How did you become interested in PRI® and when did you attend your first course?
I remember in 2001, very soon after moving to Maine from San Francisco, looking up information on the internet on breathing and the “core”. I had been working with my patients for a few years on the work of Jull, Hodges, Richardson on their concept of “drawing in” to help recruit the deep abdominal muscles to help improve segmental spinal stabilization and biasing some of my intervention strategies on this approach. However, I struggled with how to cue them on when and how to breathe when performing some of the activities, and “just breathe naturally” wasn’t cutting it. I came to the Postural Restoration Institute’s website and saw pictures with balls and bands resisting different legs in different positions and some articles which I struggled a bit to follow. I remember talking with one of my co-workers at the time and saying “I’m not exactly sure what it’s all about, but they are on to something”. I took my first course, Myokinematic Restoration, in 2002 which was taught by Ron Hruska, and, much like most people, was blown away by the information and paradigm shift in mindset it produced. I haven’t looked back since.
How do you integrate Postural Restoration within your practice?
Great question and certainly one I actually receive regularly from people—and one I remember clearly asking others early on. For starters, it is the lens I look through when observing and assessing the human system and a strong basis of my evaluations with either rehab patients or training clients. I have to develop a good idea of how patterned, compensated or pathologic they are….or are not. I know this will influence how much tone they will be carrying, aberrant muscle activity they likely have, how it affects their movement patterns and so on.
I also can’t not think this way anymore either as I have seen too many people over the years and had too much success with components of this science to not feel like it is a significant driver in people. Much like I remember hearing Ron say years ago: “Guilty until proven innocent”. I have really developed my peripheral vision over the years as I am constantly watching my patients and clients and how they orient themselves, subtle shifts in movements, what their loading response is, etc. and this also helps a fair amount in helping determine how patterned they are, are they more of a top-down or bottom-up driven individual and other such concepts.
Every person I see gets “The Talk” on breathing mechanics, some training and activities on proper breathing sequences, and I also educate them on the influence it has on movement and position. I then work on getting them to be better positioned for the things I want them to do, through manual or non-manual techniques, depending on their needs. For example, do they need to perform more supported activities early on to get going, can they start further up the hierarchical chain from an intervention strategy standpoint, or can they progress more from treatment to training. While there certainly is a significant amount of overlap between rehab and training concepts, people are also at different places functionally, have problems or conditions which will affect what they can do, and also have individual goals that have to be taken into consideration. That’s where the art plays a bigger role than science.
I feel fortunate in having developed good manual skills over the years as well from a number of different approaches. It has been quite successful in helping a lot of different problems people come to see me with and introducing the Institute’s manual interventions on top of this skillset has only helped me that much more. Any hands-on activity I do is incredibly more successful, with better carry-over, and requires less work, when the person has a ZOA and is more neutral. Period. It’s a game-changer.
I also like the roadmap that PRI provides to the areas of the body that need to be better managed with an activity. It provides a number of different things to look for and cues to use to empower the person to help them manage areas where they might be compensating or things they really should focus on more (reference centers, position changes, muscles to “find and feel”). These extra tools are incredibly helpful and are quite powerful in the influence they have on results. The educational aspect of a session with people is a critical aspect of carry-over and providing continued success in someone’s program.
It’s actually an interesting time for me professionally as I have moved away from the out-patient orthopedic physical therapy environment I have been in for the past 25 years and started a company called Integrative Rehab Training LLC (Facebook Page), where I am an independent contractor providing Fitness Rehab and Clinical Athletic Trainer services at two different facilities. I share that because it has changed how I integrate PRI into practice. I have complete autonomy in the services I now offer and as a result, have been better able to develop how I assess and provide intervention strategies. For a long time, I often had to work to either treat someone more towards the traditional model or do some kind of hybrid intervention as my co-workers were not as familiar with—or familiar at all with—PRI. Since I would be co-treating patients with others, I didn’t want to give patients mixed messages. Now I am able to utilize all the different things I have learned, and work with patients one-on-one, to really create Integrative Rehab & Training.
I know that you also have a passion for writing and teaching, how do the concepts that you learned through PRI affect those two portions of your life?
