Welcome to the Postural Restoration Community! This is where you will read the latest industry news, hear about upcoming events, find helpful deadline reminders, and view a plethora of additional resources regarding our techniques and curriculum. The great part about it is--not only can you can view the entries we post, you can also post about the things that matter to you. Did you find an interesting article about a technique you learned in one of your courses? Do you have a patient case study you want to share with other professionals? Simply click "Submit an Entry" and follow the easy steps towards getting your information published in the PRI Community!
It is always nice to have a home game. Over the last two years I have had the good fortune to teach Myokinematic Restoration on both coasts and multiple points in between. This past weekend I was able to welcome a group of movement specialists to my little mountain town, Missoula, MT.
Revo Training Center hosted the course, and we had a great group consisting of Missoulians, Montanans, as well as representatives from WA, ID, AZ, NM, and TX. We opened the weekend with a discussion of a quote from Mr. Hemingway that is found on page 1 in the manual, “Never confuse movement with action”. We endeavored to appreciate how patterns of human asymmetry dictate the position of the body and ultimately whether the movement elicited by a muscle contraction supports the action we are striving for.
We focused on action around an acetabulum on a femur, on action that is preceded by appropriate position, and on action that requires inhibition of our dominant L AIC patterning. The group had great questions and insights throughout which fostered a running discussion that was not only enjoyable, but added to the depth and applicability of the course.
Thank you to Revo Training Center for hosting and thank you to all the attendees who spent a beautiful September weekend in Missoula. While we may not have been adventuring in the great outdoors, we hopefully all had a chance to expand our view of the human body in Big Sky Country!
I had the great fortune to present Cervical Revolution to an in-person and virtual group, hailing from 10 countries. This course takes the concept of humans’ neurological proclivity for right stance at the pelvis and thorax and carries it up to the neck, teeth, and cranium.
As we know from previous courses, right stance dominance creates complex neuromuscular patterned positions and movements and is heavily influenced by gravity, respiration, and overactive chains of muscles. We introduced a new chain, the temporo-mandibular cervical chain (the TMCC), which, you guessed it, is over-referenced on the right.
The course was greatly enhanced by:
- Our in-person attendees, who were instrumental in demonstration of objective tests and treatment techniques: Lisa Bartels, DPT, PRC; Andrew Consbruck, DPT, PRC; Nate Dickes, PT; Eric Pinkall, PT, PRC; and Kurt Van Kulken, ATC.
- Kelli Reilly, MSPT; Timothy McVaney, DDS; Nancy Wehner, BSDH, COM for sharing clinical observations and expertise.
- Our virtual attendees, for thought-provoking questions and insights, most notably Evan Condry, PT; Alex de la Paz, PT; Christopher Lamb, NASM CPT; Peien Lu, PT; Donne Ordile, PT; Locatelli Rao, DPT, PRC; Laura Regan, DPT; and Alek Skorupa, LMT. To those of you watching in the wee hours of the morning or late at night, thank you for hanging in there and participating in lab.
- Jen Platt, DPT, PRC, for orchestrating everything this weekend – virtual views, answering questions, providing nourishment, and more.
Attendees gained an appreciation for the brain’s need to sense a new floor – at the occiput on atlas (OA) articulation. This articulation, when in its proper position, allows the head to remain in equilibrium with the spine below. Imbalanced left to right sensory processing and motor output occurs when the OA articulation is better sensed and over-referenced on the right side. The very health of the brain may be in peril when we over-reference our right sides too much and for too long. For example, a “twist” results in the neck, compromising a vital opening for brain: the foramen magnum, which houses the brainstem and “cisterns” for cerebral spinal fluid, bathing and protecting our nervous tissue.
The OA compression-decompression (known as OA flexion and OA extension, respectively) reverberates into the cranium at the junction where the occiput meets the sphenoid. This critical junction enables vector forces through the cranium to be distributed to the remaining paired bones of the cranium. When over-referenced on the right, two commonly seen conditions develop at the sphenoid-occipital junction, or synchondrosis: left side-bending and its pathological cousin, right torsion.
