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In March, Ron Hruska participated in a live video webinar for the American Academy of Physiological Medicine & Dentistry (AAPMD), titled “Which Side Are You On? The Cervical Revolution.” If you were unable to join the live webinar, you can now get access to this one hour video via the AAPMD webinar library, as well as many other interdisciplinary webinars on the topics of airway management, sleep, myofunctional therapy, among others. If you are interested in viewing multiple webinars in the AAPDM webinar library, becoming a member of the AAMPD will be well worth the price. Otherwise, a single webinar can be purchased for $35.00.
Impact Physical Medicine and Aquatic Center has been a long-time friend of PRI and always hosts courses in their cutting edge facility. Years ago Stan Babel CEO of Impact and Ron Hruska MPA, PT collaborated to create the very first PRISM pool. Christie Thames PT, DPT, HFS,PRC and Mara Brandsoy OTR/L, PRC played the role of host and this past weekend I presented Impingement & Instability which is one of my favorite courses to teach. We had two faculty members present Dan Houglum MSPT, ATC, PRC and Sayuri Abe-Hiraishi MS, ATC, LAT, CSCS, PRT. Dan and Sy are excellent presenters and I hope everyone gets a chance to take a course from them. I always learn from both of them and am grateful to call them my friends. We had a total of 8 PRC’s and 1 PRT in the class and they were all great with their input. If you don’t know about I&I, it is a class that coalesces the basic courses into a neuro symphony and teaches MORE on the “why” of Impingement. Why do people impinge and where? We take the time to deeply explain (sometimes more deeply than the attendee wishes 😊) the common sites of pain and the neuro-biomechanics associated with that pain. I cannot emphasize enough how helpful this class can be to your clinical practice and the class reviews were all really good! If you’ve been putting it off I can tell you that I’m teaching it again in July in Georgia and in September in NYC so go ahead and get registered ASAP and I will see you there. I can’t wait.
Over the past several months we were given the opportunity to get to know Ron and Gabe Adams as we prepared for their visit to Lincoln, and eventual presentation at the 10th Annual Interdisciplinary Integration Symposium. To be completely honest it is difficult to put into words the effect that our time together had on not only the Staff here at the Institute, but also our course attendees and family and friends who were able to hear Gabe’s Story.
Gabe was born in Brazil with Hanhart Syndrome, leaving him with no arms or legs. The Adams family, residing in St. George Utah were not currently looking to add another family member as Janelle Adams was expecting her 11th child at the time, however after hearing about Gabe it was impossible for them to stop thinking about him. He is now a 19 year old young man, and is one of thirteen children raised by the Adams’. He is entirely independent in his daily life, but the journey from where he began to where he is now is full of falls and failures, that ultimately made him who he is today.
The focus of this year’s symposium of ‘Postural Restriction’ provided a great foundation for Gabe’s presentation, as he has overcome restriction every day for 19 years. Having both Gabe and his father Ron present, allowed us to hear both their perspectives of how Gabe was raised and how he overcame his struggles. Gabe’s Mom & Dad believed that in order for Gabe to ever be fully independent as an adult he had to become fully independent as a child. For Gabe the only way this was going to happen, was by failing, repeatedly, over and over again. He was restricted by literally every single task that you and I take for granted and he learned to do them all. Most of us would have likely given up. Maybe not right away but eventually. Instead Ron and Gabe and the entire Adams Family, embraced them. The struggles changed from day to day but one thing remained the same. He never stopped smiling.
During his presentation, he had the entire room smiling as well. Besides showing us how he performs everyday tasks, such as dressing himself, brushing his teeth, combing his hair etc. he broke out into a dance routine which none of us would ever succeed at! Dance is a big part of Gabe’s life and allowed Gabe to prove to himself and the community that not only could he do it, but he could do it well! Gabe was on his high schools dance team for several seasons, and continues to enjoy it into his adult life.
Gabe’s 19 year journey of overcoming obstacles is profound, and we can never understand the trials and tribulations that he has gone through, but the most exciting thing about Gabe is what’s yet to come. It is easy to focus on how he has gotten to where he is today, but his plans for the future are just as bright. Gabe has a strong desire to one day be able to drive, allowing him to become fully self-sufficient and mobile. His motivational speaking has taken off since graduating high school and he plans to continue sharing his story as opportunities arise. Gabe also dreams of becoming an interior designer and would love to create and design personal spaces for others.
It was a tremendous honor to get to know Gabe and Ron, and as we got to know them it became very clear that Gabe is perhaps the most un-restricted 19 year old we know. Often many of the problems that your patients or clients may have, stem from their extremities. The in-ability to sense and successfully manage these extremities often leads to further issues. For Gabe, none of that is a problem. Although he has the same dominant patterns as you and I, he was forced from birth to learn to manage them and in some cases use them to perform everyday tasks. Gabe has plenty to manage throughout his day, but without extremities in his way his future is truly “Limibitless”.
