. Skip was invited to begin training to teach on the PRI faculty, shortly after he completed PRC credentialing. He began teaching Postural Respiration in 2016, and Cervical Revolution in 2020. Skip is passionate about growing the science of Postural Restoration in his profession, and he has presented at numerous national, state and even international chiropractic conferences, including the American Chiropractic Board of Sports Physicians annual conference, the American Chiropractic Association Rehab Council, the American Chiropractic Association, and the German Sports Chiropractic Association, among other state conferences. Skip is presenting next month at the California Chiropractic Sports Symposium on the “Two Roles of the Diaphragm for Chiropractic Care, Rehab and Sports Performance”. Skip is a vibrant member of our faculty, who is constantly wanting to learn more, and has become a wonderful mentor as he assists others in their training to teach PRI courses. We were incredibly honored to present the PRI Directors Dedication Award to Skip George.

Congratulations to both Joan and Skip! We are so honored, humbled, and proud to have you as friends, colleagues and PRC providers representing this Institute!

The pacific northwest has been a PRI hot bed for several years. The enthusiasm for the science and clinical application of PRI is palpable. It was my honor to have the opportunity to teach a fantastic group of movement professionals in Seattle. We had five PRC's in attendance for this newly updated I&I course.  

This course is the perfect gateway to several PRI courses, including Cranial Resolution, Forward Locomotor Movement, and the Primary Non-manual Techniques Workshop. Our conversation starts with introducing the neurological learning process that the body needs in order to inhibit patterned behavior: alternating compression and decompression. This important concept is the foundation we build from as we progressed from the calcaneus to the femur and pelvis and into the scapula.

 

Founded in the concept of alternating compression, we were able to delve into medial and lateral hamstring relationships, as well as when and how to apply the right serratus anterior and subscapularis into a program. Along the way, the necessity of compression of talar bone and calcaneus, and management of pelvic inlets and outlets provide the necessary sense the body needs to allow the body the freedom it desires above T8.

I cannot thank the staff from Alpine Physical Therapy enough. Jeremiah Ferguson, DPT, PRC, Christopher Murphy, DPT, PRC, and Eva Bilo, DPT, were the perfect hosts. A huge shout out to their friend who was kind enough to loan us his projector for the weekend. It would have been a very different course without his generosity. My sincere thanks to the Alpine crew for all of their help.

We were fortunate to have a great mixture of seasoned PRI veterans as well as several who are relatively new to PRI. My thanks to Trevor Corrado, Jeff Fjelstul, David Shamash, and Katie Schaner for their willingness to ask questions.  In addition to the Alpine staff, it was wonderful to have Erin Coomer, Zach Hawthorne, Wren McLaughlin, and Betsy Baker-Bold contribute their experience and perspective to the audience. It was helpful to have others in the audience provide their clinical validation to the topics of I&I.

Many thanks for a wonderful experience in a truly gorgeous region of the country!

Posted April 13, 2022 at 4:09PM
Categories: Courses Clinicians Science

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!

Where Would We Be Without Interference? Our Recovery Depends On It.

After talking about the molars influence on “grounded” movement and the canines influence on “guided” exploration, I become more mindful about the direction, both the Institute and these teeth have always had on the influence of “posture”. Our recovery of food going down the wrong “pipe”, our recovery of losing our balance when slipping on a rug, our recovery of mis-pronouncing when using familiar vernacular, our recovery of our visual focus when we misjudge objects in the distance, our recovery of our anti-gravitational unilateral abdominals, hamstrings, and triceps, our recovery of our breath......etc. all require a sense of ourselves, our interoception, our ‘centric’ presence, that is given to us through occlusal and podal interference.   

I have evolved my life around these human grounded and un-grounded concepts of reference and restraint guidance. And I am only hopeful, as illusory as the concepts, research and corollaries that were provided in this very highly integrated course on teeth and feet are and can be, that health care providers will appreciate how to “recover” better through the integration of the ‘floors’ the maxillae, and the ‘floors’ the feet depend on for postural balance. I am enlivened for those dentists and movement specialists who decide to immerse themselves into the world of recovery, by addressing how to put the neck to rest, through pterygoid, palatine, and plane alternation. The resonance of recovery is the most grounded state one can accomplish. Simply because the action, the guidance, and sense of limitation, which is what the sense of interference provides, protects and relaxes our necks and essentially, us.

