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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 2017

It was a wonderful weekend in Gilbert, AZ teaching Pelvis Restoration. Thanks you Connor Ryan, PT, DPT, CSCS, PRC and Foothills Sports Medicine Physical Therapy for hosting this PRI course. We had 35 attendees and we got into the nuances and details of the AFIR/AFER position as it related to the pelvis and it's relationship to gait. We had great discussion and demonstration of rectus abdominus inhibition (thanks Steven) and compensatory and non-compensatory hip position with the Pelvis (thanks Pat). It was an amazing and insightful group of clinicians.

Posted January 26, 2017 at 2:06PM

The first Postural Respiration course of the year was presented at Rehab2Perform in Frederick Maryland. This facility is a perfect blend of rehab and performance as stated in it's name! Physical therapy, functional training, group coaching provides the backdrop to the diverse group of attendees including PT's, CSCS's and even an M.D. Some of the topics that attendees, and usually all attendees have, is the difference and purpose of a right arm reach vs. a left arm reach. This issue can be vexing for even veterans of several courses. One way to remember this is a right arm reach first turns a diaphragm to the left taking a pelvis with it. Get and hold onto a left hamstring and left abdominal wall then with the help of left serratus and left low trap, a left arm reach then turns a ribcage above T-8 to the right. Caution with superior T-4's was a theme reinforced over the weekend and veterans that had some questions about the reasoning regarding which arm and when to reach with it came away more relaxed and settled with this issue. Strength and conditioning professionals got whatever you load you will reinforce so get neutral, stay neutral and then load, move and perform! All in all a great facility, hosts and especially curious students! Thanks to all that attended and Josh Funk, DPT, CSCS, PRC for providing this facility!

Posted January 26, 2017 at 8:43AM

On January 14-15 I had the opportunity to teach Myominematics in Atlanta, GA. This time however, things were a little bit different. First of all I want to thank Andrew Hauser ATC, CSCS, PRT and the rest of the Atlanta Braves staff for hosting the course and that, by itself, is an exciting validation of this exciting science! Secondly, I want to mention the true reason for this course being different: Dan Houglum MSPT, ATC, PRC. Dan is one of our newest course instructors for Myokinematics and he spent his weekend teaching most of the course. The class went very well and Dan did a great job! He was given great and useful feedback from the participants and I think Dan will be crushing Myokinematics in the upcoming courses that he is slated to teach! Finally, I want to say thank you to all of the course participants and I am always excited to see courses finally breaking into the peach state!

Posted January 23, 2017 at 11:54AM

The first thing any skier learns is how to stop!  The next is how to control speed coming down a hill and then turning skis to provide direction in what at first feels like a very awkward, sometimes out of control and for most ultimately exhilarating experience!

Positioning the skis in what is called a “snow plow” is what most beginners learn and both inside edges of the ski (medial under the arch of the foot) are used to slow, stop and turn the skis.  Essentially the feet need to evert to create resistance on the snow with the tips of the skis close to each other but not crossing and the tails of the skis wide apart.  This looks a little like a slice of pizza to most youngsters (and oldsters!) and we say “get into your pizza wedge”.  In this snow plow position, if a skier leans over to the right side, they will turn left and visa versa.

Learning how to parallel turn means both skis turn together everting and inverting at the ski boot.  Since the boot doesn’t allow for frontal plane movement of the ankle joint, frontal plane to evert and invert a ski will need to come from the hips and knees.  The feet and ankles sense frontal plane and actually determine direction of the ski. (Well the brain actually runs the whole show but needs feedback from the periphery!)   In fact, part of skiing well is termed “skiing in your boots” or having a good proprioceptive sense as to what your feet are doing, sensing and directing while sking.

Sagittal, frontal and transverse plane awareness, repositioning and training can enhance not only skiing technique and enjoyment but performance as well.

It doesn’t take much of a decline on a ski hill for a person to go faster than they are used to when walking or running.  The ability to manage and be controlled without falling even at high speeds is always a goal with skiing.  There is no shame in falling and even the best fall but the potential for injury increases without awareness and control of all three planes.

There are many ways to fall but one of the biggest culprits is leaning back or extending.  However, especially with many recreational skiers, if they come upon a steeper hill than they are used to, the tendency is to lean back out of fear of falling or inability to control speed on a steeper hill.  Training a person to push forward into their boots, bend their knees and reach forward with their arms helps to keep the center of gravity over their boots.

The standing wall reach is a prime example of a repositioning technique that trains a person to flex at the knees and the thorax, internally rotating ribs with exhalation and retracting a ribcage with inhalation.  Reaching forward is exactly what needs to occur in skiing to stay centered over your skis so you can anticipate changes in terrain and speed.

Another way to fall is while skiing on a steeper hill, instead of staying over the “down hill ski” with your weight, you lean into the hill, loose edge control and start to slide and fall.  Remember this can happen on a right turn more easily than a left because you need left inside edge control ( Left stance phase) that only comes from having a femur that can adduct and internally rotate.  You also need weight driven over into your left hemisphere or thorax so you can set that edge into the snow while your uphill leg (right leg) is inverting for outside edge contact and to some degree control.  The left leg needs to be in Left AFIR with FAIR to “crank that turn” and the right leg needs to be in Right AFER and FAER in a synchronized fashion.

