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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 2019

Todd Robbins, PT hosted Postural Respiration at one of his facilities, Robbins Rehabilitation East, this past weekend in Easton, PA.  One of his trusted friends and former co-workers, Brian Buetel, PT, had been telling Todd about PRI since his first PRI expereince and strongly suggested to not only attend but to sponsor a PRI primary course. Todd jumped in to be the host while attending his first PRI course. He also brought and personally sponsered nine of his employees with him.  And what a weekend it was for all attendees with two thirds of the class brand new to PRI!

The first PRI course experience can be exciting, challenging, over-whelming, a refreshing change to a status quo, a paradigm shift and very much like being fed water by a fire hose! What is so fun for a faculty member is to see students repeat back a new awareness and concept, put it into an application they experience during the weekend and have an enthusiastic response of wanting more PRI. This weekend was full of these new awareness moments- like the before and after of a non-manual technique or a new way to look at testing that always can be traced back to what shape and position the diaphragm is in and how it drives position of a pelvis and ribcage. Another insight that is always big is that one the of the most important muscles of respiration is the left hamstring while IO's and TA's pull a ribcage down, in and back like "hay hooks". The class could see in a new way that muscles on the one side of the body are deficient and some are biased driving us laterally to an end-range position we rely on for a perception of stability.   Superior T-4 is always an added layer of discrimination of patho-mechanical accessory muscle respiration superimposed on top of dominate patterns and position. Watching apical expansion become positive on the left during lab after the Superior T-4, or get air into the right chest wall technique, and the reasoning behind it, was a huge eye opener for the entire class.


Many thanks to Todd Robbins, PT for bringing his PT staff to Postural Respiration.  It is a leap of faith to try a new approach and he and his crew jumped right in with energy and curiosity.  Big thanks to Brian Beutel, PT for sharing PRI with Todd and being the host site contact this weekend.  His help and support was an instructor's dream and I hope to return soon to Robbins Rehab East. They already have another PRI course subject scheduled for next year. And last but not least a HUGE thank you my vetran lab assistant, Jon Herting who was a valuable resource throughout the weekend!

Posted November 14, 2019 at 10:59AM

Phoenix Arizona is a beautiful place to visit just about any time of the year, but early November in the Valley of the Sun is just about perfect. A big thank you to Jimmy Southard and the amazing staff of the LA Dodgers for hosting Postural Respiration, our flagship course. Also thank you to all of our wonderful course attendees and a special thanks to Aaron DeBord and Jim Wittekind for assisting me as lab instructors.

Postural Respiration hosted by the LA Dodgers, James Anderson, Postural Restoration Institute

The recently updated Postural Respiration course is fun to teach for many reasons. First of all, the research associated with the presentation on day one is comprehensive and clarifies concepts that have been fundamental to this institute since its onset. Emphasis on powerful PRI principles like Left Posterior Mediastinal Expansion, Right Apical Chest Wall Expansion, Autonomic Sense and Limited Functional Patterns take on new meaning in context with these newly included research articles.

Postural Respiration Primary Course, Postural Restoration Institute

Postural Respiration Manual Technique, Postural Restoration Institute

Another highlight is a new test to assess Standing Posterior Mediastinum Expansion. This group took the time to appreciate the the critical nature of this concept and to experiment with this new test and it really paid off. Many new ideas for utilization in a variety of settings were discussed and shared. Many eyes were opened up to what this institute has always been able to offer upright rotational performance and the autonomic variability for athletic performance and standing upright training activities. Fun to see and experience.

Standing Posterior Mediastinum Reach Test, Postural Restoration Institute

Thank you Jimmy Southard and thank you LA Dodgers! Always a world class organization with world class hospitality.

Posted November 13, 2019 at 10:27AM

This was the last offering of Myokinematic Restoration for 2019. And what a way to end the year! We had a great group of chiropractors, athletic trainers, physical therapists and PT assistants,  strength coaches, personal trainers, and cranial therapists.  I was very excited to get to sunny northern California, as the we got 4-6 inches of snow the day before I left. Which made for a miserable Halloween.  

Fortunately, only treats and no tricks with PRI! This course affords us the luxury of spending a lot of time in lab.  Nearly 40% of the class is spent in lab, which provides the attendee ample opportunity to find, feel, and experience the science of PRI. This course also provides ample time for us to discuss, explain, and digest the Hruska Adduction and Abduction Lift Tests as a means of determining one's ability to walk and breathe. If walking and breathing require compensation, everything will require compensation.  

