In light of what is going on around all of us and the associated uncertainty of this virus that will no doubt continue into the summer months, we have made the difficult decision to once again postpone the Interdisciplinary Integration Symposium.

We do not feel that it is in the best interest of the Institute, the Speakers, or PRINation to try and host it this August, like we had hoped would be possible when we initially rescheduled. We really want to host this as a live event, rather than a streamed event. Each of the speakers have such strong messages that will be reinforced by live participation from both the other speakers as well as a full room of course attendees. This is what makes these Symposiums so special year after year. We also feel, because of so much uncertainty regarding our economy, transportation and US CDC guidelines, there would be many individuals who would not feel comfortable attending this August. Therefore, we are re-scheduling the Symposium to April 22-23, 2021. This year’s topic on Parkinson’s Disease and Extrapyramidal Disorders has garnered a lot of interest over the past several months, and we have no doubt that next year’s symposium will be one of the best ones yet!

We are planning to have our Anniversary Celebration next April as well. As symposium speaker and PRC physical therapist Jennifer Smart said, “Twenty-one years is a special number to celebrate too . . . the Institute has really come of age once it hits 21!” We are hopeful that you will still be able to join us in Lincoln for the symposium and this special anniversary celebration. 

We apologize for having to re-schedule this again, but we do feel that we are making the best decision for everyone involved. A lot of unsettling discomfort is being felt as a result of this global crisis, but we are hopeful that we will all be able to come together stronger than ever next Spring and have a room full of attendees excited to embrace this topic without stressing over social distancing and social traveling. Enjoying each other, collaboratively, socially and professionally make these Symposiums and their associated memories very special, and we hope that you will be able to join us in April 2021 for this overdue symposium and celebration!

As we gear up for tonight's first webinar, below is Ron's breakdown with clinical reasoning for the second technique discussed in the free PRIVY trial video titled "Integrated Pulmonary Compliance". If you haven't yet checked out this free video, it is a great introduction to the webinar searies that begins this evening. Stay tuned, as we will be discussing more PRI non-manual techniques related to chest wall compliance in the coming weeks on our "PRI Breathing Mechanics in COVID Times" free webinar. To register for tonight's first webinar, please CLICK HERE!

Standing Wall Supported Resisted Ischial Femoral Ligamentous Stretch

Let’s begin with the title of this PRI Non-Manual Technique.

You will need to purchase approximately 5 to 7 feet of medium resistant therapeutic tubing. You can find information on the PRI Website under “Products” (and then click on "Materials") and purchase from Stretch Well, green colored medium elastic tubing. The Stretch Therapy Deluxe green tubing has hand handles included. However, you can perform this activity without band resistance, by placing your hands on the edge of a chair that easily slides forward as you reach forward. You will also need to find a book that is approximately 1 to 3 inches in height, at least 12 inches long and 7 to 10 inches deep.

When performing this activity in “standing” you will be able to use the floor as an anchor and a “wall” as “support” for distraction of your lower and upper posterior chest walls.  [This position on the floor and on the wall will allow you to primarily sense and focus on mid to low back lengthening as the accompanying posterior and lateral chest walls expand]. As you move your arms forward in performing the following outlined activity, the “ligamentous” soft tissue, including your accompanying hamstring muscle, that attaches to your “ischial” seat or sit bone and to your “femur” or thigh bone, more than likely, will feel tight. This tightness and/or “stretch” is the result of your abdominal wall of muscle contracting, as you reach forward with “resistance” from the therapeutic bands in your hands and the bands of elastic, soft tissue attached to your “ischial seats”. Therefore, the floor you are “standing” on, the “wall” your low back and hips are resting on, and the bands that are looped around the hands or the friction from the legs of the chair the hands are resting and pushing forward on, are all providing the forces needed for your left and right diaphragm leaflets, inside your two respective chest chambers, to open and expand and stretch both the inside and outside chest walls. This expansion, under the above guided resistance, allows one chest chamber to ideally open better when closure of the other chest chamber occurs, and vice versa. This PRI Chest Wall technique, minimizes pulmonary or lung static function, maximizes elastic tissue recoil of the chest walls, equalizes pressure when all four extremities are alternating or involved with lifting, and assists with optimizing immune responses.  

Here are some additional comments about the steps that follow the title and pictorial examples, along with the reasoning for the procedural step.

Stand with your feet parallel to each other and with your hips directly over your feet. Place a book that is 7 to 10 inches deep between the door and the back of your heels.  The back of your heels will help you sense the wall you are about to touch with your low back and hips. This heel sense, together with the sense of the floor you are standing on, will provide the anchoring your abdominal wall will require for upon contracting as you reach forward with your hands to relax and open your posterior chest wall and or back muscles.   

