Clinicians

I had the wonderful fortune to visit with Dan Houglum MSPT, ATC/L, PRC the day before this course was presented via live stream, beginning on Aug 22nd. Dan’s insight on the Institute’s past, present and upcoming future is always appreciated and questioned by me, simply because he places events, courses, course material provided in two or more courses, timelines, and approaches in an aligned state, for comparison, contrast and collocation. He and his career time have grown around this juxtaposition. He has an intuitive sense of how organizations operate by addressing and assessing this operational behavior, and therefore, he enjoys watching, and participating in, the delivery of the Impingement and Instability course; that was initially offered in 2007 without the ability of the attendee to compare it to another pre-existing course.  

The fact that the first course in February of 2007 can be compared to the last course presented in August of 2020, allows one to quickly see the similarities and the advancements. The fact of two courses, with the same title, written by the same author, can be placed close together with contrasting effects is called a juxtaposition. The juxtaposition of these two courses portray an image of position of bones in 2007 and a position of sense of these same bones in 2020. Dan took his first PRI course in 2004 and has had significant juxtaposition moments since. Juxtaposition is a word that describes the contrasting effect of two things that are placed side by side or close together. For example, two course manuals, with different dates and yet with the same information, may have juxtaposition when one of the courses have been updated, advanced or added onto. Another example of juxtaposition, is this course itself, by looking at cortical function of the human’s two sides of the body that are parallel to each other or “next to each other”. Instability on one side of the body may need to occur when the other side of the body, in the same region, is referencing impingement or the contact of two bony or joint surfaces. One side needs to cortically “loosen” up while the other side can “tighten” up.

   

This ‘positional juxtaposition’ helps us appreciate the need to experience instability, to remain on guard and prepared, as well as the need to experience impingement, to remain confident and in control, when we lose sense of composure. Parallelism of our two sides of our body, and their associated neurologic and orthopedic juxtapositions, has always been a strong interest of Dan’s, and having him by my side, when I taught this live stream course, gave me and everyone that was present, a considerable amount of favorable comparative contrast.

Posted August 31, 2020 at 9:35PM
Categories: Clinicians Courses Science

Page 22 and ‘The Room Where It Happens’  

On page 22 of this very updated course, the first bullet reads; “After significant reflection on historical ‘patterned occlusal pathomechanics’ of the teeth and corresponding feet over the years of clinical integrated interdisciplinary practice, I believe the human neck is the greatest neuromechanical mediator and indicator of treatment outcome.”  It was so enjoyable to put this course together and be able to write page 22. The organization and the establishment of content, beginning with a discussion on teeth and feet provisional occlusal interference, fulfilled my intense desire to explain how teeth and feet interfere and intercede on each other. Having twelve dentists present and willing to learn how postural mechanics are regulated by appendicular skeletal musculature interplay with oral facial skeletal musculature, was so gratifying. These dentists will play a major role in the future restoration of non-integrated feet and teeth mal-occlusal patterning. The interaction of these dentists, with other PRI minded, movement professionals, will help define what “true postural” occlusal restoration entails.

On page 22 of this very futuristic course, the second bullet reads; “Restoring normal occlusal patterns of function at specific stages of tooth to tooth contact/interference and foot to ground contact /interference, reduces cervical pathomechanics and related symptomology." This is the intent of this course …

I hope many more professionals, in the future, will want to be on page 22 where  “PATTERNED OCCLUSAL PATHOMECHANICS AND THEIR POSSIBLE UNDERLYING BIOMECHANICAL CONTRIBUTION” influence on interdisciplinary intervention decision processing, begins. I truly feel that there will be more of us in the future that will want to be like Hamilton, in the recent musical, when he said to “Mr. Burr, Sir”; “I want to be in the room where it happens.”  I believe all of our descendants, along with interdisciplinary minded professionals, will “want to be in the room where occlusion happens”.

