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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 April 2015

I had a great time teaching Myokinematics of the Hip and Pelvis largely to a group of rehab specialists at NC State this weekend!  Thanks to Ryan Holleman at NC State for being such a great host. It was awesome to share the news that this course had just been approved for Evidence Based Practice CEUS by the BOC for Athletic Trainers!! Very exciting for the science of PRI and the Certified Atheletic Trainers that practice PRI.  The group was largely new to PRI as are most Myokinematic Restoration courses these days. Also very exciting for PRI that I could teach 48, yes, 48 professionals the importance of Proper Position and Patterns as it relates to gait and Performance!  The Paradigms were shifting as were pelvis from AFER to AFIR!  Thanks to Sayuri Abe-Hiraishi and Josh Olinick for helping me with lab! Go Wolfpack!!

Posted April 30, 2015 at 11:07AM
Categories: Courses

Salem, OR was the place to be this past weekend. We had an amazing group of course attendees with 6 of 37 individuals being new!  Pelvis Restoration and synchronizing diaphragms for air flow, blood flow, and abdominal flow was appreciated.  Thank you First Call Home Health for hosting this past weekend.  The enthusiasm to learn and appreciate PRI by this group is evident.

Posted April 30, 2015 at 8:19AM
Categories: Courses

There is a “silver-lining” to nearly every negative situation in which you find yourself.  If you open yourself up, you can find the positives and then use your experience and knowledge gained to help others…hopefully, creating a “greater good” in the universe.  I hope the following story, lessons learned, perspective, and insight are informative.

The aftermath of a very personal health situation brought me in to see Lori Thomsen at the Hruska Clinic.  She took me on as a patient one year ago.   Realizing quickly that I was a candidate for PRI Vision intervention, I was assessed by Ron Hruska and Heidi Wise the same day and prescribed a specific pair of PRI lenses.  I filled the prescription and followed up with Lori the next day. 

Lori guided me through a program consisting of upright exercises.  (Exercises in the Vision program are primarily upright activities, because you are learning how to use the floor to propel yourself forward through all phases of the gait cycle, using the PRI Vision lenses as a tool.)  Coincidentally, at this same time, I was beginning to more fully appreciate the need to get my own clients “on their feet”.  Admittedly, I was designing exercise programming primarily for the supine, side-lying, and all-fours positions.  Having received Lori’s instruction for my own upright activities, I was able to more adeptly implement upright activities with my own clientele, especially when it came to teaching L mid-stance.  I believe I have been able to avoid major pitfalls/setbacks and progress my clients more quickly than I might have, if I had not been a patient of Lori’s.

[Side Note:  It is important to make a distinction between assessing one’s ability to center themselves in L or R mid-stance (as is part of the PRI Vision assessment) versus teaching L mid-stance and other phases of the gait cycle at the appropriate time in one’s rehab/training program.  Assessment does not involve cueing; teaching does.]

The most enlightening piece of information Lori taught me was the use of the quad during mid-stance.  As a member of the PRI faculty, Lori teaches the Pelvis Restoration course.  She frequently refers to her “3 Amigos”: L abdominal wall, L quad, and L hip.  It wasn’t until I was a patient, when she actually took me through the integration of the “3 Amigos” on MY body, that I fully appreciated the quad in L mid-stance.

I think perhaps that the quad is overlooked when teaching L mid-stance, due to overemphasis on the L heel.  Let me try to explain in an admittedly round-about way J 

In L mid-stance you should feel 75-80% of your body weight traveling down into the back half of your foot (mid-arch to center of heel). Your left foot should be firmly planted on the ground without the toes lifting up in front.  I have witnessed individuals lifting their toes or entire forefoot into dorsiflexion when cued to: “find your left heel” or “press down through your left heel” .  I have inadvertently used these types of cues and seen those little toes wiggling around in the shoe, trying to lift up.  Sometimes it helps to have the client go barefoot, so you can see if they are “cheating” with their toes.  “Cheating” with the toes IS cheating, because it is extension. Toe extension kicks on dorsiflexors…kicks on hip flexors…kicks on low back, etc. etc.  (There are certainly those who walk as “heel-diggers”, pulling themselves forward through this entire list of muscles. These are very extended individuals who tend to use their pecs as their abdominals and present with significant FHP.) 

