PRI Integration for Baseball (Glendale Arizona) - Camelback Ranch in Glendale Arizona was the site of this year's PRI Integration for Baseball course and it was a beautiful setting and a great course. Jimmy Southard, ATC was an excellent host. He took the extra time and energy to make sure everyone felt welcome and had everything they needed during both days of the course. I was grateful to have been able to co-teach this course again with Ben Hagar, PT, PRC. Ben is an excellent instructor that not only cares about getting it right, but makes sure questions are answered in such a way that course attendees get the most benefit from the discussion. We also appreciated having Kris Naig, PT, PRC with us to help out during lab as a lab assistant.

Roughly 1/3 of the class were first timers at a PRI course and I loved having the interaction with such a fresh group. First and foremost, we respect and appreciate that so many new professionals were willing to invest their time and resources into learning about the science of Postural Restoration. The first half of the first day was completely devoted to properly introducing fundamental principles and concepts to this new audience so we were all on the same page as we moved forward into the performance component of the material. We discussed human respiratory asymmetry, the patterns associated with this asymmetrical respiratory drive and how these patterns relate to phases in the gait cycle. We further discussed appropriate ways to minimize these patterns so movement pathways become unrestricted for baseball performance.

Then Ben moved the group into an interactive discussion around phases of early and late throwing mechanics, complete with a breakdown of slow motion video for each component of throwing. After bringing the group up to speed on the desired movement outcome for each phase of throwing, Ben was able to highlight compensatory movement tendencies for both right and left handed throwers because of the L AIC/R BC pattern. His mechanical breakdown of the throwing sequence was further expanded to include reciprocal movement assessment of the wrist, forearm, elbow and shoulder in three dimensions. These patterned considerations were also applied to early and late hitting mechanics to end the afternoon session on day 1.

Day 2 was all about thoracic performance, objective testing and treatments for Superior T4 Syndrome, a common presentation in baseball. I started the morning discussion with right vs left sided considerations for the abdominal wall, lower trapezius and serratus anterior. I also went into the rotational considerations across the axial skeleton for a R BC athlete vs a Superior T4 Syndrome athlete and discussed limitations with rotation commonly seen both before and after addressing the L AIC/R BC pattern. Ben then took over and guided the group through lecture and lab for the 3 baseball specific performance tests used in this course. It was nice to go through the testing process together in each of the lab groups and to take the time to analyze the testing results and to begin to make treatment decisions. He then took the testing information into a discussion of treatment and focused on the baseball athlete with Superior T4 Syndrome.

It was encouraging for the class to stay so focused on this particular category of rotational overhead athlete for a couple of reasons: First, because such a high percentage of baseball players develop Superior T4 Syndrome and second, because a full correction of Superior T4 Syndrome patterned and non-patterned rotational limitations corrects so many other things, for both right and left handed athletes. After learning and practicing these treatment techniques together in lab groups, Ben finished the second day outlining training considerations for both a right and left hander during stride to cocking and during acceleration to follow through. A welcome compliment to the detailed throwing analysis completed with all the slow motion video on day one. Overall, a great course with a great group of baseball professionals, that certainly helped all of us become better at what we seek to be good at.

Last weekend I enjoyed teaching Pelvis Restoration up in the Motor City. The class was hosted by the Detroit Medical Center and their staff were very accommodating and made me feel right at home. This class was a nice mix of rehab and strength and conditioning professionals. There were only 4 newbies and the rest of the class had taken PRI coursework. This always makes for a fun class with lots of integration between the respiratory and pelvic diaphragms as it relates to gait and breathing. On Sunday, we mixed it up a bit, as it was my last class of 2018. The group widely understood my L AIC “Mustang Sally” analogy. It was quite fitting as I awoke to some snow on Sunday! Brrr… it was cold up North this past weekend. My VT Yankee blood has definitely thinned! We discussed how our patients and athletes are born into a LAIC pattern and compensate with their backs to override the pattern. This led to my PEC snowstorm on the Mustang Sally asymmetrical pattern.

