Tell us about your journey with PRI that began back in 2001 at your first course. How did you become interested in Postural Restoration?

Shortly after I graduated from college I was introduced to PRI concepts at a Protonics course offered by EMPI.  However, it wasn’t until I attended a Myokinematic Restoration course that was taught by Ron that I really began to understand PRI.  The concepts were difficult to grasp, but I began using them as I treated.  My early success, particularly with chronic patients, convinced me that there was something profound to the science and I eagerly began taking more and more courses.

You’ve attended multiple courses over the years, taught and mentored other clinicians as an Associate Speaker for PRI, and served on our PRC Application Review Committee. What advice can you share with our readers for successfully integrating PRI into your practice?

First of all, PRI takes significant practice to perfect.  When you first take the course, and see PRI demonstrated, it is very exciting.  However, it is amazing the number of ways that patients will compensate effectively defeating PRI techniques.  It takes time to learn how to spot patients compensation techniques and learn to guide patients to facilitate the correct muscles and inhibit the compensating patterns.  Understand that each patient will have the potential to teach you as much as any PRI Course you may attend.  Second, you must understand PRI is not a cookbook treatment plan.  It is important to understand the basis of every test so that you may interpret the findings . The tests are the tools that guide you in your treatment progression.

You have been a private practice owner for a number of years.  Do you have any advice for therapists considering private practice?

Yes, go someplace else (lol – just kidding)!  The primary reason my business partner Carrie Langer and I decided to go into private practice was that it gave us the opportunity to treat patients as we thought they should be treated.  Unfortunately, most PT clinics we are familiar with treat 1 patient every half hour.  It is extraordinarily difficult to properly treat patients using PRI techniques in that amount of time.  Because of the hour visits we do make the same profits of a traditional PT practice.  To compensate for this, you will need to keep your overhead low.  One of the best methods we have for this is instituting EMR Software immediately after opening our clinic.  It was a significant initial expense, but has paid for itself many times over in the years since and by doing it immediately; we did not have the huge costs that would have been associated with conversion later on.

You were a member of the very first class to earn the designation of Postural Restoration Certified in 2004 (along with James Anderson, Raulan Young, Jason Masek and Carrie Langer). What made you decide to go through the Postural Restoration Certification process?

I had the luxury of working with Carrie Langer who was just as passionate as I was about the science of PRI.  Once we began to understand PRI concepts, we fed off each other’s success and enthusiasm.  Once certification was an option, wild horses couldn’t have prevented us from getting certified.  As all who have chosen the path of certification will tell you, it was the most rewarding and educational experience one can go through.

Has becoming certified presented any new opportunities you feel you wouldn’t have had otherwise?

Absolutely!  First and foremost, I wouldn’t have the love for what I do without PRI.  Second, I wouldn’t have had the opportunity to lecture and have the exposure to other medical professionals without PRI.  And third, I probably would not have gone into private practice without PRI.

You have in-serviced physicians, dentists, optometrists, trainers, etc, around your area.  Has this helped opened doors for your own practice?

Our initial in-service sessions did open some doors, but more importantly they introduced us to other medical professionals who were willing to learn PRI concepts.  Educating these professionals on an ongoing basis gives us a common understanding of PRI science so that we can work together for the best treatment of our patients.  It is the success with our shared patients that creates real opportunities for both us and our medical partners. 

What PRI non-manual techniques do you find yourself using most often?

Being in the upper Midwest we tend to see a lot of patients that are stuck in the posterior extension chain (PEC) pattern.  Therefore I tend to focus on activities that increase flexion of the spine using the abdominals, most importantly the IO/ TA.  For example: Standing Supported IO/TA with Chair or Short Seated Wall Reach with Balloon.

Out of all of the courses PRI offers, do you have a favorite?  If yes, why?

I enjoy all of the course work, but have found the Pelvic Restoration course has advanced my practice further in the last year.  I am grateful for the time that both Lori and Heather have put into the course as it has expanded my understanding of how the pelvic floor diaphragm works with the abdominal wall and respiratory diaphragm to stabilize “the core”.  I was excited to see the course has a new name which better reflects the nature of the course.  That it is not just a woman’s health course, but is applicable to all PRI practitioners.  I encourage all those who have not attended the course to look into attending in the future.

If you were to attend a non-PRI continuing education course, what would it be?

I have discussed this with other PRC therapist and I believe this is one of the most difficult challenges: to find courses that encourages growth and integrates will with PRI concepts.  I look to more neurological based course work than orthopedic.  However since PRI science is expanding, the new course work looking towards vision and auditory components will keep us busy for the foreseeable future.