These cranial positions, maintained by the Right TMCC, place the paired temporal bones in a patterned position. The temporal bones mirror the ilia of the pelvis and should exhibit alternating internal and external rotation, depending on the leg you’re standing on. The other half of temporal-mandibular joint (TMJ), the mandible, too, is directed and held in patterned state. Without temporal alternating activity, structures within the temporal bones (think mid-brain and vestibular) are deprived of their necessary compression-decompression cycles that are so vital for nerve function. Our mandibles may lose their ability to move side to side, a prerequisite for upright left to right shifting when, say, walking. In addition, alignment of our upper and lower teeth becomes skewed over time and may lead to mal-occlusions, such as cross-bites and open bites, and TMJ disc derangements. One can now appreciate the need for dental collaboration and intra-oral splints to assist the process of restoring alternating tri-planar movement of the cervical spine (30-30-30) and temporal bones and a sense of alternating floors at the OA articulation. Doing so promotes nervous system health, resolution of symptoms, and efficient functional movement.
I capped off my weekend in Lincoln with Jen Platt and her family with an awesome experience at the U. of Nebraska Women’s volleyball game. You know you’re in for a treat if 92,000+ fans pack the stadium, as they did the previous week. Put this on your to-do list the next time you’re in Lincoln on game day. Hopefully you can snag a ticket!
The Cantrell Center for Physical Therapy & Sports Medicine is a physical therapist-owned private practice and has been serving Middle Georgia for over 30 years. We’re proud to employee clinicians who have a passion for the science and value our one-on-one approach to patient care. We are currently looking to hire a licensed Physical Therapist for our booming practice!
We are proud to currently have 2 Postural Restoration Certified Therapists (PRC’s) in the clinic which makes us highly sought after by our referring physicians, our patients, and wellness members. We often have patients who travel out of town and even out of state to come to the Cantrell Center as we are the only Postural Restoration Certified Facility in the state of Georgia.
Located in Warner Robins, Georgia, the Cantrell Center is located in the Middle of the state! Just a quick drive to Atlanta or the beach, Warner Robins offers convenience to any interest without the crime rate and elevated costs of a larger city. If you love fresh air and lush green trees, this is the city for you! Visit the website of Robins Regional Chamber for more information about the city of Warner Robins.
What makes The Cantrell Center a great place to work?
We are a collaborative environment, where patient care is paramount and each team member’s gifts and experiences blend to create an atmosphere of integrity and encouragement. As part of our team, you will work side-by-side with like-minded and dedicated colleagues, while enjoying the opportunity to build your own career.
Join our team and you’ll quickly discover why our staff of 30+ calls the Cantrell Center “home”— many staff members have been with for more than 10 and even 20 years! We take care of each other.
We believe every patient has unique needs and concerns and those are best addressed by the physical therapist, one-on-one. NO COOKIE-CUTTER treatments.
WE OFFER:
Sign On Bonus
Unique and competitive salary and generous benefits package
Work/Life Balance
Commitment to clinical excellence
Team atmosphere
Constant training and learning
An excellent mentoring program for new hires – especially for new grads
The Impingement & Instability course has been a clinician’s course for a long time. And that is even more the case now than ever before. I&I has evolved into an excellent precursor for the PRI Cervical, Cranial, Voice Box, and Forward Locomotion courses. This was very evident in the most recent presentation of I&I, which just happened to be the final delivery of this course for 2023.
Since it is a Secondary Course, the course has the opportunity to go into several different directions, depending on who is in attendance and the questions the attendees ask. This is one of the primary reasons that each I&I course is different every time it’s presented.
We were able to touch upon content from a multitude of courses, but our focus remained on the value and necessity of both Impingement and Instability as great concepts, which lead us into the value of alternating compression and decompression to increase our ability to become less functionally cortically dominant. Being able to properly manage a system below C7 allows management of issues above C7 to become easier. As a result, we start drawing the connection between the scapula and calcaneus from very, very early on Day One.
