Clinicians

Malta, New York’s colorful foliage and Capital Area Physical Therapy and Wellness welcomed Postural Respiration into its PT-owned clinic. Course attendees had expertise across multiple disciplines -- physical therapy, strength and conditioning, internal medicine -- and patient populations, from pediatrics, geriatrics, basal ganglia and other movement disorders, and high school through professional athletics. Most expressed gratitude and satisfaction with getting back to a live course following the covid sequester. With so much of the weekend devoted to hands-on lab time, Postural Respiration is better experienced live.

Postural Respiration, Postural Restoration, Primary Course, Diaphragmatic Breathing, Zone of Apposition

Postural Respiration

Abundant research exists that describes the role of the diaphragm in facilitating physiologic processes and homeostasis. Less understood and studied is its role in regulating pressure within the chambers of the body to produce integrated and coordinated movement. When the diaphragm’s shape is altered from patterned postural positions, movements, and behavior, the result is asymmetrical air flow patterns that become ever more patterned. Practitioners encounter this phenomenon every day in our patients/clients and witness its influence on autonomic variability, a concept fundamental to the Postural Restoration Institute.  

Throughout the weekend, we considered questions such as:  
-    How do the left and right diaphragm position and function influence rest, recovery, and performance?  
-     Why are the right triceps, left internal obliques and transverse abdominus, and bilateral low traps and serratus anterior so crucial in establishing and maintaining effective length-tension properties of the thoracic diaphragm? And how do they influence new, unfamiliar, yet optimal, patterns of movement in our patients’/clients’ day-to-day lives?
-      When and why do the scalenes, notably on the right, conspire with the subclavius and pec minor, to produce unrelenting activity and the pathological respiratory syndrome known as superior T4?
-     How does the PRI paradigm fit within a clinician’s current approach to evaluation and treatment?  
-      If you have only thirty minutes with a patient, how do you prioritize?  
-     Why/how do patients/clients benefit from reaching activities? Balloon blowing?

It was a treat to be reunited with Kathy Metzger, PT, PRC, a fellow member of the PRC squad of 2011. Kathy applied her experienced hands on many rib cages to teach the nuances of objective tests and treatment techniques.  Thank you for all your help!  

We greatly appreciate our models:  Christopher Denio, DPT, Mike DeMille, DPT, PRC, Andrew Gaetano, DPT, Ken Jin, DPT, and Trisha Livermore, DPT.  Your willingness to participate allowed all of us to gain a deeper understanding of the tests, interpretations, and techniques.

    

A special thank you to Evan Marsh, DPT, and Andrew Gaetano, of Capital Area Physical Therapy and Wellness, for opening your doors and welcoming this wonderful group of clinicians! 

Posted October 20, 2021 at 1:30PM
Categories: Clinicians Courses Science

As we first announced a couple months ago, we are excited to now offer a PRI Mini Residency Program, a 6-week formal program of post-professional education and mentorship for PRI-minded healthcare and movement professionals that is designed to enhance one’s understanding and application of PRI concepts, objective testing, and patient/client management. The foundational science from the Postural Restoration Institute’s three primary courses will be strongly emphasized by all PRI Mini Residency Centers, however each PRI Mini Residency Center offers a unique environment and experience, and many residency centers will also include exposure to interdisciplinary integration with other healthcare or movement professionals.  

This PRI Mini Residency Program is designed for healthcare or movement professionals who are self-directed learners, have completed the required PRI coursework, and would like to enhance their clinical reasoning, interpersonal communication and dialogue using PRI terminology with other professionals as well as patients or clients, and application skills of the science of Postural Restoration® through one-on-one clinical education and mentorship with a PRC or PRT professional at a PRI Mini Residency Center.

The PRI Mini Residency Program website page is now up and running, and applications are being accepted! CLICK HERE to learn more about the PRI Mini Residency Centers that are currently accepting residents, application details, along with answers to questions that you might have. If after visiting this page, you still have questions about this program, please don't hesitate to contact me! Or, if you have questions for a PRI Mini Residency Center that you are interested in, you will find the contact information for each residency center on the "Residency Centers" tab of this page.