Do you have any projects or plans for 2012?

I continue to search for other professionals to further expand our patient’s treatment options.  We also hope to grow our staff with PRI trained therapists.  I look forward to continuing my role as adjunct facility to help spread the adoption of PRI science.

1. Give us a brief history of your background and how you became interested in the Postural Restoration Institute?
I opened my own clinic in 1999. My Empi rep invited me to a Protonics course. It cost $99 and I didn’t want to go nor did I want to give up my Saturday. She offered to pay for the course if I would go. I decided to go and was used as the subject. I fractured my right patella in a MVA in 1986. Imagine my surprise and wonder when the instructor put the brace on my left leg, had me do some exercises, and my right knee felt better. I was intrigued and had to learn more. I have given up many weekends since then in my desire to learn more about PR.

2. You’ve attended several PRI courses.  Can you tell us about your first course and your initial impression of the material?
My first course was Myokinematic Restoration in Jan 2001. I was intrigued and just had to know more. Little did I know that this would be the first of many trips to Lincoln, NE. Obviously I’m hooked because since the Protonics course in 2000, I have attended 20 other PRI courses. Just when you think that you’ve attended all the courses or just when you think you’ve got a good handle on the current information, Ron challenges and amazes you with something new. I love learning and I feel really good about patient care with this approach because I feel that I couldn’t do anymore for the patients under my care.

3. What made you decide to go through the Postural Restoration Certification process?
The funny thing is that I thought it was the culmination of a process of learning. In fact, it was just the beginning. Going through the process was a wonderful learning opportunity. I had to review the material in prep but I also learned a lot during the testing. The discussion generated while going through the test questions and lab was wonderful. I also liked the idea of being recognized for the time I had spent learning and applying this information with my patients. In a private clinic, anything that you can use to market yourself – that will help you stick out of the bunch, is very helpful so the additional certification was a helpful marketing tool.

4. Has becoming certified presented any new opportunities you feel you wouldn’t have had otherwise? Has PRI changed the way you practice?
Wow, great question. In 2007, some of the Sanford Hospital doctors went to administration and told them that Sanford needed a P.T. that provided Postural Restoration. They recognized the outcomes they were getting by using our clinic. We began discussions and in 2008, because of Postural Restoration, I sold my practice to Sanford USD Medical Center. My staff and I have stayed on and continue providing the same care in the same location.  Sanford has been very good to us and continue to support the PR work going on here including providing support for continuing education.

5. Do you have any projects you plan on working on in 2012?
I am hoping to help my colleague Kyndy Boyle, PT, PRC, PhD complete some research on PR vs. traditional PT for sacroiliac joint dysfunction. I am also going through Mariano Rocabado’s seminars on cranio-facial at St. Augustine, Florida. But I am also looking forward to some upcoming PRI courses!

6. What areas of professional practice are you most passionate about?
If it’s about patient treatment, I’m passionate about it. All of the PRI courses interconnect because PRI teaches us how are bodies systems are interconnected. I feel like I better learn it all or I’m doing a disservice to my patients.

7. Who have your mentors been over the years?
For the last 10 years, Ron Hruska has been my mentor. I hope he will be my mentor for many more years. I thank God for him and pray for his longevity  But many PRI trained therapists have been helpful at some point. I recommend the PRC annual meetings because they generate great discussion and help you build relationships so you have more life lines from which to choose.

8. Did selling your practice to the hospital change the way you approach PRI concepts?
Not at all. You must always choose to do what is right for the patient. When I sold my practice, my VP at the time said, “We want you to continue in the same entrepreneurial spirit that you have always shown in the past”. Sanford knew and agreed that this clinic would require more CE than the average P.T. or clinic. My current VP is very supportive of PR. Sanfordhealth.org will soon have a webpage on Postural Restoration that I am creating so that patients in SD, ND, MN, and IA will be able to more easily find a provider in this specialty area.

Liz, after working with a couple different large organizations you branched off and opened up your own business.  Currently, you are owner and president of Launch Sport Performance.  Tell us a little bit about your business and also how your previous experience led you to become a private business owner.
Let me put it bluntly, being the only PRI therapist in a large organization doesn’t make you the favorite…it makes you the “odd” one.  I think it is common for PRI trained therapists to get some resistance from their peers and colleagues.  We do back exercises with balloons.  We dirty up walls by putting our feet on them.  We assume that people are walking around out of their hip socket(s).  They don’t understand it.  Our work environment can be stimulating or limiting; it shapes us. 

