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Blog Posts in March 2011

Course requirements for Postural Restoration Certification (PRC) have recently been revised. The revision is due to addition of both Pelvic Floor Restoration and Impingement & Instability since the introduction of PRC in 2004. The analytical and clinical examination for PRC remains unchanged.

Required Courses: (Information from the following courses will be tested during the analytical and clinical examination.)
Myokinematic Restoration
Postural Respiration
Advanced Integration

In addition, choose one of the following courses: (Information from the following courses will not be tested, however, you must attend at least one of the course below to be eligible to apply.)
Cervical-Cranio-Mandibular Restoration
Pelvis Restoration
Impingement & Instability

Applications are due September 15, 2011. Please contact me if you have any questions.

Posted March 31, 2011 at 4:12PM

A reminder to those attending our upcoming Interdisciplinary Integration course - please make your hotel reservations as soon as possible. The hotel blocks set aside for course attendees will soon be released.

Comfort Suites by Choice Hotels
331 N Cotner Blvd, Lincoln, NE 68505
Phone 402-325-8800
Special rate of $69 per night is available to our course attendees.
To reserve a room please request the group block under “Postural Restoration Institute”. Features include: brand new hotel just 3 blocks from course, shuttle transportation (please call Emily Gifford to make arrangements at least 1 week in advance), continental breakfast, indoor heated pool and fitness center, and business center.

Chase Suite Hotel by Woodfin
200 South 68th Place, Lincoln, NE 68510
Phone (402) 483-4900 or toll free (888) 433-6183
Special rate of $79 per night is available to course attendees.
To reserve a room in our block, please ask for Roxanne in the Sales Department. Features include: complimentary city wide van transportation (including transportation to and from course and airport – upon request) and complimentary hot breakfast buffet.

New Victorian Inn & Suites
50th & O Street, Lincoln, NE 68510
Phone (402) 464-4400
Special rate of $59.99 per night is available to course attendees.
To reserve a room in our block, please mention the Postural Restoration Institute. Features include: shuttle transportation, pool/hot tub/exercise room, business center, free deluxe breakfast.

Posted March 31, 2011 at 4:02PM
Categories: Courses

Ron Hruska has limited his teaching schedule over the past couple of years but remains the only instructor for Cervical-Cranio-Mandibular Restoration. His passion for cranio-mandibular dynamics and dysfunctional management date back to his first years of practice as a physical therapist and even his initial and temporary decision to enter dental school. Attending this course offers an opportunity to learn from Ron, the founder of PRI, on a personal level and interact within a small group atmosphere. Because this course requires prior attendance of Postural Respiration and is attended by those with advanced knowledge of Postural Restoration principles, the setting is generally an intimate atmosphere and a great deal of time is spent addressing the specific questions or concerns of the group. This past weekend was a prime example of such a course. With 15 attendees in the northern suburb of Chicago, Ron felt that each attendee advanced their skills tremendously and gained answers to general PRI related questions of a personal agenda.

Comments from course evaluations:
Lots of time for Ron to help each participant. Awesome course as always!!
Speaker was very thoughtful with the audience. Great course. Amazing! Thank you!
This course was the best with lab considerations of any course I’ve taken. Excellent course.

Remaining 2011 Cervical courses:
May 21-22 Chevy Chase, MD
June 11-12 Bismarck, ND
October 1-2 Loveland, CO
November 12-13 Lincoln, NE

Posted March 29, 2011 at 4:16PM
Categories: Courses

Over the last year, we have been working hard on the PRI Library.  We are happy to say that we are getting closer to completing this project!  The books have all been categorized and we are now working on articles.  Once we have completed this project, the PRI Library will be available for any clinician wishing to do research on PRI or anyone wanting to prepare for Postural Restoration Certification

If you know of an article or a book that you feel belongs in the PRI library, please email us!