We had a great discussion about sympathetic vs. parasympathetic nervous system activity related to pelvic positioning, foot and ankle performance, and how the acetabulum position dictates femoral activity.  

My thanks to Shaun Buchanan and Joan Shepherd Mellows for hosting us and all the logistical work that goes into a successful weekend.  My thanks to Jenn Gaskin, Brian Schulman, John Garland, Cody Gilliss, Michael Serrano, and Tracy Henry for all of their great questions and help during demonstrations.  

But this weekend wouldn't have worked nearly as well if it weren't for Will Waterman, PRC, and Tim Dempsey, PRT. They were fantastic lab assistants and were a great help during the entire course. Without a doubt, they were instrumental to helping this diverse group digest this information. Looking forward to 2020!

Posted November 11, 2019 at 11:04AM
Categories: Clinicians Courses Science

Lima, Ohio. Home of the KewPee Burger!

This weekend I travelled to Lima Ohio to teach my last course of 2019. It is not the easiest site to get to, but it was so worth the effort. This course had 18 attendees of varying backgrounds. It’s nice to teach to a group of professionals with different perspectives. There were PT’s, PTA’s, Chiropractic Physicians, Athletic Trainers, Strength Coaches and a Pilates Instructor.  


We spent the weekend discussing optimizing patterns, breathing and compensations of the Pelvic girdle as they relate to frontal plane control of Inlets and Outlets. Most of the attendees were new to the science so teaching this integrated introductory course allows us to explore the integration of thoracic diaphragmatic breathing with Pelvis respiration to balance posture and gait.  Pelvis Restoration is known for its complex acronyms. I tried to move away from overuse of acronyms, and discussed proper position of inlets and outlets during upright function. I think this helped the new learner shift their perspective from orthopeadic thinking to the neurologic ANS control of patterns.

On Sunday, “Treatment Day!”, we discussed a pathway for treatment of the L AIC, PEC and the  Patho PEC patterned individual. We explored the triplanar position of the iliacus as it relates to swing and stance and sacro-iliac dysfunction. This is always an awesome opportunity to bring concepts of inhibition and activation of the same muscle in different planes of movement. This course allows me to dive deep into rabbit roles of pelvic respiration and thoracic diaphragm position. We had a great time integrating breathing throughout the weekend. By Sunday afternoon, the light bulbs were going off as were the “Ah-Ha” moments.

I enjoyed the banter with both Jason Russell, DC and Nick Goins, DC throughout the weekend. They were my Glut Gait guys! Jason, be nicer to Nick!
Carri Baumback, PT took her first course 10 years ago with Ron and brought her co-worker and friend Cynthia Nieberding, PT. It was great having them in the front row, not afraid to ask questions! Next time we have dinner ladies!

Alex Maag and his staff took very good care of me and our class. The interest in PRI in that great state of Ohio is growing. I look forward to seeing these clinicians grow and develop their PRI knowledge.


“When you go to Lima, you eat a KewPee Burger and rub the babies belly” - James Anderson
Well, I ate the burger but couldn’t reach the belly. Next time…..

Posted November 6, 2019 at 10:42AM
Categories: Clinicians Courses Science

Robert Newhelfen, DC, founder of Motus Integrative Health, describes his clinic as “a full integrative health clinic bringing new and unique treatment options to the people of Northwest Indiana.” In keeping with this vision, his clinic hosted Postural Respiration, a unique and integrative approach to addressing postural influences of rib torsion, inconsistent breathing patterns, habitual use of accessory respiratory musculature, and a positionally-restricted diaphragm. As in most PRI courses, we had an interdisciplinary group of course attendees, comprised of PTs, chiropractors, ATCs, and strength and conditioning experts in professional baseball and soccer. Also in attendance was Ruth Hennessey, MM, a vocal specialist well-known in the world of singing. Thank you, Ruth, for your insights into how singers develop faulty breathing strategies and retain undesirable tension that can affect their voice.

   

From the get-go, we discussed human asymmetry, most notably of the right and left hemi-diaphragms, leading to predictable patterns of muscle activity and movement. Our inherent asymmetry gives us a starting point from which we  shift our bodies and rotate. It is what an infant relies on to make its way from the womb to the external world. This applies to every developmental milestone, from crawling to running. However, when patterned muscle activity "goes rogue", from too much sitting or engaging in the same, repetitive activities, day in and day out, the results are patterned restrictions, injury, and fatigue.  

