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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!

Blog Posts in March 2023

Last weekend I had to pleasure of travelling to Mizzou country and teaching Pelvis Restoration at Missouri Orthopaedic Institute. I was assisted by Hayley Kava our newest faculty trainee. Hayley used to work for me back in Southern Pines, NC. We had a great weekend together catching up and planning for the future of her teaching Pelvis Restoration.  

This class was a nice mix of clinicians new to the science of PRI and those who were refining their PRI skills. Pelvis Restoration is a great first course for clinicians to help gain a better understanding of the influences of pelvic and thorax internal pressure management, frontal plane control and how patients develop compensatory movements.  

Patient management, testing and algorithms of treatment for the left AIC, PEC and patho PEC were explored and explained. Questions were asked and theoretical concepts were discussed for a variety of patients experiencing not only pelvic floor disorders, but also lower back pain, SIJ dysfunction, pubalgia and stress incontinence.

Hayley provided great insight for clinicians working with internal pelvic floor therapy. I look forward to learning more about her insights as she begins teaching Pelvis Restoration!

Posted March 29, 2023 at 1:51PM
Categories: Courses Science

The ENT Institute of Atlanta played host to the most recent Postural Respiration. This course encouraged attendees to look below the head and neck for “bottom-up” influences on the conditions you treat. What do hip pathology, low back pain, headaches, and TMD have in common? A thoracic diaphragm that is patterned in its position and activity.

We discussed how the static asymmetries of our torso lead to overactive chains of muscle below the diaphragm (anterior interior chain and posterior exterior chain) and above the diaphragm (brachial chain). These chains create dynamic patterns of breathing that become entrained in our nervous system and that can restrict healthy alternating, reciprocal movement when upright. Numerous videos were presented that reflect how patterned breathing influences walking: poor posterior right arm swing, reduced thorax rotation and center of mass shift onto the left leg, and waddling, to name a few. Our stronger, better leveraged right diaphragm creates twist and torsion of the airway which, in turn, promotes inefficient strategies to pull air in, including belly and neck breathing, with their associated forward head posture, hyperinflation, and overly extended thoracic spine and rib cage. Neurologically-driven patterns of airflow define how we sense ourselves in the space around us, how we move through it, and our vulnerability to pain and injury.  

Many thanks to Kaitlin Blankenship, ATC; Jose Crespo, PT; Mischelle Hardwick, PT; Allison Robbins, PT; Tre Tate, CPT; and Adria Wofford, PT for volunteering to model the tests and techniques.    

Kristen Spencer, PT, PRC, was invaluable in assisting with lab and adding clarity to questions and concepts.  

The practitioners at ENT Institute did an awesome job of accommodating us guests: Jose; Ann Gerber, PT; Jennifer Hansen, PTA; Mischell; Jennifer Harrell, PT; Deisy Nunez Aguirre, PT; Allison; Olivia Terrell, PT; and Cristen Walker, PTA.   

I hope you get the chance to host again. If so, Cervical Revolution would be a natural fit for your caseload.  You will learn about the influences of an additional chain of muscles, the temporal mandibular cervical chain. You will gain an understanding of how the concepts of Postural Respiration and patterned air flow apply to the cervical spine and cranial patterns and their potential to create malocclusion, TMJ dysfunction, headaches, and visual-vestibular disturbances, all of which you routinely address in the clinic.

Posted March 23, 2023 at 10:32AM
Categories: Courses Science

The first Cervical Revolution course of 2023 was presented at the Postural Restoration Institute to an international group of students. Attendees present were from all around the globe including China, Japan, Singapore, Canada, England, Ireland, Germany and Bulgaria as well as from every part of the U.S.A.  Professions included physical therapists, chiropractors, strength and conditioning professionals, an osteopath and a medical doctor to learn PRI concepts of the cervical, cranial and occlusal system.

Cervical Revolution is the introduction to the PRI concept of "top down" while acknowledging that "bottom up" is always at play since humans need to manage upright posture, gravity and gas! One of the biggest topics is that if you lose the floor then a new ground up into the cervical spine, cranium and even jaw will occur. When this over reliance on the neck occurs, cranial torsion or pathology is almost certain. This course unlocks the path into the cranium and a deeper dive into neurology which is then presented in tertiary PRI courses.

