Clinicians

If there are three bones that have always had an impact on my course of study as related to respiration, airway, occlusion, oral function, head and neck position, speech, vocal cord dysfunction, tongue compensation, nasal flow, autonomics in general, auditory sense and the soft and hard palates, it is the temporal and occipital bones. Three very important nerves go through the most infamous foramen of mankind, the Internal Jugular Foramen (IJF). When the lumen or congruence of this foremen is challenged our bodies know it. Cranial mal-position and underlying associated predictable human torsional constraint increases the need for compensation and  work around this malpositioned set of paired bones, on an accompanying occiput bone that orients and houses the medulla and brain stem in off-centered state of un-rest. This positional state of unrest feeds neurologic information to our mid brain and associated cortices that are directly associated with my course of study, outlined above.   

Re-orientation of these two paired IJFs can have a major impact on ANS, SoNS and CNS function and behavior, secondary to the compression or lack of compression on these three nerves. The glossopharyngeal nerve innervates the stylopharyngeus muscles, the vagus nerve innervates the levator veli palatini, the salingopharyngeus, the palatoglossus, the palatopharyngeus, and the pharyngeal constrictor muscles, and the accessory nerve innervates the trapezius and the sternocleidomastoid muscles. I will not go over these three nerves sensory innervation, but these nerves are instrumental in how we physically, physiologically and psychologically behave and operate. Cranial mal-guidance provided by the calvaria, temporal and occiput bones and their associated torsional patterns of function can be resolved through PRI based sacral cranial repositioning and through PRI based thoracic cranial resolution, that incorporates cranial oscillatory alternation. Having the opportunity to outline and teach the reasoning behind these PRI techniques and considerations, offered by this unique course, through the involvement of the sinus cavities, the palatine bones, and the pharynx, is as fulfilling for me as any course I have ever written, designed or taught.

 

I would like to thank Amy Goddard PT, DPT, OCS, CSC, PRC and her staff, once again, for hosting another PRI course at her expansive and accommodating facility. Gail Kaiser PT, OCS, thank you for your willingness to participate in my demonstration autonomic orthotics. And Stephanie Irizarry Pt, CLT-LANA, PRC your presence is always welcomed because of your love for Pantone 269 C (purple), your predictable body performance through autonomic filtering, and your on-going smile. Jennifer Bullock PT, DPT, OCS, PRC your input, discussion and feedback was so invaluable. I honestly believe, this is ‘your course’ if there ever was one offered by PRI. I truly love everything you stand for and represent.  

    

Posted March 4, 2020 at 10:08PM

PRI nation, it’s good to be back!  

I returned this week from my first opportunity to visit the great state of Louisiana.  What a fantastic welcome this instructor received!  I had the pleasure of introducing nearly the entire class to the science of Pelvis Restoration thanks to the host and hostess Chris and Karlie McDougall at Renew Physical Therapy. Chris, Karlie and the whole team at Renew were kind and gracious, and provided King Cake, and other local delicacies…and I got the baby, so I’ll be back!  

The course involved great conversation and discussion about the theory, science and specifics of inhibiting, facilitating and integrating alternating function of a pelvis into our neuromechanical system. Thank you to PRC, Kyle Babin for your time and energy serving as the lab assistant during our many lab breakouts, you were excellent! This instructor enjoyed the discussion of how to implement PRI objective tests into a comprehensive triplanar picture of the position and tendency of a pelvis as part of the individual human system we assess. Many thanks to Payton Spell, Shaun Lopez, Jessica Lamothe, Lonnie Arroyo, David Giardina (even in the short time!) and more for your help with lab demonstrations and observation of objective tests and treatment techniques.

 

This group had an exceptional array of patterned movement strategies that made this an enjoyable cross-section overview of the greater population and a great venue for learning first hand. I did my part to eat Covington out of Gumbo and I very much appreciated being welcomed to enjoy an evening with the McDougall family for my very first Marti Gras parade. What an enjoyable spectacle!

Thank you again, my fine Louisiana friends, for an enjoyable learning experience in The Bayou, my best to each of you!

Posted February 26, 2020 at 5:29PM
Categories: Courses Clinicians Science

Do you have an interest in learning Postural Restoration but are not sure where to start? Would you like to be more efficient at using the PRI framework to evaluate your clients or patients? If you said yes to either of those, then the Affiliate course for Fitness and Movement is a perfect course for you!

This past weekend, James Anderson and I traveled up the west edge of Illinois to present at Advance Physical Therapy in Quincy. We had a large group with a mix of personal trainers, strength coaches, athletic trainers, football coaches, and physical therapists. For some attendees, this was their first course and then others had attended several previous PRI courses.... And that is the beauty of this course, it has something for everyone and is a good introduction or review of invaluable principles that can transform how we work with our clients, athletes, and patients.

Thank you to PRC Eric Ley, Natalie Stratton and the other Advanced PT owners for supporting their staff’s continuing education. It was a great opportunity to have so many team members at one course all together!

PRI Integration for Fitness and Movement is an advanced course that focuses on helping us look at movement and posture differently while integrating key Postural Restoration principles that promote symmetrical form and balance between the two halves of our axial frame. We are looking at how the ribs, thorax, pelvis and hips work together to empower the diaphragmatic mechanical advantage, optimize spinal relationships and the range of motion of our proximal ball and socket joints.