Course attendees served as one another’s case studies as they compiled PRI objective data to assess for both lower and upper body neuromuscular dys-synchrony and to guide treatment. Thank you to Rebecca Custer, DPT, and Wynne Conklin, CPT, our templates for the entire class for right BC over-activity and its pathological sibling, superior T4 syndrome. We discussed how this syndrome limits first rib mobility. The first rib is the driver behind the mechanics of the entire thorax and, therefore, must remain mobile! This course was updated a year ago. It includes a new test for the brachial chain as well as where, when, and what inhibition techniques fit into the treatment scheme. If you haven’t taken Postural Respiration in a while, it’s time for a refresher!


 
Thank you everyone for your thoughtful questions. Nate Kloosterman, DPT, OCS, gets the prize for most questions asked, keeping this instructor on her toes. A special thank you goes to Adrian Gutierrez, DC, for handling the set-up, food, sign-in, etc.   You were a gracious host and helped make this weekend an enjoyable experience.

Posted November 5, 2019 at 10:16AM
Categories: Clinicians Courses Science

FINALLY!  The long-awaited first offering of the PRI Integration for Pediatrics course is in the books!  James and I had a great time with 8 therapists who are new to PRI, including one pediatric Speech Language Pathologist and one pediatric Occupational Therapist. James did an awesome job making sure the new folks were understanding the PRI language and science, and the experienced PRI-trained clinicians and 7 PRC’s mentioned enjoying the review... there are always old concept to reconsider!

We unveiled the 8 component “Desired Sequential Movement” (DSM) reference guide to aid in treatment planning and exercise progression for 2 groups of pediatric patients, depending on their level of abilities. Of course, there were lots of fun photos and videos of adorable kiddos to entertain, enjoy and to help us teach. A big shout out to all my pediatric “models” who helped explain these fun, kid-friendly tests and techniques this weekend! And thanks to my home clinic, Advance Physical Therapy, Susan Henning, PT, PRC, Joe Belding, PT, PRC and crew for creating a comfortable environment with the best snacks around. And, last but not least a HUGE thanks to Danielle Wild who came in from home to help with commuter issues over the weekend!

See what others had to say about this inaugural course below!

"Last weekend I attended the first ever Pediatrics Affiliate Course written and presented by Lisa Mangino and James Anderson. I literally had been waiting all year for this course! It did not disappoint. My entire career I have worked with an adolescent to adult population. This is my comfort zone. In what appear to happen gradually, but then started smacking me in the face was the age of my patient was getting younger and younger. I have raised to 2 daughters, so I know kids, right? Wrong. I found myself challenged to switch gears from doing what I knew with adults and applying it to kids. The little wiggle worms do not like to lay on a table and have tests performed on them. They want to explore and play. I was at a loss. When I heard Lisa was going to be writing this course, I just couldn’t wait. Last weekend the wait was over and they did not disappoint. I left there with simple tests that I could use with my littles, as I like to call them. Cool fun techniques that will allow them to play and me to treat. What was even better is I can apply these tests to my “Big Littles” too. It really starts with Pediatrics. If we can begin to change their patterns young, we can prevent a lifetime of pain and compensations. Do not feel like you have to treat kids to take this course. I have maybe 2-3 on my caseload now, but feel I have the tools to help my adults too. Can’t wait to whip out my new toys and tools to help my littles. Balloons, bubbles, stickers, markers, games and puff balls! How fun!
James is an excellent mentor, I know first hand about that! The interaction and flow between James and Lisa was awesome. James sets the stage of PRI concepts in a simple way that I wish I had heard early in my PRI evolution. He is a gifted teacher.  Lisa is a humble, gracious teacher. I really could listen to her all day. She is knowledgeable, answers questions well and really is a gift to her patients, and now her PRI students. Sign up now, this course will surely be a sell out." - Jen Poulin, PT, PRC

"I have been asking for a PRI course focused on pediatrics for years, and this course was everything I'd hoped it to be, and more! An excellent introduction to PRI and the science if you are new to PRI, and serves as a thorough refresher for those of us who are familiar with it. I am excited to try out the new functional tests with my pediatric patients and I'm confident that they are equally as effective tests for an adult population. The names and modifications to PRI exercises for a pediatric population and thoughtful and creative. The cues and ideas for active play were insightful and can be applied to patients requiring a high level of assistance all the way to those who have the highest function. I feel some of the cues would even be beneficial for our adults to achieve proper positioning! I highly recommend this course for those working in a pediatric population, but I also know many adults that are "big kids," and this is helpful for those patients too!" - Sarah Luin, PT, DPT, PRC, BSPTS Schroth Certified Therapist (C1)

This past weekend I travelled up to Cranston Rhode Island to teach Myokinematics of the Hip and Pelvis. Elite Physical Therapy was hosting their first PRI course! They had several clinicians in attendance and Ryan Toher, DPT was a great host. They were all new to the science of PRI as were 90% of the course attendees. This was a larger class with  45 clinicians in the room. I was joined by Miguel Aragoncillo, CSCS, PRT and Tyler Tanaka, DPT PRC as my lab assistants. They did a great job offering help during labs and comments from their experiences during lecture. The class was made up of mostly rehab professionals and strength and conditioning specialists. It was super fun meeting Tyler’s college friend Daniel Gardner, DPT aka “Gator” and helping him begin his PRI journey!