Posted October 6, 2021 at 4:58PM
Categories: Clinicians Science

The Cervical Revolution Course last weekend was taken to a new level in it's development of being the course that introduces " top down" concepts and the neurologic connection of the body with the brain and cranium.  What made this cervical-cranial-occlusal course extraordinary had many components. The technology provided by an international audience online revealed a growing international hunger for PRI. From the Western Pacific, Australia, Japan, Hong Kong, New Zealand and Singapore were represented. On the other side of the world students from Canada, Iceland, Belarus, Malta, Ireland, Poland and the UK were present as well as all over the USA. There was a great local representation from Nebraska in the live audience that provided energy and interest with questions, feedback and lab demonstration that all in attendance benefitted from.


One of the best questions, and one that is central to this course, is how is it that the occipital bone can move into A/O flexion on one side and A/O extension on the other if it is one bone? During tri-planer movement of this highly neurologic joint a sliding or gliding of the condyles of the occiput in the fossa of the atlas provides a rocking motion the looks like a bowl (occiput) rolling in a tri-planer motion side to side with one side going up and forward as the other side is coming back and down in a balanced alternating fashion. If this alternating/oscillating movement ceases to occur driving the occiput down into the atlas coming up on the ride side, torsions that are torque-like scoliosis patterns occur in the cranium. Hence, in this regard, the neck runs the neurologic and cranial/occlusal system.

Cervical Revolution, Postural Restoration Course, Secondary Course


What really made this course is not only the student participation and international diversity, but Dr. James Carlson, a world renown dentist, was in attendance. As the course got deeper into the cervical-cranial-occlusal subjects, this instructor went to student mode personally and asked Dr. Carlson for his input. I'm not sure if new students realize what a special opportunity it was to have Dr. Carlson describe occlusal issues as it applies to this course and a holistic approach it provides to all healthcare disciplines in attendance.


What then added to this course was to have PRI faculty members Louise Kelly and Dan Hoglum in attendance. Big "wow" factor for the entire weekend. Louise broke down the Standing Stomatonathic Squat in such detail that described a bottom up and top down integration of ground, vision, occlusion. She will be teaching Cervical Revolution soon and not to be missed!  Dan Hoglum is the Impingement and Instability "rock" in PRI and provided a powerful, concise description of one of the main concepts of this course being "Top Down"!  Both Louise and Dan brought "extra credit" and value along with Dr. Carlson to all our learning experience.


There is no way this weekend could have been pulled off without Jennifer Platt getting to the institute early and the last one to leave the building to facilitate the entire weekend and make it a successful learning environment for all. None of this could happen without her. Not only that, but Jen has so much experience in these courses as well as PRIVY and her knowledge and sharing what she knows gave this weekend so much more depth and color. To my "co-instructors", Dr. Carlson, Louise, Dan and Jen thank you all. And to everyone in attendance thank you for being such a great group!

Posted October 5, 2021 at 4:06PM
Categories: Clinicians Courses Science

Hello fellow scoliosis practitioners and PRI NATION! We are offering our STRATER Level One course via Live Stream In October!

A 3-Dimensional Approach for the Conservative Treatment of Scoliosis

LIVE STREAM: Saturday October 2nd and Sunday October 3rd, 2021

15 CEU’s from North Carolina Physical Therapy Association

This introductory lecture and lab course is designed to teach scoliosis practitioners assessment and treatment techniques for adolescents and adults with curvature of the spine. Participants will gain a greater understanding of:

  • Tri-planar asymmetry in scoliosis
  • Factors determining risk of scoliosis progression
  • Spinal precautions
  • Understanding curve patterns
  • Safe performance of ADLs
  • Screening and evaluation of scoliosis
  • Reviewing x-rays in scoliosis
  • Bracing in scoliosis: types & necessity
  • Specific 3-dimensional treatment techniques
  • Special considerations for adults with scoliosis

All course instructors hold multiple, advanced certifications pertaining to clinical management of scoliosis and actively treat patients with scoliosis as the core of our practice: 

Susan Henning, PT, PRC, SBC-C2 

Jean Masse, PT, DPT, PRC, OCS, ATC, SBC-C2 

Lisa Mangino, PT, DPT, C/NDT, PCS, PRC, SBC-C2

See also instructors' related publication in: Innovations in Spinal Deformities and Postural Disorders

For more information, please see our flyer!

To Register, go to https://straterscoliosis.com/course-registration

We hope to see you virtually in October!