Significantly. I have been very fortunate over the years and learned some incredible things in this field from some amazing practitioners from a number of different disciplines and approaches. This has given me an improved understanding, a well-rounded background, a solid set of strategies and an appreciation for the complexity that is the human system. Because of different environments I’ve been exposed to, I’ve had to be able to speak to professionals with little to no exposure to PRI and therefore have had to develop an ability to have dialogue on a more common level. This has carried over to my writings and lectures in that I can vary the depth of the information based on the audience I am trying to educate. Introductory PRI concepts with less of the language or more in-depth concepts if the audience has some background. I truly enjoy educating others and sharing things I’ve learned and PRI offers a lot more variability in information I am able to provide.
What would you say to people who are considering taking a PRI class or becoming Postural Restoration Certified™ or Postural Restoration Trained™?
I am certainly a bit biased, but I would definitely say go for it! The information and education I learned early on in my career was very valuable in providing a baseline of understanding of the body and different assessment and intervention strategies. It got me going so I could then go out and grow more in the field. The Postural Restoration programs are an important part of that growth in order to get an improved understand of how all the systems work together. While I feel strongly it would be beneficial for this information to be part of many health science’s curriculums, the courses offer a great educational opportunity to become better aware of the influences that are affecting our bodies.
With respect to someone getting their PRC or PRT, again, I would definitely recommend it. When they feel they have a good understanding of the tenets and guiding principles of the Institute and they have had the opportunity to apply the different strategies for awhile, then absolutely they should go through the process. The application and certification process in and of itself is an amazing learning opportunity. For me, it also helped me gain more confidence because it made me recognize that the Institute felt I had an appreciation of the science to then go out and utilize it and educate others on it.
Who have been your mentor(s) in your career?
At the very beginning of my career, there was an orthopaedic surgeon I worked with in New Hampshire named Jim Vailas who was instrumental in helping me recognize and respect the important aspects of being a health professional, working as part of a team, taking time to freely exchange information in our fields and how to be an important part of the community you serve.
When I moved to San Francisco in the 90’s, I was the Coordinator of Rehab Services for an orthopaedic surgeon named Kevin Stone who had a fairly prestigious practice. It was here that I learned a lot about surgical techniques and post-op care, cutting edge intervention strategies, publishing articles and doing research, working with high-level athletes and well-known people and organizations, and the multiple ways to help market a practice.
Both of these people and the opportunities these environments provided were incredible times of growth for me early on, but the list of others whom I have learned from over the years is endless. Whether it is through personal exchange, taking courses or reading information from them from different sources, there are a number of MD’s, DO’s, PT’s, OT’s, ATC’s, massage therapists, performance coaches, administrators, facility managers, front desk people, etc. that have all helped shape me professionally.
How do you go about mentoring others in your profession?
There is actually a few different ways I go about doing that. I am on Clinical Adjunct Faculty at the University of New England and have had an intern with me most semesters for the past 10 years from the athletic training department who are looking for a rehabilitation internship. They definitely leave with their world a little shaken up with the paradigm shift they experience. In an effort to teach, it’s kind of fun when they leave with concepts like: “When you are taking your boards, this is the answer to this question, but the reality is that it really means this.” I also lecture regularly at UNE for the athletic training students in the rehabilitation classes, in the physical therapy program and in the university’s dance classes.
I get together with people whenever I can, wherever I can, in small groups, one-on-one, have them come and observe me at my work and in other similar formats. I like to think that the lecturing I do at different conferences, symposiums, and half- to one-day programs I teach also helps in that regard.
I also work very hard to make myself available to others through e-mail, phone, social media, etc. who might have questions or want some insight into something professionally. It means the world to me to know I may have had a small influence on someone being better able to understand a concept or improve their skills.
Which PRI course has been the most influential in your development as a professional?
Yikes! Not sure I have an answer to that one as they all have their benefits and can all be taken multiple times and one leaves with a lot more insight each and every time. I lab assist for any of the local primary courses I am able to and still learn things each time I am part of that. Certainly the secondary courses really help further build and develop one’s understanding of the science that much more and tie together concepts from the primary programs. They are also great opportunities to spend time with those who are a little further along their PRI journey so the dialogue and exchange of information is really exciting.
I know you love to be outside and active, what activities do you enjoy doing in your free time in Maine?
Another long list, but certainly time with my wife Kay and my children Mitchel and Natalie tops the list. I like to cycle, alpine and nordic ski, weight train, paddleboard, run, hike, snowshoe….essentially, I like to play. I enjoy the ocean, lakes, mountains, city and all four seasons which is why Maine totally suits me because it has all of that!