My thanks to Torin Berge, PT, PRC, for his help digest and break down the 4 unique non-manual techniques that are in this course. We were able to have an in-depth discussion about the value of these techniques, which was a treat. My thanks to Nancy Hammond, PT, PRC and Hayley Kava, PT, PRC for their questions and presence. And none of the live-stream would have been possible without RJ Hruska and his direction and production of this course. It is not lost on us that the live-stream has expanded PRI Nation, and I am eternally grateful for all of those in attendance who live in other parts of the world.
If you haven’t had an opportunity to attend the I&I course, I would encourage you to do so as every course is different, depending on the movement specialists present. My thanks to all of the movement specialists who were in attendance, and I look forward to teaching this course in 2024.
Last weekend I had the honor of presenting Cranial Resolution in Chapel Hill, NC. Although most in attendance had previously taken this course, a few multiple times, several were dipping their toes into this material for the first time. I was proud, gratified, and extremely relieved that, by the end of the weekend, everyone was expressing an energized and clinically relevant understanding of the functional relationship between the ANS and CNS – and the role that our lateralized cortical and subcortical biases and nasal passages play in influencing what we so often ‘orthopedically’ address. I had the privilege of witnessing the occurrence of serial eureka moments. These were illustrated through the cognitively insightful questions and enlightening discussions that, as one attendee put it . . . were “cathartic.”
The PRI giants at Advance PT, Susan Henning, Jean Masse and Lisa Mangino, who hosted the course, could not have been more welcoming. Their hospitality went above and beyond. I also owe a huge thanks to the incredible avatars who could not have demonstrated the autonomic concepts any better. Jean, for allowing us to use her beautifully neutral system to illustrate how the interruption of nasal flow can immediately and predictably alter one’s sense of ground and gravity (and so dramatically change a SLR test)! Kaisa for demonstrating how someone progresses through the treatment algorithm, including when and how to address an apparent dysfunctional autonomic limitation by effectively using one of the thoracic cranial resolution techniques. And a special thanks to Joe, who let me positionally challenge him to illustrate how, when, and why modifications may need to be made, and what significant gains can be achieved by addressing the autonomic nervous system.
I finished Sunday more excited than ever to be teaching this material. I cannot express how grateful I am to the institute for having the confidence in me to translate and present this aspect of Ron’s monumental work. To me, the ANS is where PRI begins. I honestly feel that gaining a basic grasp of how the ANS integrates with the CNS makes all the other courses so much easier to comprehend. It explains why things are happening and illuminates (and fortifies) the importance of the positioning, referencing, and sequencing of each and every one of the steps that are so methodically spelled out in all of the non-manual techniques.
This was my first time teaching this course solo and I will be eternally grateful to everyone who attended for making it such a successful and meaningful experience. The dynamic of this group was incredible.
I had the great pleasure of teaching Myokinematic Restoration in Lincoln, NE on August 11th and 12th. It was two days of soaking in an attitude of gratitude to be able to discuss something I am passionate about to a worldwide audience. United States, Australia, China, and Canada were represented with clinicians spread out all over the county from Florida to Washington and everywhere in between.
I also had the great privilege of attending the musical Hamilton in Lincoln with my PRI Family on Friday night. Hamilton’s message of hope, perseverance, and coming together resonated well with the Myokinematic themes of persevering through our right biasness and getting appropriate muscles to come together to balance our imbalances.
We had a fantastic in person audience who didn’t want to loose their "Shot" at learning and appreciating patterns and positions. Nicolas took a break from his final semester of PT school in Florida to remind us the learning is "Non-Stop" and gave us a great student perspective on the material. When he becomes a Physical Therapist in December he will remember to never be "Satisfied" unless he is integrating test and retest principles of A-B-A evidence based practice.
