Clinicians

As one attends conferences organized by various boards and professional groups of education, it becomes apparent that many of them, no matter which organization is of the primary focus, are alike. This is now our second time attending the AAPMD Airway Summit, and it again was distinguishable from any other conference in the past. I believe it is important to understand the truly collaborative effort of all the organizations involved as the level of discussion was already set high because of the many disciplines present during these four days.


We were proud to join a long list of sponsors which included; The American College for Advancement in Medicine, The American Academy of Physiological Medicine & Dentistry, The Academy of Applied Myofunctional Sciences, The American Academy for Oral Systemic Health, The Institute of Physical Art, The Foundation for Airway Health, The North American Association of Facial Orthotropics, The International Academy of Oral Medicine & Toxicology and the American Academy of Craniofacial Pain.If you made it through the list above, it may be easier to understand the vastness of conversations had, professions in attendance, speaker topics presented and overall interest in integration. As I spent four days discussing and fielding various questions related to the relevance and strong presence of our Institute at this event, we immediately became aware of the potential and power that this science of Postural Restoration can have on a collaborative group of minds which we were surrounded by. After having these conversations between various Dentists, Oral Facial Myologists, Hygienists, Speech & Language Pathologists, Craniofacial Pain Physicians, and many other systemic health and physiology professionals, their desire for integrative and collaborative care was at an all-time high.


Many of them however were curious and sometimes cautious about where to begin, who to reach out to, and how those other professionals may benefit their patients overall plan of care and most importantly their treatment outcomes. Then comes “The Important Collaborative Role of PT and Airway Health” which was presented by Ron Hruska, Gregg Johnson and Brad Gilden. Which in and of itself was a milestone in the collaborative effort to introduce the important role PT’s have in viewing and treating airway and all other forms of dysfunction. Not only is the role of the physical therapist becoming more apparent but the roles of ALL individual professionals involved are becoming more appreciated. We were fortunate to have the presence of PRC, Steve Cuddy who has been practicing PRI and integrating with other disciplines in the Austin area for many years. Steve, it was truly an absolute gift to have you there as a representative of our credentialed providers across the country and abroad as these other professions look to you and others like you, who have become a PRI provider. The professionals mentioned above will be reaching out to all of you in the days, months and years to come, as a resource for integration of the science of PRI within their approaches of treating Airway Dysfunction and overall health!

“Attending the Collaboration Cures Airway Conference was an eye-opening, yet reassuring experience.  Eye-opening in the sense that the collection of airway-related issues is more complex and prevalent than, I believe, anyone truly understands.  Reassuring because I’m more confident than ever that we as PRI practitioners are uniquely positioned to play an integral role in the detection and treatment of obstructive airway conditions. Returning back to our homes, I’m sure that all attendees are more hopeful after listening to and meeting a wide range of passionate practitioners. This would include Ron who gave a few very insightful presentations.  I’m here to tell everyone in PRI Land that airway obstruction and the anterior neck are areas that we understand, thanks in very large part to the information that Ron has put together for us. My hope is that we make that clear to all allied airway health professions in our communities as we continue our own Postural Restoration journeys.”
Steve Cuddy

A huge thank you to Dr. Howard Hindin, and the AAPMD Organization for once again including us in this effort. Dr. Hindin was awarded the “Howard G. Hindin, Breath of Life Award” for his dedication and role in this collaborative movement and because of his efforts Airway Health has been brought to the forefront of Healthcare. Thank you again and we look forward to continuing our involvement with and alongside you all. Next year’s Collaboration Cures conference will be held in Seattle, on November 12-14th! See you there.

Posted October 23, 2019 at 4:44PM
Categories: Website Clinicians Science

On page 16 of the Cranial Resolution manual, there is a bullet I wrote that states ‘If we don’t balance rotational events through hemispheric oscillation, occipital alternation or lateralized rhythm, we remain resolved to compensate for our rewarded over-reaction and autonomic drive to repeat.’ 

