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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 2009

Michal Niedzielski and Gregory Parfianowicz recently returned from their trip to Poland.  On March 20th through the 23rd Michal and Gregory taught Myokinematic Restoration in both Warszawa and Olsztyn.  This year marked a new chapter for PRI as this was the first time PRI has been presented in Poland.  Michal and Gregory put in months of preparation for this course and we are honored to have both of them represent PRI!  Here are some photos from their trip…

Warszawa

PRI in Poland PRI in Poland
PRI in Poland PRI in Poland
PRI in Poland PRI in Poland
PRI in Poland PRI in Poland

Olsztyn

PRI in Poland PRI in Poland
PRI in Poland PRI in Poland
PRI in Poland PRI in Poland

Posted April 8, 2009 at 1:45PM
Categories: Courses

The 2009 shoe guide that is!  Before the Interdisciplinary Integration course we met with The Lincoln Running Company to hear all about the newest shoes on the market.  After much conversation and a little debating, PRI and Dr. Paul Coffin came up with recommendations for the best shoes out there. Guess what shoe still tops the list…Asics Foundation!  To see the entire list, click here!

Posted April 6, 2009 at 2:32PM
Categories: Products

If patient can’t maintain re-positioning…

Breathing

  • Are they diaphragmatically breathing?
  • Quality of respiration?
  • Symmetry of respiration?
  • Decreased diaphragmatic motion, increased descent of pelvic floor, altered breathing patterns associated with pelvic pain.
  • Diaphragmatic and TA muscle activity reduced with hypercapnea.
  • Pelvic floor depression associated with breath holding/Valsalva maneuver.

Abdominals

  • Can they isolate IO / TA?
  • Symmetrical or Asymmetical?

Abdominals

  • Palpate approximately 2 cm medial and inferior to ASIS.
  • Slowly & gently draw in your abdominals away from your fingers.
  • Sub maximal contraction.
  • Change positions (supine, side lying).
  • Monitor for substitutions.
  • Is IO / TA activity sustained with breathing?

Abdominals

  • Can they maintain IO / TA contraction with upright static & dynamic control?

Walking Seated Ball Pregnancy Squat

Pelvic Floor

  • Can they isolate their pelvic floor muscles?
  • Can they actively contract and relax the pelvic floor?
  • Do they feel an up & in contraction?
  • Are they substituting (glute squeeze, breath holding, adductor squeeze, bearing down)?
  • Is there symmetry?
  • Is there appropriate motor planning?
  • Voluntary contraction of the abdominal muscles stimulates pelvic floor contraction.
  • TA and IO recruited during all pelvic floor muscle contractions.
  • Relaxed abdominals resulted in only 25% of maximum pelvic floor contraction.
  • Women with stress incontinence have increased OE activity (increased OE increases IAP).
  • Back pain more common in women with incontinence , increased probability of LBP if have symptoms of incontinence.
  • Pelvic floor muscles are part of preprogrammed response to postural adjustment.
  • Decreased pelvic floor strength, endurance and thickness noted in women with incontinence.
  • Increased pelvic floor activity with postural perturbations noted with women with incontinence.
  • Pelvic floor tonic activity at rest, with cough automatic phasic response, in women incontinence unsustained tonic pattern with asymmetrical recruitment.
  • Timing deficit of muscle recruitment lost with women with incontinence.
  • Higher resting tone of pelvic floor with dysfunction, need to teach down training.
  • High resting tone does not always mean a strong pelvic floor.
  • The pelvic floor needs to relearn how to function within a neutral pelvis.
  • Feel the pelvic floor contract and relax.
  • Reported cure rate of pelvic for urinary incontinence ranges between 44-69%.
  • 30% of contractions are performed incorrectly; 50% of contraction are strong enough to increase urethral pressure.
  • Pelvic floor muscle activity alone does not predict UI, activity related to UI needs to be considered.
  • Isolated contraction of pelvic floor produces greatest displacement of pelvic floor.

Hypermobility - But Still Have Symptoms

  • Is there global hypermobility?
  • There is a high correlation of pelvic dysfunction with a reduction in tissue collegan concentration.

Abdominal Binder

Referral

  • Has there been trauma?  Consider referral early on if patient not progressing appropriately.
  • Patient can reposition but they still have symptoms- are they able to relax their pelvic floor?
  • Is there psyco-social issues?

