Community News

Advanced Integration and specifically the Integration symbol itself, represent one’s ability to integrate not only the Primary Course concepts, but also one’s ability to recognize the asymmetrical patterns of behavior themselves. In fact your predisposition, perspectives and past experiences will all dictate how you perceive this symbol and consequentially appreciate this 4 day course. Advanced Integration allows us to come together once a year, for a detailed, didactic and sometimes difficult discussion of the most advanced considerations covered in Myokinematic Restoration, Postural Respiration and Pelvis Restoration throughout the year. It allows us to welcome individuals with various degrees of professional practice, differing levels of clinical understanding and multiple locations of living across the globe. This year we were joined by our PRI Family from 26 states, as well as the countries of Malaysia, Australia, Iceland, Germany and Japan. With Valerie Chai (PRC Class of 2019) traveling 35 hours to attend, the dedication of these individuals is something that is continually humbling, and appreciated beyond our measure.

Our Japanese family continues to grow and integrate their own understanding of these concepts as they are now offering all three Primary Courses, and working to present Impingement & Instability in the year ahead. We are also excited to announce the creation of the PRP, (Postural Restoration Provider ™ ) credentialing program that will be offered in Japan in the years ahead. Following these four days we were able to spend an additional two days with the PRC class of 2019, and welcomed 14 new providers from these countries.

The four days of Advanced Integration included some of the best presentations we have seen from Lori Thomsen, Jennifer Poulin and a special appearance by James Anderson representing the concepts they teach throughout the year in the Myokinematic, Pelvis, and Postural course work. If you have not heard these individuals teach this material I highly encourage you to attend one of their courses in 2020, as well as any other Faculty Member that may challenge your current understanding by receiving a different perspective from a different presenter.

The fourth day in particular allows us to reflect solely on Curvatures of the Spine and the effects that Torsion, Torticollis, and too much Torque can have on our already twisted systems. Lisa Mangino, Jean Masse, and Susan Henning have truly spent the better part of their collective careers to understand these concepts and the chance to learn from their intervention strategies was truly a gift to us all.

It is hard to wrap up an entire year of PRI course work through this one four day event. However the opportunity it gives us to come together as a family and challenge each other in a positive manner is one that we never take for granted. As you reach towards the year ahead, may you all appreciate the journey this past year has been for you as we do each December. May you reflect on those that mean the most to you along that journey, and welcome the challenges that will continue in the year ahead.

Our PRI Family starts with our Faculty and Staff and extends from there to all of you. I wish you and your Families a Happy Holiday Season and an Integrative year ahead!   

It was a great weekend in New York teaching Pelvis Restoration. We had 48 clinicians attending the course and 13 were attending their first PRI Course….they made it! Pelvis entails positioning of the pelvic inlet and outlet coupled with muscles facilitation and inhibition with respiration. It’s a lot. I felt the class did an amazing job absorbing the material and asking wonderful questions. Edmund, Sebastian, and Romina your thinking and questioning benefiting the entire class, thank you. Frontal plane appreciation with synchronization of the respiratory and pelvic diaphragm were emphasized with demonstration. Nicole is your left ischial condylar adductor still burning? Geri, I hope you appreciated frontal plane of the left inlet and outlet to re-direct airflow into the right apical chest wall and left posterior mediastinum. Physical appreciation of PRI is powerful, thank you both for letting me teach throught you to the class. The weekend went way too fast, I appreciated everyone and their willingness to come and learn. Thank you Dave, Cuyler, and Brendan and Finish Line for hosting. Neal and Sean thank you for lab assisting! I was able to see the Rockettes in their annual Christmas show,  it was specatular!  Bucket List for me since I was young. Thank You again!

We had a huge turn-out in Minneapolis for the Postural Restoration Integration for Pilates course this weekend and attendees had fantastic questions!  We spent the morning of Day 1 nailing down breathing mechanics and  obtaining the Zone of Apposition and practicing it in lab even before lunch. We followed up by getting into the nitty gritty of the L AIC and R BC pattern and using the Reformer Supine Gait Integration Test and the Reformer Quadruped Abdominal Lateralization to test to see how well people could properly stand and shift over one leg and counter rotate the upper thorax ("legally"). We finished up day 1 with sagittal plane focused exercises.