Posted March 28, 2011 at 4:33PM
Categories: Articles

If you have a chance, check out this article, “Individuals with low back pain breathe differently than healthy individuals during a lifting task” published in JOSPT this month.  This article found that individuals with low back pain inspire more lung volume than individuals without low back pain during a lifting task.  These finding indicate that breath control may be a relevant area of focus in the management of low back pain. 

Posted March 28, 2011 at 4:25PM
Categories: Articles

Thank you to everyone who attended the presentation by Ron Hruska and Jason Masek at the Mid-American Athletic Trainer’s Association (MAATA) - Annual Symposium in Omaha, Nebraska.  Please click on the presentation titles below to view or print the Power Point presentation. To learn even more, we hope you’ll consider attending one of our introductory courses: Myokinematic Restoration or Postural Respiration. PRI is recognized by the Board of Certification, Inc (BOC) to offer continuing education for certified athletic trainers (#P2376). This approval currently applies to PRI live and home study courses

Postural Restoration - Biomechanical Influences on the Athlete’s Lower Half
Postural Restoration - Biomechanical Influences on the Athlete’s Upper Half

Should you have any additional questions or feedback from the Symposium presentation, please contact us.

Posted March 18, 2011 at 1:05PM

A while back we received a great question from Joyce Wasserman, PT, PRC on Tinnitus.  Read her question and Ron Hruska’s response…

“I am looking for references that link tinnitus to suboptimal dental occlusion or absence of centric occlusion. I’d appreciate any leads, names of journals or websites, that I should be looking at. Has any of the PRC therapists been able to help people with tinnitus, alone or in collaboration with a dentist?”

Tinnitus, or ringing in the ears, can be a very confusing and often poorly understood symptom.  Tinnitus and dizziness are the two most frequently asked about symptoms, both here in the clinic and through the internet.  From the reading that I have done, it is thought to occur when the brain areas involved in hearing spontaneously increase their activity.  Therefore, it is associated with virtually all disorders of the auditory system.  It is not limited to ringing of the ears, but may be perceived as whistling, buzzing, humming, hissing, roaring, chirping or other related sounds. 

There appears to be three forms of tinnitus.  The last is more of an osteopathic thought process approach.  Nonetheless, I’d like to cover all three briefly in this response to a question received by a PRC therapist about the relationship between tinnitus and dental occlusion.  The first most common form of tinnitus according to James B. Snow Jr., a physician at the University of Pennsylvania, and former director of the National Institute on Deafness and other communication disorders, arises from damage to the inner ear, or cochlea, caused by exposure to high volumes of sound.  Dr. Snow also states that drugs such as aspirin, quinine and aminoglycoside antibiotics, cancer chemotherapeutics and other ototoxic agents, and infections and head injuries.  He goes on to state that if the inner ear is damaged, input decreases from the cochlea to the auditory centers of the brainstem, such as the dorso cochlear nucleus.  This input loss may lead to increased spontaneous activity in the nucleus neurons as a result of inhibition that has spontaneously been removed. 

The second most common form or theory of tinnitus is autonomic nervous system stimulation from increased neuromuscular tension.  Retraining therapy, a process that can take a long time, often two years or more, can help reduce this tension from the autonomic nervous system.  This process is called habituation of reaction.  Tinnitus then becomes quieter for longer periods of time and eventually or hopefully will disappear or become a natural part of the background noise or “sound of silence”.  This is sometimes referred to as habituation of perception.  This won’t happen if or while the tinnitus is still classified by the person experiencing it as a threat, negative experience, an undiagnosed symptom, or while the individual is under a lot of emotional stress.  Many tinnitus patients have hyperacousis or high degrees of sensitivity to external noise and therefore they seek and search for quiet environments to work in.  In this respect, according to information from, they are their own worst enemy.  Supposedly, if strong beliefs about the threatening nature of tinnitus are maintained, the survival style or condition response mechanisms in the subconscious brain insure that it is continuously monitored and therefore the condition itself will not improve.  Imaging studies confirm increased neural activity in the auditory cortices of those experiencing tinnitus.  Their brains also show increased activity in the limbic structures associated with emotional processing.  Other symptoms that sometimes appear alongside tinnitus, such as emotional distress, depression, dizziness, and insomnia, may have a common basis in some limbic structure such as a nucleus accumbens. 