Posted August 7, 2020 at 7:33PM
Categories: Clinicians Courses Science

Ron Hruska is excited to be an upcoming presenter for the AAMS Virtual Congress Reimagined. This virtual congress is featuring over 100 speakers in 9 tracks, over the month of August. Ron will be presenting on Friday, August 14th, on "Postural Interplay Between the Tongue, Teeth and Throat - A Novel Model of Interdisciplinary Integration". Virtual congress attendees are able to participate via live stream for the upcoming presentations, and attendees will also receive access to all presentations on demand until October 1st. CLICK HERE to view the program and register at www.aamsinfo.org/2020-congress.

Posted August 6, 2020 at 1:21PM
Categories: Clinicians Science

Teaching the Geriatrics Course via live-stream was awesome for a number of reasons. First, it was great to be in Lincoln Nebraska in person at the Postural Restoration Institute. You take something like that for granted when travel and human interaction is restricted the way it has been. I love being at the institute and associating with their staff because it reminds me of coming home to good friends and family. So good to see Hannah, Matt and Jen and to spend time getting caught up with all the fun events in their lives. It was also super great to have Jen’s expert assistance as the producer of the entire course experience. I couldn’t have done it without her and the amazing AV technology and teaching environment available at the institute. Thank you so much for ensuring that things went so well for the course attendees.

A second reason the course was awesome is that these live-stream courses give the instructor more time to discuss and practice the actual exercise techniques. The break out lab sessions to practice testing and treatments in traditional live courses become individualized learning sessions that can be taught very efficiently via live-stream. Not only are the tests and treatments taught more efficiently, but the recording of the course is available to the learner for further review at home after the course to solidify the learning experience. So I was able to teach, demonstrate and guide the course attendees through more of the actual exercise techniques with this new learning format than I am normally able to.

And the last reason the course was awesome was the actual course attendees and the things they had to contribute. We had a broad range of professionals from all parts of the US, across Asia and Europe. We were all together at the same time, irregardless of time zone, and shared in one another’s learning. There are too many of you to thank, but please know your attendance at the course and your contributions made the experience much better for all of us. The questions you asked via live discussion and via chat submission, together with the many comments shared throughout both days made the course especially fun for me. Thank you everyone and I hope the additional review days after the course proved to be a strong addition to your overall learning.

Posted July 28, 2020 at 8:43PM

We are excited to announce a Free “PRI Breathing Mechanics in COVID Times” Webinar Series beginning next week. We have been receiving phone calls and emails with questions on how the science and techniques of PRI can be applied to COVID-19 patients. What do we recommend, and why? Well, if you have been wondering the same, we will discuss all of this and more over the next several weeks on this webinar series.

As Ron discussed earlier this week in our Zoom Director’s Meeting, he feels like he has come full circle, that is 360 degrees from where he started almost 40 years ago; and where the profession of physical therapy started. Many of the first non-military patients that were treated in 1918, when the Women’s Physical Therapeutic Association was started, were children who were having difficulty breathing because of the Polio epidemic that ramped up in the United States in 1910. Chest physical therapy was well recognized by 1948 and physical therapists and physiotherapists around the world were taking responsible measures and opportunities to ‘restore lung function’ after acquiring an illness or after surgery.

In more recent years, several studies have questioned the use of intermittent positive pressure breathing (IPPB) machines and have caused many respiratory therapy departments to look to chest physical therapy as a replacement for IPPB. Respiration, ventilation and breathing are all influenced by our postural positions and patterns we are in at the time we are exchanging gas. Therefore, breathing mechanics are postural mechanics. The Postural Restoration Institute’s (PRI) concepts and scientific applications, are today used by many health care providers who collaborate with other disciplines that are mindful of the importance of keeping oral airway and lung airways open. This interdisciplinary practice reflects our early colleague’s effort in taking responsibility for the restoration of lung function through human mechanical intervention, prior to or following events that challenged lung airway position and drainage.  

Postural positioning is necessary for postural drainage, and the importance of coupling proper breathing mechanics with positioning enhances lung perfusion, expansion, and compliance to help fight off respiratory illnesses such as COVID-19 and to help acquire lung and chest wall function that speed up recovery following COVID or other viral acquisitions. This is why we are so excited to share PRI concepts, considerations and advice on how to keep your chest and lungs mechanically efficient and physiologically effective.