Referral To

  • If symptoms have not subsided consider referral to OB GYN/Urologists/Primary MD
  • PT with pelvic floor specific training (biofeedback, internal evaluation, condition specific integration)
  • Podiatry (correlation of foot flexibility and SUI)
  • Dentist
  • Neuro - Optometrist
Posted April 6, 2009 at 2:16PM
Categories: Courses

If you attended day four of our Interdisciplinary Integration course, you learned about Pelvic Floor Dysfunction and the positive effects squatting can have on treatment of this condition.  Following the course, one of the attendees sent us this email that confirmed PRI’s position on the power of squatting…

I wanted to share something else with you all, especially Lori and Ron.  Lori highlighted the importance of squatting and it’s impact on constipation.  My 3 year old, has struggled with constipation since birth.  She literally will go poop once to maybe twice a week if she is lucky and it is always with tears and an all day event.  We have tried everything, from suppositories, Miralax, Benefiber supplements, high fiber diet, Flax oil, Mineral oil, infant tummy massage, etc.  Anyway when I got home Sunday night she was still awake.  After the excitement of seeing each other again, I put her on the toilet in the squat position and she immediately started pooping!  I was ecstatic!  We did the same thing yesterday and today with the same results!  This makes arecord three days in a row of her pooping without tears or pain!  I truly feel that God brought me down to Lincoln for many reasons and this is definitely one of them.  Thanks to you all for all of the work you do to help people.  This simple thing will be life changing for everyone in my daughter’s life, as it was always so hard to watch her be so uncomfortable and not be able to help her.  Thanks again!

Posted April 6, 2009 at 1:42PM
Categories: Techniques

Karen Jiran, MPT, PRC was the instructor last weekend for our one day clinical course called Postural Restoration.  For those of you unaware of what this course is, this course is an individualized, one day class, that covers concepts requested by the attendees.  In short, the entire day is spent reviewing concepts taught in one of our two day courses.  This course happened to be organized by PRI but we often schedule the courses on request.  Here is some feedback from the attendees:

“Great course, Karen did an excellent job!  I would recommend this class to everyone.  It was a fun, dynamic learning experience!”

“Excellent course, please offer more of them!  It’s nice to have a small class size to have practice time!”

“Very, very good!  The case studies and small group discussion made the problem solving effective!”

“It’s nice to have a source to get questions answered.”

If you are interested in having a one day clinical course at your office, please contact us! This is a great opportunity for more advanced, hands on clinical application for you and your colleagues!

Posted April 3, 2009 at 2:34PM
Categories: Courses

The Myokinematic Restoration course scheduled in Syracuse, NY this weekend has been cancelled. If you are registered to attend, please give us a call for more information

Posted April 2, 2009 at 2:36PM

to our first Interdisciplinary Integration course, you missed out on a fantastic weekend!  Let me give you a quick overview on each day…

Day one which covered Podiatric Integration started out with information covering gait analysis and it’s relevance to PRI related treatment.  It was a great overview of the reciprocal process that takes place as our body moves through the motion of gait and what PRI considerations we should keep in mind as we are treating different phases of gait.  The afternoon carried on with information regarding orthotics and what purpose a PRI orthotic serves in reducing neuromotor pathomechanics provided by Dr. Paul Coffin.  The day couldn’t have ended better than with Ann Ringlein, from the Lincoln Running Company, covering proper shoe wear.  Here are some comments from attendees of day one:

“Excellent clinical application I can use immediately.”

“Fantastic, fascinating guy; we could learn a lot more from him!”

“Excellent information and application for our clinic.”

“The videos and pictures of those walking was so helpful!”

Day two was devoted to Dental Integration provided by Dr. Mike Hoefs.  The entire day was spent by a passionate, enthusiastic dentist talking about the importance of position and maintaining cranial symmetry.  Dr. Hoefs is one of the few dentists in our country treating craniofacial pain and dental discrepancies through gnathic orthopedic positioning.  The highlight of the day was when he took our very own, Lisa Bartels, DPT, PRC, and placed a twin block ALF appliance in her mouth in front of the whole class.  It was incredible to see the postural changes that took place immediately following the application of this appliance!  Here is what others had to say about the day…

“Interesting, informative and very helpful for understanding when and how to refer to an appropriate dentist!”

“This was such an eye opener; I really appreciate all the information given!”

“The demonstrations used during this course were very applicable for use in the clinic.”

“Wow, Dr. Hoefs is the Ron Hruska of dentistry!  He is such an innovator!”

Day three was spent on Vision Vestibular Integration.  The first part of the day covered optokinetic learning taught by Ron Hruska, MPT, PT.  We learned all about vision and its influence on balance and the vestibular system. The morning provided an excellent overview on how to integrate and communicate with optometrists.  Dr. James Nedrow discussed his expertise in neuro-optometry and the treatment of visual midline shift and post traumatic visual dysfunction.  Here is what others had to say:

“I have a better idea of when to request optometry and neuro optometry.”