Michael attended his 14th PRI class and gave us a fantastic historical perspective as he has known Ron Hurska since 1994, knowing that "You’ll Be Back" for more as we are traveling on our PRI journeys. Matt, a former employee of the institute and Ron’s "Right Hand Man", spent time with us before he begins his role as a P.A. next week in Omaha.
We had an absolute gift in Allison who was our primary avatar for demonstration. She helped us learn that if you don’t feel the "Burn" of a left IC Adductor and left anterior glute med you may be "Helpless" managing left stance phase of gait with a pathological left hip capsule. She was able to "Blow Us All Away" by getting a 4/5 Hruska Adduction Lift score at the end of Day 2 by being such a great PRI demonstrator for the camera.
Gavin brought high level thought process and questions and taught the class to "Say No to This" overactive right adductor we often deal with. Cas’s left hip wanted to be in "The Room Where it Happens" of left AF IR to assist in reducing torque at the knee, while Joshua was excited for "What Comes Next?" as it relates to AF position and shoulder function and control for his baseball players at Baylor.
Chase and Kyle were kind enough to sit up front and "Wait For It" until Sunday afternoon for treatment techniques based off the Hruska Adduction Lift Test so that their neurological patterning and need for left stance and right swing could "Stay Alive".
Wyatt thought "That Would Be Enough" after the facilitation techniques, but was kind enough to "Take a Break" at the end of Day 2 in order to demonstrate a proper Plantar Flexor inhibition in the All 4 Belly Lift Walk.
In the end, I think all of us realized that the "World Was Wide Enough" for more knowledge and integration of PRI concepts, appreciating asymmetries, patterns, and positions. "Who Lives, Who Dies, Who Tells Your Story" may depend on our ability to efficiently assist our patients and clients in managing out right and left sides of our body.
Big thanks to everyone attending the live stream and contributing to the discussion with their questions and attentiveness. Special shout out and thanks to RJ for running such a smooth two days juggling the technology, answering and facilitating questions, and being such a positive influence for the Institute.
I had the distinct pleasure to have the opportunity to travel to Munich, Germany, and teach the PRI courses Myokinematic Restoration and Impingement and Instability. It was a very rewarding experience to see how the science of PRI is received in another part of the world. And it was a great experience to be immersed in a different culture for almost two weeks.
The first course presented was Myokin. We had 25 people attend the course from varying parts of Germany as well as neighboring countries Spain, Slovakia, Slovenia, and Austria. This was a unique experience because usually when Myokin is presented, 90% of the attendees have never taken a PRI course before. For this course,19 of the attendees had taken multiple PRI courses, as well as Myokin previously. I made a point right away to make sure we ensured that those who had not taken a PRI course previously had a great experience.
As a result of so many of the attendees being PRI veterans, we had many, many great questions and discussions. And while some of questions pertained to other PRI coursework, we were able to stay on course and continue to meet the needs of those who were new to PRI. I’m not sure I have ever taught a PRI course where every single attendee asked at least one question. But that was the case with this stellar group. Such energy and interest in the science an application of PRI concepts!
The second course we presented was Impingement and Instability. Because this is a Secondary Course in PRI, everyone had taken several PRI courses previously. Again, this led to lively discussion and questions. We were able to use the concepts of I&I and start building a bridge between the Primary PRI courses and the other Secondary and Tertiary PRI Courses. I&I is an ever-evolving course. It was immensely rewarding to have the opportunity to help these attendees in their PRI journey to better understand and apply the science and concepts of PRI.
My eternal gratitude to the Lindbergs Academy for hosting us for back-to-back weekends. Their hospitality was top notch. My thanks to Julia Felbar, FRA, Maria Sowmardi Jauker, FRA, Angelo Gorsch, PT, and Dr. Hooman Skaraztavakol for their questions and interest in all things PRI. It was awesome to have Kazu Nishimura, PT, PRC with me and helping with lab during Myokin. Spending time with Kazu was such a blessing, and his contribution was immensely appreciated and valuable to me and the other attendees.
It was an experience I will not forget. Those in attendance were lovely and soaked up the material. PRI is global. And the science does translate to other countries and cultures as we are all humans and we all have patterns. Thank you, Munich!