On Day 2 we started with a heavy discussion on lateralized gait and understanding early–>mid stance and mid–>late stance in regards to the L AIC/R BC pattern. There may have been some dancing involved….like some sagittal pelvic tilts, frontal plane "hula hips" and transverse plane "salsa twists." Then we went through The Reformer Side lying Stance Test that really looks at the frontal plane followed by a lab of frontal plane exercises on the reformer. We finished up the day with talking about the principle of sensing, including cuing and special reference points for the hands and feet to promote L AF IR and R upper trunk rotation. The final lab added transverse plane integration including a personal favorite exercise of mine, scooter. We wrapped up the day having a frank logistical discussion on how does one start implementing these concepts without getting too overwhelmed, starting with getting a L ZOA and mastering the sagittal plane with a L hamstring. A big thank you to Kristin Procopio and Studio U, for hosting this rendition of our Pilates course at her beautiful new facility, and a shout out to Christine Peh who traveled all the way from Kuala Lumpur to be with us over the weekend!

In the later part of 2004 I met with Stan Babel through Karen Jiran MPT, PRC and Carrie Langer MPT, ATC, PRC. Stan who owned and managed Physical Medicine Diagnostics Rehabilitation (PD Midway) and wanted to build a pool. At that time I was really interested in hydrodynamics and had countless discussions with my brother who is an engineer regarding pump power, jet nozzles, etc. And more importantly I wanted to design a pool for patterned neuromuscular isolation and inhibition through the use of directional water to maximize specific aquatic afferentation, as well as compensatory push and pull recognized by the autonomic and central nervous systems. My first PRI Sequential Movement (PRISM) pool design was developed and constructed through Stan. All eight of the stations provide neuromuscular isolation and feed forward activation of groups of muscles to resolve postural related dysfunctional autonomic and physiologic behavior through the flow of water. With the arrival of this pool and its science, PDR Midway, became IMPACT Physical Medicine and Aquatic Center.

Presenting course material that is related to the brain’s lateralized hemispheric specialization and the autonomic nervous influence on our central nervous system’s compensatory behavior, fifteen years later, made my amygdala related emotional, sentimental and nostalgic feelings flow uncontrollably. Stan and his wonderful staff over the years has enabled me to continue to move in directions that I patiently outlined, ballooned and flowed with. I feel so indebted and grateful to him and his staffs over the years. Many of those affiliated with this integrated minded center were in this class.

This particular class also made me feel somewhat sentimental, because I have known most, if not all of them, for so many years. They were watched, observed, tested and judged by me. They were my independent, dependent and constant variables for my research effort on knowing when, how and what to deliver to get where we were on November 2nd, 2019. There were 18 Credentialed providers in the room that affectionately tolerated me being somewhat unfiltered regarding autonomic and central nervous systems and their influence on each other and our patterned behavior.  

This course is such a joy for me to teach and resonate around. Just as aquatic flow can re-balance, re-engage, and re-tense us, so can mandibular latero- molar trusive contact, sphenoid (pterygoid) and temporal (temporalis) oscillation, and palatopharyngeus  (diameter of the pharynx) and tensor veli palatine (diameter of the eustacian tube) ANS control. Before Stan, before the pools, before PRI certification, I remember a quote by Socrates that remains with me today. “I cannot teach anybody, I can only make them think” and I am grateful for those who continue to flow and follow thought processes that make them sequentially think.  

The staff at IMPACT are always such wonderful hosts. The morning breakfast, break food and afternoon warm cookies (thank you Stan) are so appreciated. Christie Amundson PT, DPT, HFS,PRC and Mara Brandsoy OTR/L, PRC have a system in place for courses like this. Their and their fellow team-mate’s effort does not go unnoticed.  I also want to thank Amy Pennaz PT and Catherine Shelton PT for their willingness to work with me in demonstrating how to resolve postural related dysfunctional autonomic behavior.

Todd Robbins, PT hosted Postural Respiration at one of his facilities, Robbins Rehabilitation East, this past weekend in Easton, PA.  One of his trusted friends and former co-workers, Brian Buetel, PT, had been telling Todd about PRI since his first PRI experience and strongly suggested to not only attend but to sponsor a PRI primary course. Todd jumped in to be the host while attending his first PRI course. He also brought and personally sponsered nine of his employees with him.  And what a weekend it was for all attendees with two thirds of the class brand new to PRI!