(Gabe showing the group how he writes)
(Course attendees trying to write like Gabe)
Click HERE to watch Gabe's story at Shriner's Hospital
It has been a couple weeks now since we wrapped up our 10th Annual Interdisciplinary Integration Symposium, but we are all still boasting with excitement over the two days that we had on April 19-20th! It was such a pleasure to host Matt Wallden and Phillip Beach, Osteopaths from across the pond who were our keynote speakers this year. Their clinical and educational backgrounds allowed them to expand on topics of tissue restriction, evolutionary and development factors, archetypal postures, and contractile fields relating to the symposium’s overall topic of “Postural Restriction”. Jacqueline Shakar blended her extensive clinical experience in assessment and treatment of the foot and ankle, with different methodologies, including PRI, Graston Technique, SFMA, and others, giving us all further appreciation of the role that the foot and ankle plays in restriction from the floor up and other areas of the body. Robert “Skip” George shared his personal journey as a chiropractor, the restrictions encountered within his profession and also some of the common clinical restrictions that occur in the cervical spine. Heidi Wise opened our eyes further to the role that extraocular muscles have on (or in response to) postural patterns, and possible restrictions that might occur with the EOMs. Pat Davidson took us through a fun journey reminding us how we have lost “authentic environments” that our ancestors thrived upon, and how this is influencing today’s healthcare and fitness industries. Ron Hruska got to further expand on chest wall restriction and the role of clavicle, hyoid and scapula position and alignment. His discussion on management of hyoid muscle ‘sling’ activity was brought to life with the ‘PRI Suprahyoid Sling Model’ that attendees received to help them further understand, and also educate their colleagues, patients or clients how mandibular and hyoid position/alignment influences suprahyoid muscle activity. And finally, it was an honor to have Gabe Adams speak, dance, and answer questions for our attendees on Thursday evening. His story (along with his father Ron) was more than inspiring, and reminded all of us that the thorax runs the show. With ribcage and thorax movement, you can walk, dance, and live life to its fullest!
While we are still boasting in excitement two weeks later, we are even more excited to be working on next year’s Interdisciplinary Integration Symposium topic and speakers. Save the date for April 11-12, 2019, and stay tuned for the topic and speaker announcements in the coming months!
This past weekend I had the pleasure of enjoying teaching Myokinematic Restoration at Indiana State University. Cody Inskeep, ATC who I met originally at a Pelvis Course in Seattle invited PRI back to his stomping grounds in Indiana, and I am very glad he did! This weekend's course was one involving learning on all fronts. We learned about muscles that move an acetabulum over a femur on one side compared to the other in the femoro-acetabular-ilio-sacro-pubic ring of bones and joints that affect position, balance normal asymmetry and allow us to optimize our gait and respiration. We touched on the fact that integration will involve muscular control of this pelvic ring to control both acetabulum and femur, what muscles in what position will assist in this venture, and toward the end of lab and lecture we discussed what we might consider learning if patients still have residual components of symptoms after acetabulo-femoral and femoral-acetabular lateralized control is established. This group was motivated and dynamic, attending for as many reasons as there were clinicians. Thanks Aaron Ford, DC and Canaan McClure for your story about why you attended your first course--a reference to PRI in a book by author Kate Bowler who noted PRI was the reason she could now fully function after a long span of ADL limitation, avoiding scheduled bilateral first rib removal. Thank you Sharon Wellbrook, DC and Tim Demchak, ATC for taking a weekend to learn principles of PRI that you can reference and teach your students in your respective learning institutions. Thank you Denny Wongosari, ATC, LMT among others for coming to learning functional strategies to allow your athletes to better perform. It was my pleasure working with all of these movement professionals as we worked to integrate Myokinematic tests, clinical reasoning and treatment strategies into their respective practices. Thank you Robert Pawlak for recognizing and initiating PRI science into your soon-to-be Orthopedic Surgery practice. Each of your stories encouraged this clinician-first faculty member with regard to the future of integrated medicine. Bravo!
Thoroughly enjoyed lab sessions where Kelly (Kelly) Brock, DAT, LAT, ATC, Tim "The Beautiful Mess" Demchack, ATC, Wendy "PS I Love You" Schmidt, OT, former SD native Cara "Caragami" Lemon, ATC, among multiple others helped me demonstrate, nonmanual and manual techniques as well as theoretical principles to the class.
As a bonus this weekend, I got to visit the statue devoted of one of the greatest basketball players to put on short shorts--Larry Bird. The statue commemorates the 1979 ISU team that faced Magic Johnson's MSU for the national championship game and was soul food for this old baller. Also interestingly, I learned that Larry played one game of college baseball that year in an effort to increase attendance at ISU's baseball games--and it worked, of course. Thanks again Cody for your time, energy and for your insightful insider information on ISU history and thanks to each participant for making this course a blast!