Last weekend, August 5-6, at Hidef Physical Therapy in Bellevue, WA, I had the pleasure of teaching Postural Respiration to a wide range of professionals that included a chiropractic student, physical therapists, LMT’s, strength and conditioning professionals and an osteopathic physician that wanted to learn more about respiration, neurology and biomechanics.
Every PRI course that is presented is always different in terms of questions asked and what is discovered during demonstration and lab. For example, often after re-positioning a pelvis on Day 1 with non-manual techniques, the student will become immediately neutral to the "oohs and awes" of the course attendees. The PRI magic seems almost easy and effortless with a technique that targets inhibition of the L AIC.
Since this course is an integrated approach to the treatment of patterned thoraco-abdominal pathomechanics, it is also likely that the PRI magic is not apparent on day 1 as the student being demonstrated on may not get neutral with any non-manual technique on Day 1 or even into the morning of Day 2.
This is where the process of following the guidelines on page 50 in the course manual come to life. What if your best efforts with non-manual techniques don’t seem to be making a difference clinically? The roadmap then takes the whole group of students through a journey of applying manual techniques to create first a ZOA, then right apical chest wall expansion. If after doing the right apical expansion or superior T-4 manual technique does not result if all of your tests turning negative, or you have limited cervical axial rotation to the left and especially a positive left apical expansion test, then you have a definitive Superior T-4 pathomechanical respiratory process.
In every course there is someone that is Superior T-4. In this course the students that were the demonstratees were all Superior T-4. Much to the instructor’s relief they all became neutral after a subclavius release and infraclavicular pump! The most gratifying part is to walk the class through a process that they need to practice and apply clinically, especially for the more complex cases that present to their offices. Accessory muscle overuse, the over-reliance of end range lateralization, the inability to reciprocate and alternate side to side and especially being aware of delivery of airflow pressure sense into a chest wall for the purpose of neuro-respiratory, physiological and biomechanical variability is the heart and soul of this course.
Thank you to my most professional lab assistant Paige McNerthney, PT for all of your help this weekend and to all of the students who brought their "A" game of attention, focus and energy. Thanks to Hidef for hosting Postural Respiration.
Each year, this image pops up on my Facebook Memories towards the end of July, when I was working on my PRC application back in 2011. I was a full time PT at the Hruska Clinic at the time, and just two years out of PT school. I began taking courses when I was still in PT school, had an awesome clinical instructor Lori Thomsen for one of my final clinical rotations, and landed my dream job after graduation at the Hruska Clinic. I was surrounded by the best mentors ever, yet I must admit that I was a little scared at the thought of completing the PRC application and testing. However, having been on both sides (a scared and nervous applicant, now 12 years ago, and today the Director of Education and Credentialing running the show), here are some tips to hopefully ease your anxiety about the process.
My Top 3 tips for preparing your PRC or PRT application:
1. Set aside larger chunks of time to work on your application.
When I first started my application, I was working on it for a couple hours at a time in the evening, or when I had a patient cancellation during the day. But, I found that by the time I would get my stuff out (all of my course binders, my case study patient charts, stacks of research articles, etc), and I mentally prepared myself to get started, I didn’t have much time to get actual work done on my application. Therefore, I found my groove when I set aside a full Saturday (which is what this picture is representing from 12 years ago). I set up a table to work, had all of my course manuals accessible and I got major work done! I did this a couple more days over the next couple months and finished the application. It isn’t too late to start on your application for this year, if you are able to dedicate a couple weekends to the process.