As hard as it is to be away from family and friends on the weekends and the rigors of travel, I am always excited to see the light bulbs and Ah Ha moments that new clinicians experience learning about autonomics, breathing and polyarticular chains as it relates to concepts of lateralization, habit and movement dysfunction. I enjoyed meeting my front row newly inducted PRI front row Trisha Livemore, DPT, Steve( CSCS) and Amanda Zariello,DPT, Valerie Perron, LPTA, LMT, Elizabeth Johnson, MPT, ATC and Anne Ruffus, DPT, CSCS.

A very special shout out goes to Gustavo Woff, PT who flew 15 hours from Argentina to take his first PRI course this weekend. It is so inspiring to be part of the PRI Faculty and watch it grow and spread throughout the world.  I am truly honored to be a part of the process.

Alpine Physical Therapy has been the center of advanced PRI courses for over two years. The three amigos, Chris "Murph" Murphy, DPT, PRC, Jeremiah Ferguson, DPT, PRC and Eli Zygmuntowicz, DPT, PRC hosted Cervical Revolution at their facility this past weekend and it was a pleasure seeing the guys again and having their support hosting this course. Cervical Revolution has been evolving for the past two years with course manual changes, thanks in a large part to Jason Masek, MSPT, PRC, and his diagram of the atlas and occipital bone in the left and right TMCC pattern. One of the biggest learning challenges in any PRI course is to connect a pattern to position and have a tri-planer picture in mind from a two dimension drawing from a book. Jason's description is a vital learning tool to understand position of atlas relative to occiput before the discussion of occiput on atlas in a patho-mechanical compensation called right torsion occurs.  

Postural Restoration Cervical Revolution course

In addition, several revisions to the course manual have been made with the help of Ron Hruska and Mike Cantrell to make this course flow even better.   The emphasis has become even greater on the O/A junction being the driving factor for autonomics, cranial position and especially oscillatory lateralized function. The connection with the L AIC, R BC, R TMCC and LSB cranial position, and the need to alternate and reciprocate, was integrated deeply this past weekend with ample lab time and insightful clinical discussion.

Cervical Revolution Postural Restoration

Attendees in the course included six PRC's as well as practitioners on the verge of becoming PRC's with much PRI exposure and practice.  Along with the "veterans" there were practitioners with just a few PRI courses under their belts including PT's, myofunctional speech therapists, and strength and conditioning personal with a strong emphasis on working with baseball players from little league to the pro's.  Joseph Yousefian, DDS, an orthodontist, was in attendance for his first PRI course.  He was thrown right in the middle of PRI nation and was such a valuable voice when it came to occlusion and a dentist's perspective.  In this course the discussion on occlusion is one that is interdisciplinary, and that more often than not, we need to work with a specific dentist to help with occlusion to "free up" a neck and let it revolve!

Thank you to all attendees and especially Murph, Jeremiah and Eli. I also want to thank Ron and Mike for their mentorship over the past two years. They have been so generous in their time and energy helping me understand the content and learn how to teach Cervical Revolution. This was my first solo Cervical Revolution as a faculty member and it was such a rewarding experience to be so well prepared with the help of Ron and Mike. Also, thank you to Jennifer Platt, MPT, PRC for all of your mentorship, emails and phone calls in this learning process!

If you have attended Myokinematic Restoration in the past, but not since the course received a make-over in 2016, I suggest you strongly consider attending. If you haven't started your PRI journey, this course is one of the PRI introductory courses, and is a great way to begin that journey. A couple of changes that were made in 2016 that I appreciate compared to the version I first took in 2004 are that now we have a lot more time for lab, we are able to discuss and spend time in lab on both of the Hruska Lift tests, and we are discussing some ankle mechanics related to the L AIC pattern.

