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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 2023

Postural Respiration was presented April 15-16, 2023 at Spooner Physical Therapy in Chandler, AZ to an enthusiastic mix of PT's, Chiropractors, OT's and fitness professionals. There were students from Alaska, California and Idaho that made the trip to AZ. Dr. Victor Elmurr, D.C. was the motivating force in contacting the staff at Spooner several months ago and facilitated the return of PRI to the Phoenix area.


Among the new attendees to PRI, most of the students were new to Postural Respiration and their purpose was to understand and integrate delivery of airflow into the thorax with their knowledge of pelvis, lumbar spine and femur myokinematics. The response from them, and understanding that this course is the flagship of PRI, was that this course completes a picture of diaphragmatic function and how it affects not only delivery of air pressure sense into the thorax but the position, posture and movement of the entire axial skeleton.  


Since posture is not a static concept often thought of in a normal sense, the dynamic, tri-planer function of air flow pressure and sense allowing alternation, reciprocation and variability were all defined and experienced by every student.


As with every Postural Respiration course, Superior T-4 is the patho-mechanical portion of the weekend that is explored in detail on day two.  Rhythmic airflow and it's physiologic effects are discussed on day one in terms of dynamic airflow considerations.  Next, the importance of the first rib, especially on the right, is discussed in this context of rhythmic airflow and the first rib being an "initiator" of rostal to caudal rib movement.  With overuse of accessory muscles like the scalenes, the first rib will be lifted out of "sync" with the ribs below leading to patho-mechanical respiration as described in this course.


One of the students was used as a "demo" on the first day of the course for PRI exam, NMT and then a left ZOA manual technique. The inability to adduct a femur along with positive BC testing after NMT and manual techniques on the first day lead into day two of the course to explore if this individual was a Superior T-4. With definitive testing and after following the treatment guidelines on page 50 in the course manual, his Superior T-4 was discovered, treated and resolved for everyone to experience the progression to resolve patho-mechanical respiration considerations.


This course was such a pleasure to teach and thank you to the staff at Spooner especially Jessica who got there early and stayed late to lock and clean up. Thank you also to Carly, Sarah and the rest of the Spooner crew and thank you Ben for allowing us to share PRI with your clinic and the community. 

Posted April 20, 2023 at 3:21PM
Categories: Courses

I had such an amazing weekend teaching Myokinematics of the Hip and Pelvis to an engaged group of clinicians at the Finish Line. This was my 4th time returning to this facility and it really now if feeling like my NY home away from home. The clinicians at the Finish Line were great hosts and do a great job making us all feel welcome at their clinic. This group were all taking their first Myokinematics course and some had more experience than others, but for the most part the group was new to the science of PRI.  


I personally had the pleasure of bringing my husband Chris and daughter Devon with me this weekend. Sorry Madison couldn't join us this time, she's busy "adulting" now!  


On Saturday night, we enjoyed the Musical MJ on Broadway. This made for a new musical reference for me as I was able to reference Michael as the star of the musical, but the back up performers and supporting characters brought his talent to life. This is true for PRI non-Manual techniques. Depending on the level of strength and integrated control, there was typically one muscle that was "the star" of the technique. Whether it was the left hamstring, left adductor or right glut max, we all learned how to integrate these all important muscles to inhibit the left AIC pattern. For those of you who know my teaching style, you know of my Lady Gaga, Beyonce and Dua Lipa references!  Now I can add Michael Jackson to my repertoire of teaching analogies. At one point a course attendee asked me "who is the MJ of this exercise?"

 
We got through alot of material in our non manual technique section including upright integreation, the importance of alternating and reciprocal activities and of course inhibition!
The energy was high and I was not sure if it was NYC, or PRI! Either way, a good learning time was had by all!  
I appreciate my lab assistant Neal Hallinan for taking the early train into the city to help me and offer his insights during break-outs and lab. 

Posted April 20, 2023 at 3:09PM
Categories: Courses Science

Any time I get to teach in Lincoln, it always feels like a homecoming. It’s an honor to be able to teach at PRI and get to spend time with the PRI family. The group of attendees in person really embraced the idea of family. We had pelvic floor PTs, PT students from Regis University in Denver, strength and conditioning specialists from University of Nebraska, a chiropractor and a plethora of other PTs all uniting for the two days over Myokinematic Restoration. By the end of it, a sign up sheet had been passed around so they could all stay in touch. As an instructor, this was such a special thing to see.