By also anchoring therapeutic tubing in the door at a height slightly above shoulder level, and around both of your hands, you will begin to sense the need to engage your abs, lower your head and shoulders and move your upper chest walls forward as your mid back and chest walls simultaneously move back. The same type of activity will occur if you place your hands on the top of a chair or stool on wheels.  

If you have difficulty sensing your abdomen muscles contract and it is difficult to round out your middle to lower part of your back, your anterior chest wall is too elevated.  Place a rolled-up towel between the upper part of your thighs, as high as you can get it. This rolled-up towel should be wide enough so that when you bring your knees together your knees will not touch. By placing this bolster between your upper thighs and squeezing your knees toward each other, your back muscles will relax and your ligaments at the back of your hips will be more easily stretched out as you lower your body with your muscles that attach to the two ischial seats. These muscles are called your hamstrings and will enable you to maximize your diaphragm’s influence on chest wall mechanical activity that will enable better upright perfusion of oxygen into posterior and lateral lobes of the lungs, that may be ‘locked up’ because of over contracting back muscles used for postural stabilization. Therefore, by pulling your two hips apart with the bolster between the knees, that are moving toward each other, you are essentially decompressing not only the pelvis that lies between the hips, but also the spine that lies between both chest walls. This decompression of the ‘chest wall’ spine decongests the lung tissue associated with congestion of lung tissue (alveola) that is incapable of opening because of spinal compression. By squeezing the bolster between your thighs, as you are doing with this PRI technique, you are essentially reducing the ‘squeeze’ on the posterior lungs.  

To place as much low back on the wall that you can, in Step 4, you may want to slowly and carefully bring your knees slightly forward as you are exhaling through your pursed lips. Try to keep your heels and feet flat on the floor as you are reaching forward with your outstretched hands and arms. Many of you will not be able to place your low back on the wall, and may only be able to sense your rear on the wall, as you attempt to round your back while reaching forward with your arms and knees as your body gently lowers. The most important thing about Step 4, is to reach with your hands and arms, resisted or unresisted, while you “round” your mid to low back, during this exhalation phase of movement.

Step 5, is where the magic happens. The magic is when your inhalation effort through your nose, after performing Step 4, continues to open up the entire chest wall cavities on both sides, along with all the underlying alveolar tissue in your lungs. The position you worked so hard in achieving is now serving as a platform for diaphragmatic inhalation without resorting to muscles that over compress the posterior lung tissue. Those muscles lie both directly in front of your neck and in the back of your chest walls.  
As you continue to breathe in through your nose and out through your mouth, or through pursed lips, let the air move your chest. Assist this chest movement by drawing in the air (Step 7) and compressing it out by reaching further forward with your arms, as the weight of your anterior body opens up the posterior body (Step 8).

The resistance provided by the forces through the arms, the wall and the floor allow you to receive the floor, the wall and the space in front of your arms as the space inside of your chest walls expand and elevate your body; as it is being lowered gently, softly and peacefully to the ground. When you stand up, in Step 10, focus on maintaining “push” through the heels, the hands and the inner thighs as your entire chest remains opened, relaxed and uncoiled. Breathing should be effortless at this stage, because of true postural support offered by muscles that keep the posterior chest walls elevated, and the anterior chest wall opened and lowered, for maximum lung perfusion and ventilation.

We are excited to announce a Free “PRI Breathing Mechanics in COVID Times” Webinar Series beginning next week. We have been receiving phone calls and emails with questions on how the science and techniques of PRI can be applied to COVID-19 patients. What do we recommend, and why? Well, if you have been wondering the same, we will discuss all of this and more over the next several weeks on this webinar series.

As Ron discussed earlier this week in our Zoom Director’s Meeting, he feels like he has come full circle, that is 360 degrees from where he started almost 40 years ago; and where the profession of physical therapy started. Many of the first non-military patients that were treated in 1918, when the Women’s Physical Therapeutic Association was started, were children who were having difficulty breathing because of the Polio epidemic that ramped up in the United States in 1910. Chest physical therapy was well recognized by 1948 and physical therapists and physiotherapists around the world were taking responsible measures and opportunities to ‘restore lung function’ after acquiring an illness or after surgery.

In more recent years, several studies have questioned the use of intermittent positive pressure breathing (IPPB) machines and have caused many respiratory therapy departments to look to chest physical therapy as a replacement for IPPB. Respiration, ventilation and breathing are all influenced by our postural positions and patterns we are in at the time we are exchanging gas. Therefore, breathing mechanics are postural mechanics. The Postural Restoration Institute’s (PRI) concepts and scientific applications, are today used by many health care providers who collaborate with other disciplines that are mindful of the importance of keeping oral airway and lung airways open. This interdisciplinary practice reflects our early colleague’s effort in taking responsibility for the restoration of lung function through human mechanical intervention, prior to or following events that challenged lung airway position and drainage.  