The first PRI course experience can be exciting, challenging, over-whelming, a refreshing change to a status quo, a paradigm shift and very much like being fed water by a fire hose! What is so fun for a faculty member is to see students repeat back a new awareness and concept, put it into an application they experience during the weekend and have an enthusiastic response of wanting more PRI. This weekend was full of these new awareness moments- like the before and after of a non-manual technique or a new way to look at testing that always can be traced back to what shape and position the diaphragm is in and how it drives position of a pelvis and ribcage. Another insight that is always big is that one of the most important muscles of respiration is the left hamstring while IO’s and TA’s pull a ribcage down, in and back like "hay hooks". The class could see in a new way that muscles on the one side of the body are deficient and some are biased driving us laterally to an end-range position we rely on for a perception of stability.   Superior T-4 is always an added layer of discrimination of patho-mechanical accessory muscle respiration superimposed on top of dominate patterns and position. Watching apical expansion become positive on the left during lab after the Superior T-4, or get air into the right chest wall technique, and the reasoning behind it, was a huge eye opener for the entire class.

Many thanks to Todd Robbins, PT for bringing his PT staff to Postural Respiration.  It is a leap of faith to try a new approach and he and his crew jumped right in with energy and curiosity.  Big thanks to Brian Beutel, PT for sharing PRI with Todd and being the host site contact this weekend.  His help and support was an instructor’s dream and I hope to return soon to Robbins Rehab East. They already have another PRI course subject scheduled for next year. And last but not least a HUGE thank you my veteran lab assistant, Jon Herting who was a valuable resource throughout the weekend!

This was the last offering of Myokinematic Restoration for 2019. And what a way to end the year! We had a great group of chiropractors, athletic trainers, physical therapists and PT assistants,  strength coaches, personal trainers, and cranial therapists.  I was very excited to get to sunny northern California, as the we got 4-6 inches of snow the day before I left. Which made for a miserable Halloween.  

Fortunately, only treats and no tricks with PRI! This course affords us the luxury of spending a lot of time in lab.  Nearly 40% of the class is spent in lab, which provides the attendee ample opportunity to find, feel, and experience the science of PRI. This course also provides ample time for us to discuss, explain, and digest the Hruska Adduction and Abduction Lift Tests as a means of determining one’s ability to walk and breathe. If walking and breathing require compensation, everything will require compensation.  

We had a great discussion about sympathetic vs. parasympathetic nervous system activity related to pelvic positioning, foot and ankle performance, and how the acetabulum position dictates femoral activity.  

My thanks to Shaun Buchanan and Joan Shepherd Mellows for hosting us and all the logistical work that goes into a successful weekend.  My thanks to Jenn Gaskin, Brian Schulman, John Garland, Cody Gilliss, Michael Serrano, and Tracy Henry for all of their great questions and help during demonstrations.  

But this weekend wouldn’t have worked nearly as well if it weren’t for Will Waterman, PRC, and Tim Dempsey, PRT. They were fantastic lab assistants and were a great help during the entire course. Without a doubt, they were instrumental to helping this diverse group digest this information. Looking forward to 2020!

Lima, Ohio. Home of the KewPee Burger!

This weekend I travelled to Lima Ohio to teach my last course of 2019. It is not the easiest site to get to, but it was so worth the effort. This course had 18 attendees of varying backgrounds. It’s nice to teach to a group of professionals with different perspectives. There were PT’s, PTA’s, Chiropractic Physicians, Athletic Trainers, Strength Coaches and a Pilates Instructor.  

We spent the weekend discussing optimizing patterns, breathing and compensations of the Pelvic girdle as they relate to frontal plane control of Inlets and Outlets. Most of the attendees were new to the science so teaching this integrated introductory course allows us to explore the integration of thoracic diaphragmatic breathing with Pelvis respiration to balance posture and gait.  Pelvis Restoration is known for its complex acronyms. I tried to move away from overuse of acronyms, and discussed proper position of inlets and outlets during upright function. I think this helped the new learner shift their perspective from orthopeadic thinking to the neurologic ANS control of patterns.