We discussed the importance of determining position before facilitation; what a left anterior chain objectively presents as; the ability to determine a hip with some soft tissue pathology vs non pathology; and a host of treatment techniques to help these findings.


The online attendees had excellent questions and the lab times were fulfilled to the max because of the eagerness among the attendees. It was a great course and I look forward to my next time in Lincoln.

Posted April 20, 2023 at 9:38AM

It was a chilly and windy weekend in Fort Collins last weekend for my first solo offering of the Human Evoluation course at Pro Active Physical Therapy. The crew was more than welcoming, and the altitude is no joke! We had some fun discussions about how human beings evolve, are challenged, learn, and balance… their bodies, their sensory systems, their upright abilities against gravity, and how they express joy through movement of their mandibles, arms, femurs and their floors. Attention was made to offering opportunities to experience a LEFT ATNR (see photo below). We had enriched conversations about the importance of crawling on hands and knees, self-actualization through lowering oneself with control, walking behind a push toy (to name a few) and how to achieve the ultimate goal of walking down the stairs backwards with the realization of our most posterior group of muscles, our glutes!  Concepts of motor control were reviewed and support for the use of the cross-referencing clinical tool was supported by 9 foundational PRI principles.

In attendance were 15 clinicians including a personal trainer, a pediartic OT, a doctor of Chiropractic, a dentist and, of course, physical therapists. Although the air up there was thin, and it favorably challenged my patterns, it did not stop us from learning from more than 100 patient video examples of course concepts and treatment techniques. I will say, I appreciate the ground more after lowering myself with control back down to sea level where my sensory systems and cognitive pocesses are familar, though so grateful for the novel experience.

Thanks so much to my fellow PRI faculty member and host Craig Depperschmidt, ProActive Physical Therapy clinic owners Brian Benjamin and Andy Collingwood, course attendees Tracy Benjamin, Rachel Kroncke, Sara Truelsen, and Ruth Waller-Liddle. Feeling so grateful and honored to have met such a wonderful group of clinicians. Thank you!

It was so appropriate to have my first attempt to be the lead instructor for the entire, two-day Cranial Resolution Course to occur on St Patrick’s Day, since I was feeling quite green regarding how to teach this tertiary material. Fortunately, people were very kind and appeared to appreciate my simplifications, analogies and/or clinical examples of the frequently complex didactic concepts that are introduced in this course (like how the ANS and CNS interact with each other). Ron, who was sitting in the front row, was remarkably restrained, even though it must have been hard for him since these are the concepts that have been behind PRI, and so dear to his heart, right from the very start.  

What I found so exciting was that out of the 46 people in attendance from all over the globe, half of them were attending Cranial Resolution for the first time! That indicates to me that more people are recognizing the need, and are now ready to start, to integrate neurological concepts into their PRI practice. From my own personal experience, I accept that learning when and how to consciously introduce such things as lateralized neural rhythms into your practice may take a while to grasp. What I truly wanted to get across, especially to those first-time attendees, was that the techniques taught in this cranial course were never meant to replace the foundational material from the primary and secondary courses, they were meant to augment it. And that appropriately using the concepts introduced in Cranial Resolution may be able to help your patients make changes faster, more effectively and in a way that is perceived differently. Learning how and when to utilize them may not be quite as algorithmic as techniques learned in the primary courses, but I hope that I was able to share enough specific examples to progress practitioners from ‘just trying’ seemingly random, sensory-modifying techniques to better understanding WHY and WHEN they might appropriately recruit them to each of their client’s unique situations.

 

I was thrilled to have 6 PRI faculty in attendance at my inaugural session of teaching this course. Their supportive presence constantly reminded me of the strong foundation this course stands upon. Because even though I personally have found that the concepts taught in Cranial Resolution have been a game changer for my practice, there is no way anything can ‘change the game’ if there isn’t already a game being played by a strong set of recognized and accepted premises and principles.  

I know I was nervous, I read from the slides more than I wanted to, and I spoke too fast. These are all issues that I will actively work on for future renditions of this course. But like I said earlier, even though I may be comfortable with the material presented, I am still green at presenting it, especially to all the bright and inquisitive individuals who have pursued PRI to this tertiary level. What I hope came across, however, is how much I love this material – and want to get others to feel the same way. It’s not hard, it’s just different. And ‘different’ is cyclically needed, otherwise we have nothing to which we can compare or reference normal.  