In addition to the two most common forms of Tinnitus, that is damage to the inner ear and increased tension from the autonomic nervous system stimulation, I find that there is a very strong relationship between tinnitus and those who are experiencing temporal bone disorganization or temporalis overuse.  Clenchers, grinders, and trismus oriented individuals often experience tinnitus associated with hyperactivity of musculature that is attached directly to the temporal bone which houses the inner ear.  There does not appear to be a relationship between tinnitus and externally or internally rotated temporal bones at this time according to the literature, however, it does stand to reason that this third reason for tinnitus is strongly related to the position and orientation of a muscle called the tensor tympani muscle that inserts on the manubrium of the malleus bone and originates or attaches directly to the sphenoid bone and the temporal bone.  It lies in our auditory tube and its main action is to tense the tympanic membrane along with the stapedius muscle of the ear.  It also contains cerebellar input related to the ability to adapt to vision as well as hearing.  Since this muscle makes the tympanic membrane taught if it is put in a position where it is lengthened it can also influence its own innervation by the mandibular division of the trigeminal nerve.  It can have a direct impact on the external surface of the tympanic membrane. 

The external surface of the tympanic membrane is innervated by the oriculo temporal branch of the mandibular nerve and the oricular branch of the vagus nerve.  The internal surface of the membrane is supplied by the tympanic branch of the glossopharyngeal nerve.  Temporal and sphenoid orientation, therefore, can have a both direct and indirect impact on the autonomic nervous system, trigeminal innervation, and vagal activity.  Clinically, keeping the temporal innominates aligned, stable, and functioning in a reciprocal manner with respiration and mandibular activity is important to keep the tympanic membrane, tympanic cavity, and septum of the auditory muscular canal aligned.  Through manual or non-manual techniques using PRI principles and philosophy, I have been able to change the frequency and intensity of this irritant.  Many of these same patients also need to be evaluated by a dentist with a strong background in TMD and occlusion and it’s always helpful to work with a dentist who has a cranial-gnathic orthopedic mind.  Being familiar with the different lesions of the cranium that can occur with malocclusion is always helpful in restoring proper cranial symmetry with a bite. 

In addition to this I’ve also had success in working with optometrists, specifically COVD trained optometrists, who presently understands the autonomic nervous systems influence on accommodation and tension across the cranium as a result of vestibular constraint secondary to visual and spatial lack of integration.  Hopefully, this overview will help anyone working with a patient experiencing tinnitus.  Obviously, we’re excited that the physical and physiological implications associated with tinnitus, can be corrected or reduced using methodology that diminishes the asymmetrical issues at the temporal region as well as the hypersensitivity associated with torque placed on the temporal bone itself. 

Posted March 17, 2011 at 1:35PM
Categories: Science

Ron Hruska and Dr. Wise are diligently working on the Interdisciplinary Integration course this morning! As a result, I now have in hand, four pre-reading recommendations for your weekend enjoyment:)

Astigmatism…with a Twist by Steve Gallop, OD
Vision Development by Heidi Wise, OD
Visual Conditions of Symphony Musicians by Paul Harris, OD
Reflexes, Learning and Behavior by Sally Goddard

Posted March 11, 2011 at 2:18PM

We are thrilled that so many of you are planning to attend the upcoming Annual Interdisciplinary Integration course! The course is filling up quickly. With just 4 seats remaining, I encourage you to register soon to ensure your seat at the course. You won’t want to miss this opportunity!

“The three days will offer anyone with an interest in vision or the vestibular systems an opportunity to learn how basic cranial, cervical and thoracic mechanics can be influenced not by what we see, but by where we have to put ourselves to see it.”

Posted March 11, 2011 at 2:10PM


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