Clinicians

Beautiful weekend in Oakland California talking PRI for the frail, the immobile and the chronic with a super group of medical professionals at the Alta Bates Summit Medical Center. A huge thanks to our host site coordinator Shaun Buchanan for thinking of everything and making sure we had a wonderful weekend. Your hosting was amazing Shaun. Also thank you to Tim Dempsey, CSCS, CPT, PRT who assisting me this weekend as a lab instructor and made sure the group had a good experience.

 The night before the course was fun and relaxing for me because I got to attend a Golden State Warriors basketball game in the new Chase Center arena. I have been to several games in the historic Oracle Arena in Oakland, but getting to attend a game in their newly completed arena across the bay in San Francisco was an awesome experience. After the game, I picked up a souvenir that helped me teach the course the next day. It was a Matryoshka or nesting doll painted as one of my favorite players, Klay Thompson. Klay turned out to be great asset for giving the class context for rotational diaphragm performance, lumbopelvic rotation and contralateral respiratory rotation through the rib cage during transitional activities and gait. Who knew?

This PRI Integration for Geriatrics course does a great job assessing and making treatment recommendations for different aspects of the human gait cycle. The design of the Seated Gait Integration Test is to determine early to mid stance performance and the design of the Seated Eversion with Abduction Test is to determine late stance/pre-swing performance for the geriatric athlete. These components of upright performance are essential for dynamic upright balance activities, transfers in and out of the standing position and delivering efficient gait mechanics. Seeing the L AIC/R BC pattern in context with different components of gait allows the practitioner to make meaningful changes to gait deficiencies and upright balance and transfer problems. Preventing falls in these populations is by far the most meaningful thing you can do to preserve upright function.

Another powerful aspect of this course if the time spent on Functional Routines in the Home from both a patterned and a preferred standpoint. Thank you John Maynarich, OT for helping our class stay functionally minded throughout the course and for representing the profession of Occupational Therapy so well. You were right, this material is well designed for OT practitioners and should be an important part of all geriatric care. Our ability to make positive changes in daily functional routines really is the whole point, isn't it?

Lastly, I wanted to give a shout out to our 3 first-time course attendees in the class. Thank you Tom Borremeo, Christina Cherg and Fabrice Rockich. You guys were amazing. And thank you Carol Cahn, PT, PRC for personally bringing your friend and co-worker Tom to the course. As I said, you 3 newbies are VIPs from my perspective and it was an honor to cater the content of the presentation to your level of understanding as we went along. Thank you for being willing to ask questions and for the great class discussions you helped to generate. You literally are the reason the Affiliate program exists and we thank you for being there.  

NEXT LEVEL PT IS HIRING A PHYSICAL THERAPIST

Next Level Physical Therapy, a PRI-focused clinic in Hamilton, New Jersey, is looking to hire a PHYSICAL THERAPIST.

This opportunity is perfect for any PT looking for an ideal treatment environment working nearly exclusively with athletes and active people. For the right PT, this is truly a special work environment:

Amazing Patients:  Our patient population consists primarily of highly motivated athletes (high school/college/professional) and active adults (ages 35-55). We are an out-of-network/cash-based clinic, meaning our patients understand the importance of investing in their health.

One-on-One Sessions:  Our PTs see no more than 6-8 patients/day. All sessions are one-on-one (the average session is one-on-one for an hour).

Work With Other Passionate, Like-Minded PTs:  Collectively, our clinical staff has taken well over 30 PRI courses. We all share similar beliefs and principles when it comes to treatment, and we are always working to improve. We have dedicated time blocked each week for clinical training.

Integrated Strength & Conditioning:  Our clinic features an open area concept with a wide variety of fitness equipment that supports our integration of strength & conditioning principles into the rehab process. All of our PTs have backgrounds as strength coaches.

Multi-Disciplinary Integration:  We have established relationships with a dentist, orthodontist, and optometrist who we refer to and collaborate with regularly for complex cases. We also accompany appropriate patients to a local running store to assist in shoe fittings, and regularly use Dr. Paul Coffin for PRI custom orthotics. 