Another way to fall is turning from the left to the right.  If an individual has the inability to have a neutral left oriented pelvis, go into left AFIR, drop a left shoulder over their ski with abdominal control and achieve a ZOA so they can reach forward with a left hand and right counter trunk rotation, then the transition from a left to right turn can be an issue.  Oh and don’t forget, their posterior mediastinum  still needs inhibition while the lower trap on the left needs to help with left frontal plane control of a left hemisphere! Whew!  So,  they are stuck in an extension moment as they attempt to get onto their left leg to turn right and as they do so they lean back and have a tendency for an extension rotation fall.

There are about as many ways to fall as there are types of snow and skiing conditions!  These three are not an exclusive list for sure.

In PRI we all know that sagittal plane control and maintaining position is key to our rehab and performance goals.  Without a neutral pelvis we are inhibited in achieving adduction of a femur especially on the left with Left AFIR and the ability to turn right as well.  Without a neutral pelvis, a ZOA is not possible especially on the left.  Without a ZOA you soon run into the painful limitations of end range loading and excessive torque in the spine, hips and knees.

If you watch an advanced or expert skier they are almost always reaching down hill with flexed knees and a rounded back.  Are they neutral in their pelvis and thorax?  Well, no, if they haven’t been introduced to PRI!  But I do know that  some of the really good skiers I’ve skied with over the years and learned from, tend to fight nagging back and knee issues. (Excluding knee injuries!)  

Performance skiing for recreational skiers who just want to have some fun to the more serious competitor or expert skier could combine PRI principles through a strong foundation of a pelvic floor for starters.  A strong pelvic floor and a neutral pelvis drive the femurs and knees forward into the feet and ski boots to flatten that arch shaped ski for edge control and the ability to turn at will.  A neutral pelvis with equal AFIR/FAIR of a provides right turns as well as left turn ability and strength.  Being able to counter rotate a ribcage over a right or left oriented pelvis allows for efficient transfer of weight right to left side for edge control and quick turn transitioning.  Reaching forward down the hill engages the abdominal wall,  serratus anteriors, lower traps all in a harmony to provide a neutral thoracic curve with a retracted ribcage maintaining center of gravity with bent knees right on top of your feet a driving forward through the shins into the ski boots.

It is my humble opinion that PRI principles can help any skier of any ability, especially turning right as well as turning left!  See you all on the slopes.  We have a great winter just starting!      

Posted January 19, 2017 at 4:57PM

The Hruska Clinic and our PRIME team are proud to officially announce the addition of Megan King to our PRIME program as our dedicated PRIME patient care coordinator.  She is a valuable resource for our program to assist in coordinating patients coming into the program.  Her background professionally and personally makes her a great asset to our team!  If you have any questions about PRIME and how we can help you with multidisciplinary engagement in Lincoln, Nebraska she would love to talk to you at our new dedicated PRIME phone number 402-975-8533.  She can also be reached at primengagement@gmail.com or feel free to check our new website at www.primengagement.com.  For those who have worked with Stacy Masek in the past she still part of our team and is now the primary contact for PRI Vision and can still be reached at privisioncenters@gmail.com or at 402-261-6793.

Posted January 19, 2017 at 9:46AM
Posted January 19, 2017 at 9:33AM

Management of position, posture and weight distribution are key elements to skiing.  In the “pattern”, our weight is over the right leg driven in part by a dominate right antero-lateral abdominal wall.  This works in our favor with a left turn.  The pelvis is oriented to the right, we have Right AFIR, right shoulder is down with left trunk rotation and a right arm forward. 

Weight distribution over the right ski, or downhill ski, in a left turn is pretty important especially with the ability to adduct and internally rotate on the right.  The inside portion of the ski, or the inside edge, is necessary so that we don’t slide or fall straight down the hill.  This is called edge control and the ability to evert the downhill ski while we invert the uphill ski gives us direction and control. This is also called a parallel turn.

 The ankles in a ski boot are fixed and move very little so frontal plane control has got to come from the hips and knees.  But the feet and ankles have an important role with sensing the ground and signaling the brain and rest of the kinetic chain the position of the skis and helping to control shifting of weight side to side, forward and backwards. 

Tri-planer thinking starts with sagittal plane and having a neutral pelvis is necessary to transfer load from right to left side, left turn to right turn.  Without sagittal plane control and maintaining it, frontal plane control will suffer since adducting a femur then internally rotating it will be limited at best. Without sagittal and frontal plane management, a ZOA on the left will also be compromised and limit the ability to turn a pelvis to the left to stay effectively in left stance with right trunk counter rotation.  As a side note, this directional separation of pelvis and rib cage is another critical component to performance. Trying to teach someone to just “get better” at right turns without a tri-planer position awareness will be a limiting factor at best.      

Posted January 13, 2017 at 10:25AM

We are excited to announce and congratulate the Postural Restoration Trained (PRT) Class of 2017!  PRT is the result of completing multiple advanced PRI courses, demonstrating a thorough understanding of the science through completion of the PRT application, and successfully participating in practical and analytical testing. Eight individuals earned the designation of Postural Restoration Trained (PRT) under the direction of Ron Hruska, Neil Rampe and Jennifer Platt.

