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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 November 2019

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!

Posted November 21, 2019 at 11:13AM
Categories: Courses Clinicians Science

Getting to visit the beautiful state of Alaska is always a gift and if you haven’t been there before, you get a taste of the rugged and majestic way of life the minute you step off your plane at the airport. A beautiful bull moose graces the main hallway and a world record 459 lb. halibut graces the wall as you head down to get your luggage. Both of these beautiful creatures instantly remind me of trips I have taken to Alaska with my Dad and my son to catch salmon and halibut and to enjoy the great big Alaska outdoors. Great memories for me indeed.

Historically, my trips to Alaska began in 2011 when I traveled up to speak at the Alaska Physical Therapy Association annual conference at the Alyeska Ski Resort. Over 100 people listened to Myokinematic Restoration that day and the group struggled to appreciate the value of the science and to understand how the principles of PRI fit into what they “knew”. To be honest, we may not have had continued opportunities to grow PRI in Alaska were it not for one innovative pioneer who quietly sat in that class named Joy Backstrum, PT, PRC. Thank you Joy. Thank you for your patient, thoughtful, open-mindedness and for your commitment to be a mentor to your peers. Thank you for the difference your drive and persistence has made in so many lives from that first course until today. It was special to see the members of this Impingement and Instability class recognize that you are the reason they are able to be so far along in their PRI journey.

And thank you to the entire team at The Physical Therapy Place for being such great great hosts this weekend. You guys went out of your way to make sure I felt welcome and appreciated in every way. From making sure I had everything I needed to taking me to awesome Anchorage restaurants like Hearth Artisan Pizza and The Moose’s Tooth, you guys did it all.

This Impingement and Instability course went off quite well. We started the first day explaining how impingement and instability are actually good things, when seen in the proper context. Instability where you have previously experienced impingement and impingement where you have previously experienced instability are essential for the alternating reciprocal rhythm your autonomic nervous system seeks. Your sense of the floor and your sense of the PRI Reference Centers on both sides of your body help your autonomic nervous system appreciate this desirable rhythm.

Calcaneal instability, femoral instability, Ilial instability and scapular instability were all discussed in context with this desirable rhythm and variable autonomic function. When the body starts to look like a system where regions of the body rely on other regions of the body for what they need, then you can begin to move past introductory level PRI thinking into secondary and even advanced PRI thinking. This class is really fun to teach because it does such a good job bringing concepts together and it helps the course attendees advance to the next level without losing any fundamental components. If you haven’t taken Impingement and Instability in a while or at all, I hope you can join us for this innovative course in 2020. You’ll be glad you did.

Posted November 20, 2019 at 11:19AM
Categories: Clinicians Courses Science

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.

Posted November 19, 2019 at 4:03PM
Categories: Clinicians Courses Science

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!

Posted November 14, 2019 at 10:59AM

Phoenix Arizona is a beautiful place to visit just about any time of the year, but early November in the Valley of the Sun is just about perfect. A big thank you to Jimmy Southard and the amazing staff of the LA Dodgers for hosting Postural Respiration, our flagship course. Also thank you to all of our wonderful course attendees and a special thanks to Aaron DeBord and Jim Wittekind for assisting me as lab instructors.

Postural Respiration hosted by the LA Dodgers, James Anderson, Postural Restoration Institute

The recently updated Postural Respiration course is fun to teach for many reasons. First of all, the research associated with the presentation on day one is comprehensive and clarifies concepts that have been fundamental to this institute since its onset. Emphasis on powerful PRI principles like Left Posterior Mediastinal Expansion, Right Apical Chest Wall Expansion, Autonomic Sense and Limited Functional Patterns take on new meaning in context with these newly included research articles.

Postural Respiration Primary Course, Postural Restoration Institute

Postural Respiration Manual Technique, Postural Restoration Institute

Another highlight is a new test to assess Standing Posterior Mediastinum Expansion. This group took the time to appreciate the the critical nature of this concept and to experiment with this new test and it really paid off. Many new ideas for utilization in a variety of settings were discussed and shared. Many eyes were opened up to what this institute has always been able to offer upright rotational performance and the autonomic variability for athletic performance and standing upright training activities. Fun to see and experience.