Yet there were 14 PRCs, 1 PRT and the rest of the class who have taken a minimum of 7 PRI courses. Needless to say, they were “repeaters”. Their drive to continue to learn how to balance rotation with frontal oscillation is on a continuum. The host couple emulates this drive. Thank you Josh and Katie Olinick for hosting another PRI course in the manner you did. (The coffee was just a tad bit cold. Just kidding. I did not need the sugar. Your sweetness diffused into my body before my first sip.) Your hospitality and reception is truly reflective of “home”. Sangini Rane PT, PRC thank you for bringing a patient for all of us to evaluate and make suggestions reflecting autonomics and the course material. Everything about this course I love. The material has been strengthened over my last 30 years of clinical practice. And the messages are being delivered to a body of people who now can appreciate what my autonomic and somatic nervous systems were integrating 30 years ago, with a platform, called ‘PRI’. Any time I get a hug from Susan Henning PT, PRC I feel better than a cold cup of coffee. 

Essex Junction, VT

Home of Essex Physical Therapy and it’s famous PRC Owner Estelle Leclair MSPT, PRC. Estelle’s clinic has the only modern PRISM pool in the country!  Impact Physical Medicine and Aquatic Center in St. Paul, MN has the original prototype and Essex has the latest state-of-the-art iteration of the famous PRISM Pool. Yes, the one developed by Ron Hruska. Estelle and her husband Jeff decided that it was time to truly move forward and be the first in the nation to put into action this amazing PRI-based pool! I got in it and it was awesome!

During the weekend while I was there I taught Impingement and Instability (I&I) to about 30 great clinicians and we had more fun than a clown on fire!! For those of you not familiar, I&I is a deep-dive advanced course that explores exactly WHY people impinge body parts and have pain. You may be thinking that I am making it sound as though they have a choice. They DO! We choose to impinge and if you ever make it to this class you will discover not only WHY but also what to do about it. You will learn that every orthopaedic site of Impingement is actually the end result of neurologic phenomena. Sound wack?!  Listen to what one of the attendants said from this past weekend in VT. “I cannot believe that we could so easily correct what seems to be hard and fast positioning! Your demonstrations sealed the deal for me! I will NEVER look at a rotator cuff impingement syndrome the same again...EVER!!” You can also find yourself seeing the light through a lovely purple filter as well by taking this course. Oh, and if you’ve taken it before, keep in mind: A lot may have changed since then so it may be time to revisit!  God bless you all!!

Posted October 15, 2019 at 4:26PM
Categories: Courses Clinicians Science

This past weekend, I visited one of my favorite places to teach PRI courses. The energy of  "the City that never sleeps" always seems to match the energy and enthusiasm for the science of PRI. This was my third trip back to New York to teach a class. On a personal note, it was great to bring my husband Chris and daughter Devon along again this weekend. We basically ate our way through the city and thankfully were able to walk most of what we indulged on off over the course of the 4 days! A friend and future PRT Kyle Langworthy’s brother Brandon Langworthy, DPT was attending his first PRI class. Brandon lives close to me in NC, so I look forward to seeing him again as well as the other attendees that were taking their first or second PRI course. I was also honored to be part of Kasey Aiken’s mentorship as she prepares to teach this course next year. I will let Kasey share her thoughts and experiences from the weekend. 

- Jen Poulin

From Kasey: "The class brought the energy from the city into the two full packed days of learning Myokinematic Restoration. With 80% of the class being their first PRI course ever, the questions and ability to learn and regurgitate the material was very impressive. We even had a DO that lives in Belgium fly over to learn the science of PRI. The combination of strength and conditioning specialists, PTs, and even PT students in the course is what keeps PRI applicable and beneficial to all different disciplines. They mastered exercises in lab to reposition the pelvis as well as strengthen the pelvis in the new neutral state. The attendees began to understand the correlation between the infamous Hruska ADDuction and ABDuction lift scores in regards to the gait cycle. Being able to tag team teaching with Jen Poulin was an absolute honor and appropriate considering she was the first faculty member to present Myokinematic Restoration to me several years back. A thanks to Brad Gillen, for assisting in lab, we couldn't have done it without your help and expertise to hit home for such a large group of attendees."

Posted September 30, 2019 at 4:13PM

“I have several cases I can apply this to already.”

“The course met the objectives to the full extent. Loved the course!”

“I am so glad I finally got to do a PRI course!”