**For more information about Next Level, visit www.mynextlvl.com

If you would like more information about the opportunity, or think that you may be a good fit, please send a short intro email with your resume to hiring@mynextlvl.com.

Posted February 5, 2020 at 7:54PM
Categories: Athletics Clinicians

“This course was mind blowing!”
“This was my third of the basic PRI courses. This really helped to bring all the information together.”
 “Before working on shoulders, I now know I need to retrain the diaphragm and restore rib position.”

Attendees came from far and wide to the most recent Postural Respiration course, held at Body Dynamics in Falls Church, VA.  Nicholas Clark, PhD, PT, hails from London, where he recently stumbled across the science of PRI on YouTube.  “After trying a couple of the PRI exercises, my arm numbness, that I had been dealing with for many months, resolved.” That experience convinced him he needed to learn more.   

Half of the attendees were brand new to PRI, their eyes opened to a new and different perspective on human movement and behavior.  The clinicians at Body Dynamics (Lisa Clarkson, PT; Jennifer Gamboa, PT; Deborah Gilpin, PT, ATC; Gwynn Hegyi, LMT; Kathryn Sparks, LMT; Ashley Templer, PT; and Jorge Villalobos, PT) hosted Myokinematics a year ago, and they were ready to deepen their PRI knowledge.  Many Myokinematics concepts were presented and reviewed, most importantly the left anterior interior chain of muscles’ influence on pelvic-femoral dynamics and a person’s ability to shift their center of mass fully and effectively to the left.  Once the body’s foundation was established, we moved up to the thorax and assessed its ability to function in three dimensions.  

Discussion began with our body’s normal, typical asymmetries which create lateralization to the right.  Countering this lateralized state begins with establishing a zone of apposition of the left hemi-diaphragm, which allows us to deflate a left chest wall, giving us a sense of weight on the left, and inflate a right chest wall to enable rotation of the thorax.  When people engage in occupations and sports that require repetitive movements (think lawyers, dentists, musicians, runners, and baseball players -- the list goes on), the ZOA becomes compromised, leading to the postural maladies that we clinicians witness every day:  hyperinflation, forward head posture, concave chests, scoliosis, winging scapulas, and thoracic flat backs.

Ample time was spent in lab to experience PRI’s non-manual and manual techniques.  Attendees learned concepts such as sensing rib expansion, biasing air flow patterns, sensing reference centers to re-direct the nervous system to new strategies of movement and perception of stability, and guiding a patient through a logical progression, from supine 90-90 positions to upright, rotational performance called gait.

Our labs were enhanced by our attendee-models:  Grace Ball, Pilates trainer; Scott Birch, PT; Nicholas; Bethany Middleton, PTA; and Keith Zrinyi, DC.  Thank you to all of you!

It was awesome to have Sarah Ratti, PT, PRC, in attendance, who brought her colleagues from Bon Secours in Richmond.  Tom Van Ornum, PT, also introduced his colleagues from M.O.S.T. to the science of PRI.  A huge thank you goes out to Karen Soiles, PT, PRC.  Karen is highly experienced and knowledgeable in the science of PRI, and she provided helpful guidance, clarity, and context throughout the weekend.  

Posted January 31, 2020 at 10:31PM
Categories: Clinicians Courses Science

Kelsie Giles, PTA, and her team at Elite Physical Therapy (Michael Brown, PT, Kara Patterson, PTA, Luke Rowan, PT, and Matthew Thomas, PT), hosted Postural Respiration, the first-ever PRI course held in Mississippi!
Attendees grasped key concepts, including what is the ZOA, how do we establish it on the left, how does it change pathological patterned air flow, and what areas of the thorax need to expand to achieve alternating, reciprocal movement when we move?  How does hyperinflation restrict our movement from side to side?  How does blowing up a balloon change pelvic orientation, rib mechanics, and scapular position?  How does the right lower trap and tricep help us feel the ground under our left foot?  Why would Jimmy Kimmel benefit from a PRI program?


