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Blog Posts in 2010

We received this great question last week from a clinician who has attended a PRI course.  He brought up an interesting perspective…

During a conversation with a colleague a confusing issue came up.  PRI stuff is interesting and one of the things that is most interesting to me is that they pretty much say “everyone has this presentation” (left anterior, tension in right hamstring, anterior tilt, etc…). If you have ever read Wolf Schamberger’s “Malalignment Syndrome”, he actually talks about the most common presentation being people anteriorly rotated on the right, posterior on the left - which is opposite to PRI’s thought process.  Who is right?  I think it is okay to notice trends (I have actually seen more people fall in the presentation from the Malalignment Syndrome - anterior rotation on right), but to group everyone into the same presentation is a bit strange.

It’s all a matter of perspective, which is what PRI challenges the most.  Humans lateralize their center of gravity to the right more than to the left because of many objective reasons.  If one establishes a neuromuscular pattern of stable, secure foundation through the right lower extremity, utilizing the right vastus lateralis, right hamstring, right adductors and right gluteus medius, you will find an anteriorly positioned or oriented innominate on the right.  Subsequently, the left ASIS may “feel” more anteriorly rotated on the left and possibly the evaluator may “find” the right innominate more posteriorly rotated on the right.  Inter-rater reliability in these situations, without further integrated objective testing is poor at best.  In this case, in standing, the evaluator would find more lumbar-thoracic lordosis on the left. 
If one becomes lordotic bilaterally, as often is seen with those who are tight and over-active with their posterior exterior chained paravertebrals (PEC patients) the right and left innominates move in an anteriorly rotated direction around the frontal axis going through both central acetabulums.  Discussing axis of the sacral rotation complex, varies in every individual and has no validation in today’s research.  This individual will now need to begin moving the left innominate out or externally rotated it around the vertical left SI axis to offset weight distribution to the right, resulting in:

Hyperactive right quadratus lumborum activity
Hyperactive left gluteus maximus and TFL
Hypermobility and possible laxity of left pubefemoral and iliofemoral ligament and soft tissue
Inhibition of left adductor and hamstrings
A left ASIS that feels “posteriorly” rotated compared to the “anteriorly” rotated right innominate

I am fairly certain, this compensatory activity associated with the human characteristic pattern of bilateral innominate anterior rotation (lumbar-thoracic lordosis) is what the “Wolf Schamberger’s Malalignment Syndrome” is all about.
Again, it’s all about perspective, position and pattern of the tester and the tested.  Please realize that palpating ASIS’s and PSIS’s of those in sitting, standing, on one leg, supine, etc all result in various, ambiguous outcomes…a whole different discussion and set of circumstances. 

Posted March 15, 2010 at 11:06AM

Over the past 10 weeks we have had the privilege to work with an incredible illustrator, Elizabeth Cunningham.  In her short time here, she has finished several amazing illustrations that were inspired by the science behind the Postural Restoration Institute.  She has also developed images for the coloring sections of our Myokinematic Restoration and Cervical-Cranio-Mandibular Restoration courses.  We are sad to announce that this will be her last day here at PRI but we are happy to know our relationship will continue while she pursues a career in Boston. 

Posted March 12, 2010 at 11:10AM

by Jen Poulin, PT, PRC

Today I received a call from a college student who lives in New Hampshire.  He was referred to me for consultation from a therapist in Omaha, NE who had treated this young man with PRI techniques while he was living in Nebraska.  The student currently goes to school at Wash U in St. Louis.  His parents moved to New Hampshire and he was home visiting his parents over spring break.  It was closer for him to drive to Vermont for treatment than wait until he returned to school and fly to Nebraska to seek PRI treatment.  I called his original therapist who now lives in Oregon to get some history on this young man’s hip problems prior to his appointment.  We collaborated on his case and had established continuity in his plan of care.  He was seen at Poulin Performance and I discovered his hip imbalances had reemerged.  I educated him on how to realign his hip and sent him back home to New Hampshire.  He will continue working with his therapist in Nebraska when he returns to school and now has made a connection via the PRI network in Vermont.  This is the strength of the PRI network and obtaining certification in postural restoration concepts.  I am seeing more and more patients from surrounding areas that do not think twice about driving to Vermont to seek care when other remedies have failed.  This young man felt comfortable driving the distance because of my certification and collaboration with a fellow PRC. 

Posted March 11, 2010 at 11:14AM

Jeffrey Banaszak, PT, CSCS, Founder and President of Back9Fitness® will be hosting our Myokinematic Restoration in Fort Worth, TX on April 24-25. Back9Fitness® is a recognized industry leader in golf fitness & performance. We are excited for the upcoming opportunity to collaborate with this organization. To read more about the integration of postural restoration with golf in an article titled The Biomechanical Link Between Low Back Pain and Golf written by Allen Gruver, click here. To learn more about Back9Fitness®, click here!

Posted March 10, 2010 at 11:18AM

Dr. Rutledge will be presenting at our Rest Integration course being held April 17th, 2010.  He will be presenting on his clinical experience with sleep disorders and treatment.  Read more about Dr. Rutledge below:

Dr. Rutledge is board certified by the American Board of Psychiatry & Neurology with over 35 years of clinical experience.  He has taught medical and nursing students as well as psychiatric residents at St. Louis University.  In addition to office practice, he has had a special interest in complex cases that involve neurologic, endocrine, and sleep disorders which complicate anxiety and depressive illness.

He obtained his MD degree at St. Louis University.  Residency training was at the University of Pennsylvania Hospital and St. Louis University Hospital.  His training was based on psychodynamic therapy with extensive additional study in psychopharmacology.  Dr. Rutledge credits his experience with both for his ability to identify sleep disorders at the rate of two to three per month.  He believes that sleep disorders are the most overlooked cause of treatment resistant depression.