“I learned a tremendous amount of information that my client base can benefit from.”

The physical therapy team of Charles George VA Medical Center hosted the most recent Postural Respiration course. This facility is considered among the top VA hospitals in the country, noted for its clinicians’ care and expertise. Surrounded by the splendor of the Blue Ridge Mountains, the 40 attendees, comprising PTs, OTs, PTAs, ATCs, DCs, and one student contemplated the asymmetrical diaphragm and its influence on pelvic-femoral and rib cage position and function. Movement starts with diaphragm, driving our lower half to one side while our upper half counter-rotates to the other. It’s a neurological concept, and it's what allows humans to be adept at things like throwing a ball, dancing, and doing flips and twists mid-air. Rib cages come in all shapes and sizes, formed not just by genetics but also by the activities a person engages in, positions they hold themselves in, and his or her unique responses to physical and emotional stress. However, regardless of rib morphology, every cage is under the influence of a powerful diaphragm that pulls it to the right, driving predictable patterns of air flow and movement. When not countered, and if skewed too far for too long, the result is pain, rib deformity, poor physiology, shortness of breath, anxiety, etc.

Lab time was generous to allow proficiency in PRI techniques, both manual and non-manual, and objective tests that indicate an individual’s neurological patterning and presence of pathology. Attendees experienced the power and swiftness of PRI’s neurological techniques -- inhibition and facilitation – to create changes to pathology-producing patterns. There isn’t a patient population out there that wouldn’t benefit from the PRI approach. Thank you to lab assistants Josh Owen, ATC, PRT, and Tracy-Lynn “I am SO ready to get my PRC” Schuster, DPT, whose guidance and clinical expertise provided clarity throughout the weekend. Great to see PRC clinics well-represented: Josh Olinick’s Steps for Recovery, Jen and Chris Poulin’s Sandhills Sports Performance, Advance PT, and Tracy Lynn’s Schuster Physical Therapy. Thank you to our avatars Debra Albrecht, PT; Nathan Crosby, DPT; Charles Fairbanks, PTA; Anthony Figuera, DPT; Linda Gutowski, DPT; Carl Heldman, DPT; Megan Humpal, PT; Caroline Lounsbury, ATC; Christiana Marron, DPT; and Pete West, DPT. Also thank you to our reader, Onyeamaechi Arinze, PT (my apologies again for botching your name all weekend. If we meet again, I’ll need to shorten it to “O”!). Finally, thank you so much to our hosts, who made the weekend go smoothly: Nathan, Anthony, Carol Harty, Deanna Mihok, Monica Sety, Keith Silcox, Pete, and Sharon Wisner. It was a pleasure to meet you all! Charles George VA will be hosting Pelvis Restoration in 2020. I highly recommend a visit to Asheville for this course. Be sure to treat yourself to a few days before or after the course to enjoy the gorgeous hikes and all that Asheville has to offer.

Posted September 27, 2019 at 4:59PM

This Geriatrics course is a refreshing Affiliate Course that frequently surprises attendees because all of the useful information it has in it. After the course C.M. writes, “This is one of the most influential PRI courses I have taken, providing a thorough overview of the science and concepts that challenge both the beginner and the experienced PRI clinician. Excellent.” B.B. said, “This was a great review of PRI which brought so many pieces together, while simplifying the exercises for geriatric patients.” CV said, “I love the evaluation and treatments, and they can immediately be applied to all patient types, especially geriatric and frail. The manual was easy to navigate and overall, this was a fantastic course. My favorite so far!”

James anderson teching PRI for Geriatrics in Seattle WA

Seattle Washington is is a great place to be most any time of the year. Loved all the chic waterfront restaurants and cool shops on this trip. A big thank you to the crew at Alpine Physical Therapy for being such great hosts, ...again. 3 PRC credentialed practitioners in the same clinic makes for a great learning environment. Thank you Jeremiah, Chris, and Eli. We look forward to being back next year in February for the other end of the spectrum when Lisa Mangino and I present the new Pediatrics Course. So excited to share this exciting material with all the cool practicians in the Seattle Area.