I felt an inner pull toward private practice so I could serve patients to the best of my ability….giving them as much time as they needed, not the amount of time reimbursed by an insurance company.  I wanted to be free to practice rehabilitation the way my mind and heart thinks it should be done.  I wanted to create a healthy environment where learning could happen, where new ideas can be pursued and expressed, and where I would be encouraged to go against the norm rather than to “go with the flow.” 

That being said, I went into private practice.  And it has been the best career move I’ve made this far! 

Launch Sport Performance was started in April 2010.  It started with one rented office space in a local gym. I got word-of-mouth referrals and walk-in “gym rats.”  Now it’s expanded into a Postural Restoration Certified Center and a three person business that operates out of an elite sports performance center in Bethesda, MD.  We have two physical therapists and one executive assistant.

Kristen Spencer PRC, MPT was added to the business when she moved to Maryland from Georgia.  She has been an excellent addition with her passion for sports and performance.  Kristen treats patients at the clinic, while managing mom and wife and military duty.  She has recently gotten involved in our local figure skating community and has become known as a local expert in relating PRI concepts to figure skating.  Watch for her work to come out in literature…! 

As for me, there is no such thing as a “typical day in the office.”  I am fortunate to work with professional athletes from many teams and multiple sports.  I travel a lot and consult with athletes, teams, and large organizations.  I have the opportunity to do some independent research here and there for sport-related devices.  I am a clinical instructor for DPT students, and I get to do some classroom teaching here and there.  When I’m not traveling around, I see patients at the clinic or at their homes/offices.

We operate as a cash-based clinic.  We do not accept insurance.  Out of corporate social responsibility and the leanings of our moral values, we adjust our rates so we don’t limit accessibility to certain sectors of our country’s socioeconomic status.  We would prefer that patients go through a full course of rehabilitation, than just affording one or two sessions.  This cash-based system has proven to be hastle-free and really is embraced by the patients.  They seem to take more responsibility and pride in their rehabilitation process if they are paying for it.  And it is a good accountability factor for us…our patients need to find value enough in our services to pay for their treatment.  Acting as autonomous practicitioners, and having direct access, allows physical therapists the freedom to choose this type of business set-up.  I strongly encourage others to try it. 

Aside from running your own business, you have also served as the Team Physical Therapist for the Washington Nationals Baseball Club and also for the Maryland Stingers Women’s Rugby Team.  Tell us how you became involved with these athletic programs.
My relationship with the Washington Nationals began when I received a phone call from the team’s orthopedic surgeon asking for me to send him my resume immediately. Without time for questions, I emailed it to him…..come to find out that he submitted it to the Nationals GM for consideration for the team physical therapist position.  Long story made short, I got the job.  An absolute dream come true!  Later, I found out that the doctor had purposefully been sending me his “difficult” patients for a year…and was pleasantly surprised at the good outcomes, so he thought I deserved a chance to work with the pros.  He would tell his patients “Go see the voodoo doc, I have no clue what she does, but it works.” 

The Maryland Stinger’s Women’s Rugby team affiliation began after I treated the team captain for a “really bad neck.”  She was told by a physician that she needed to retire from rugby…but that just wasn’t an option in her mind.  It’s the same story that many of you face; a patient walks into the office and gives you the history of already seeing multiple physical therapists, doing exercises at home that didn’t really help, and trying all kinds of modalities.  Come to find out, she couldn’t breathe!  So PRI was the perfect thing for her…and it worked!  She found restored faith in the field of PT and asked if I would be willing to be their team PT.  I accepted, gratefully. 

I’ve realized that these opportunities are a healthy balance of what you know and who you know.  I truly believe that the reason I got both of those positions (and many other sport affiliations) is because of Postural Restoration.  No doubt.  It sets me apart from other mainstream PTs.  It’s all about those PRC initials. 

Are you currently involved with any other athletic programs?
I’ve been blessed to be involved with the NFL Combine, Washington Nationals, Washington Freedom, Maryland Stingers, USA Track & Field, USA Bobsledding, Under Armour Senior Bowl, NSSF Track & Field National Championships, US Olympians, Reebok Running School, private ballet companies, Penn Relays, and Nike Football Combine.  These are ongoing commitments along with private, pro athlete contracts.  Life is good!  I love my job 

On top of running your own business, you have managed to stay involved with current continuing education.  Aside from attending courses offered through the Postural Restoration Institute, what other continuing education courses have you found beneficial to the way you run your practice?
I’m a big nerd and I love to learn.  My favorite courses are PRI courses.  Big shocker!  I’ve gone to the PRI courses multiple times and I feel that I learn new things even the 4th time I’ve taken a course. 

