I always look forward to receiving the Journal of Craniomandibular Practice every quarter.  The Guest Editorial of the July issue was Brendon Stack D.D.S., M.S.  Needless to say, I was more interested in his editorial comments, than the excellent information in this issue that was devoted to the ear.  Dr. Stack outlined his “journey” of treating patients “from orthodontics to craniofacial pain and then to movement disorders.”  He reflects on how his underlying treatment philosophy evolved into the fact that many, but not all, of the movement disorder patients had underlying internal derangement of the cranium which results in abnormal maxillomandibular relationships. He recalls how for over a century, Tourette’s syndrome was considered a psychological disorder, a neurological brain disorder and then an infectious disease caused by streptococcus. It was never considered a disorder that was due to a structural abnormality, which then could manifest itself as a neurological problem. Dr. Stack pointed out that today Tourette’s is considered a “structural – reflex disorder”  that responds well to the use of intraoral orthotics that require no medicine or surgery. 

As the result of the success in his treatment of Tourette’s, he applied the same principles to the treatment of Parkinson’s, cervical torticollis, and other types of “movement disorders.” He feels that the “motor component” of the movement disorder is the key to his 47 year journey of treating cranio-related pain through “repositioning”, “decompression” and reprogramming to “eliminate noxious input through the fifth cranial nerve into the central nervous system.”  After 32 years of practice, I believe in this approach and belong to a similar patterned journey. I just hope that in the next 15 years, I don’t change my “ position”  behavior, so that I too, can reflect on my 47 years and report that my journey was “ filled with learning and personal satisfaction of having made a difference in the lives of my patients.” 

Maryland SportsCare & Rehab is a unique PT owned sports medicine/orthopedic clinic. We have been teaming up with PRI in recent years in order to train our diverse staff of PTs, ATCs, and strength coaches. In our Frederick, MD region, we have 7 high schools in which we have ATCs providing exceptional sports medicine services. They work closely with the community and the clinic therapists all of which are have been trained with Postural Restoration courses. This gives us the ability to screen athletes using PRI principles and treat when indicated in the local clinics.

Having attended several PRI courses and a passionate therapist with OCS credentials myself, I am developing an Orthopedic Clinical Residency Program that will be credentialed by the APTA. Since I have taken many courses and plan to apply for PRC in 2013, I will be certainly incorporating PRI principles as well.  We are looking for anyone with passion for excellence. Candidates do not have to complete a residency. There are plenty of opportunities available. There are currently 3 prime openings to join this movement at Maryland SportsCare & Rehab. We offer a very competitive salary and are willing to pay for PRC, as well as OCS. We have hosted PRI courses in the past and are excited to host the Cervical-Cranio-Mandibular Restoration course in February, 2013.

For more information on this opportunity or if you are interested in applying, please email your resume to Chris Roosa .

To see all of the career opportunities, visit our Careers page!

Would you like to know what Ron was thinking during his Saturday morning coffee? Check out his blog below, as he shares some thoughts!

The last patient of my week, on last Friday, was a 19 year old young man that was referred to me for anterior shin pain and chronic shin “splints”.  He had a history of back pain and is a runner and was an avid hockey player.  He reports when he doesn’t do anything, his anterior shin pain does not bother him.  He has been to every specialist possible for this type of problem, except by someone who has taken a PRI course or is trained or certified in PRI.

The first thing I read in my Saturday local paper, over a cup of coffee, was an article written by a physician and professor at Harvard Medical School. “Give shin splints time to heal” was the title of the article.  Needless to say, after reading the article, I had a hard time finishing my coffee, and I could feel my body begin to “splint”.  The physician reported that shin splints develop because of overuse of the posterior tibialis muscle in the lower leg near the shin.  He did mention that shin splints can be caused by tibial stress fractures.  His advice; rest, ice, compress, elevate and non-steroidal anti-inflammatory drugs.  As the pain gradually goes away, start with a walking program.  Accordingly, if you return to your training too early or too intense your shin splint may come back.  He goes on to talk about the need for warm ups, to use the 10 percent rule or not to increase time or intensity of your workouts more than 10 percent per week, and to strengthen the muscles around you “lower” legs and ankles.  In his opinion, “Many great runners have experienced shin splints, rested the muscle and gone on to glory.”  This syndicate writer did not mention what a shoe orthotic, a good supportive shoe, a biomechanical oriented program for the upper leg including the pelvis and hips, or a myokinematic program for transverse plane stability at the femur or calcaneus might do for this “splint” pain.

The word “splint” according to Webster, means ‘a rigid device used to prevent motion of a joint or the ends of a fractured bone’.  When one is splinting they are in a feed forward process.  Pain does not allow one to relax and therefore makes one ‘splint’.  The pain, may subside if they do nothing.  However, that does not address the neurologic feed forward system issues because the dysfunctional torsion on the bone has not been addressed. 

My Friday afternoon patient did well with a PRI approach and actually could alter his shin splint pain after his left AIC, right BC and right TMCC patterns were considered.  The torsion on his tibial bone appeared to be coming from a right forward shoulder and the lack of a left posterior mediastinum, an extended postural pattern that was reinforced by a former head injury, and a deep lordotic back (40 to 50 degrees of straight leg raise).  He felt his shin “splints” come and go in the clinic when he learned how to move over his left hip properly, flex his thorax and lumbar spine correctly with ambulation and visually see and feel the ground in front of him, appropriately. 

My Monday morning cup of coffee was more enjoyable, only because this message allowed me to splint a little less.  Thank you.

The University of Michigan Health System Continuing Education Program will be sponsoring Myokinematic Restoration on September 8-9th, 2012 in Ann Arbor, Michigan. To register for this course, CLICK HERE!