Just yesterday, a good friend and colleague, Cheryl Chase, PT, PRC emailed us and shared an old book that she pulled out of her desk titled “Postural Drainage and Respiratory Control, 3rd Ed”, which was published in 1971. Her colleague is going to provide an in-service on postural drainage, something that all physical therapy education programs cover, yet many PT’s have never clinically used. In the direct words of Cheryl, “I am so saddened by our current pandemic crisis, but also delighted that this current situation creates opportunities for new dialogues. It seems strangely serendipitous to coincide with the 20th anniversary of the Institute.” This message truly hit home. This is not how we imagined we would be celebrating our 20th anniversary. Yet, in some ways, it is blessing because with all of the messages and questions we have been receiving, we know that we can contribute to this opportunity for new dialogues amongst the general public and across multiple disciplines.

So, we invite you, and your friends and family to join us for this free webinar series, happening every Tuesday at 6pm CT (starting May 5th). Invite someone who has always wanted to know more about PRI, or maybe those who have questioned the “why” behind your use of Postural Restoration®. During this pandemic, we have witnessed humanity helping each other more than ever, and we are hopeful that the dialogues we can spread through this webinar will help thousands across the world.

*If you miss any of the weekly live webinars, they will also be posted to our website, so you can go back and view them later.

PRI Breathing Mechanics in COVID Times
Tuesdays at 6pm CT
CLICK HERE to register to join the webinar

*Pre-registration with your name and email will be required each week

Posted May 1, 2020 at 3:22PM

On April 18th and 19th our Institute hosted its first live stream course on the importance of maintaining and facilitating the tone and tension needed for 30 degrees of cervical symbiotic movement. Two cortical hemispheres, two communities of inter-neuronal highways, two lateralized sets of appendages and two autonomic systems of drive, that are all associated with one “neck” of their being.  Regardless of the side of the relationship that is more dominant, or more sensed, or more patterned around a vertical axis, or more associated with emotion, fear, decision making, or physiology, both sides have to communicate with biased biologic messages going up and down through their one and only neck.

   

A few minutes ago I finished a face time conversation with Maureen Henderson PT, PRC regarding our 20th year anniversary as an Institute. She also told me she would be sending me a book written by Robin Wall Kimmer, entitled ‘Braiding Sweet Grass’.  She said the book reminded her of our relationship and the role the Postural Restoration Institute serves for masting. Mast seeding, also called "masting", is the production of many seeds by a plant every two or more years in regional synchrony with other plants of the same species. Mast seeding is an effective defense because the seed predators become satiated before all the seeds have been consumed.

   

On November 3rd, 2001 Maureen attended her first PRI course, Postural Restoration (the name of this course was changed to Postural Respiration in 2004) on the campus of the University of Minnesota. She reminded me that she was tired and had jet lag but wanted to go to this course because of the inter-connectedness associated with the material in a course she received from a recent course she attended on ‘Protonics’ that was taught by Karen Swanson PT, through the Postural Restoration Institute. “The core of my being is that everything is connected and meeting you and hearing you for the first time satisfied my core”, was a statement that resonated with me, because we truly have similar DNA, similar thoughts about purpose, similar respect for nature and trees… Both Maureen, and my son, RJ, know that we are all truly connected, just as all trees are.

  

Trees and plants talk to each other using an internet of fungus. Hidden under our feet is an information superhighway that allows plants to communicate and help each other out. Mycelial networks of fungus allows individuals (trees) who may be widely separated, to communicate and help each other learn new ways to survive, commit new mistakes, and to boost their host plants’ immune systems.  Fungi have been called ‘Earths’ natural internet (Paul Stamets 2008 TED talk on “Earth’s Natural Internet”). Both the tree trunks and our human necks need biologic tone, social tension and regional connected support that is enhanced through “masting”, so that a few of us who breathe and respect the science of PRI can further nurture the evidence behind the need for 30 degrees of cervical rest. Our “masting” effort, our inter-neuronal highways, and our interconnected hemispheres just got a huge boost from live streaming on April 18th and 19th , through the use of the internet; just like the trees we walk under that are getting a huge boost from the Mycelia fungi that never stop networking.