But, to be a well-rounded practitioner, and better serve my patients that are pro athletes, I desire to know more about their world.  I need to know techniques that their team athletic trainers are using on them.  I need to know acronyms that team doctors use in their written referrals.  So, I’ve attended Graston courses, Visceral Manipulation, Trigger Point Therapy, Michigan State Manual Medicine, Institute of Physical Art, and Active Release Technique courses. 

In terms of strength and conditioning, I’ve attended Perform Better Functional Training Seminars, National Strength Professionals Association courses, Professional Baseball Athletic Trainers Association Annual Meetings, and done the CSCS certification readings (testing soon!). 

Finally, as a doctor of physical therapy, I feel that it is important to keep up with the latest medical information, too.  I really enjoy attending Grand Rounds at local hospitals, going to symposiums, and doing small group discussions on differential diagnoses. 

In 2010, you completed the process of Postural Restoration Certification.  What made you decide to take part in this process?
There were three main things that went into the decision to pursue the PRC initials; (1) acquiring TRUE knowledge, (2) serving patients to the best of my ability, and (3) because I’m competitive. 

I remember sitting in school saying to myself “There has to be more to this [physical therapy] than Theraband and modalities.”  I was bored with straight leg raises, ultrasound, shoulder sleeper internal rotation stretches, and everything to do with traditional outpatient physical therapy.  I had a thirst for something real and true…then along came Ron Hruska.  Since the first day I learned about PRI I was hooked, and knew I wanted to pursue PRC.  I seemed to understand this material on a gut level and it made sense to me in terms of anatomy and physics.  I was so lucky to have been exposed to PRI as a DPT student. 

In life we are given gifts to use to serve other people; thus, I feel a strong professional responsibility to serve patients to the best of my ability.  I never felt comfortable telling a patient “You have scapular dyskinesis and you need to strengthen your scapular muscles.”  There was more to that story…but I didn’t know the rest of the story…until PRI.  I much prefer to tell patients WHY they have the dysfunction and HOW to get a lasting fix for the problem.  To me, that is professional excellence.  Any practitioner can visually identify altered biomechanics; that is a learned skill.  Most practitioners can pull tricks out of a bag and treat the uncovered dysfunctions; that is what we learn in school and continuing education.  But only PRCs can confidently explain why the problem happened and then successfully treat the root cause of the problem. 

And, finally, in the world of sports and performance, it matters to have a lot of initials after your name.  It is a competitive world.  Who can have the latest credential?  Who has the most credentials?  Blah, blah, blah.  Sadly, the significance of those initials doesn’t really matter.  To me, PRC are the best initials to say that I work really hard at finding the root cause of the issue and giving the patient a lasting solution.  PRC is my competitive advantage.

What advice would you offer other’s interested in Postural Restoration Certification?
Be prepared to verbalize your rationale for everything!  There are some right and wrong answers, but there is a strong respect for a good rationale behind either answer.  PRC is about putting the pieces together and connecting the dots; it’s about integration.  It’s not about regurgitating memorized patterns and ligamentous muscles.  Know the information, don’t simply memorize it. 

Last year was a busy year for you professionally, any big plans for 2011?
Of course!  I’ve got plans in the works right now…a bigger business plan, more certifications, getting some research projects published, and teaching some PRI concepts in a university curriculum.  However, the big 2011 dream is to get PRI integrated into the sports world of performance, conditioning, and strength training.

Jen graduated from the University of Vermont earning a Bachelor’s of Science in Physical Therapy.  Jen began her post-graduate study in Postural Restoration in 1998 and was one of the first therapists in Vermont to earn Certification in Postural Restoration. Jen and her husband Chris opened their own practice in 2002. Poulin Performance specializes in Postural Restoration principles and Sports Performance programs.  She has mentored many therapists, trainers and students and is eager to begin teaching Myokinematic Restoration next year. In her free time, Jen enjoys running, skiing, snowshoeing and spending time with her husband Chris and daughters Madison and Devon.

Tell us about your background and current practice.
I am a 1991 graduate of the University of Vermont.  I began my study of PRI in 1999 when the Institute was just beginning.  I knew right away that PRI concepts were what I was looking for in my practice.  My husband Chris and I own two practices in Vermont. Poulin Performance and Rehab is located in South Burlington and Poulin and Associates is our partnership located at the Green Mountain Valley School in Waitsfield.  Vermont is a great place to live and work if you love the outdoors!  Most of our patients are active Baby Boomers and their kids.  We see primarily orthopedic injuries brought about by sports or physical lifestyles activities.  Our practice integrates PRI concepts into a Wellness Sports Performance model, which allows us to take our clients to different levels once they complete their PRI rehab goals.

