Dan Houglum, PT, MSPT, ATC, PRC
How were you first introduced to PRI and when did you attend your first course?
I first met Ron in the spring of 1998 in Lincoln at St. Elizabeth’s. I was doing my first orthopedic rotation in PT school, and it happened to be at St. E’s. My CI was not Ron, but because I went to the osteopathic school in Des Moines and he knew my instructor, he was kind enough to show me some things. He would pull me into a room and I would watch him work his magic. He did a good job of not overwhelming me, but he showed me that what I was learning in school was just the tip of the iceberg. It did get my mind working in that as much as we got osteopathically, there obviously was more to it.
I started to work in Illinois in 1999, and Ron called me and said he was going to be in Chicago for a Saturday course and it was $100 and he would really like for me to attend. I had just moved and started this new job, and I literally had $17 to my name. I really wanted to go, but I couldn’t swing it because of the timing. I got busy with life and kind of put PRI on the back burner.
One of my classmates from PT school who had worked for Ron for about a year called me in February 2003. He said Ron was coming back to Chicago to do the a Myokinematic Restoration course, and was wondering if I could attend. This time it worked out great, and that was the first course I took. There were only about 8 of us in that class, but I was hooked. I had a better grasp of what I was seeing and doing compared to 1998 and could apply the information. I took the Postural Respiration that October, and then got lost. I didn’t take another course for over 2 years because I wanted to make sure I had the first two courses down well enough before I started to invest more time and money in future courses. At that time, my clinic was slow enough that I could take the time to methodically go through the manuals and invest the time to apply the concepts to patients. Those 2+ years were vital for me to be able to comprehend and apply the concepts. I started to re-take the courses and every time I took the courses, I got more out of it because of the two years I had to take to digest the information.
We know that you have been very successful implementing Postural Restoration into your practice setting without owning your own practice. How did you go about gaining the support from your administration and fellow colleagues at your employer?
When I started taking the courses, no one knew what I was doing. My boss still doesn’t know what I do. But I was fortunate to be working for a PT who owned the company that didn’t care what I did, as long as patients and doctors were happy. In the nearly 10 years since I have made the clinical change to doing only PRI, none of my superiors have ever questioned it. After I felt that I was well versed enough and had enough experience to begin explaining it to others, I began hosting courses. Once again, my boss gave me the latitude to do whatever I wanted to do. I was the director of continuing education for our company (Sports Physical Therapy at that time), so that helped as well. The results spoke for themselves. The therapists I worked with could see I was getting results they could not and were not getting, so that helped sell PRI as well. I now have 4 other PT’s doing PRI quite a bit, and I am trying to get another to take her first class. Now that we have merged with Accelerated Rehab, I have been with the company long enough and have a strong enough following that I can do whatever I need to do. I was very fortunate that my boss is a PT and he has never made any comments or judgments as to how to treat as long as the results were there. When I was taking my time those 2 years and the clinic was slow, I was fortunate that there was no outside pressure from him to change what I was doing, and it has paid off. I think the big thing was that my boss is not a micro-manager and gave us the freedom to grow as clinicians.
Your facility has now hosted a couple PRI courses, how has this experience been for you and your co-workers?
Hosting has been a bigger learning experience for me than I had anticipated. Originally, I just wanted to make it easier for my co-workers to take the courses. But having to field questions from the other PT’s taking the course was a bigger learning experience than I had expected. And it provided my co-workers the opportunity to take the class and see what I am doing and see where I am getting the information from.
What areas of clinical practice are you most passionate about?
My interests in PRI have evolved over the years. Originally, I really liked working with athletes because it was fun and they responded so quickly. But then it evolved into taking PRI to other, less obvious diagnoses like plantar fasciitis, bunions, and biceps tendonitis. Now my interests are more in the integrative aspect of treating patients. I guess my treatment approach has evolved to be more integrative, which is the expectation. I enjoy working with the patho (L) AIC patients, superior 4 patients, and the more chronic patients who have had pain for a long time. Those used to scare me as a younger therapist, but now they are not nearly as daunting. My next challenge is to find a dentist I can work with, because that is a piece I am missing. I know I need to take some patients out of their bite, but I have not been able to do that marketing piece yet.
As you pursue becoming a Postural Restoration Certified (PRC) therapist this year, who have been your mentors?
I guess my mentor in PRI has been Ron. He’s the first, and really only one, I have looked to for guidance. I was fortunate to know Ron before the Postural Restoration Institute existed and see his challenges doing PRI while working in a hospital based outpatient setting. That is where I am now, so I can appreciate the similarities. Ron has been very kind to me, and I greatly appreciate that.
Ron likes to know everyone’s story. What has been your story in your career? Is there any advice you would give to PT’s out there reading this interview?
My story with PRI started with Ron in 1998, and even as a student, I could tell this was different and the results were amazing. As a student, it was like magic. So I went back to school following my first clinical rotation in Lincoln realizing that in order to be the kind of therapist I wanted to be, I had to take the information I was getting in school and follow PRI down the rabbit hole. So in school, I had this idea in the back of my mind that there was more, but I had to learn the basic stuff first. I had to take other continuing education courses to help build a baseline skill level in order to appreciate and apply PRI. But the big thing for me was taking the time and, through trial and error, applying the Myokinematic Restoration and Postural Respiration courses to patients. I was very lucky to be in a very slow clinic that afforded me the luxury to do that. I was at a slight disadvantage that I had no one in my region that I could bounce ideas off of, so that is why it took me so long to digest the information, but it was well worth it.
My advice to people starting out in PRI is to be patient. The other piece of advice I would offer to new grads is to practice for a few years first and take other continuing education courses to see what is out there and to find out what you don’t know. You need to struggle and realize that there is something missing in all the other treatment approaches. It does take time to apply the concepts and shift your mind set to a different approach of seeing the body and how it works. The biggest challenge I had was I had to stop treating the diagnosis and treat the person. A plantar fasciitis patient is not a plantar fasciitis patient; they are a (L) AIC, R BC, and can’t breathe with their diaphragm or locate a ZOA with a road map. I needed to get out of my box mentality and stop putting patients into boxes. The other thing I did is make the conscious decision was to apply PRI to everyone I could regardless of protocol, diagnosis, and not even tell the doctor I was doing it. The doctors care about patient satisfaction and improvement. With PRI, I was able to get both, so the MD’s and the patients never questioned it. But you have to commit to it. The more you do it, the better you get, the better the results are, the easier it is to not get questioned about what you are doing. By the same token, I was not violating MD protocols or doing things that was against MD orders. In order to build a practice, I needed to observe the MD orders. But in that framework, I also was able to apply PRI a lot and get the desired results.
PRI has radically changed my treatment approach! Meeting Ron in 1998 has changed my career path and made me a better therapist. If you are able to commit to practicing PRI and take the time to learn, it will revolutionize your practice. But it is not a quick change. It does take time and it is a learning process, but it is beyond worth it. PRI is a different way of looking at how the body functions, but it works. If you are able to accept the notion that everything you have learned up to the point of your first PRI class is high school level education in that it is mostly correct, but not nearly the full picture, and accept that, by comparison, PRI is graduate level education, you will have a greater level of success. PRI is taking your knowledge, expanding on it, and applying it in a more functional manner that it appears to be dramatically different, but it really isn’t.