The Postural Restoration Institute® established this credentialing process in 2011 as a way to recognize and identify individuals with advanced training, extraordinary interest and devotion to the science of postural adaptations, asymmetrical patterns and the influence of polyarticular chains of muscles on the human body as defined by the Postural Restoration Institute®.  The PRT credential is available to Certified Athletic Trainers, Certified Athletic Therapists and Certified Strength and Conditioning Specialists who have completed the course requirements, application and testing process. With the addition of this class, there are now 41 PRT professionals throughout the U.S.

PRT credentialed athletic trainers and strength and conditioning specialists offer a unique approach to physical medicine and fitness called Postural Restoration. This approach addresses underlying biomechanics which can often lead to symptoms of pain and dysfunction. All mechanical influences on the body that restrict movement and contribute to improper joint and muscle position are considered, examined, and assessed. Techniques are utilized to restore proper alignment of the body while proper respiratory dynamics are considered. Management encompasses prevention and lifetime integration for long-term successful outcomes.

Congratulations!

Pictured from left to right: (Back Row) Ron Hruska, Neal Hallinan, Taylor Lewis, Michael Schofield, Yusuke Nejo, Neal Rampe (Front Row) Jeffrey Eckhouse, Elizabeth Kais, Anne Bradley, Miguel Aragoncillo

Click here to view more photos.

Posted January 12, 2017 at 3:14PM

Dominant neurologic patterns and natural human asymmetries drive every form of breathing, position and movement.  The inability to manage patterns, asymmetries and breathing shows up in performance from simply walking to every sport or physical activity. 

Skiing is no exception and it is especially true with the ability to ski-turn to the right as well as to the left.  Ask most skiers which turn is easier and invariably they will mention their left turn going downhill is easier that their right.  Knowing the PRI definition of “AFIR” and “AFER” can help even the non-skier understand the mechanics and problems facing a skier attempting to get into left stance or Left AFIR as well as their right stance or Right AFIR.

For most people in the “pattern” (Left AIC, Right BC), they get into Right AFIR more easily than their left.  They can get so good at it that they are stuck in it.  For some in what we refer to a PEC pattern, they really don’t do right or left stance very well but they tend towards right stance easier.

The point is to do both well especially on the left and that means getting the socket over the ball (acetabulum over femur) as well as the femur turning internally in the socket (femur under socket).

For an effective right turn, the pelvis has to orient from the right to the left for Left AFIR.  Being able to position a left inominate bone from flexion towards extension into neutral is the job of the left hamstring and glute.  Then having the ability to put that ball joint into the socket depends on an anterior lateral abdominal wall, an anterior glute medius and a distal left adductor that has an internal rotation component to it. 

None of this will happen without getting a hemi-diaphragm to “dome” or create a “Zone of Apposition” (ZOA) and help to inhibit a left psoas muscle that contributes to the inability to put the pelvis in a position so a femur can adduct.  With sport performance, not only do both femurs need to be able to adduct in stance phase, but they need to be able to adduct with strength and power.

Adduction of a femur is critical for a ski turn along with internal rotation of a femur driving the knee medially for frontal plane control of the “inside edge” of the ski, left and right side, but especially left since this is the side most of us have difficulty with.  Many skiers are great compensators, like many athletes, and they find a way to have decent turns to the right even without the ability to adduct or get into Left AFIR fully.  But this comes at a cost with extension of a spine and compensatory torque into a knee that often can lead to reliance of end ranges for stability. 

Skiing, like walking, requires that our brains sense the ground or in this case the snow under a ski.  Getting into left stance is critical for this process proprioceptively so the brain can trust being on the left side for a right turn.  Without the ability to get into Left AFIR, dominate patterns will prevail and most skiers will fight with a right turn to some degree regardless of their ability. 

         

Posted January 10, 2017 at 9:58AM

We are excited to announce that PRI will be featured throughout 2017 on public television networks' "Voices in America with James Earl Jones" educational segment. The video segment has been distrubuted to public television networks in all 50 states. While airing schedules are not available to us, you might hear from patients or clients who happen to see this educational segment on Postural Restoration®.

In addition to the educational segment that they will be airing on public television, two other segments: "PRI in 6 Minutes" and "PRI in 60 Seconds" were produced and made available to us, and will be on our home page soon (see below). You are welcome to embed these videos onto your personal or professional website to help educate patients, clients, and the general public on the history behind the science of Postural Restoration®.

The "PRI in 60 Seconds" commercial will also be airing nationally on CNBC on Friday, January 6th at 8:30pm Eastern, 7:30pm Central, 6:30pm Mountain and 5:30pm Pacific time. So, set your DVRs or tune in to CNBC tomorrow night! Please note the commercial airing could land anywhere within an hour of the above scheduled times. In the past, we have been told that they have typically aired within 15 minutes of the schedule. Following this national airing, it will continue to air on CNBC in several different regions across the country.

Posted January 5, 2017 at 9:08AM
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