You’ve attended many PRI courses over the years and completed Postural Restoration Certification in 2005.  Can you tell us about this journey?
I can’t get enough of PRI and Ron’s teachings!  I am often at courses because I am the forever student!  I always see things with a new perspective with every course.  One the best things about PRI is it is always evolving.  When the Institute announced the certification concept in 2004, I knew I wanted to not only be recognized for my commitment to PRI, but also become an advocate for the Institute to expose as many people to PRI.  I am proud of this accomplishment and feel certification was only the beginning of my professional development. 

Who have your mentors been over the years?
My first mentor was Jim Downs, PT.  Jim was my first business partner early in my career.  He taught me so much about business and giving back to the profession of PT.  Although Jim was not a PRI therapist, he continues to support my efforts to grow as a therapist.  It was a difficult decision to leave our original partnership, but I respect Jim for who he is and what he taught me to stand for early in my career.  Ron is my obvious PRI mentor and both these gentlemen gave me the strength and courage to take risks and not be afraid to stand up for what I believe in.  My more recent mentors are James and Mike.  I have learned so much from these two and look forward to this training year to continue to grow in my clinical application and teaching techniques.  They bring honesty, compassion and a sense of humor that will be hard to follow!

What areas of professional practice are you most passionate about?
I love working with runners!  I know they are a crazy group, but after the birth of my first daughter, I took up running and now I can relate to the craziness of the sport!  Must be those Endorphins! Runners as a whole LOVE PRI and they are so accepting of the whole body approach.  I treat the age range of runners, from the middle school athlete to my 70 year old marathon runner!

You are very active in education outside of patient care. Can you share with us your experiences or tell us about the projects you are involved with?
I have mentored many therapists over the years and helped them integrate PRI into their practice.  I LOVE seeing the light bulbs go off and when they have success with what seems like the simplest exercise.  We have reintroduced Clinical Education into our practice; it is great to open the minds of the PT students during the affiliations at our practice.  I am proud to announce our latest student Cory Billows will be joining our practice this summer!  I look forward to mentoring Cory on his PRI journey.  Chris and I have been very active in community education.  I have spoke to many civic groups, doctors’ offices and high schools on the PRI methods in Physical Therapy.  Most recently I spoke at a Civic Group and my first mentor Sam Feitelberg, PT was in the audience.  He is still active with the profession and I was honored to have the role reversal!

We are absolutely thrilled that you will be joining Mike and James in teaching Myokinematic Restoration next year!  What most excites you about this opportunity?
I believe all things happen for a reason.  I met Ron at a time in my career where I was contemplating leaving the profession.  I did not feel I was really connecting the dots and helping people.  They liked me and liked coming, but my standards of care were higher.  I look forward to sharing my story and personal experiences with the therapists who attend my classes.  I hope to turn things around for just one therapist who has or is walking the shoes I was wearing the day I met Ron.  Physical Therapy is such an amazing profession and we all give so much time and effort to the study.  I look forward to sharing Ron’s wisdom with others to help them see the human body through a different lens.

Each speaker brings a unique perspective to the course material and a unique presentation style.  Can you tell potential attendees what they might expect from you?
I hope to teach a humble, honest style with a clinician’s perspective.  I want the attendees to leave excited about PRI and ready to sign up for the next class.  I will bring a lightness, common sense and sense of humor Northern style!  Mikes’ got that Southern thing covered!  I will hope to unravel some of the mysteries of PRI on the very foundation of concepts.  Myokinematic Restoration is often the first class therapists take; I want to teach it in a way that they can go back on Monday and begin integrating PRI into their practice.  I am looking forward to joining the Faculty and am honored by this opportunity!

Can you give us a brief overview of your professional background and perhaps discuss any mentors who have been influential in your life?
I attended St. Louis University and graduated in 1983 with a BS in PT.  After my first year of work, I wanted to know so much more and so returned to grad school while continuing to practice.  I completed a Master of Science in Research in Anatomy and Neurobiology and continued in the doctoral program in 1989 during which I completed original animal research that investigated the effect of ultrasound with hydrocortisone on the morphology of joints.  This research was presented at national and international conferences. 

All through graduate school, I continued to work in outpatient rehab, working in orthopedics & sports medicine, working primarily with endurance athletes.  I also had an opportunity to work in the pitching staff of a Major League Baseball team.  I found that I was drawn to the more complex patient problems and eventually took a job working as a member of a multidisciplinary team at St. Louis University Pain Management program.  Working as part of this team was one of the most challenging and rewarding things I have done in my career.  It was here that I developed a real appreciation for interdisciplinary integration of patient care.  However, because of the ever-changing nature of the business of medicine, over a period of time, this program was dismantled, eventually opening the door for me to join with some colleagues in developing a private practice that operates along the same line.

