PRI Integration for Geriatrics (Minneapolis, MN)- An awesome weekend in the Twin Cities of Minnesota with the great team at IMPACT Physical Medicine and their course coordinator, Christie Amundson, PT, DPT, HFS, PRC. Their owner, Mr. Stan Babel is a long-time friend of mine and both a gentlemen and a scholar, simply stated. I have been fortunate enough to work with their clinic over the last 17-18 years teaching and consulting and Stan has always treated me with the upmost kindness and respect (and for the record, he takes me to the best restaurants in St. Paul). This weekend reminded me of all my friendships over the years within this organization and the many memories I've been able to make over the different generations of IMPACT employees during this time. A big thanks to all of you, past and present.

There were a lot of great people from the Midwest in attendance, and I want to thank my two lab assistants, Christie Amundson, PT, DPT, HFS, PRC and Tom Tardiff, PT, DPT, CSCS, PRC for helping make the experience great for the class. You two were very helpful. Beyond all the great Minnesota people in attendance, I was especially appreciative of Matt Rosenboom, OT, for traveling all the way from New York City. I appreciate Matt for a couple of reasons, first because he was willing to travel away from the large coastal cities to attend a course like this in the Midwest, secondly, because he is an Occupational Therapist, and lastly, I love that he has already created collaborative learning with a hand full of PRI experienced people, including an old Protege of mine, Minh Nguyen, OT, PRC.

I highlight the fact that Matt is an OT, because this course has Occupational Therapy written all over it. Besides Matt, there were 9 other Occupational Therapists in attendance and the Physical Therapists got to take time to explore the world of OT, not the other way around. This is meaningful for us because PRI has always been a big fan of interdisciplinary work and appreciating everybody's contribution to the "whole" team. The "Gerald" handout of patterned and preferred "Functional Routines" we discussed on the second day really sums up the functional objectives of this course and helps make the material very practical.

This course has been a gem to share over the last 5 years, especially since completing the updates to the techniques section 2 years ago. People continue to love the exercise appendix, organized into bed, recliner, chair, transfer and standing sections. A couple of you have seen both versions of this course and provided us some valuable feedback on the updates. Thank you in particular, Stephanie Boespfug, PTA, PRC for your valuable insights and the positive feedback on how these new updates have helped you with clinical application working with Geriatrics. It was fun to have you there with us again.

Another reason this course is so fun to present is that it serves as a great introduction to the science of PRI and helps connect people to our fundamental concepts in a simple and non-confusing way. One course attendee wrote, "as a more experienced PRI clinician, I appreciated the amount I still learned exploring basic PRI concepts in this course." Another attendee from last weekend reported, "I am excited to get back to using PRI. I feel like I had stopped, but this course pulled some pieces together for me that I was definitely missing. Thank you." Another course attendee wrote, "Overall, one of the best courses I've been to. Great clinical application for all clinicians working with Geriatrics, not just home health. Pleasantly surprised with my ability to apply this in an outpatient setting. Thank you."

Landing in Munich is like coming home for me. I have family here and I was afforded the opportunity to see my cousins and connect. My mother’s side comes from Munich and Bavaria and our roots are deep here. My sister wrote of my father’s meeting with my mother in WWII in a series of novels the first of which is called: The Reason of Fools by Dodie Cantrell Bickley (see the youtube trailer). After arriving in Munich we settled-in and then had an opportunity to see the city and acclimate to Germany and the time zone change. When I met with Daniel Mueller Osteopath and Eduard “Eddie” Erdeljac MD, DO1, I was greeted with warm smiles and Bavarian hospitality. Lindebergs Academy is like nothing you’ve seen and promises to be a hot bed of PRI in the coming years. This Saturday I started with Myokinematic Restoration and by the time we finished on Sunday, the class was full of excitement and gratitude for learning a new science and a new way to manage clients. Betsy Baker-Bold was a fantastic addition as a lab assistant and her input was incredibly valuable. I am always amazed as I travel around the world disseminating the PRI news along with my interpretation of Ron Hruska’s vision, how friendly and caring the souls are that I meet. We may be from varying backgrounds and walks of life but we are no different at all really. I’m grateful to be here and I will keep you posted on next weekend’s adventures with Postural Respiration!