 

This most recent Myokin class is an excellent representative sample of these changes.  This class was nearly 40% lab.  So everyone was able to find, feel, and experience the muscles required to inhibit the L AIC pattern.  We were able to spend a solid amount of time on the Hruska ABD and ADD Lift tests with lab and explanation of both tests.  And we had a lively discussion about how calcaneal position and mechanics influence and are influenced by the L AIC pattern.

This class had a lot of great participation, as every single participant asked a question, which helps everyone learn. My thanks to Ken Guzzardo for hosting our course. My thanks to Amy Corbin, Amanda McDevitt, Jaclyn Marino, Ivan Salazar, Kristian Flores, Aidan Scotland, and Jamil Skakoor for their excellent questions and re-states. Really, my thanks to all the course attendees for their interest and many awesome questions.  

It was a true pleasure to have Neal Hallinan as the lab assistant. He's a PRI Black Belt, and he's speaking at Interdisciplinary Integration in April 2020. He's going to kill it! 

Posted October 28, 2019 at 11:48AM
Categories: Clinicians Courses Science

As one attends conferences organized by various boards and professional groups of education, it becomes apparent that many of them, no matter which organization is of the primary focus, are alike. This is now our second time attending the AAPMD Airway Summit, and it again was distinguishable from any other conference in the past. I believe it is important to understand the truly collaborative effort of all the organizations involved as the level of discussion was already set high because of the many disciplines present during these four days.


We were proud to join a long list of sponsors which included; The American College for Advancement in Medicine, The American Academy of Physiological Medicine & Dentistry, The Academy of Applied Myofunctional Sciences, The American Academy for Oral Systemic Health, The Institute of Physical Art, The Foundation for Airway Health, The North American Association of Facial Orthotropics, The International Academy of Oral Medicine & Toxicology and the American Academy of Craniofacial Pain.If you made it through the list above, it may be easier to understand the vastness of conversations had, professions in attendance, speaker topics presented and overall interest in integration. As I spent four days discussing and fielding various questions related to the relevance and strong presence of our Institute at this event, we immediately became aware of the potential and power that this science of Postural Restoration can have on a collaborative group of minds which we were surrounded by. After having these conversations between various Dentists, Oral Facial Myologists, Hygienists, Speech & Language Pathologists, Craniofacial Pain Physicians, and many other systemic health and physiology professionals, their desire for integrative and collaborative care was at an all-time high.


Many of them however were curious and sometimes cautious about where to begin, who to reach out to, and how those other professionals may benefit their patients overall plan of care and most importantly their treatment outcomes. Then comes “The Important Collaborative Role of PT and Airway Health” which was presented by Ron Hruska, Gregg Johnson and Brad Gilden. Which in and of itself was a milestone in the collaborative effort to introduce the important role PT’s have in viewing and treating airway and all other forms of dysfunction. Not only is the role of the physical therapist becoming more apparent but the roles of ALL individual professionals involved are becoming more appreciated. We were fortunate to have the presence of PRC, Steve Cuddy who has been practicing PRI and integrating with other disciplines in the Austin area for many years. Steve, it was truly an absolute gift to have you there as a representative of our credentialed providers across the country and abroad as these other professions look to you and others like you, who have become a PRI provider. The professionals mentioned above will be reaching out to all of you in the days, months and years to come, as a resource for integration of the science of PRI within their approaches of treating Airway Dysfunction and overall health!

“Attending the Collaboration Cures Airway Conference was an eye-opening, yet reassuring experience.  Eye-opening in the sense that the collection of airway-related issues is more complex and prevalent than, I believe, anyone truly understands.  Reassuring because I’m more confident than ever that we as PRI practitioners are uniquely positioned to play an integral role in the detection and treatment of obstructive airway conditions. Returning back to our homes, I’m sure that all attendees are more hopeful after listening to and meeting a wide range of passionate practitioners. This would include Ron who gave a few very insightful presentations.  I’m here to tell everyone in PRI Land that airway obstruction and the anterior neck are areas that we understand, thanks in very large part to the information that Ron has put together for us. My hope is that we make that clear to all allied airway health professions in our communities as we continue our own Postural Restoration journeys.”
Steve Cuddy

A huge thank you to Dr. Howard Hindin, and the AAPMD Organization for once again including us in this effort. Dr. Hindin was awarded the “Howard G. Hindin, Breath of Life Award” for his dedication and role in this collaborative movement and because of his efforts Airway Health has been brought to the forefront of Healthcare. Thank you again and we look forward to continuing our involvement with and alongside you all. Next year’s Collaboration Cures conference will be held in Seattle, on November 12-14th! See you there.

Posted October 23, 2019 at 11:44AM
Categories: Website Clinicians Science
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