As the profession has moved toward an entry-level doctorate, I decided that I wanted to have the highest credential of my profession and so I enrolled in the DPT program at Des Moines University.  I was the Graduate with Distinction in the 2007 graduating class from that program.  This degree has helped me to broaden my understanding of rehabilitation and to consider the patients underlying and co-morbid medical conditions in the development of a treatment plan.  Having a better understanding of what is going on with a patient systemically can have a significant impact on their ability to engage in and fully benefit from rehabilitation.

Mentors:
I have been very fortunate to have several outstanding mentors during my career.  First, my orthopedics professor, Mary Lou Kopp, has continued to mentor me throughout my career.  She has helped me to think through patient problems in a much broader and more complete way.  She has forgotten more about joint function than I will ever know.  We continue to meet regularly. 

While working as part of the Pain Management team at St. Louis University, Dr. Raymond Tait began to mentor me.  Dr. Tait is a Research Psychologist and he continues to teach me much about the world of research, especially in the area of pain management. 

Dr. John Yetter, a sports medicine physician and Dr. Larry Berarducci, a cardiologist, both have very similar treatment philosophies and have always been available to consult on a broad range of professional matters.

You currently own your own practice, CORE Rehab Services in St. Louis, Missouri.  Tell us about your practice.  Do you specialize in any certain area?
CORE Rehab Services was established over 10 years ago as an independent multidisciplinary pain management program.  My business partner, Mark Murray and I decided to open this practice in order to have some sense of autonomy in the ever-changing business of health care.  Working for a corporate health care company did not allow us to spend the kind of time we needed to with our patients.  We have purposefully kept our practice small and have few network contracts in order to allow us to practice as independently as possible.  Clearly, we must be doing something right, because we continue to be a thriving practice ten years later.

We frequently receive referrals from our colleagues in the area for some of their more difficult patient problems.  A typical patient referral may be one with multiple pain complaints and complex system involvement.  The patient that we often see has been through and failed multiple different treatment programs.  Other clinicians and facilities may find these patient types frustrating, but we excel at treating them.  We are fortunate to use a team approach, including biofeedback and psychological services to help us deal with the long-term effects that impact patients with these types of pain problems.

You are an experienced teacher at the University level and for continuing education. Can you tell us what courses you are currently teaching?
I am currently serving in an advisory capacity for a transitional DPT program working with students with their capstone projects.  I also have a series of continuing education courses that I teach offering an integrated approach to treatment of cervical, thoracic and lumbopelvic dysfunctions.  Additionally, I work with St. Louis University in the Practical Anatomy Workshop to develop and present a variety of course offerings that have an anatomical dissection component to the course.  Recent and upcoming offerings include ‘Anatomy of Respiration’ ‘Treatment of Non-Surgical Scoliosis’ and ‘Treatment of Tempromandibular Disorders’.  These courses include anatomy prosection and we always incorporate medical/dental aspects of these problems in the course program.  This sort of multidisciplinary teaching approach helps to engender communication among health care providers from various disciplines.

As you know, Postural Restoration is an approach that promotes ‘integration’ of the systems of the body as well as ‘integration’ of professional disciplines.  Who do you find it helpful to integrate with and why?
When I perform an initial evaluation, I always gather systems review information.  In accordance with the direction of the APTA, I believe that it is important to have at least a cursory knowledge of how various organ systems function.  As a PT, I know that there is much that can be done from a physical therapy perspective to influence these systems.  When I took my first course from the Postural Restoration Institute, I was very excited to see that this is definitely the approach of the Postural Restoration Institute.  The underlying philosophy of PRI fits in so well with the philosophy of CORE and I believe this should be the direction that the profession of physical therapy should go. 

CORE Services, Inc. was founded as a multidisciplinary practice, so we naturally integrate different disciplines into our regular treatment programs.  Our practice consists of physical therapy, biofeedback, neurofeedback and psychological services.  We also have relationships with a number of providers from other medical disciplines.  Specifically, we work with an neuro-optometrist, a pedorthotist, several dentists who specializes in TMD, a pulmonologist who specializes in evaluation and treatment of sleep disorders, several GYN’s and endocrinologists who help identify and treat endocrine disorders that have an impact on our patients neuromusculoskeletal problems and a neuropsychiatrist, who will be presenting at this course and who is a very skilled clinician that seems to be able to correlate many of these problems that we find in our patients.

