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Blog Posts in November 2016

Had a great couple of days teaching the PRI Integration for Baseball course in beautiful Port St. Lucie, Florida. It was my first opportunity to present this course with our new instructor, Ben Hagar, DPT, PRC and he did a fantastic job. You know things are going well integrating a new instructor when nobody in the room knew that this was his first time presenting and everybody did a great job connecting with the material. As a current MLB Physical Therapist and a long time protege of course author Allen Gruver, PT, ATC, PRC, Ben made the transition to Affiliate Course Instructor look pretty easy. Thanks for your high level of professionalism, your eye for detail and your commitment to making sure the course was a great experience for every single course attendee. It was truly an honor to mentor you and to get to work with you presenting this course Ben.

Also a big thank you to the New York Mets organization for being such a great host site for the course. We felt right at home with your staff and really sensed we were in an environment committed to getting better and working to help those around you get better. You were willing to learn with us, share so much of what you knew and contribute to a collaborative environment that really made for a great course. We look forward to being able to share more of our science with your staff in the future.

As for the highlights, Ben's slow motion video analysis of phases of throwing and hitting really set the stage for relevant and successful application of PRI to the patterned baseball athlete. The sitting trunk rotation test, the quadruped thorax on scapula movement assessment test and the standing eversion with abduction test were provided to help determine which components of rotational body function were deficient for both the right and left handed baseball player. The practical lab for each of these tests really gave the course attendee valuable insight into which components of movement needed to be addressed in order to restore tri-planer movement variability to the overarm rotational athlete. The Left AIC/Right BC pattern was presented in great detail, as well as the respiratory-driven Superior T4 Syndrome and the repetitive rotation-driven Superior T8 Syndrome, with treatment and training recommendations given for each presentation. Sidebar discussions about softball, volleyball, golf, handball and football, using the same conceptual model of analyzing rotational movement were very insightful to professionals working in these settings. It became clear to the group that the content of this course has application way beyond just baseball.

Posted November 29, 2016 at 10:12AM

So grateful for the wonderful weekend in beautiful Scottsdale, Arizona at the Diamondback’s facility. The course was jammed packed with 55 Fitness and Movement Professionals. Ken and Ryan have an amazing staff and I would like to thank them and all their guys for their hospitality and participation. We had some great side dialogue promoting key discussion points and ideas to benefit and better further develop the course which was greatly appreciated. The affiliate course material was well received as it focuses on components of gait, biological foundations of posture and movement, and reminds us how to respect our asymmetrical axial design when upright working against gravity and external loads. One thing I continue to love about this course, is how we break down the basics of thoraco-abdominal mechanics and emphasis the value in integrating both ab walls and the frontal plane in fitness based movement patterns. Lets face it, if you can’t achieve some functional symmetry in your frontal plane when upright and integrate your thorax with your hips rotationally, your biological system will suffer. Our fitness training and conditioning programs only become as strong as our weakest link! I look forward to changing things up in the PRI Fitness course for 2017. We will be adding new activities, more videos, and strategically adding in more lab break-out sessions. It's going to be great! --- so don’t wait too long to sign up! Every course was sold out this past year and with the improvements we make I’m super excited for teaching in 2017 :) Happy Holidays to all!!

Posted November 29, 2016 at 9:54AM

Greetings PRI Community,

I recently received an inquiry from a fellow PRI colleague who was unable to attend this past spring's symposium on the auditory system. The question related to the reasoning behind why one of his client's hearing improved despite a diagnosis of otosclerosis and accompanying prognosis that did not include the ability to get better. Below is my response that I thought was worth sharing with the rest of the PRI community. It was also posted on the Postural Restoration Google Group. If you are not yet a member of this group of practitioners where we have a forum to discuss PRI related topics please email me at to join. 

Our ability to "hear" is determined by a number of factors but here are the ones that are applicable to position and movement from a PRI perspective. 

The inner ear is composed of the cochlea (frequency/sound analyzer) and the vestibule (motion/position analyzer). Our cochlea receives auditory afferent sensory input via sound conduction through the air but also via our bones. The latter is particularly important in relaying the true fundamental tones of sound back to the nervous system. When our bones do not vibrate appropriately it is difficult for us to perceive authentic sound characteristics.  The vibrations created by the larynx are transferred to the spine and cranial bones providing important auditory afferentation.