After a nearly 18-month hiatus, it was a thrill to present Postural Respiration to my fellow clinicians in the very place the science originated. The combination of live and zoom attendees -- PTs, PTAs, ATCs, Massage Therapists, Chiropractors, Students, Strength and Conditioning Specialists, a Pilates Instructor, and a Kinesiologist -- hailed from the US, Canada, Germany, and Ireland.

The weekend was devoted to the asymmetrical, patterned thoracic diaphragm and its influence on the autonomic nervous system, patterned movement, and the brain’s sense of itself in space. We learned that our asymmetrical body is a necessary design for survival and is kept “in check” when we engage in varied activities throughout our lives. However, most of our patients-clients fail to do so, which kick starts pain, pathology, and injury.

As the Olympics come to their conclusion, it seems apt to compare PRI’s treatment approach to a track relay:
Leading off and exploding out of the blocks are the abdominals (internal obliques and transverse abdominus), which enable full lung expulsion of air and establish the (left hemi-) diaphragm ZOA.
The second leg, the diaphragm itself, now pulls air in with an adequate ZOA and hands off the baton to the third leg…
…the rib cage, whose external rotation and internal rotation properties are restored, particularly in the left posterior mediastinum and right apical and lateral chest wall regions.
Finally, our anchor leg, the lungs, bring the baton home. They now have the space to expand into and out of regions that were previously closed off, for the health of the many vital vessels that travel in, around, and through the thorax.  Moreover, the restoration of alternating, reciprocal lung compression-expansion produces alternating, reciprocal movement, both simple and complex.

More HERE

Ample lab time was devoted to assessment of the patterned body so that each attendee had confidence come Monday morning with replicating the tests on their patient-client. Instruction in manual rib cage techniques was also heavily emphasized, so that attendees had both observational and tactile sense of patterned air flow. Finally, many non-manual techniques were discussed and performed, including when and why you choose them and how to coach your patient-client through them.

Thank you to all of those who asked questions. You enhanced the course experience for all. Thank you to our avatars Brett Dougherty, PT, Matt Mandich, SCCC, CSCCA,  Joshua Werk, ATC, CSCS, and Tammi Zimmerman, LMT for allowing us to bring the tests and techniques to life.     

Thank you to Justin Pastoor, MS, CSCS, for your clear verbal instruction while tests and techniques were demonstrated.  

I now fully understand what Ron means when he says he couldn’t have presented the material with the same easy flow and energy without the assistance of Jen Platt. Thank you for ensuring there were no technology glitches, deftly navigating the camera angles, monitoring questions, and keeping this instructor and live attendees well-hydrated and fed.

Looking forward to seeing many of you again as you continue your PRI journey!

Posted August 18, 2021 at 3:40PM

We are excited to announce that we will soon begin offering a PRI Mini Residency Program, a formal program of post-professional education and mentorship for PRI-minded healthcare and movement professionals that is designed to enhance one’s understanding and application of PRI concepts, objective testing, and patient/client management. The foundational science from the Postural Restoration Institute’s three primary courses will be strongly emphasized by all PRI Mini Residency Centers, however each PRI Mini Residency Center offers a unique environment and experience, and many residency centers will also include exposure to interdisciplinary integration with other healthcare or movement professionals.   

This PRI Mini Residency Program is designed for healthcare or movement professionals who are self-directed learners, have completed the required PRI coursework, and would like to enhance their clinical reasoning, interpersonal communication and dialogue using PRI terminology with other professionals as well as patients or clients, and application skills of the science of Postural Restoration® through one-on-one clinical education and mentorship with a PRC or PRT professional at a PRI Mini Residency Center.

To learn more about this 6-week PRI Mini Residency Program, please CLICK HERE! And stay tuned for more information coming soon to our website, including information about the approved PRI Mini Residency Centers and the application for those interested in completing a PRI Mini Residency Program!

It would be a colossal understatement to say that the last 18 months have been a substantial change for everyone on the planet. However, for this one weekend, it was very refreshing to get a slice of normalcy. It was my distinct honor to teach Myokinematic Restoration to a group of movement specialists in Lombard, IL. It was exceptionally refreshing for me to interact with this diverse and eager group of peers.  