Coming in April, PRI is hosting its 2nd Annual Interdisciplinary Integration course that includes you as a guest speaker.  You will be presenting on the 4th day – Rest Integration.  What do you plan on covering in this course?
We are planning to present an overview of sleep architecture and sleep hygiene.  In order for the attendees to understand how sleep impacts their patients, we will discuss the vital functions that sleep provides for optimal function.  We will discuss normal and disordered sleep and learn about sleep studies.  We will present examples of sleep studies and discuss how to interpret the studies and suggest how that interpretation might impact the rehabilitation process.  We will introduce the research that suggests that certain types and/or stages of sleep are critical for motor learning and motor planning.  The timing and quality of sleep seems to have a more important role in successful rehab than we might have understood before.  We will discuss some ways that course participants can recognize patients who may have sleep disorders and suggest some screening tools that can be utilized in an average clinical setting.  We will also discuss appropriate intervention and suggest ways for participants to identify individuals in their professional communities with whom they may collaborate to identify and treat patients with sleep disorders.

During this course you will introduce us to Dr. J. Paul Rutledge, MD who is a Neuropsychiatrist in St. Louis. He will also be presenting.  Tell us a little bit about him.  How did you two end up working so closely together?
Dr. Paul Rutledge and I have worked together for a number of years.  Dr. Rutledge has been practicing psychiatry in St. Louis for over thirty years.  During the course of our professional relationship, Dr. Rutledge and I have had the opportunity to co-treat a number of patients.  Through discussion with him, I was first introduced to the study of sleep and sleep disorders.  Many of the patients that we see together have sleep disorder as part of their problem set and Dr. Rutledge’s in-depth knowledge of this area has led to substantial improvement in patient treatment.  I refer patients to Dr. Rutledge who seem to have a sleep disorder and who may also have an over-arching depression or other psychiatric disorder, as is often found in patients with chronic pain disorders.  By adding this dimension to the patient’s care, we seem to have a better overall outcome.

What topics does Dr. Rutledge plan on covering at the Interdisciplinary Integration Course?
Dr. Rutledge will be discussing the evaluation of patients with sleep disorders and will discuss the interplay between sleep disorders and psychological and psychiatric disorders.  He will also discuss the impact of certain medications on sleep disorders and the role of various medications in the treatment of sleep disorders.

How do you see PRI and your area of expertise working together in the future?
As discussed above, I see a close relationship in the philosophy of the Postural Restoration Institute and the practice philosophy of CORE Services, Inc.  I believe that the integrative and interdisciplinary approach defines physical therapy.  We will continue to work with PRI to promote this approach.

Aside from the Interdisciplinary Integration course in April, do you have any other projects you are working on in 2010?
We continue to work to improve our facility and our delivery of patient care. 

We are working toward developing some new niche markets that are particularly appropriate for our area of skills.

We will be offering a number of community education classes including some in the areas of women’s health for those over 50.  This class series is called ‘Red Hot Red Hats. Other community class offerings will be geared toward the ‘weekend warrior’ athletes and we are hoping to do a ‘coaches clinic’ with Dr. Cyd Williams that will have a strong component of PRI concepts. 

We have a significant amount of continuing education projects, including expanding to level II courses for both the Lumbopelvic and the Cervicothoracic courses. 

My professional goals include becoming Board Certified through the APTA as an orthopedic specialist.  I will also be expanding my skills in the areas of manual and manipulative therapy.

Janie received her Bachelor of Science in Business Administration from the University of Nebraska-Lincoln and her Physical Therapist Assistant certificate from Clarkson College in Omaha, Nebraska. Her background in both business and physical therapy has provided a foundation for clinical and administrative roles at the Postural Restoration Institute. As Education Coordinator, Janie specializes in course development and creation of education materials and resources. As Director of Certification, she is growing a national network of therapists identified as leaders and advocates of Postural Restoration.

Tell us about your background.  When did you first start working at the Institute?
It’s been ten years already! I started at PRI after graduating from Clarkson College in Omaha with a PTA degree. I then went on to complete my Bachelor Degree in Business Administration at the University of Nebraska – Lincoln.

How has your position evolved?
Looking back gives me some perspective of just how much the science and Institute have grown. I knew back then that I had come into something very exciting; that the work we were doing was very important and the science could have such a profound implication for physical medicine. I’m not sure I could have predicted just how far we could come in such a short time.  To think that we now have certified 40 therapists from across the country, that PRI courses are translated and instructed in other countries, that we have compiled hundreds of techniques on CD’s and DVD’s… it’s pretty awesome.