On Sunday, “Treatment Day!”, we discussed a pathway for treatment of the L AIC, PEC and the  Patho PEC patterned individual. We explored the triplanar position of the iliacus as it relates to swing and stance and sacro-iliac dysfunction. This is always an awesome opportunity to bring concepts of inhibition and activation of the same muscle in different planes of movement. This course allows me to dive deep into rabbit roles of pelvic respiration and thoracic diaphragm position. We had a great time integrating breathing throughout the weekend. By Sunday afternoon, the light bulbs were going off as were the “Ah-Ha” moments.

I enjoyed the banter with both Jason Russell, DC and Nick Goins, DC throughout the weekend. They were my Glut Gait guys! Jason, be nicer to Nick!
Carri Baumback, PT took her first course 10 years ago with Ron and brought her co-worker and friend Cynthia Nieberding, PT. It was great having them in the front row, not afraid to ask questions! Next time we have dinner ladies!

Alex Maag and his staff took very good care of me and our class. The interest in PRI in that great state of Ohio is growing. I look forward to seeing these clinicians grow and develop their PRI knowledge.

“When you go to Lima, you eat a KewPee Burger and rub the babies belly” – James Anderson
Well, I ate the burger but couldn’t reach the belly. Next time…..

Robert Newhelfen, DC, founder of Motus Integrative Health, describes his clinic as “a full integrative health clinic bringing new and unique treatment options to the people of Northwest Indiana.” In keeping with this vision, his clinic hosted Postural Respiration, a unique and integrative approach to addressing postural influences of rib torsion, inconsistent breathing patterns, habitual use of accessory respiratory musculature, and a positionally-restricted diaphragm. As in most PRI courses, we had an interdisciplinary group of course attendees, comprised of PTs, chiropractors, ATCs, and strength and conditioning experts in professional baseball and soccer. Also in attendance was Ruth Hennessey, MM, a vocal specialist well-known in the world of singing. Thank you, Ruth, for your insights into how singers develop faulty breathing strategies and retain undesirable tension that can affect their voice.

From the get-go, we discussed human asymmetry, most notably of the right and left hemi-diaphragms, leading to predictable patterns of muscle activity and movement. Our inherent asymmetry gives us a starting point from which we  shift our bodies and rotate. It is what an infant relies on to make its way from the womb to the external world. This applies to every developmental milestone, from crawling to running. However, when patterned muscle activity "goes rogue", from too much sitting or engaging in the same, repetitive activities, day in and day out, the results are patterned restrictions, injury, and fatigue.  

Course attendees served as one another’s case studies as they compiled PRI objective data to assess for both lower and upper body neuromuscular dys-synchrony and to guide treatment. Thank you to Rebecca Custer, DPT, and Wynne Conklin, CPT, our templates for the entire class for right BC over-activity and its pathological sibling, superior T4 syndrome. We discussed how this syndrome limits first rib mobility. The first rib is the driver behind the mechanics of the entire thorax and, therefore, must remain mobile! This course was updated a year ago. It includes a new test for the brachial chain as well as where, when, and what inhibition techniques fit into the treatment scheme. If you haven’t taken Postural Respiration in a while, it’s time for a refresher!

 
Thank you everyone for your thoughtful questions. Nate Kloosterman, DPT, OCS, gets the prize for most questions asked, keeping this instructor on her toes. A special thank you goes to Adrian Gutierrez, DC, for handling the set-up, food, sign-in, etc.   You were a gracious host and helped make this weekend an enjoyable experience.

This past weekend I travelled up to Cranston Rhode Island to teach Myokinematics of the Hip and Pelvis. Elite Physical Therapy was hosting their first PRI course! They had several clinicians in attendance and Ryan Toher, DPT was a great host. They were all new to the science of PRI as were 90% of the course attendees. This was a larger class with  45 clinicians in the room. I was joined by Miguel Aragoncillo, CSCS, PRT and Tyler Tanaka, DPT PRC as my lab assistants. They did a great job offering help during labs and comments from their experiences during lecture. The class was made up of mostly rehab professionals and strength and conditioning specialists. It was super fun meeting Tyler’s college friend Daniel Gardner, DPT aka “Gator” and helping him begin his PRI journey!

As hard as it is to be away from family and friends on the weekends and the rigors of travel, I am always excited to see the light bulbs and Ah Ha moments that new clinicians experience learning about autonomics, breathing and polyarticular chains as it relates to concepts of lateralization, habit and movement dysfunction. I enjoyed meeting my front row newly inducted PRI front row Trisha Livemore, DPT, Steve( CSCS) and Amanda Zariello,DPT, Valerie Perron, LPTA, LMT, Elizabeth Johnson, MPT, ATC and Anne Ruffus, DPT, CSCS.