Postural positioning is necessary for postural drainage, and the importance of coupling proper breathing mechanics with positioning enhances lung perfusion, expansion, and compliance to help fight off respiratory illnesses such as COVID-19 and to help acquire lung and chest wall function that speed up recovery following COVID or other viral acquisitions. This is why we are so excited to share PRI concepts, considerations and advice on how to keep your chest and lungs mechanically efficient and physiologically effective.

Just yesterday, a good friend and colleague, Cheryl Chase, PT, PRC emailed us and shared an old book that she pulled out of her desk titled “Postural Drainage and Respiratory Control, 3rd Ed”, which was published in 1971. Her colleague is going to provide an in-service on postural drainage, something that all physical therapy education programs cover, yet many PT’s have never clinically used. In the direct words of Cheryl, “I am so saddened by our current pandemic crisis, but also delighted that this current situation creates opportunities for new dialogues. It seems strangely serendipitous to coincide with the 20th anniversary of the Institute.” This message truly hit home. This is not how we imagined we would be celebrating our 20th anniversary. Yet, in some ways, it is blessing because with all of the messages and questions we have been receiving, we know that we can contribute to this opportunity for new dialogues amongst the general public and across multiple disciplines.

So, we invite you, and your friends and family to join us for this free webinar series, happening every Tuesday at 6pm CT (starting May 5th). Invite someone who has always wanted to know more about PRI, or maybe those who have questioned the “why” behind your use of Postural Restoration®. During this pandemic, we have witnessed humanity helping each other more than ever, and we are hopeful that the dialogues we can spread through this webinar will help thousands across the world.

*If you miss any of the weekly live webinars, they will also be posted to our website, so you can go back and view them later.

PRI Breathing Mechanics in COVID Times
Tuesdays at 6pm CT
CLICK HERE to register to join the webinar
*Pre-registration with your name and email will be required each week

On April 18th and 19th our Institute hosted its first live stream course on the importance of maintaining and facilitating the tone and tension needed for 30 degrees of cervical symbiotic movement. Two cortical hemispheres, two communities of inter-neuronal highways, two lateralized sets of appendages and two autonomic systems of drive, that are all associated with one “neck” of their being.  Regardless of the side of the relationship that is more dominant, or more sensed, or more patterned around a vertical axis, or more associated with emotion, fear, decision making, or physiology, both sides have to communicate with biased biologic messages going up and down through their one and only neck.

A few minutes ago I finished a face time conversation with Maureen Henderson PT, PRC regarding our 20th year anniversary as an Institute. She also told me she would be sending me a book written by Robin Wall Kimmer, entitled ‘Braiding Sweet Grass’.  She said the book reminded her of our relationship and the role the Postural Restoration Institute serves for masting. Mast seeding, also called "masting", is the production of many seeds by a plant every two or more years in regional synchrony with other plants of the same species. Mast seeding is an effective defense because the seed predators become satiated before all the seeds have been consumed.

On November 3rd, 2001 Maureen attended her first PRI course, Postural Restoration (the name of this course was changed to Postural Respiration in 2004) on the campus of the University of Minnesota. She reminded me that she was tired and had jet lag but wanted to go to this course because of the inter-connectedness associated with the material in a course she received from a recent course she attended on ‘Protonics’ that was taught by Karen Swanson PT, through the Postural Restoration Institute. “The core of my being is that everything is connected and meeting you and hearing you for the first time satisfied my core”, was a statement that resonated with me, because we truly have similar DNA, similar thoughts about purpose, similar respect for nature and trees… Both Maureen, and my son, RJ, know that we are all truly connected, just as all trees are.

Trees and plants talk to each other using an internet of fungus. Hidden under our feet is an information superhighway that allows plants to communicate and help each other out. Mycelial networks of fungus allows individuals (trees) who may be widely separated, to communicate and help each other learn new ways to survive, commit new mistakes, and to boost their host plants’ immune systems.  Fungi have been called ‘Earths’ natural internet (Paul Stamets 2008 TED talk on “Earth’s Natural Internet”). Both the tree trunks and our human necks need biologic tone, social tension and regional connected support that is enhanced through “masting”, so that a few of us who breathe and respect the science of PRI can further nurture the evidence behind the need for 30 degrees of cervical rest. Our “masting” effort, our inter-neuronal highways, and our interconnected hemispheres just got a huge boost from live streaming on April 18th and 19th , through the use of the internet; just like the trees we walk under that are getting a huge boost from the Mycelia fungi that never stop networking.

Full Cervical Revolution Live Stream Photo Album

Kind Regards,
Ron