“Both the morning and the afternoon came together for me and showed me where to look to study and begin tying things together.  The whole day was fascinating!”

“This course opened my eyes to the importance of treating the entire system.”

“Wow, this course definitely helped clarify the relationship of the vision-vestibular system and posture.  Ron and Dr. Nedrow did a great job of presenting this information and demonstrating the importance of interdisciplinary integration.”

And finally, day four!  Pelvic Floor Dysfunction was the topic of this day given by Heather Engelbert, PT, PRC and Lori Thomsen, PT, PRC.  What an incredible day covering the importance of establishing a positioned pelvic floor, before addressing pelvic floor dysfunction.  Not only was pelvic asymmetry discussed but also covered was the importance of the respiratory system and its influences on the pelvic floor!  The afternoon was spent on treatment techniques for pelvic floor dysfunction and we were given several new activities to use with our patients.  Here is what other attendees had to say about it…

“Great explanation of the Left AIC pattern and how it affects pelvic floor dysfunction.  I loved the “egg”, pelvic floor and diaphragm diagrams; it helped me to understand position of the pelvic floor and the pelvic diaphragm.”

“The clinical application with treatment strategy and reasoning behind these strategies was one of the best discussions I have ever heard!”

“This was a wonderful way of improving my understanding of how to fit the pelvic floor in the PRI picture.”

“This course exceeded my expectations; I now know what is going on at the bottom of the egg and what to do about it!”

Interdisciplinary Integration

Posted April 1, 2009 at 2:42PM
Categories: Courses

The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science written by Norman Doidge is a highly recommended PRI reading!  This book was discussed throughout our Interdisciplinary Integration course this past weekend and it was decided that this book is a must have!!  To learn more about this book, click hereHere is what the New York Times had to say about it!

Posted April 1, 2009 at 2:38PM
Categories: Books

Abdominal Discord

  • Abdominal weakness- dorsal stabilizers become tight and static, exhalation becomes passive and rate of inhalation increases.
  • Belly breathing associated with increased lordosis.
  • Unilateral or bilateral rib flare.
  • Rotation dysfunction increases with internal oblique weakness on side toward which the body is rotated, external obliques weakness on opposite side.
  • Strains sacral iliac ligaments.

Common Compensatory Pattern

1.  Pope, R. The common compensatory pattern: it’s origin and relationship to the postural model.  AAOJ 14(4):19-40.
2.  Zink G, Lawson W. An osteopathic structural examination and functional interpretation of the soma. Osteopathic Annals, 1979 Dec 7(12):433-440.

Posted March 29, 2009 at 2:07PM
Categories: Courses

PRI Gait Analysis of the Accelerated “Asymmetrical” American

1.  The left foot goes through a toe-out gait pattern at early push-off compared to the right.  Secondary to poor abductor co-contraction of adductors and anterior gluteus medius.

2.  The right lower extremity externally rotates more overall than the left.  During swing because of overactive iliacus and during stance because of innominate orientation of legs and trunk to the right.

3.  The right heel lifts early at mid-stance compared to the left and at push-off.  Secondary to longer interval of right weight acceptance and trunk glide and longer shorter swing and ‘stride’ with left leg.

4.  The femurs significantly internally rotate at push-off.  At late mid stance and trunk glide phases innominates are forwardly rotated too much contributing to FA IR orientation or position.  Especially seen in hyperextended individuals. 

5.  There appears to be a higher ‘active’ mid foot arch on the right at mid stance.  Secondary to overactive, shortened strong right adductor influence on foot and ankle.

6.  No sufficient resupination of the left foot occurs after midstance to stabilize or “lock” the tarsus in the sagittal plane and allow for efficient propulsion.  Contributed by weak right acetabular femoral external rotational strength.

7.  The right 1st metatarsal is not secure in plantar-flexion against the ground during forefoot loading.  Contributed by C.O.G. over-distributed to the right and overactive left TFL during swing. 

8.  The right 1st MTP joint does not dorsiflex freely for forward gait progression without compensatory dorsiflexion from smaller toes and shifting of COG to the right.  Secondary to forefoot and possibly rearfoot varus and overactive posterior gluteus medius and iliacus. 

9.  The right arm does not move forward upon right toe-off.  Secondary to poor left lateral abdominal integration and overactive right thoracic abductors reinforcing right arm adduction. 

10.  The left shoulder does not drop upon left toe-off.  Contributed by weak left gluteus medius and left lateral abdominals at late mid stance or trunk glide. 

Posted March 26, 2009 at 2:10PM
Categories: Courses
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