Thanks to all who attended – and plan to attend in the future!

Posted April 4, 2023 at 11:15AM
Categories: Courses Science

Last weekend I had to pleasure of travelling to Mizzou country and teaching Pelvis Restoration at Missouri Orthopaedic Institute. I was assisted by Hayley Kava our newest faculty trainee. Hayley used to work for me back in Southern Pines, NC. We had a great weekend together catching up and planning for the future of her teaching Pelvis Restoration.  

This class was a nice mix of clinicians new to the science of PRI and those who were refining their PRI skills. Pelvis Restoration is a great first course for clinicians to help gain a better understanding of the influences of pelvic and thorax internal pressure management, frontal plane control and how patients develop compensatory movements.  

Patient management, testing and algorithms of treatment for the left AIC, PEC and patho PEC were explored and explained. Questions were asked and theoretical concepts were discussed for a variety of patients experiencing not only pelvic floor disorders, but also lower back pain, SIJ dysfunction, pubalgia and stress incontinence.

Hayley provided great insight for clinicians working with internal pelvic floor therapy. I look forward to learning more about her insights as she begins teaching Pelvis Restoration!

Posted March 29, 2023 at 1:51PM
Categories: Courses Science

The ENT Institute of Atlanta played host to the most recent Postural Respiration. This course encouraged attendees to look below the head and neck for “bottom-up” influences on the conditions you treat. What do hip pathology, low back pain, headaches, and TMD have in common? A thoracic diaphragm that is patterned in its position and activity.

We discussed how the static asymmetries of our torso lead to overactive chains of muscle below the diaphragm (anterior interior chain and posterior exterior chain) and above the diaphragm (brachial chain). These chains create dynamic patterns of breathing that become entrained in our nervous system and that can restrict healthy alternating, reciprocal movement when upright. Numerous videos were presented that reflect how patterned breathing influences walking: poor posterior right arm swing, reduced thorax rotation and center of mass shift onto the left leg, and waddling, to name a few. Our stronger, better leveraged right diaphragm creates twist and torsion of the airway which, in turn, promotes inefficient strategies to pull air in, including belly and neck breathing, with their associated forward head posture, hyperinflation, and overly extended thoracic spine and rib cage. Neurologically-driven patterns of airflow define how we sense ourselves in the space around us, how we move through it, and our vulnerability to pain and injury.  

Many thanks to Kaitlin Blankenship, ATC; Jose Crespo, PT; Mischelle Hardwick, PT; Allison Robbins, PT; Tre Tate, CPT; and Adria Wofford, PT for volunteering to model the tests and techniques.    

Kristen Spencer, PT, PRC, was invaluable in assisting with lab and adding clarity to questions and concepts.  

The practitioners at ENT Institute did an awesome job of accommodating us guests: Jose; Ann Gerber, PT; Jennifer Hansen, PTA; Mischell; Jennifer Harrell, PT; Deisy Nunez Aguirre, PT; Allison; Olivia Terrell, PT; and Cristen Walker, PTA.   

I hope you get the chance to host again. If so, Cervical Revolution would be a natural fit for your caseload.  You will learn about the influences of an additional chain of muscles, the temporal mandibular cervical chain. You will gain an understanding of how the concepts of Postural Respiration and patterned air flow apply to the cervical spine and cranial patterns and their potential to create malocclusion, TMJ dysfunction, headaches, and visual-vestibular disturbances, all of which you routinely address in the clinic.

Posted March 23, 2023 at 10:32AM
Categories: Courses Science

The first Cervical Revolution course of 2023 was presented at the Postural Restoration Institute to an international group of students. Attendees present were from all around the globe including China, Japan, Singapore, Canada, England, Ireland, Germany and Bulgaria as well as from every part of the U.S.A.  Professions included physical therapists, chiropractors, strength and conditioning professionals, an osteopath and a medical doctor to learn PRI concepts of the cervical, cranial and occlusal system.

Cervical Revolution is the introduction to the PRI concept of "top down" while acknowledging that "bottom up" is always at play since humans need to manage upright posture, gravity and gas! One of the biggest topics is that if you lose the floor then a new ground up into the cervical spine, cranium and even jaw will occur. When this over reliance on the neck occurs, cranial torsion or pathology is almost certain. This course unlocks the path into the cranium and a deeper dive into neurology which is then presented in tertiary PRI courses.