Our exploration into normal mechanics and eventually transferring into the patho-compensatory mechanics that can result from living and performing in a pattern. Discussing which muscles are properly positioned compared to muscles that are poorly positioned allowed us to proceed to testing. This is the only course in PRI that allows us to explain and have lab time specific to the Hruska Abduction and Adduction Lift tests. The relatively small class size provided us ample opportunity for lab on Day 2. This course has always had a lot of lab time built into it, and we had nearly 7 hours of lab time. We were able to explain and perform 16 PRI Non-manual activities. It was a blessing to have that much lab time.

 

It was wonderful to have a PRI veteran, Ryne Gioviano, in attendance. Having his perspective and insight with very helpful. Brandee Barbee, Terris Hightower, Ryan Daniels, Kasia Galica, and Shirley Montoya were exceptionally helpful with their questions and perspective. It was an honor to have Dr. Stephen Sikorsky in attendance as well. Having a chiropractor in the audience provides level of clinical experience and expertise that is undeniable and very helpful to fellow attendees.

 

Thank you to those who attended as it felt closer to normal. Here's hoping we all get back to normal sooner than later.     

Posted August 10, 2021 at 3:26PM
Categories: Clinicians Courses Science

We all know someone who experience difficulties with simple movements and at the same time can move or carry out, what appears to be more complex movements easily. This phenomenon of ‘Kinesia Paradoxa’ is one that is often seen with individuals who have been diagnosed with a basal ganglia disease called Parkinson’s Disease. However, by studying basal ganglia diseases we can learn so much about the precursors and the stages of this disease and its developmental patterns and symptomology. I believe, I have been on a journey of researching coupling and identifying similarities in people who have oscillator conflict at the caudate nucleus and putamen or dorsal striatum, at the subthalamic nucleus, at the globus pallidus, and at the substantial nigra pars reticulata, and didn’t really know it. For this is where the majority of our paradoxical function really begins, is initiated and looped. For these are the areas that make up the basal ganglia. Ganglia that reflect the parts of the brain that are not often even thought about, when sequencing steps in a “exercise”, or movement technique.

I always enjoy the amount of time, energy, thought and ideas that go into these PRI Symposiums. Ideas, that flow far in advance of the actual delivery of material and madness. I love every moment of these preparatory mental madness moments. Because that is what is exactly going on in our basal ganglia. Frenzied, chaotic, pandemonium mayhem, that can lead to periods of deranged decisions or a flow of indiscreet ideas. It’s the latter that we would never experience if we were controlled by frequencies of neuro-synapses that didn’t loop with other unfamiliar neuroreceptors, once in a while; like every 10 milliseconds.

Ron Hruska, Basal Ganglia Disease, Annual Symposium, Parkinson's Disease

Click HERE to view the full photo album.

There is a fine line between sanity and conflict. I personally need both in my life, and I am fairly certain you do too. Jennifer Smart DPT, PRC, Neal Hallinan CSCS, LMT, PRT and myself put a manual together, delivered content, and digressed into areas that reflect ideology of some of our most important ganglia we have. We enjoyed the time together in this presentation of ideas, in the preparation of ideas, and in the exchange of ideas that will hopefully strengthen the balance of movement associated with asymmetrical sanity and movement associated with symmetrical conflict. We, the speakers, learned so much from each other and the science that actually does support our zaniness and Zen-like ideas, all because of our respect for life’s paradoxes.

Here are a few of the comments we received from the class participants/attendees:

“Yes the material outlined "bigger picture" neurological influences on all humans that manifest as pathology in some. All people will benefit from this mindset of looking at human neurological function.”

“Love that these symposiums build on prior knowledge and become useful not as cookbook ways of treating patients but as ways to understand human behavior and provide frameworks to improve outcomes for all humans.”

“It brought the new perspective in how I look at Parkinsons and how big Inhibition is!”

“Just one fun thing. I was talking to my almost 91 year old mother who now uses a Rollator and she was asking about a stand up walker the night the course ended. Her next statement was funny (no knowledge of the course) and she said that the main thing she missed in her walking was "swinging her arms". I went down and worked with her with swinging hiking sticks in her hands (except I was using 2 reachers) and progressed her to using a trowel and hand clippers and she walked about 60 feet 4 times (back and forth in her driveway) unassisted and non stop. Cannot express how much fun it was to give her some freedom (she still loves to garden). Thank you all for a fantastic event as always. It is great to be able to go back an implement changes in my patients.”