Our middle ear is composed of 3 vibrating ossicles (hammer, anvil, stirrup in order from outer to inner) which transmit sound from the outer ear to the inner ear. Therefore, proper vibrational capability of these bones is important for sound conduction. There are two muscles within this complex. The tensor tympani is attached to the hammer and is a flexor. The stapedius is attached to the stirrup and is an extensor. Consistent with PRI's functional perspective of poly-articular chains of muscle, these muscles can also be included in these neuromuscular synergies. Therefore, if there is an excessive degree of extensor facilitation in the the body it will likely translate to the stapedius exhibiting hypertonicity. Likewise, stapedius hypertonicity can impact the rest of the postural extensor system. The same may apply with the tensor tympani. This could be extrapolated a step further when considering the asymmetrical tendencies of the cranial system (R typically more in extension and the L typically more in flexion). Therefore, when the system is not able to spend time in neutrality, it will likely have difficulty producing appropriate neuromuscular tone thus impacting position and vibrational capability of the skeletal system. 

The position of the larynx is important for sound generation and that forward head patterns, as described in Cervical Revolution, will negatively impact its ability to properly posture and thus vibrate appropriately. Furthermore, the length/tension relationships of the surrounding laryngeal musculature, ligaments, and tendons are concurrently providing additional somatosensory information also contributing to auditory perception. If these relationships are inefficient so will the corresponding sensory input.

Let's take this a step further and remember that a huge contributor to the position of the neck is the position and poly-articular patterning coming from the thorax/diaphragm and pelvis. Our diaphragm position exerts signficant control over the exhalation power behind the voice.

In summary, our bodies need to have the ability to vibrate. If one is locked into asymmetrical or bilateral patterns that do not allow appropriate range of movement, one's resonance is dampened. This will reduce important sensory input to the system further contributing stress as sensory deficits are ultimately stressors. 

Posted November 27, 2016 at 8:36PM

The PRI office will be closed Thursday and Friday November 24-25 to celebrate Thanksgiving with our friends and family. We will return to the office with normal buisness hours starting Monday November 28. Happy Thanksgiving!

Posted November 23, 2016 at 4:00PM

We are excited to announce the schedule and speakers for the 2017 Interdisciplinary Integration: Postural Destabilization: An Interdisciplinary Approach to Remodel Dynamic Perception and Behavior. For more information and to sign up click here. Be sure to sign up soon as seats are limited.

Posted November 23, 2016 at 9:59AM

Phoenix Satisfaction

Teaching in Phoenix, in November, is always a treat for a Nebraskan.  Teaching at the Seattle Mariners Training Complex makes the experience even sweeter, because of their hospitality.   And teaching Cervical Revolution to a group of attendees who ask great questions on how to make sense out of “sense” is even more satisfying.  This group worked each other and worked off each other.   There was a good mixture of disciplines that all appreciated the need for temporal-occipital and maxillary-sphenoid rotational correspondence.   The demonstrations put on by Tiffany Enache DPT and James Wittekind PT, DPT helped everyone better understand the influences that Standing Cervical-Cranial Repositioning and Standing Alternating Reciprocal Cranial Expansion can have on occlusion and sphenoid orientation.  I truly enjoyed explaining how a persistent LAIC and RBC patterned individual may be receiving false information from periodontal ligament and teeth that reflect a RTMCC pattern. 

Posted November 18, 2016 at 3:50PM

Last weekend I had the pleasure of teaching Pelvis Restoration to an engaged group of movement scientists from a wide variety of settings who converged in Bethesda to enjoy a weekend of learning about the dynamics of pelvis movement, function and performance. Many thanks to Haim Hechtmann for keeping an eye out to ensure that Point Performance was up and running, to Alison Haynes and Daniel Rodrigues for their diligence with the behind the scenes action of host site duties and to Louise Kelley for being a gracious host coordinator to us all amidst her daughter's state championship field hockey weekend! Great host, great field hockey fan and great mom as well!

This instructor enjoyed the intense attention and energy paid by first PRI course attendees including Jill Tender, Sebi Varghese, James Murphy, Nicholas Deacon, Stephanie Currey among others as well as the highly integrated discussions of pubosacral dynamics initiated by Nicholas Jan, Julie Shein, Zachary Cohen, Eileen Kokosinski and 2016 PRC applicant Joshua Funk. I appreciate the energy, effort and assistance of Clarisse Labor and Nicholas Deacon who provided us with their effort during technique demonstration for management of PEC and the always underlying Left AIC patterned movers as the course progressed. Louise Kelley was her usual subtle, but effective leader in the crowd during discussions and lab demonstrations, enabling a lively group to engage in the learning process to the fullest--thank you again Louise!