Posted September 16, 2019 at 9:34PM
Categories: Courses Clinicians Science

Jason Miller, PT, PRC, was our host for Myokinematic Restoration last weekend in Missoula, MT.  Jason has been using PRI for quite a while, and this was a great opportunity for Jason's co-workers to get exposed to the science of PRI.  Nearly half the audience were from Jason's facility, which will really assist those new to PRI in their journey.  It's always easier to have co-workers along side for the ride.  My thanks to Marla, Seth, Samantha, Kristina, Kailey, Erika, Jessica, and Sydney, as well as Jason's wife, Jill,  for their willingness to learn and ask great questions.  

Dan Houglum, Myokinematic Restoration, Postural Restoration Institute, Primary Course

It was a great group of movement professionals, and a nice mix of those new to PRI, and those who had been exposed to PRI previously.  We started the weekend talking about positional influences on femur position and performance, as well as why and how AF position directs FA performance. We proceeded into which muscles are available and unavailable while in the L AIC pattern. This introductory 5.5 hours of didactic information is the foundation upon which the rest of our weekend was built. And it will provide a solid foundation for those new to PRI to build from as well.  

Myokinematic Restoration - Postural Restoration Primary Course

Once the groundwork had been laid, then we can start getting into the real value of PRI: getting off the right leg and onto the left leg correctly without compensation. The role the Hruska ADD and ABD tests play in that endeavor cannot be overstated. We were fortunate to have a lot of time to dedicate to these valuable tests. Additionally, we were able to experience, find, and feel inhibitory and faciliatory techniques, which allowed us to bring together both days of learning into a great time of lab.

Myokinematic Restoration - PRI Primary Course

We had a great crew of attendees. In addition to Missoula Bone & Joint group, I greatly appreciated Tim Cordial's questions, Amy Downing's help in lab, and Mandi Nystrom's willingness to be our volunteer during demonstration.

Again, my thanks to Jason and his crew for a great weekend. Looking forward to the next trip to Missoula!

As all the PRI Faculty will tell you, having the opportunity to teach a PRI course in Lincoln at the Postural Restoration Institute is kind of like a homecoming. Even though it isn't really our "home court," it does feel like it. That's a testament to Hannah, RJ, Sage, and, of course, Ron and Jen. As I said in our introduction at the beginning of the course, those new to PRI couldn't have picked a better course than this one for their first dive into the science of PRI.

Myokinematic Restoration, Lincoln NE, Postural Restoration Institute

It was such a great experience to teach with Kasey Aikin, our newest PRI faculty member. She did an awesome job, and I'm eager to watch her develop and grow into her new role. We had two other PRC's in attendance as well this weekend: Lisa Bartels and Jason Masek. They have been integrated in PRI for many years, and it was so beneficial to the attendees to have them in class and during lab. Additionally, we had five other attendees who had attended multiple PRI courses prior to this one.

Myokinematic Restoration, Lincoln NE, Postural Restoration Institute

Myokinematic Restoration, Lincoln NE, Postural Restoration Institute

With all the experience in the room, with Ron and Jen providing context during the course and lab, and with the interest and energy from the attendees, the course proved to be a very fertile environment for those new to the science of PRI. Kasey presented an excellent opening and really set the table for the rest of the weekend. We opened the course with discussing osteokinematics and myokinematics surrounding the relationship between the pelvis and femur. And we finished the day with a great repositioning wrap up, which lead us right into Day 2. Kasey again set the table with another stellar opening session, and the table was set for our day of lab.

Dan Houglum, Postural Restoration Institute

Our lab times were very productive and engaging. And a lot of it was due to where we were, and the expertise in the room. I have to thank Lisa, Jason, and Jen for their help during our labs. Kasey ran a great lab session on Sunday afternoon, as well. We were fortunate to have nearly 7 hours of lab during this course. We had a 4.5:1 ratio of student to PRC in the lab. I'm not sure the first time attendees realized how valuable the lab time was, and how much we were able to get out of the time we had.

My thanks to Jennifer Bacon, Meghann Vanslager, Kelli Reilly, Kellen Goertzen, Joe Siracusano, Kristen Wassung, and Benjamin Sandman for their wonderful questions. Honestly, we had great questions from nearly everyone in the room. I think every course attendee asked a question at some point during the weekend, which just shows how great a group we were fortunate to have. For many reasons, this particular Myokinematic Restoration course was unique, and Kasey and I feel very fortunate to have been a part of it.