PRI programming accentuates “sensing” or “feeling” your left heel making contact with the ground in mid-stance, because those in LAIC patterns tend to bypass the L heel altogether during the gait cycle.  Their L foot tends to be in constant plantar flexion, so the first part of the foot that hits the ground on heel-strike is the arch or the ball of the foot (late mid-stance to early toe-off phase).  Maybe we take the client/patient through proper heel-strike phase, but in mid-stance, we should be teaching them to merely “sense” or “feel” their left heel vs. “press” or “dig” their left heel.

Back to the quad…  In L mid-stance, the quads should be in an eccentric contraction phase around the knee joint, counter-balancing the eccentric contraction of the hamstrings.  Because the knee is slightly flexed in mid-stance, the quad is on a slight stretch but holding tension, getting prepared for the propulsion phase where the concentric action of the quad takes over (stretch-shortening).  There is a “springiness” to the quad, unless the L foot is not firmly planted or the L hemi-pelvis is anteriorly tilted.   In either of these cases, the quad is acting more concentrically. 

I like the word “springiness”, because it reflects my most recent reflections on mid-stance.  “The first modal peak [of the vertical component of ground reaction forces (GRF)] occurs during the first half of support and characterizes the portion of support when the total body is lowered after foot contact.” (Hamill and Knutzen, Biomechanical Basis of Human Movement).  This is mid-stance. 

When I ask my clients if they “feel” the floor under their feet, sometimes they look at me like I am crazy.  When teaching L mid-stance, I have begun asking them if can “drop” their bodyweight (75-80%) into the L foot and “allow” the L left leg to “accept” that weight.  Now, maybe they can sense some weight, actually the GRF pushing up into their left foot (through the “springy” eccentric quad).  Now they have a point of contact from which to propel forward.  They are not in a constant state of  “pulling” or “lifting” themselves off the floor with vision, jaw, neck, shoulder, low back, and/or gastroc muscles.  [Side note in regards to Cervical Revolution:  all of this “lifting” and “pulling” through the kinetic chain, bottom-up, is to no avail, because ultimately there is gravity crushing down on all of those lifting forces, meeting at the skull and generating cranial compression.]

When you really think about this, walking is hard stuff!!  Each leg has to be able to “accept” 75-80% of your body weight in able to propel forward and not evade this difficult task with the above-listed extensor and pulling muscles. 

Again, back to the quad…  “If you can feel your L quad, Lilla, your L abs should automatically be kicking on”, Lori says during our session.  The quad is one of the markers for integration from the ribcage to the pelvic inlet through the pelvic outlet to the femur. 

I’m in L stance with pelvis rotated left, L foot flat on ground, upper body rotated right, reaching out and down with left arm to facilitate both trunk rotation and thoracic flexion, a bit of thoracic abduction to help find L abs.  I’m doing everything right, but still no abs.  When I “press” down into the ground, as suggested, I am concentrically activating my quad, and it is difficult to posteriorly tilt my pelvis and reach the knees forward.  However, when I think of “dropping” my weight onto my L leg (feeling those GRFs and a “springy” eccentric quad), I can reach my knees forward with posterior pelvic tilt, effectively bringing my pelvis under my ribcage so that they are in a position to access the side abs.  YEAH and whew!

I didn’t mention the third amigo, the L hip (Glute Med), which comes into play in the frontal plane, balancing the forces of the IC Adductor.  I am certainly not downplaying the role of this amigo in L mid-stance!  I only wanted to emphasize the important role of the quad (a muscle that is not given as much “press” in teaching L mid-stance), because Lori’s instruction certainly helped me, both personally and professionally.

Attached are 2 short video demonstrations.

Toe Extension MCS

Quad MCS

Lilla Marhefka, PhD, HFS, CSCS, PRT

Posted April 28, 2015 at 9:11AM
Categories: Videos Clinicians Science

Beginning in 2014, Athletic Trainers are required to complete a minimum number of continuing education units (CEUs) in the BOC Approved Evidence Based Practice (EBP) Category.

We are very pleased to announce that the Board of Certification, Inc. (BOC) has reviewed and APPROVED our Evidence Based Practice (EBP) program, Myokinematic Restoration - An Integrated Approach to Treatment of Patterned Lumbo-Pelvic-Femoral Pathomechanics (Live and Home Study). The course has been approved for 15 EBP CEUs.

Additional EBP course approval applications for Postural Respiration and Pelvis Restoration are underway.

Posted April 24, 2015 at 1:24PM
Categories: Courses
The article that originally appeared in the April issue of Men's Health is now online, you can read it here.