As is the case so very often, I leave Point Performance refreshed and excited about the future of the application of the science of PRI. Thank you each for your contribution to this weekend's Pelvis Restoration learning event--what a blast!

Posted November 17, 2016 at 8:56AM

Mike and the crew at the West Chester location of Premier Orthopaedics and Sports Medicine were great hosts and really took a liking to the Postural Respiration course material. Most of the class were present when they hosted Myokinematic Restoration 1 year earlier with Jennifer Poulin and they felt this course really helped bring the 2 courses together. It was so great to team teach this course with Louise Kelly and see the group come alive as their understanding of both courses was brought together. Its not as common to be able to team up with another one of our faculty, like Louise and I were able to do, but its definitely a treat for both of us and for the course attendees, because we all are able to learn so much from each other.

I was the primary presenter for the first half of the first day, introducing concepts associated with thoracoabdominal pathomechanics and outlining the framework for the course. Louise took the lead during the second half of the first day as we transitioned into the L AIC pattern and both non-manual and manual techniques for treating this pattern. She also was the primary presenter for the first half of the second day, moving into the R BC and Superior T4 Syndrome issues. She did a fantastic job going over rib mechanics, compensatory breathing patterns and methods to treat both of these conditions. The manual techniques were especially helpful to this group and they came to appreciate the different manual approaches they needed to take for different types of compensatory thoracic patterns. We had a lot of fun in the lab for the manual rib techniques and it was great to have someone as experienced and helpful as Louise to help it all go so well.

While in the Philadelphia area, I had the opportunity to take in some of the sights and sounds this great city has to offer. I went to the Rodin Sculpture Museum and also to the Barnes Foundation Museum of Art on Benjamin Franklin Parkway. It was just the tip of the iceberg of Philadelphia museums, but its all I had time for. Next time I want to go to the Philadelphia Art Museum and run up the stairs to the front door, just like Rocky Balboa. I've been to the statue of Balboa out in front of the museum, but I've never taken the time to go inside and enjoy the art. Too many museums, not enough time. Philadelphia is definitely one of my favorite cities, when it comes to art and culture.

Posted November 14, 2016 at 11:14AM

Hosts Joy Backstrum PT, PRC and Katie Piraino, PT made this weekend a most rewarding one to teach Postural Respiration. There was a lively discussion throughout the weekend with intelligent questions always on point supported with a curious attitude to understand the concepts and application of PRI principles. In addition to numerous P.T.'s there was an ATC, two CSCS strength professionals, a cranial/sacral therapist, one dentist and an optometrist! The dentist is most interested in sleep apnea, airway management and how PRI principles can be applied to her holistic approach to dentistry. Several attendees had been PRI patients and were hungry to learn more and share their personal experience of PRI with their patients. For several students this was their third primary course that connected the pelvis with the thorax and connecting the dots that femurs need to adduct and a thorax needs to flex with ribs that can internally rotate for reciprocal and alternating function. The topic of "separation" of a pelvis and thorax was explored as well as a discussion that not only to feet often need an orthotic, but the optometrist and dentist appreciated that eyes and a TMJ or the teeth need an orthotic as well. It was such an addition to have these two professionals and their enthusiasm. Thank you to The Physical Therapy Place for being such a great host site!

Posted November 10, 2016 at 8:23AM

I had a great time teaching Myokinematics of the Hip and Pelvis last weekend in Salem Oregon! The staff of Hope Orthopedics have been waiting for a PRI class for a year and I hopefully did not disappoint them! Suzie and her co-workers made me feel very welcomed and Norm kept me from running into various obstacles as I discussed the finer points of human patterned asymmetry as it relates to an A on an F and a F on an A! Minh Nyugen, OT PRC is a dear friend of mine who hadn't seen me teach since my last training course with James in the fall of 2010. I love to see my PRI family and meet new friends. I was also able to spend a few extra days with my own personal family that made traveling out of my EST zone that much better! The new and improved Myokin course was a pleasure to teach and although we NEVER have enough time to go over all of the finer points in an Intro course, I feel confident that the course manual will guide their clinical practice. Thank-you to all of the course attendees who came to my last course of 2016! I will work on refining my sometimes unorganized delivery and my jokes in my off-season. Thank-you to all I humbly had the pleasure to teach to this past year. I am honored to be a part of this amazing team. Have a great Holiday season PRINation! See you all in 2017!

Posted November 9, 2016 at 11:39AM
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