Austin! The Texas state capital. I traveled there to visit with the best little PT house in Texas! Star Physical Therapy. I was there to teach Impingement & Instability.  Jon Hupp PT, PRC is the owner of Star and he is a dang good clinician and a good man.  Many of you may know Jon but did you know that his daughter Skylar is an elite gymnast? She will likely get a nice scholarship as a result of her gymnastic skills. His son Sterling just started his senior year in high school football and has been doing some good playing so far! Jon’s wife’s name is Bear. Yes! Bear! I LOVE that! I met her and the minute I did I knew she was a nice lady and a kind person. She spends her time taking care of the kids and doing a ton of administrative work for Star. 

Speaking of a ton, this I&I class had a TON of participants!  Around 40. That’s a big class size for a secondary course but...well...Texas.  A dentist named Alice Lam dropped by the first morning to visit. I do some work with Dr. Lam in Houston and she is fascinated with PRI.  I&I is a complex course that explores WHY your patients have Impingement phenomena.  Did you know that they WANT to impinge? It’s neurological. That’s probably why so many veteran PRI clinicians were there. There were 5 PRC’s there: Jon Hupp, Steve Cuddy, James Guzman, Sarah Luin and Josh Elrod as well as PRT, Josh Ogden.  At the other end of the spectrum we had two PT students there. Both of them are my friends: Steven Blair and Phillip Wuellner. 

I&I explores calcaneal, patellar, hip and scapular Instability and the varied impingements that can and do occur as a result. Be prepared for multiple surprises when you take this class.  Some comments from this past weekend: “This changed how I look at the Hruska Adduction Lift Test!” “It changed how I consider the position of the heel as I address my scapular programs to decrease humeral glenoid mechanics.” Oh, and did I mention the ribcage? The deep-dive into detailed mechanics of the existing respiratory variations puts a massive neurological spin on ribcage-scapular function. Whew! I got a little crazy there for a second. Thanks Ron Hruska, for my mild derangement. I cannot WAIT to see all of you in this most fascinating course.

"Wow" was the word of the weekend at Cantrell Center for Physical Therapy, Sports Medicine and Wellness. This was one of the most enthusiastic groups this faculty member has observed with half of the attendees being new to PRI. In addition, The Cantrell Center had half of the total number of students in attendance which made this a real team effort for their facility and created a stronger culture of PRI for their facility. What I loved about this group was the balance of great questions and re-states from every one of the new students as well as the "veterans". There were two PRC's, including lab assistant Ken Smith, who stated what we all experience attending a PRI course-no matter how many courses we have had is that there is always more to absorb and learn!

Cantrell Center Exercise Physiologist "Gentle" Giant Jalen Lawrence asked some great questions on how to apply PRI to power lifting and being able to learn how to better "axial load" when lifting. This was one of the most important questions for his athletes. In addition, we discussed that PRI loves extension for performance. We just don't want to live there all the time and that flexing and internally rotating ribs is needed to down-regulate a system and help restore autonomic balance. HRV or heart rate variability was discussed in the context of Postural Respiration concepts. Autonomic function with parasympathetic inhibition upon inhalation vs. parasympathetic facilitation upon exhalation was discussed as a needed balance for HRV. Since breathing is such a common dysfunction, considering most of our patients present in a hyper-inflated, neurologically extended state, understanding diaphragm function and airflow management is a critical issue. This is not only an issue with people that come into our clinics with pain and dysfunction. It is a performance/recovery issue as well. Shout out to Mehmet, Marion and Michael from Florida who asked great questions and brought great energy. Thank you to all in attendance for making my weekend flow so well with all of you especially the "Cantrell Gang" who can collaborate and apply PRI in a supportive setting. Ken Smith, PTA, PRC was golden as our lab assistant and his energy helped move all of us along. Finally, thank you Tassie Cantrell for such a beautiful facility, great food and wonderful staff that attended and helped all weekend with set-up and clean-up duties.

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