Standing Posterior Mediastinum Reach Test, Postural Restoration Institute

Thank you Jimmy Southard and thank you LA Dodgers! Always a world class organization with world class hospitality.

Posted November 13, 2019 at 10:27AM

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!

Posted November 11, 2019 at 11:04AM
Categories: Clinicians Courses Science

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…..

Posted November 6, 2019 at 10:42AM
Categories: Clinicians Courses Science

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.

Posted November 5, 2019 at 10:16AM
Categories: Clinicians Courses Science

FINALLY!  The long-awaited first offering of the PRI Integration for Pediatrics course is in the books!  James and I had a great time with 8 therapists who are new to PRI, including one pediatric Speech Language Pathologist and one pediatric Occupational Therapist. James did an awesome job making sure the new folks were understanding the PRI language and science, and the experienced PRI-trained clinicians and 7 PRC’s mentioned enjoying the review... there are always old concept to reconsider!

We unveiled the 8 component “Desired Sequential Movement” (DSM) reference guide to aid in treatment planning and exercise progression for 2 groups of pediatric patients, depending on their level of abilities. Of course, there were lots of fun photos and videos of adorable kiddos to entertain, enjoy and to help us teach. A big shout out to all my pediatric “models” who helped explain these fun, kid-friendly tests and techniques this weekend! And thanks to my home clinic, Advance Physical Therapy, Susan Henning, PT, PRC, Joe Belding, PT, PRC and crew for creating a comfortable environment with the best snacks around. And, last but not least a HUGE thanks to Danielle Wild who came in from home to help with commuter issues over the weekend!

See what others had to say about this inaugural course below!

"Last weekend I attended the first ever Pediatrics Affiliate Course written and presented by Lisa Mangino and James Anderson. I literally had been waiting all year for this course! It did not disappoint. My entire career I have worked with an adolescent to adult population. This is my comfort zone. In what appear to happen gradually, but then started smacking me in the face was the age of my patient was getting younger and younger. I have raised to 2 daughters, so I know kids, right? Wrong. I found myself challenged to switch gears from doing what I knew with adults and applying it to kids. The little wiggle worms do not like to lay on a table and have tests performed on them. They want to explore and play. I was at a loss. When I heard Lisa was going to be writing this course, I just couldn’t wait. Last weekend the wait was over and they did not disappoint. I left there with simple tests that I could use with my littles, as I like to call them. Cool fun techniques that will allow them to play and me to treat. What was even better is I can apply these tests to my “Big Littles” too. It really starts with Pediatrics. If we can begin to change their patterns young, we can prevent a lifetime of pain and compensations. Do not feel like you have to treat kids to take this course. I have maybe 2-3 on my caseload now, but feel I have the tools to help my adults too. Can’t wait to whip out my new toys and tools to help my littles. Balloons, bubbles, stickers, markers, games and puff balls! How fun!
James is an excellent mentor, I know first hand about that! The interaction and flow between James and Lisa was awesome. James sets the stage of PRI concepts in a simple way that I wish I had heard early in my PRI evolution. He is a gifted teacher.  Lisa is a humble, gracious teacher. I really could listen to her all day. She is knowledgeable, answers questions well and really is a gift to her patients, and now her PRI students. Sign up now, this course will surely be a sell out." - Jen Poulin, PT, PRC

"I have been asking for a PRI course focused on pediatrics for years, and this course was everything I'd hoped it to be, and more! An excellent introduction to PRI and the science if you are new to PRI, and serves as a thorough refresher for those of us who are familiar with it. I am excited to try out the new functional tests with my pediatric patients and I'm confident that they are equally as effective tests for an adult population. The names and modifications to PRI exercises for a pediatric population and thoughtful and creative. The cues and ideas for active play were insightful and can be applied to patients requiring a high level of assistance all the way to those who have the highest function. I feel some of the cues would even be beneficial for our adults to achieve proper positioning! I highly recommend this course for those working in a pediatric population, but I also know many adults that are "big kids," and this is helpful for those patients too!" - Sarah Luin, PT, DPT, PRC, BSPTS Schroth Certified Therapist (C1)

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.

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