The course cites multiple research articles and includes numerous photos of typical humans with typical jobs and hobbies to illustrate how patterned breathing, from patterned position, stemming from the natural, normal asymmetries within us all, feed patterns of muscle over-activity. These patterns become entrained in our nervous system and underlie and explain the onset of neuro-musculoskeletal pathologies. Thank you to our models, Kelsie and Michael for helping the class better understand the superior T4 syndrome – what it looks like and how to address it.  Our other models, Kaitlyn Keyser, TP, Kara, Herb Reinhard, ATC, Luke, and Nathan Yost, ATC, were game to take on some challenging non-manual techniques.  There were lots of good questions to clarify concepts, most notably from Micheal Brown and Donna Rush, PT.  Jason Reeves, PT – your oratory skills were much appreciated as we guided our models through non-manual techniques.


Thank you to the entire group for a wonderful weekend.  Your southern hospitality was a treat for this Marylander!

Posted January 24, 2020 at 5:28PM

The New Year for PRI was kicked off with the first Cervical Revolution course hosted by Advance Physical Therapy January 18-19th. This host site is a Postural Restoration Center with some of the most experienced and professional clinicians I have ever met. Their experience and  knowledge of PRI, Schroth Method for Scoliosis, pediatrics and working with dental professionals for occlusal reference is truly interdisciplinary and artful in approach.

Cervical Revolution has  had a lot of "evolution" this past year with a refined, step-by-step description of atlas on occipital bone position that is clear cut and more easy to understand in the Right vs. Left TMCC. This weekend students learned to appreciate and understand what seems to be at first the challenging subtleties of atlas on occipital function. Visualizing how "A" on "O" drives the sphenoid and how the sphenoid positions temporal bones and ultimately the jaw for a tri-planer picture of how the neck, cranium and TMJ complex affects the entire postural system seems daunting to everyone at first. In this course, autonomics is a prime focus as the neck is the neurologic appendage that drives the rest of the body.


This high level PRI group of practitioners was engaged from the first minute on Saturday to the last minute on Sunday actively asking questions, contributing to the professional dialogue and just working really hard to take in the detailed insights of an advanced PRI course. And then, be enthusiastic about how to apply the basic concepts of this course on Monday morning. This weekend there was a strong emphasis on the basics with a straight forward path to application of course principles.

This was a dream course for any faculty member with this kind of energy and participation from students. What made this course rewarding for me was the staff at Advance Physical Therapy. It was such a comfort to be with physical therapists and PRC's Lisa Mangino, Jean Masse, Joe Belding, Susan Henning, Josh Olinick from STEPS for Recovery, Sangini Rane and of course Jennifer Smart in attendance. Jennifer Smart will be presenting at the next Interdisciplinary Symposium in April and her presentation is not to be missed! In addition, this group of veteran PRC's offered clinical discussion and were all lab assistants in one way or another to lighten the load for the entire class and elevate everyone's experience. Shout out to Angela Ellis, DDS who works with Advance Physical Therapy. She is a dentist and was a first time attendee to a PRI course and she could not have been more delightful and engaged! Thank you again Advance Physical Therapy for hosting Cervical Revolution and supporting PRI.

What a great weekend in Tucson, Arizona this past weekend! I not only got to enjoy blue skies and 65 degrees (Lincoln, NE snowy and 20 degrees), but I also had the pleasure of introducing a third of the class to PRI. It was a great weekend of pelvic inlet and pelvic outlet going into the weeds of detail with muscle actions, positions, and objective testing. The class participation was great with questions, participation, and engagement. I felt the participants appreciated the objective tests and how they can make improved PRI exercise selections when understanding what these tests are showing them. I also felt the power of the respiratory and pelvic diaphragms for internal pressure regulation and air flow were better understood with correct pelvic position. The facility was amazing and thank you to Ben and the University of Arizona for hosting Pelvis Restoration this past weekend. It was a great start to 2020!

Posted January 17, 2020 at 8:15PM
Categories: Clinicians Courses 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 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
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