Full Cervical Revolution Live Stream Photo Album

Kind Regards,
Ron

Posted April 24, 2020 at 8:38PM

Please check out this 6 minute video and accompanying blog article to learn a PRI based technique to help improve lung health amidst COVID-19.

It was a high honor for me to teach the updated Impingement and Instability course for the first time at Pro-Active Physical Therapy in Ft. Collins, Colorado. Preparing for this course over the last couple of months with Ron has been one of the more exciting and inspiring times in my career. I showed up on the first day of the course wearing a purple dress shirt, a color I have never worn for a PRI course in all my years as a presenter.

You may know that purple is the signature color of this institute, for many intriguing reasons. The color purple represents passion. It also represents royalty, and the institute’s longstanding acknowledgement of cortical function as the true king of human movement and performance. Wearing purple to this new updated Impingement and Instability course represented my newfound commitment to principles I have heard Ron talk about for nearly 20 years, but have not fully understood until I came to appreciate how he organized the new material in this updated course. I wore purple to declare that I am “all in” on concepts that I now realize have always guided Ron and that truly make this institute what it is, a neurological institute.

Impingement & Instability, Fort Collins, CO - James Anderson

We began the first day exploring the intriguing and powerful concept Ron has termed “functional cortical dominance”. On the surface it seemed like a novel concept. But in retrospect, it didn’t seem new at all, having listened closely to Ron develop and define this concept at essentially every Interdisciplinary Symposium since the institute started having them. We discussed sensory input from both sides of the body to both sides of the thalmus and midbrain, and the magic of the corpus collosum when assessing the pre-patterned sense our bodies and brains experience before they become a pattern. We also discussed the concepts of interoception, egocentric sense, esoteric sense, corporeal sense and compression sense to round out a truly “mind-blowing” sensory morning.

Postural Restoration, Impingement & Instability, James Anderson

And then our learning took on a new dimension when we brought Hilary O’Conner, PT up front for an exploration of some of these new concepts. Thank you Hilary for being willing to demonstrate your lack of intuitive sense on and for your sinister side, your inability to perceive your non-routine hand when standing on your routine leg and your inability to sense compression, centering and grounding on your incorporeal side because you lacked the necessary compressive sense across both of your scapulas. And all of this made it difficult for your hands to direct properly sensed and sequenced forward locomotor motion (a dynamic integrated full body sensory experience I used to inadequately refer to as mechanical gait).

Impingemenet & Instability, Postural Restoration Institute, James Anderson

Postural Restoration Institute, Impingement and Instability

Wow, really? Did I just say all that? We need to take a serious time-out at this point and state the obvious… this post sounds more like Ron Hruska than Ron Hruska himself as I look back at what I’ve just written. But the way he has designed the new course content really helps me appreciate more clearly what he has always been trying to convey to persistent and loyal PRI learners like myself. And he advanced my understanding of sensory integration and cortical function, without losing any of the longstanding content we have all come to appreciate in the Impingement and Instability manual, making the old material look quite new. Pretty cool Ron. Two words… patient leadership.

With many other things that could be said about the updated Impingement and Instability course, let me just summarize this course write up with the following. It’s a personal testimony in the form of a question posed by a very attentive and intuitive course attendee on the morning of the second day. Ben Hendricks, PT raised his hand and asked, “Is it possible that a person could feel more grounded on the left side just by listening to your presentation yesterday?” All I could do was smile and laugh as I looked around the room and saw the concepts sink in just a little further. From Ben’s written evaluation survey at the end of the course, I share the following: “Mind blowing! I was able to go to my left leg for the first time, just by listening to the lecture. Afterwards, by hearing to get onto my left leg over and over during that first day of lecture, and going back to the right leg felt different, as if I couldn’t go there as good as before. It doesn’t get more neuro than that.” 

Posted March 19, 2020 at 5:01PM
Categories: Clinicians Courses Science

“Lots of evidence-based practice.”
“I plan to integrate the information immediately into my practice.”