During the weekend, PRI examination of the cervical spine was then integrated with repositioning techniques that addressed position of the cervical spine, occiput, sphenoid and temporal bones all at the same time. This is part of the magic of this course in understanding how to integrate many parts to restore alternation of the whole with oscillation of atlas and occipital bones, freedom of a sphenoid, wobble of temporal bones and jaws that can freely swing or truse! Louise Kelley, PT assisted me greatly in this endeavor with lab exam, PRI techniques and answering tough questions from curious students.

  

For over a year, Louise Kelley, DPT, has been training with me to teach Cervical Revolution. This past weekend was her last training course as she will be "flying solo" in May to teach this course on her own. During this time working with Louise I have been so impressed by her knowledge and dedication to the science of PRI. Over the weekend and over the past year I have watched her grow into becoming a stellar faculty member especially in her understanding of PRI principles as well as describing and breaking down techniques to restore alternating cervical and whole structure alternating function. I will miss spending time with Louise and she will be a brilliant Cervical Revolution teacher! 

Posted March 9, 2023 at 10:32AM
Categories: Courses Techniques Science

I felt right at home with the clinicians at Finish Line Physical Therapy, all seasoned runners. Photos of their and their patients’ running accomplishments, all smiles at the completion of a race, adorn the space – and make for the perfect back-drop to discuss the impact of undesirable airflow patterns, habitual use of accessory muscles of breathing, and a restricted diaphragm on movement.


Asymmetry is the rule of the body and brain. As such, humans, by design, exhibit a right-sided preference, which is reinforced by a culture that favors sitting and a lifestyle made easier by technology. The result is a form of “hemi-neglect” of left sided muscles of grounding – hamstrings, gluts, and abdominals – needed for weight-shifting. Rib cages remain under the influence of muscles that don’t promote alternating internal and external rotation and the associated sense of expansion and recoil. The result is a form of left or bilateral COPD, with its distinctive hyperinflation.

   
Stiff, patterned rib cages and abdominal oblique disuse cause the diaphragm to undergo twist and torsion that, in many cases, cannot get out of. This twist of our respiratory system is a significant mechanism underlying the many syndromes and injuries that we confront in the clinic.


Many thanks to our weekend avatars, whose willingness to demonstrate and receive techniques enabled us all to better understand PRI concepts: Patrick Cronin, PT; Laura Gibbons, PT; Laura Loftus; Iris Platt, PT; RikkiLynn Shields. Thank you Yohei Takada, PT, PRC and Andrew Xenophontos, CSCS, PRT for your tremendous help in lab, coaching the attendees in the nuances of the manual and non-manual techniques, allowing them to experience the power and influence of these techniques on the neuro-muscular system. Finally, thank you to the physical therapists at Finish Line PT for being gracious hosts: Mandy “I WILL blow up a balloon” Fox, Connor Hesselbirg, Jaclyn Massi, Ryan Matisko, Timothy Waanders, and Jimmy Williams.

 
Finish Line PT is a clinic for runners and triathletes, people who strive to be their best selves. To all of the course attendees, I hope the material you learned this weekend will help take you to new heights in your careers and shift your stride to a new way of looking at, and improving, movement.  

Posted March 9, 2023 at 9:37AM
Categories: Courses Science

Thank you Elizabeth Makous for the invitation to come to the Henry Mayo Fitness Center to present Pelvis Restoration this past weekend. Southern California saw snow, rain, and hail Friday and Saturday, but it didn't stop the quest for learning in this group!!!  

I truly enjoyed teaching this past weekend with this group of clinicians. The questions, attention to detail, and intellect was fabulous and assisted the whole class in learning the material. We went into the "weeds" to understand the pelvic inlet and outlet position influencing neuro-muscular need for inhibition and facilitation of muscle for ascension and descension of the respiratory and pelvic diaphragms. This is desired for internal compression and decompression for forward movement. This material can be complicated, but worth the journey for improved patient and client outcomes.

Loc, thank you for being an amazing lab assistant. Thank you to all the course attendees spending a weekend with PRI and learning new concepts and being open to them. Again, thank you to Henry Mayo Fitness and Elizabeth for hosting.

I should note--I did return home to Nebraska to blue skies, sunshine, and 60 degrees!!!

Posted March 7, 2023 at 11:49AM
Categories: Clinicians Courses Science

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