Here are some comments from this past weekends attendees:

“Great experience for my first PRI course. I feel like I can start looking at my clients posture differently while performing exercises and give more beneficial cues to prevent injury and improve overall function.”

“Absolutely the best explanation of ZOA that I have ever heard”

“I learned so much! The speakers were great and personal”

“Good course. I really took home more than other PRI courses I’ve attended. Speakers broke things down to understand ZOA effectively. I plan to incorporate this course in my current patient’s plan of care.”  

Thanks again to Advance Physical Therapy in Quincy for hosting and coordinating with PRI to have us come out there! Check out the Affiliate course schedule to learn more and get to one of our affiliate courses this year! We have courses coming up in Richmond, VA and Fort Worth TX.

Posted February 21, 2020 at 9:48PM

Pasadena Physical Therapy was the location of last weekend's Cervical Revolution. Locatelli Rao, P.T. hosted this course and it is always a pleasure to share time and knowledge with "Loc" on this PRI journey. I first met Loc two years ago in L.A. when I taught Postural Respiration and the questions he was asking then and now are some of the best. What is really gratifying is when a student can take a complex subject, like Cervical Rev, and break it down into component parts to provide a simple, sequential and detailed description of the concepts of the course. This has been a goal in Cervical Revolution to have students take a course and "get" the primary concepts with motivation to go back into the course manual and absorb more completely the material. Application on Monday morning means just getting the most important concepts, start to practice examinations of the cervical spine/neck, know the basics of what they mean and then experiment and provide PRI techniques! Yes PRI courses make our brains hurt a little as most students will attest while their enthusiasm for more expands with their craniums! One of the most powerful PRI techniques and taught in this course is the Active Left Lateral Pterygoid in Protrusion. After testing a student in lab with bi-lateral positive findings, this technique with just a few breathes demonstrated how powerful inhibiting a Right TMCC can be with a left lateral pterygoid. Not only was the R TMCC inhibited, but so were the BC and AIC chains bilaterally.

PRI Cervical Revolution Course - Skip George

PRI Cervical Revolution - Skip George
Follow up recommendations included Standing Cervical Cranial Repositioning with a Supine Active Sacro-Spheno Flexion which were demonstrated in lab with other students all producing immediate neutrality.  A manual technique was provided on another student in lab called the Frontal Occipital Hold who was also bilaterally positive in testing. After this technique, he was neutral upon testing. That was astounding to all, especially this instructor! This course is really about autonomics and reflexive oscillatory function of a neck that has to be free to turn. Cervical Revolution is so fun to teach because of the power in it's application just like all the courses in PRI. Big Shout Out to Chad Moreau, D.C., CCSP, PRC for being our lab assistant again. Your support and presence always brings a positive force to the room. Thanks again Loc for you support, questions, restates, hosting and always expanding your knowledge. 

 

Posted February 18, 2020 at 5:28PM

Dominant cortical behavior and function as related to human bias and behavior has always been a strong interest, and passion of mine. In 2007 I wrote and compiled a course entitled ‘Impingement and Instability’ to begin a journey with those who have interest in the gifts of contact and oscillation. Four tabs were selected based on their importance in corporeal-sense, hemispheric influence, and biased lateralized behavior. Interaction of calcaneus, femur, hip/pelvis, and scapula anatomy through our extrapyramidal system is critical for reflexes, forward locomotor motion, complex dominant driven function and postural control. This has always been an ‘extrapyramidal’ based course. However, after thirteen years of presentation, I feel the Institute is at a great place to incorporate the significance of pressure, pronation, and push as it relates to these sites of interactive referenced modulated motor activity.

 

The extent of our creativity and capriciousness depends on both our soul and the soles we use to develop behavioral patterns associated with confidence built off of integrating contralateral, hemispheric and bio-tensegrity input. I was so excited this last weekend to discuss how we are regulated by self-regulating pressure of the scapula to capitalize on our ability to perform with things that push, propel and please us. The ground developed, directed and designed our anatomical behavior, while the earth’s gravity gave us the security to defend, offend and create without loss of life. This updated course has not really taken on a new course of direction, but definitely will take those, who attend, into dimensions never before looked at or addressed in the manner they are now presented and applied, with evidence that was not considered when addressing the reasoning for symptomology related to feet and hand haptics.

   

The re-assurance from the wonderful feedback I received after this course, re-assured me that the PRI nation is ready for the importance of variable femoral and scapula instability, and associated counterpart contralateral stability, as related to the metric embracement of calcaneal and pelvis impingement that directs and orchestrates the possible disharmony and dysfunction associated with pre-patterned forward locomotor movement. Thank you One on One Physical Therapy for hosting another PRI course. You all were so gracious with your time, support and assistance. Karen Warren PT, MPT, OCS, ATC the coffee was great from both cups, even when you lifted the left hand with the cup in it and your body’s mass moved to the right, (LAIC, RBC coffee). Dan Houglum MSPT, ATC/L, PRC, Jennifer Smart DPT,PRC and Michael DuBois DPT, OCS, TDN, CS USPHS/HIS provided so much insight and instructional feedback, thank you.

Posted February 12, 2020 at 2:44PM
Categories: Courses Clinicians Science

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.

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