We wrapped up the year for PRI Integration for Fitness and Movement courses outside of Philadelphia at Maplezone Sports Institute/The Training Room Physical Therapy in Garnet Valley, PA. We had a very awesome group that digested the principles of Breathing, Thoracic Posture, and Sensing Position and the Ground quite well. It really was a fun group to end the year with, so thank you to all that attended! And special thank you to The Training Room Physical Therapy staff and Rob Rabena at MSI for hosting!

 This PRI course heavily teaches components of breathing, pillar strength and axial frame mobility and their three dimensional relationship for cueing and coaching thoracic posture with proper pelvic position. A good coach can value learning how to coach and cue the core differently based off the position the athlete or client is in, i.e. with a unilateral asymmetrical loaded movement pattern and a symmetrical loaded movement pattern and we look to highlight those relationships in this course.

This year we emphasized the parable of “parachutes and pancakes”. Teaching this parable throughout the year we’ve learned a few things on how people train and see (or don’t see) the diaphragm as an important core muscle. Our emphasis in teaching this parable is on helping attendees appreciate how training oblique abdominals and hamstrings to optimize respiratory postural balance is a key ingredient that should be incorporated in fitness and movement exercises. We know that when the ribs and thoracic cage are too stiff and rigid with ribs in external rotation, hyperextension, and hyperactivity the respiratory diaphragm can become tonic, flattened and underused, we could risk training the core in a compromised position and the “pancakes will become crepes” as the spinal mechanics becomes stressed which could further limit triplanar performance and lock up functional movement patterns, inhibiting gluts and other powerful muscles. On the flip side with people that might misuse abdominals or overdo flexion without unlocking the thoracic rings, we could create a different faulty pattern of forced thoracic folding when proper rib IR and thoracic retraction are not coordinated with a neutral pelvis. This could be a problem and would “fold pancakes into a pseudo folded parachute” which will bring about a different set of issues. Confusing?…. well maybe, but bottom line here, if you followed that, you get the parable!

The core was designed to be mobile and dynamic. If you learn to value rib movement and recognize key axial structure landmarks you can tell when you are training pancakes verse parachutes. The more we can train parachutes in various positions, the more we can help our clients be resilient and durable. #trainparachutesnotpancakes

I’m looking forward to teaching this course in 2019. This year was such a blessing to learn from the attendees and help fill the gaps with new material as well as streamline how to teach the material. We’ve listened to feedback and continued to improve the course to share with the diverse crowds and specialty professionals working in various Fitness and Movement settings. A special thank you to James Anderson, our Affiliate course director, for all his hard work and dedication to make these affiliate courses a success. Hope to see many of you next year!

Ron Hruska and I attended the 2018 International Association of Orofacial Myologists (IAOM) this weekend in Charlotte, NC.  It was an informative conference attended by Speech Language Pathologists (SLP),  Registered Dental Hygienists (RDH), Dentists and one other PT. The speakers included physicians (MD and DO), dentists, and SLP’s who spoke about topics including but not limited to: connecting the mouth to the rest of the body, guiding orofacial development in children, techniques for speaking and feeding in children with special needs, techniques for addressing tethered oral tissue (TOT; tongue and lip ties), wound management from TOT surgery, the tongues effect on the body, genetic disorders, and publication trends and evidence in Orofacial Myofunctional Therapy literature.

Ron spoke on Orofacial Myologic Disorders (OMD) Relationship to Postural Asymmetry. It was a well – received lecture where Ron focused on respecting the neck, asymmetry, anatomy, forward head posture and the importance of recognizing sense. He performed a test/ retest demonstration of how a PRI technique results in neutrality. They were amazed to say the least!

Following this lecture Ron and I received many questions from the course attendees about the value of physical therapy. We tried hard to explain to them that their local PT without PRI experience may not be able to address their patient’s issues as demonstrated by Ron in the lecture. It is likely these course attendees (SLP’s and RDH’s) will be contacting you from the PRI website as a clinician to help them treat their patients.  Understand that they believe they are the ones who should be treating the tongue and mouth directly. It will be a nice opportunity for PRC’s to help guide these practitioner’s understanding how the position of the neck and body, and the underlying asymmetry, we all appreciate, can have a significant influence on their treatment, approach and results when addressing oral myology pathology and disorders.  We both came away with a high degree of respect and appreciation for these interactive and collaborative, multi-disciplinarians.