This past weekend I had the pleasure to present Postural Respiration to a diverse mix of new attendees and "veterans" of PRI at Pro Sport in Redmond, WA. I would rename this weekend "Superior T-4 Syndrome in Seattle" considering how many course attendees presented with this patho-mechanical respiratory compensation and asked so many questions about patho-mechanical rib kinematics as it relates to this subject! We had an opportunity to demonstrate in front of class at least four students that looked like they could possibly be patho-mechanical in terms of their respiration and body type.
One take away is you may suspect a positional issue but always test and retest. Two of the students demonstrated the definitive assessment of decreased left apical expansion after a Superior T-4 manual technique. Superior T-4 came up during discussion on Saturday and was a topic that came up often during the entire weekend on how to define, assess and then treat it both manually and non-manually. One of the students that had non-manual techniques provided experienced the left side of her body in a way that she expressed with an enthusiastic smile and a new place that she could feel and find in her body! In addition, she felt a bit "unstable" when she first started walking and liked it! Welcome to variability! She not only found neutral, but she experienced transitioning right to left side and back again, alternating and reciprocating, lateralizing and realizing what tri-planer position, gait and breathing is all about. What a lesson for all to see, experience and what it means to reduce the reliance on end-ranges driven by asymmetries, respiration and patterns driven by neurology!
The enthusiasm and new awareness of Superior T-4, especially for students new to PRI, was totally fun for all involved including this instructor! Thank you PRI dedicated veterans Erin Rajca and Michael Ball, both PT's and PRC's, for their help and knowledge.
This course was a joy for all with them in attendance providing energy, experience and caring. Thank you Cory and Amanda for hosting at PRO SPORT and all of your hard work! And shout out to all of the students in attendance for your most outstanding questions and persistence in wanting to understand PRI principles especially regarding Superior T-4.
Saranac Lake, NY, was the site of the most recent Myokinematic Restoration class, and it was a very eventful class for a variety of reasons. One of them was the 4-6 inches that fell Sunday during the course. It was a very beautiful scene, until you realized it was April 29th.
More importantly, it was a course where we had the opportunity for as much, if not more, lab time compared to any course I have taught previously. We were fortunate to have two experienced and great lab assistants, Michelin Carroll, PT, ATC, and Sean Fitzgerald, PT, PRC. They have been in and around PRI for a long time, and having them help in lab was invaluable. My thanks to them!
We were able to delve into the differences between normal mechanics the L AIC pattern presents, as well as normal and pathological compensations that will arise. This led us into the polyarticular behavior the muscles of the pelvis and femur have on each leg as a result of the L AIC pattern. We were fortunate to have a lot of time to practice the positional assessments, as well as discuss what the positional tests indicate.
The value of the Hruska Abduction and Adduction Lift tests relative to the gait cycle and respiratory cycle was a significant topic of conversation and lab. We were fortunate to have two very good demonstrations with Matt Powers and Brendon Olsen. Matt gave us a good example of how to reposition someone who is in a L AIC pattern. And Brendon gave us a great example of how to get someone who is in a PEC pattern, and help them become inhibited enough to turn into a L AIC pattern.
My thanks to Shauna Thomas for helping us link the L AIC pattern to what she is seeing in her womens' health population; Megan Haught for her great questions and re-states; co-workers Bill Doherty and Linda Horizny for their enthusiasm in learning this new material; and Hilary O'Connor, who is a student physical therapist attending this course.
We all need a little more "Bruce Wayne" and a little less "Batman," and we need to make sure we have the proper "boy band" in our lives!
This past weekend the PRI Fitness and Movement course was sold out in Salem, Oregon and the entire west coast from represented from California to Alaska. Thank you to all that attended and traveled in! It really was a great group!
The audience had great diversity with personal trainers, strength coaches, physical therapists, chiropractors, massage and fascial bodyworkers, CrossFit and fitness enthusiasts and it was awesome to see them all working together to learn and enhance their understanding of the PRI science and key biomechanical relationships. This weekend was jammed pack with a ton of lab as I broke down the complex core axial system into digestible parts which could be trained. Breathing patterns along with thoracic and pelvic positions were emphasized to enhance neuromuscular and biomechanical patterning. Great discussions and lab experiences were had all around. Special thanks to Salem’s hidden gem - The Press Room - for hosting, Aaron Hague and his team were gracious hosts and a special shout out to PRCs Minh Nguyen and Joy Backstrum for helping make lab an enjoyable experience for the large group we had! The abs were reshaping the pancakes... and attendees we were feeling the parachuted love!
We will be at the University of Vermont next month and then North Carolina and California. This course keeps getting better and James and I hope to see you there! Check out the Affiliate Course page for more details and be sure to program in some summertime learning today!