We began our treatment algorithms discussing the Patho PEC pattern management and related that compensation to a Winter Snow storm on top of our Mustang Sally. We reviewed the 3 signs of pathology and how these patients will maximize end range and stabilize on their joints vs. good muscle control. A lot of time and discussion was spent on the importance of securing inlet extension with IOs and TAs and inhibiting back extensors before moving into L AIC clinical efforts. Once we brushed off the compensations of the Patho PEC and PEC, we got down to business to review the RAIC treatment plan. This switch in presenting the material was appreciated as a lot of our Pelvis patients are in a PEC pattern and lack frontal plane control.

Craig Stasio, PT from Simio Physical Therapy, assisted me. Thanks to Nick Jensen ATC from the Atlanta Braves for enduring my Right Iliacus emphasis and Mary Ann’s early question regarding respiration and the Pelvic Diaphragm. I look forward to taking a little break over Thanksgiving and seeing everyone in Lincoln for Advanced Integration in December!

Impingement and Instability (Lima, Ohio)- Enjoyed my first trip to the historic city of Lima in Northwest Ohio and it was a fun interesting weekend. Thank you to Alex Maag, DPT, PRC for your generosity as our host site coordinator and to the entire Lima Memorial Hospital rehab team for making the visit such a nice one.

I learned some cool things about Lima Ohio, before even getting there. Several people who knew I was going to Lima had the same question for me, "while you are there, are you gonna go to Kewpee Burger?" I didn't know much about it, but enough people asked me about it and shared their enthusiasm for the place, I knew I had to visit the historic burger joint while in town (twice :). I learned the small burger chain began in Flint Michigan in 1923 and it was named after the Kewpee Doll, originally being called the "Kewpee Motel Hamburg". The burgers were square and tasted a lot like a Wendy's hamburger and they were offered with chocolate shakes that tasted a lot like a Wendy's Frosty. C'mon Dave Thomas (headquartered in nearby Columbus), come clean and acknowledge that your great idea for a burger chain may not have been that original. And to Kewpee Burger, thank you for all the great innovative ideas and for your tasty offerings.

 Impingement and Instability, ... speaking of innovative ideas and useful offerings. In this case the innovation and usefulness was designed for the world of rehabilitation and performance medicine. I have been grateful to Ron Hruska for putting this body of work together since i first had exposure to the material back in 2004 (the first formal I & I course was actually taught in 2007) and I appreciate the honor he has given me to teach it. It is the course that keeps on giving. I have attended and taught this course more than probably anybody else, except maybe Mike Cantrell, MPT, PRC and I learn something new each time I teach it. I can't believe how truly innovative this material was 14 years ago when I was first exposed to it and it continues to challenge and impress me to this day.

The course is all about neurological awareness and sense of three things: 1) breath, 2) body position and 3) upright frontal plane control of center of gravity in space. When you lose these senses and/or the neurological awareness of these senses, instability can emerge in several different areas. This course goes over the neurological reference centers needed to minimize instability at the calcaneus, femur, ilium and scapula. The course then goes on to provide treatment recommendations for stabilization of the foot and ankle, tibia, femur, ilium and scapula, designed to be superimposed on top of the good preliminary work of AF and TS repositioning and stabilization, learned in PRI's introductory courses. Thank you Ron for an awesome body of work that continues to challenge and inspire.

We are so excited to announce the agenda and speakers for our 2019 Interdisciplinary Integration Symposium, titled "Airway Oscillation: An Interdisciplinary Approach to the Production of Voice, Airflow, and Resonance". The 11th Annual Interdisciplinary Integration Symposium will be held in Lincoln, NE on April 11-12, 2019.

The speaker line up and two day agenda are outlined below. To learn more about the course (including description and objectives), and to register online, CLICK HERE. Don't wait to sign up, this one is sure to fill up!

Speakers:
Ron Hruska, MPA, PT
Dr. Rosalba Courtney, ND, DO, PhD
Dr. Brad Story, PhD
Ruth Hennessy, MM, Indiana University
Mandy Harvey, America's Got Talent Season 12 Finalist
Dr. Howard Hindin, DDS
Dr. Ingo Titze, PhD