“It doesn’t matter whether you’re an 80-year-old smoker, a 23-year-old Olympian, or a regular, fit guy-odds are the way you’re breathing right now is flooding your body with stress hormones, compromising your joints and mobility, bottlenecking your energy and undermining your performance in the gym and everyday life. Fourteen times a minute, you become a little weaker and a bit duller.

Hruska is on a mission to change that. Step one is understanding how your body is organized.”

1/ Lungs
They come as a pair, but the left Is smaller to accommodate the heart.
2/ Heart
We shift weight onto our right leg in part to counterbalance this organ.
3/ Diaphragm
It has two sides, but the right is thicker and stronger than the left.
4/ Liver
It also has two lobes, but the right is much larger (by a factor of six).

Ron Hruska was recently interviewed by Men’s Health along with Bill Hartman and Neil Rampe discussing Postural Restoration, after Trevor Thieme, Senior Editor for Men's Health attended a Postural Respiration course last year. Topics discussed include: optimal breathing and the typical respiration patterns, asymmetry, PRI in pro baseball, and common compensations that can cause neck, back and joint pain.  

The 90/90 hip lift with balloon was shown as a way to get your diaphragm in a position to work correctly, helping you to breathe appropriately and avoid chronic stress which can increase your risk of dementia by 67%, stroke by 59% and diabetes by 45%.

“You can think of neutrality of being functionally symmetrical- the ability to shift your center of gravity from one side to the other, to breathe efficiently with both lungs, and to maintain position of your true core. “Being neutral helps everything,” says All-Star first baseman Paul Goldschmidt. “When I lift, I’m stronger. When I run, I’m faster. It allows me to fully express my power and speed.”

If you haven't already, go out and grab the April 2015 Men’s Health issue and flip to page 144 to read the article, which they refer to as the "#1 Greatest Health Tip Ever!"

Posted April 24, 2015 at 10:58AM

For all you PRI clinicians in the Colorado area, we are planning a PRI meet up on May 9th from 10:30a.m. to 12:30p.m. at  Rogue Strength and Performance 8045 W 48th Ave, Wheat Ridge, CO. The folks at Rogue will go over ways they are incorporating PRI concepts into their gym. Very informal and we are open for questions and discussion. Anyone interested in the Postural Restoration Institue are welcome to join. Email craig.depperschmidt@reboundsportspt.com if you are interested or with questions. 

Posted April 22, 2015 at 1:18PM

Have you ever struggled to explain to a colleague, patient, family member or friend what the Postural Restoration Institute is? If so, you will love this new video that we have created. While it was a couple years in the making, it turned out great, and kudos to Matt Hornung for finishing up this project over the past few months! Hope you enjoy it!

Posted April 21, 2015 at 3:50PM
Categories: Videos Courses Science

We will be out of the office April 16-April 17 for our annual Interdisciplinary Integration symposium. Please keep this in mind as you are ordering any products or home studies, we will send out products and home studies on Monday April 20, 2015.

Posted April 15, 2015 at 3:13PM

In PRI, we are typically focusing on creating a reciprocal and alternating neuromuscular system. However, our neuromuscular system is connected with all the other systems in our body. There appears to be a coupling between autonomic, central, endocrine, and gastrointestinal systems which, in parallel with our neuromuscular system, are also asymmetrical and rhythmically shifting. “Asymmetry, Lateralization, and Alternating Rhythms of the Human Body” has been broken up into 5 parts describing this phenomenon in addition to the story of how and why our asymmetry came to be. It can also be accessed at on my website where I have written on other various topics that relate to PRI. 

CLICK HERE to read Part 5: "Connecting Ultraradian and Neuromuscular Rhythms of the Human Body"

CLICK HERE to read Part 4: "How Does One Reconcile an Asymmetrical Neuromuscular System?"

CLICK HERE to read Part 3: "How Did Humans Become Asymmetric?"

CLICK HERE to read Part 2: "What Does Asymmetry Provide for a Human Being?” 

CLICK HERE to read Part 1: "The Prevalence of Human Asymmetry and Lateralization"

Posted April 14, 2015 at 8:32AM
Categories: Articles Science

Jennifer and Chris Poulin were recently interviewed by Joe Heiler on TheSportsRehabExpert.com. Topics discussed include PRI in Sports Performance, Injury Prevention, PRI with Military personnel and PRI with the Geriatric population. Chris discussed PRI application in golfers and changes that happen with aging golfers and also typical patterns that he sees with them. He sees typical L AIC patterns that will usually have limited L hip IR, a collapsed R arch in a R handed golfers and have a tough time using their R Glute Max. Click HERE to listen to the whole interview.

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