2. The review committee isn’t looking for perfection.
The application review is a peer-reviewed process (PRCs and PRTs). Each application is reviewed by two members of the review committee for which you are applying (either PRC or PRT), and their recommendations are provided for review by Ron and myself. Based on their feedback, we then determine if the applicant is prepared for testing, and the applicant then receives the reviewer’s feedback. None of us are perfect in what we do, and thus the review committee is not looking for perfection. Rather, they want to see your ‘thought process’ and ‘decision-making’ with the PRI concepts from the four pre-requisite courses displayed on paper throughout your application. Therefore, I would recommend that even if you look back at a case study or client program that you put together and think "wow, I would have totally not selected that technique now that I know more…." (that is fine), you can still use that case study, and at the end of your case study discussion, reflect on what you would do different now (and why….knowing what you know now, that you didn’t know then).
3. The application in itself is an educational experience.
I hear this often when people are here for PRC and PRT testing, and I felt the same way myself. I learned SO much when I was preparing my application. It forced me to review content from the courses and find answers to questions that I still had myself. I vividly remember that I didn’t fully understand the Superior T4 Syndrome until this day 12 years ago, when I went back and studied my manual, watched the home study course again and reviewed the manual techniques. I had an ‘ah-ha’ moment in preparing my application that day. The application made me reflect on my decision making process, consider what I might do different now, identify favorite techniques (which is difficult when there are so many), and it allowed me to realize how much I did know (even though there was still a lot I didn’t know). This last one is important. Preparing your application is not an easy task, and it takes a lot of time, but it should give you a little boost of confidence (you are studying for the exam while you prepare your application), and that is the hidden gem. Last but not least, the feedback from the reviewer’s is so incredibly helpful!
If you are considering applying for PRC or PRT, and you have any questions, please do not hesitate to reach out to me! The PRC application deadline (for testing in December) is September 15th and the PRT application deadline (for testing in January) is October 15th.
I also recorded some videos a few years back, which I hope you will find helpful as you prepare your application. These videos can be found on the PRC page and PRT page of our website.
Higher Physio is a very special private practice in Uptown Manhattan, New York City.
Julie Zapata, MSPT, the founder and director, specializes in Postural Restoration. She is looking to work with a similarly trained therapist to collaborate and work in order to continue to grow this amazing practice. We are down to earth, caring and compassionate. (Hard to find in a big city like New York)
The practice currently consists of One full time and two part time DPTs, as well as other contractors who provide Massage therapy, Pilates and Yoga training, and Acupuncture.
In addition to PRI, which she only started in 2014, Julie has been extensively trained with Institute of Physical Art and Myofascial Release. She has always believed in individualized one-on-one care. Julie would love to collaborate with and or mentor a younger therapist to become a partner in this journey.
Essential Duties and Responsibilities of the Therapist who joins the practice:
• To perform initial evaluations, PRI based, and establishing a treatment plan with functional goals and treatment progression with discharge planning documented in a timely, compliant manner using web based EMR (webPT)
• To participate in establishing and developing professional relationships with referral sources and the community
Expectations:
• Great patient care and service with a focus on Manual Therapy and Postural Restoration.
• A positive, self-motivated attitude
• LIFELONG LEARNER
• A PASSION for your profession and your patients
We offer:
• Competitive pay
• Paid CEUs and training to be considered
Our practice is friendly and down to earth, and stands out from the competition because of our one-on-one care and compassion. In addition, it is spacious and bright (1000 square feet)
The Postural Respiration course was tweaked in 2022 to emphasize more neurology and deemphasize some basic orthopedic concepts that had been a staple of previous iterations of the course. Over the last three or four years, much of the course material in PRI has shifted to a more neurological perspective, with extensive research to support this shift. The interesting thing is that the neurology has been present the entire time in PRI course material, but we are now in a position to present the material in a manner that is different than it has been presented previously. The intent of Postural Restoration has always been to use neurology to affect a postural change on the outside of the body by influencing how the body perceives and uses pressure on the inside. Postural Respiration is one of those courses that is now presented in a different manner than it ever used to be.
This past weekend I had the privilege of teaching Pelvis Restoration at Northeastern University. Thank you, Steve, Katie, Jai, Mark, and Emily, for hosting. Your enthusiasm for Postural Restoration is evident and I believe this was your 11th course to host for the Institute. You guys are amazing.