If after reading this, you become more curious about our need for balance built off of interferences, please consider taking this course, offered on October 14th and the 15th, or consider attending this year’s Spring Symposium on “The Stomatognathic System: An Interdisciplinary Approach In The Management of Spatial Navigation and Structural Strength” on April 22nd and the 23rd.

Melissa Truska, thank you for balancing me out those two days. With you on my left and Jen Platt on my right, I felt so grounded and supported, as a presenter in front of a screen of so many I truly wanted to personally interact with, individually. There were countless questions, that were answered by Jen Platt. I appreciate her so much. Her talent and historical presence in this Institute allows me to do what I appreciate doing. And that is presenting material that has foundation, regardless of how familiar one is with that foundation of science. PRI applications and techniques, are built off of and around my beliefs, practice and principles. And Jen and her staff keep me, the faculty and all of us grounded, secured and consistent, in a world full of confusion and mis-interference.

Posted April 1, 2022 at 2:12PM
Categories: Clinicians Courses Science

I had a great time this weekend in Lincoln NE, at the Postural Restoration Insitute. I had the pleasure of teaching Myokinematics of the HIp and Pelvis to 12 in person and 55 live stream attendees. The Institute continues to grow and it was my pleasure mentoring both Jason Miller and Craig Depperschmidt. They were not only my lab assistants for the weekend, but they both jumped right in to help me teach the Sunday afternoon clinical application of both facilitation and inhibition non manual techniques.


I really enjoy teaching and helping both new and seasoned PRI clinicians along their PRI journeys. We had some great discussions on the differences between orientation (uncompensated) and compensations that are commonly seen at the FA joint when a pelvis gets positioned in a L AIC pattern. No two courses in PRI are taught the same and this course was no different. I had the privilege of sharing my 20 years of PRI clinical experience and 11 years of teaching with this weekend's course attendees. We had fun using some of my favorite musicians references Lady Gaga (born this way), Beyonce (to the left) and new to 2022 Dua Lipa (Levitate)! Go get those 5/5 HADLT and see those patients levitate off the table! Cheers until we meet again PRInation! Thanks to Kevin Fay for giving me yet another musical reference from Idina Menzel (let it go) to help us all remember how important inhibition is early in a program!

Posted February 23, 2022 at 4:53PM
Categories: Clinicians Courses Science

The Impingement and Instability course was the kick-off for PRI in 2022, and I was fortunate to be able to have several friends and colleagues in the audience. With this course being updated only two years ago, it has a decided different feel compared to the previous iterations. We were fortunate to have nearly 50 attendees via Zoom from 10 different countries, and 8 movement professionals in-person. With so much PRI experience "in the room", both in-person and virtual, we were afforded the luxury of delving into the neurology of PRI.  

Our ability to make substantial and long-standing change to our posture is dependent upon our ability to change how our brain perceives the environment and gravity.  This course explains how that occurs and why reference centers are a better "road map" for us to be able to modify our patterns and habits.  Starting at the calcaneus and talus, we discussed integration of the femur and why we need it to be unstable, which lead us to the pelvis and why pelvic inlets and outlets are linked to the calcaneus.  We were able to spend nearly 4 hours on linking the scapula and underlying thorax to the pelvis and femur and calcaneus.  Our ability to compress and decompress several different "floors" on each side allows our body to make sense of this Morse Code-like alternation for improved posture, patterns, and respiration.  

My thanks to the entire crew from Edge Physical Therapy: Beth, Mike, Brett, and Eric. Thank you for your questions and dialogue. And thank you to Meg and allowing us to learn from your experience of what it finally means to feel the floor under your feet.  And thanks to Lori Thompson and taking the time to go through the Shoe List.  That was a perfect conversation at the part of the course, and I truly hope those in attendance understand just how unique that experience was for all of us.  Thanks to all of those who attended, and here's to a wonderful 2022!

Posted January 20, 2022 at 11:04PM
Categories: Courses Clinicians Science
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