During the weekend, PRI examination of the cervical spine was then integrated with repositioning techniques that addressed position of the cervical spine, occiput, sphenoid and temporal bones all at the same time. This is part of the magic of this course in understanding how to integrate many parts to restore alternation of the whole with oscillation of atlas and occipital bones, freedom of a sphenoid, wobble of temporal bones and jaws that can freely swing or truse! Louise Kelley, PT assisted me greatly in this endeavor with lab exam, PRI techniques and answering tough questions from curious students.

  

For over a year, Louise Kelley, DPT, has been training with me to teach Cervical Revolution. This past weekend was her last training course as she will be "flying solo" in May to teach this course on her own. During this time working with Louise I have been so impressed by her knowledge and dedication to the science of PRI. Over the weekend and over the past year I have watched her grow into becoming a stellar faculty member especially in her understanding of PRI principles as well as describing and breaking down techniques to restore alternating cervical and whole structure alternating function. I will miss spending time with Louise and she will be a brilliant Cervical Revolution teacher! 

Posted March 9, 2023 at 10:32AM
Categories: Courses Techniques Science

I felt right at home with the clinicians at Finish Line Physical Therapy, all seasoned runners. Photos of their and their patients’ running accomplishments, all smiles at the completion of a race, adorn the space – and make for the perfect back-drop to discuss the impact of undesirable airflow patterns, habitual use of accessory muscles of breathing, and a restricted diaphragm on movement.


Asymmetry is the rule of the body and brain. As such, humans, by design, exhibit a right-sided preference, which is reinforced by a culture that favors sitting and a lifestyle made easier by technology. The result is a form of “hemi-neglect” of left sided muscles of grounding – hamstrings, gluts, and abdominals – needed for weight-shifting. Rib cages remain under the influence of muscles that don’t promote alternating internal and external rotation and the associated sense of expansion and recoil. The result is a form of left or bilateral COPD, with its distinctive hyperinflation.

   
Stiff, patterned rib cages and abdominal oblique disuse cause the diaphragm to undergo twist and torsion that, in many cases, cannot get out of. This twist of our respiratory system is a significant mechanism underlying the many syndromes and injuries that we confront in the clinic.


Many thanks to our weekend avatars, whose willingness to demonstrate and receive techniques enabled us all to better understand PRI concepts: Patrick Cronin, PT; Laura Gibbons, PT; Laura Loftus; Iris Platt, PT; RikkiLynn Shields. Thank you Yohei Takada, PT, PRC and Andrew Xenophontos, CSCS, PRT for your tremendous help in lab, coaching the attendees in the nuances of the manual and non-manual techniques, allowing them to experience the power and influence of these techniques on the neuro-muscular system. Finally, thank you to the physical therapists at Finish Line PT for being gracious hosts: Mandy “I WILL blow up a balloon” Fox, Connor Hesselbirg, Jaclyn Massi, Ryan Matisko, Timothy Waanders, and Jimmy Williams.

 
Finish Line PT is a clinic for runners and triathletes, people who strive to be their best selves. To all of the course attendees, I hope the material you learned this weekend will help take you to new heights in your careers and shift your stride to a new way of looking at, and improving, movement.  

Posted March 9, 2023 at 9:37AM
Categories: Courses Science

Thank you Elizabeth Makous for the invitation to come to the Henry Mayo Fitness Center to present Pelvis Restoration this past weekend. Southern California saw snow, rain, and hail Friday and Saturday, but it didn't stop the quest for learning in this group!!!  

I truly enjoyed teaching this past weekend with this group of clinicians. The questions, attention to detail, and intellect was fabulous and assisted the whole class in learning the material. We went into the "weeds" to understand the pelvic inlet and outlet position influencing neuro-muscular need for inhibition and facilitation of muscle for ascension and descension of the respiratory and pelvic diaphragms. This is desired for internal compression and decompression for forward movement. This material can be complicated, but worth the journey for improved patient and client outcomes.

Loc, thank you for being an amazing lab assistant. Thank you to all the course attendees spending a weekend with PRI and learning new concepts and being open to them. Again, thank you to Henry Mayo Fitness and Elizabeth for hosting.

I should note--I did return home to Nebraska to blue skies, sunshine, and 60 degrees!!!

Posted March 7, 2023 at 11:49AM
Categories: Clinicians Courses Science
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