A very special shout out goes to Gustavo Woff, PT who flew 15 hours from Argentina to take his first PRI course this weekend. It is so inspiring to be part of the PRI Faculty and watch it grow and spread throughout the world.  I am truly honored to be a part of the process.

Alpine Physical Therapy has been the center of advanced PRI courses for over two years. The three amigos, Chris "Murph" Murphy, DPT, PRC, Jeremiah Ferguson, DPT, PRC and Eli Zygmuntowicz, DPT, PRC hosted Cervical Revolution at their facility this past weekend and it was a pleasure seeing the guys again and having their support hosting this course. Cervical Revolution has been evolving for the past two years with course manual changes, thanks in a large part to Jason Masek, MSPT, PRC, and his diagram of the atlas and occipital bone in the left and right TMCC pattern. One of the biggest learning challenges in any PRI course is to connect a pattern to position and have a tri-planer picture in mind from a two dimension drawing from a book. Jason’s description is a vital learning tool to understand position of atlas relative to occiput before the discussion of occiput on atlas in a patho-mechanical compensation called right torsion occurs.  

In addition, several revisions to the course manual have been made with the help of Ron Hruska and Mike Cantrell to make this course flow even better.   The emphasis has become even greater on the O/A junction being the driving factor for autonomics, cranial position and especially oscillatory lateralized function. The connection with the L AIC, R BC, R TMCC and LSB cranial position, and the need to alternate and reciprocate, was integrated deeply this past weekend with ample lab time and insightful clinical discussion.

Attendees in the course included six PRC’s as well as practitioners on the verge of becoming PRC’s with much PRI exposure and practice.  Along with the "veterans" there were practitioners with just a few PRI courses under their belts including PT’s, myofunctional speech therapists, and strength and conditioning personal with a strong emphasis on working with baseball players from little league to the pro’s.  Joseph Yousefian, DDS, an orthodontist, was in attendance for his first PRI course.  He was thrown right in the middle of PRI nation and was such a valuable voice when it came to occlusion and a dentist’s perspective.  In this course the discussion on occlusion is one that is interdisciplinary, and that more often than not, we need to work with a specific dentist to help with occlusion to "free up" a neck and let it revolve!

Thank you to all attendees and especially Murph, Jeremiah and Eli. I also want to thank Ron and Mike for their mentorship over the past two years. They have been so generous in their time and energy helping me understand the content and learn how to teach Cervical Revolution. This was my first solo Cervical Revolution as a faculty member and it was such a rewarding experience to be so well prepared with the help of Ron and Mike. Also, thank you to Jennifer Platt, MPT, PRC for all of your mentorship, emails and phone calls in this learning process!

If you have attended Myokinematic Restoration in the past, but not since the course received a make-over in 2016, I suggest you strongly consider attending. If you haven’t started your PRI journey, this course is one of the PRI introductory courses, and is a great way to begin that journey. A couple of changes that were made in 2016 that I appreciate compared to the version I first took in 2004 are that now we have a lot more time for lab, we are able to discuss and spend time in lab on both of the Hruska Lift tests, and we are discussing some ankle mechanics related to the L AIC pattern.

This most recent Myokin class is an excellent representative sample of these changes.  This class was nearly 40% lab.  So everyone was able to find, feel, and experience the muscles required to inhibit the L AIC pattern.  We were able to spend a solid amount of time on the Hruska ABD and ADD Lift tests with lab and explanation of both tests.  And we had a lively discussion about how calcaneal position and mechanics influence and are influenced by the L AIC pattern.

This class had a lot of great participation, as every single participant asked a question, which helps everyone learn. My thanks to Ken Guzzardo for hosting our course. My thanks to Amy Corbin, Amanda McDevitt, Jaclyn Marino, Ivan Salazar, Kristian Flores, Aidan Scotland, and Jamil Skakoor for their excellent questions and re-states. Really, my thanks to all the course attendees for their interest and many awesome questions.  

It was a true pleasure to have Neal Hallinan as the lab assistant. He’s a PRI Black Belt, and he’s speaking at Interdisciplinary Integration in April 2020. He’s going to kill it!