“It felt balanced between the three presenters. I felt that Jennifer utilized her time the best, she did a good job of communicating her work, her experience, research, and I am grateful for her efforts. All presenters did an excellent job. Ron helped me to appreciate the basal ganglia, I really had never thought about this part of the brain in my day to day life and now it is imprinted. Neal was very engaging and enthusiastic, His passion moved me to appreciate dance and rhythm in a whole new way.”

“This Symposium was over flowing with important information about a new way of thinking for working with all our patients or clients, not just those with Parkinson's disease.”

“This was a great course to expand my knowledge of Basal Ganglia disease and treatment options. I have been certified in the LSVT BIG program for years but would also like to branch out and have other options for my patients. This course gave me lots of ideas”

The last comment above summarizes our basal ganglia’s ability to keep us resonating with bombardment of relaying information that allow us to flow with “lots of ideas” that are recognized and required for satisfactory frontal cortex creativity. And if we don’t occasionally fulfill our dopaminergic ideas, that we create, generate and plan, we may just be laying down the framework for future unplanned kinesia paradoxa, that we want to avoid.

Posted May 5, 2021 at 3:34PM
Categories: Courses Clinicians Science

Earlier this month, I was in Fort Collins, CO teaching Pelvis Restoration after 14 months out of the faculty circuit. For many reasons that will prove impossible to come close to articulating here, this course in review proved difficult to concisely write. These past two years, objectively, I have lost a lot—a child to disease, a dear co-worker to miscommunication, contact with a dear friend and colleague to culture, contact with another dear friend and colleague to a series of business casualties...to name a few. I mention these losses because I am certain this same window has been uniquely difficult year for most everyone reading this, regardless of where you find yourself. I’m sorry for each of your losses, yet very much hopeful.

Just through that window, I take heart, because I am confident that all of these losses are temporary, and will prove to be blessings, each in their own way, though I may not understand how presently. For certain, goodness was found in Fort Collins!  It is also difficult to encapsulate how thankful I am for my good, longtime friend and colleague Craig Depperschmidt, a 2012 PRC graduate and PRI hub in Colorado, to have welcomed me back to Fort Collins with undeserving hospitality. It was tremendous working with newer friends Brian Benjamin, who served tremendously as host site coordinator, as well as Rachel Kroncke, Sara Truelsen, and Ruth Waller-Liddle in the ProActive PT Center family who welcomed PRI and me into their work home fully. Thank you each so much for your warm welcome!

Pelvis Restoration course on asymetrical pelvic influence

Pelvis Restoration course on asymetrical influences of the pelvis

The course was akin to being back on one’s favorite horse—saddle and content were true and just as they should be. Many thanks to Matthew McLaughlin for great discussion during the course and during break times. Thank you to Jason Huang, Ryan LaFountaine, Jessica Robinson, Cristi Cuellar and multiple others for your help with demonstration during lab sessions as we explored the many facets of this primary course about a pelvic inlet and outlet. Many interactions during both lecture and lab about clinical application hopefully proved beneficial to experienced veteran course participants and to the six-pack of those new to the science of PRI. This instructor enjoyed the respectful and vigorous participation from the class as we discussed optimizing neuromechanical position and triplanar control of hemipelvic inlets and outlets in order to allow alternating integrated function of synchronized ipsilateral pelvic and thoracic diaphraghms. Thank you all from ProActive PT and PRI who made this course possible once again, it really was and is good to be back!

It was a wonderful weekend teaching a Pelvis Restoration as a “hybrid" course. Teaching to professionals attending the course in person and through Zoom was exciting and humbling. Thank you to everyone who attended. Your desire to learn and passion for the Science of PRI is amazing. We had great questions and interaction through both forums this past weekend. We had energy. We had passion. We had a desire to learn. I felt an improved understanding of the “external” support of the pelvis with tri-planar movement (especially the frontal plane) was understood at a deeper level for improved regulation of internal pressure and airflow. I felt course attendees appreciated the PRI objective tests and how they can assist them clinically to improve PRI Non-Manual Techniques selection for patient treatment. I also felt in insight was also gained in not only “re-positioning” the pelvis but then “re-training” that pelvis for left stance and right swing with our goal to “restore” for reciprocal and alternating movement.

We were “world-wide” this past weekend with course attendees from all across the U.S. and internationally. Thank you again for all that came. It was great to teach as it makes me a better clinician.

Posted April 21, 2021 at 4:36PM
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