Each of the PRI courses take on a personality, over time. Of course this personality can be modified by the speaker who is presenting or the people in attendance. After presenting the Myokinematic course material a few weeks ago, I realize how important our basic courses are and how important they are in providing the ground and foundation for all the other courses. I also appreciate, now more than ever, the need for guidelines and boundaries from each of our courses and each of our speakers. The one course that provides the most clinical guidelines and references for system flexion maintenance and symmetrical integrity, is the Impingement and Instability course.  This course offers historical reference and allows the attendee to reflect on those events that shaped and developed their “check” points and stability limits.

When I was young, I would occasionally walk the railroad tracks to town. I would see how far I could go, placing one foot in front of another on a steel non-ending beam, before I would fall off. I would never quite get over the bridge however, walking on one rail. There is something about a train rail, going across a bridge, that would always throw my calcaneus and foot arches off in my worn leather high top farm shoes. I learned early that vision influenced the foot and balance. When your system wobbles the feet become marbles. 

I also will never forget how nervous my wife and I were when we let our oldest daughter finally ride her bike around the block without us. This seven year old took off and was never to cross a street. A maiden voyage. At the first corner there was the big oak tree that we walked and rode around many time prior to this sole expedition. At the second corner there was the dilapidated boat and at the third corner there was the fire hydrant. Will she remember the oak tree, the boat and the hydrant? Although I am not as nervous about my patients ability to remember the left hamstring, the left adductor or the left gluteus medius as I was for my little girl’s safety around her block she lived on, I am pretty nervous when a patient can’t feel these muscles or their left ischial tuberosity. 

After attending a wedding reception this weekend I reflected on the biblical story on how God created a woman from a man’s rib. A rib! What a wonderful guidance center. (I wonder if a left one was used or a right one. Can’t wait to ask.) None the less, the ribs are attachment sites for highly integrated abdominals, scapulas and diaphragms.

Aren’t door ways great? We occasionally run into them, hit them inadvertently, close the door hard on them when we are mad, etc. and without them we could never enter a room. They provide contact boundaries in the middle of the night and guidance for a closing door, just like our anterior and posterior hip capsules. When we slam into them we know it.

Rail road beams, city block markers, ribs and doorways all have personalities. They direct our attention, are an allusion to an occurrence or a situation, and indirectly in some cases, and directly in others, become pointed and meaningful, just like the posterior calcaneus, the middle arch of our feet, the ischial tuberosities, the lateral abdominals and the hip capsules. Thank God we have them, other wise we would be in “time out” because of the inflammatory process would constantly take over and situational instability would be inherent. These life long reference center personalities need to be recognized and correctly used regularly. When did you check in with your reference centers, and when did they check you?