In his free time, he and his wife enjoy time with their three married children and four, soon to be five, grandchildren.  As time allows, he enjoys DIY home projects, yard work, or just relaxing with his wife and Old English Sheepdog. 

Posted March 9, 2010 at 11:19AM

We recently attended an in-service given by John Macy, PT, PRC on Visceral Manipulation and Postural Restoration.  This was a fascinating in-service on how visceral manipulation can be incorporated into a PRI program.  John describes visceral manipulation as “the use of only minimal force to enhance the inherent motion of a particular organ or tissue in order to restore the body’s ability to self correct dysfunction.”  Following the in-service, we asked John where we could get more information and he suggested checking out The Barral Institute.  Another great resource is the book, Visceral Manipulation, written by Jean-Pierre Barrel. 

Posted March 4, 2010 at 11:22AM

Lori Thomsen, MPT, PRC recently discussed the importance of a proper running warm up in a short video demonstration.  Check it out HERE!

Posted March 1, 2010 at 11:31AM

We are excited for Dr. Edward’s upcoming presentation on Day 3 of our Interdisciplinary Integration course. Here is what you can expect…

Day Three - Vision Vestibular Integration
8-9 Do you see what I see?
              Pointers and banters from each professional point of view.
9-10 The Rock Star and the Back Up Band
              A rather nontechnical, but memorable introduction to the Ambient Visual System.
10-10:15 Break
10-11 Can you stand on your own? Or do you have a visual midline shift?
              An introduction to screening patients quickly and effectively for visual-perceptual problems that are preventing effective PRI treatment.
              Supervised, small group, breakout sessions will be integrated with demonstrations of various techniques for measuring visual midline shifts.
              An opportunity to thoroughly experience normal and abnormal posturing of the visual midline.
11-12 Spend Another $6 for Equipment and Have Some of the Most Memorable Therapy Sessions Of Your Life
              Further screening techniques for visual perceptual problems.
              Techniques for on-the-spot trials for amending the response of the visual system.
              Gauging the changes in PRI response and body posturing response.
12-1 Lunch (on your own)
1 – 1:30 Waking the Sleeping Giant
              Visual-perceptual neglect is more common than you think. Learn how visual-spacial neglect impacts patients with traumatic histories.
              Easy screening techniques for neglect.
1:30-2:30 Visual Fields - Can we accept what has been taught for a hundred years?
              Screening tests for the determination of visual field loss.
              Techniques for the rehabilitation of field loss in patients with stroke, TBI, brain hemorrhages, and neurotoxicity.
              Strategies for determining which fields are more receptive to rehabilitation.
              Application of acute care techniques to patients with long term field loss.
2:30-3 Okay, my patient needs an optometrist. What do I do now?             
              Resources for finding an optometrist.
              Key questions to ask when looking for the right optometrist.
              Examples of optometric referral.
3-3:15 Break
3:15-5 Have you ever seen this?             
              Case presentation of patients who have been rehabilitated with PRI and optometric referrals.

Posted March 1, 2010 at 11:28AM

Memo from Jen Poulin, PT, PRC:

The second annual PRC Forum had an unexpected visitor this year…Mother Nature!  And I know for sure she was not on the guest list!  She blew into Atlanta on Friday night and wiped out half of the committed PRC’s.  We were sorry those planning on attending were unable to fly or drive into snowy, icy Atlanta!  We would have been better off meeting in Vermont!

Mike Cantrell, James Anderson, Jen Poulin, Sangini Rane, and Scott Pruitt managed to make it in and spent the day discussing how we, as PRC’s, can help support the Institute and further the science and also went back to some fundamental concepts of myokinematics to help streamline our treatment efforts. 

James prepared a paper “Differences between the left and right abdominals, lower trap and serratus anterior function in the left AIC/right BC pattern”.
Mike presented his thoughts on the Left AIC pattern as it relates to baseball pitchers and Scott discussed the implications for the golf swing.
Jen finally got a 3/5 Hruska Adduction Lift Score, so all went home happy!

Stay tuned for further details on the meeting and thoughts on planning the third annual PRC meeting!

- Jen Poulin, PT PRC

Posted February 24, 2010 at 9:24AM

In a conversation between Ron Hruska and his daughter living in New York City, Ron describes why we associate smells with memories:

“Hi Rachelle! I enjoyed reading your tumbler message to me about the dry cleaners smell of your oxford shirt and the memories it stirred up.  I walked by a bakery in Warsaw and immediately thought of grandma Rita because of the bakery aroma.  When I smell tractor grease I immediately think of my dad and when I smell freshly cut alfalfa in the field I immediately think of my grandpa John.  When I smell freshly turned soil in the garden I think of grandma Rose and picking up potatoes that were just dug up, when we were little. When I smell new crayons exposed for the first time by opening their box lid I think of my school days at Dist. 31.  These smells are so precious to me. These odors and smells enter the nose and are recognized by the olfactory sensors and the signals are sent to the olfactory bulb that is located right above the eyes.  From there the sorted smell information is then sent to the limbic system, the primitive part of the brain that includes areas that control emotions, memory and behavior.  As the same information goes to the cortex or the outer brain for conscious thought, it is sent to the sensory cortex to create the sense of flavor.  The message sent to the cortex and the limbic system triggers memories that are stored in the hippocampus, and through relational memories your blue oxford shirt reminded you of me.  Thank God for the hippocampus! - Love Dad”

Posted February 23, 2010 at 9:30AM
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