Thank you to Heather Golly, ATC, PhD, Beth Marschner, DPT, and Dawn Mattern, MD, faculty at Minot State University, in Minot, North Dakota, for hosting Postural Respiration this past weekend. We were able to sneak this course in before the travel and conference bans were enacted and had plenty of hand-sanitizer at our disposal!  

MSU was the host site for Myokinematics last year, so most attendees had that course under their belt.  It served as a springboard to understanding how the top half of the body, the thorax, influences and is influenced by the lower half.

Our ability to fully and properly compress and decompress our bodies – the thorax, abdominal, pelvic, and cranial chambers -- in the space around us is dictated by air flow patterns provided by hemi-diaphragms that are in position to do so.  This is compromised if abdominals, which wrap around the lower ribs and shape the hemi-diaphragms within to preserve their length-tension properties, aren’t sensed and facilitated.  Therefore, training the abdominals first and foremost for respiration, not core stability, is imperative.  All our movements and physiology, from HRV, digestion, and the ability to concentrate, depend on this.

One attendee grappled with when to consider prone “I’s”, “Y’s”, and “T’s” in their program.  This led to a helpful discussion, and paradigm shift, on the need to first address thoraco-scapular mechanics, as achieved by diaphragm position, rib cage expansion, and alterations of air flow patterns, before introducing scapula on thorax activity.  Without proper respiratory mechanics in place, muscles of the scapula acting on the thorax are simply out of position and lack meaningful leverage to provide safe, effective cervical and upper extremity joint performance.

Everyone appreciated and learned from those who stepped up to demonstrate non-manual techniques and to act as patient models for lab:  Stephanie Boespflug, PTA, PRC (my fellow PRC 2011 alum), Beth Marschner, Kirk Mason, DC, Terry Quijano, ATC student, Rebekah Rye, ATC, and Shane Williams, ATC student.  They enhanced and clarified how we define R BC/L AIC patterned activity and how we differentiate this presentation and its treatment considerations from that of superior T4 and B PEC compensations. Thank you also to Kari Harris, DPT, and Heidi Folk, PT, for adding to the discussion with insightful questions and personal clinical examples. I appreciated everyone’s warmth and hospitality, North Dakota-style. Thank you all for a wonderful weekend. The Institute looks forward to bringing more courses to your neck of the woods!

Posted March 13, 2020 at 8:49PM
Categories: Courses Clinicians Science

 Surrounded by the tall pine trees of North Carolina and golf courses in every direction one can look, we had 2 full exciting days exploring the power of myokinematic restoration. Discussing how the acetabulum moves on the femur was an appropriate discussion in a community full of golfers when discussing rotation and the appropriate muscles of the hip complex to help achieve rotation. We learned about the inherent pattern (s) of the human body that position our pelvis and ribcage along with tests that help guide our treatment to restore these positions. We had a sharp group of attendees who remained interested and engaged through the last hour of the course which was impressive. We had attendees that made the trip from Canada which is always exciting to see the science of PRI spreading to other countries!


- Kasey Aiken

I had a great weekend hosting, teaching and mentoring Kasey at my home clinic Sandhills Sports PerformanceKasey Aiken did a great job introducing the principles of PRI as they relate to the hip and pelvis. We discussed a dominant left AIC and patho and non-patho compensatory patterns during upright activity as it relates to the Hip and Pelvis.

We were joined by PT’s, CSCS, SPTs, SPTA, ATCs, new graduate of PT, Massage therapist and a chiropractic physician!

Our clinic was represented by Pat Tanner, ATC, Jena Landgam, SPTA, Kelsie Giannoulis, DPT, Brooke Thomas, DPT and brand new to our group Pierce Adams CSCS and Johanna Nisenholtz.  Johanna was my PT student earlier this year. It was so great to have her in her first official PRI class. We look forward to Johanna joining our staff this year!

Thanks #PRINation for growing with us!

Posted March 12, 2020 at 9:50PM
Categories: Clinicians Courses Science
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