Tell us about your role at the Institute?
As the Education Coordinator I plan the course dates and locations, manage speaker schedules, complete many CE applications, strategize our advertising and marketing plans, respond to many emails and phone calls and work closely with Ron, Bobbie, James, Mike and our PRC therapists on a number of different projects. Each day has its own unique challenges and opportunities.
As Director of Certification I see that our PRC therapists stay abreast of PRI course development and clinical updates, oversee the application, review and testing process and see that the process continues to grow.

There are a lot of new things taking place at the Institute.  What can we look forward to in 2010?
We are excited about our Interdisciplinary Integration course this April. This will be only the 2nd year for this course. The idea of bringing together professionals from such diverse backgrounds and areas of expertise to find commonality in treatment is the very mission of PRI and what identifies our Institute. We have 3 new speakers for this course: J. Paul Rutledge, MD, Neuropsychiatrist, Julie Hereford, DPT, and Curt Johnson, PT. Also new for 2010, a course titled, “Pelvic Floor Dysfunction” taught by Heather Engelbert and Lori Thomsen. Bobbie and my project list for 2010 includes the release of a 4th Edition CD of new PRI techniques. And I’m certain we will see some exciting opportunities next year that are unforeseen today.

On a different note, we will soon begin major renovations to our PRI office here in Lincoln. This includes a PRI Reference Library complete with electronic library software. The hundreds of PRI references will be easily accessible to all!

What new course locations are being offered in 2010?
We have first time host sites in Connecticut, Maryland, Virginia, and New Mexico. I’m hoping to confirm additional courses for 2010 later this week or next week.

Let’s hear about some fun facts that others might not know…

What course is the most popular course taken?
Without looking at any statistical data, I would say Myokinematic Restoration.

How many courses does PRI typically offer in one calendar year?
In 2009 we scheduled 42 courses. 2010 will have a similar number of planned courses. We try to leave some room for the unexpected. This past year, we added courses in South Korea and a presentation in Poland.

Is there any strategy to planning course locations or is it based off of request?
A mix of strategy and request. When a course is requested, we will always try to make that happen. For 2010, we received a record number of hosting requests. Many of the requests were from clinics in the Midwest and Northeast so the schedule is weighted in those areas. Strategically, we try to make courses available in all regions of the US and staggered throughout the year.

I’m sure you have heard and witnessed some funny stuff at courses.  What’s the funniest story about Ron Hruska that comes to mind?  James Anderson? Mike Cantrell?
I’ve been waiting a long time for this opportunity!

Ron is notorious for leaving his laptop and projector lay right outside his hotel room door when traveling.  Some nice person will always knock on his door and give him back his (expensive and irreplaceable) equipment needed for the next day.

If we had a “speaker of the year” award, James would have claimed the prize last year. After a canceled flight, a rental car and an overnight Greyhound bus ride he made it to a course where he taught 12 attendees! Now that is what I call dedication!

I’ll always remember Mike’s prank phone call during a course break. He has a sense of humor and ability to disguise his voice unlike any other! Fifteen minutes is all he needs to get everyone laughing for the remainder of a day (and longer!).

Gregory has earned the designation of Postural Restoration Certified (PRC) as a result of advanced training, extraordinary interest & devotion to the science of postural adaptations, asymmetrical patterns & the influence of polyarticular chains of muscles on the human body as defined by the Postural Restoration Institute™.

“I feel I have been using a PRI – like approach (of course not to this extent) since my graduation in 1992 from the Academy of Physical Education in Warsaw, Poland which had a very strong Biomechanics Department. I continued my quest for more knowledge through continuing education courses offered by the University of St. Augustine (Manual Therapy Certification -2002) and the McKenzie Institute (Certified MDT-2005). Both of them, however, fell short in explaining human biomechanics, relating one body part to another, treating our body as a whole unit, etc. Ron Hruska was the first teacher/practitioner who was able to correlate the left side to the right in a logical, biomechanical way which I have been looking for since my graduation in 1992.”

You, Ron and Jason recently returned from Poland where you presented at the 1st International Congress of Polish Rehabilitation and also taught the PRI Myokinematic Restoration review course. How did this opportunity come about?
For the last couple years, myself and Michal Niedzielski were working very hard to promote PRI concepts in Poland. I do believe that we were successful enough that with the help of our friends (among them Dean of Academy of Physical Education) Ron was invited as the only clinician to speak at the opening ceremony. The opening ceremony was well attended by at least three hundred medical professionals from Poland and other countries.  I had a chance to introduce Ron who then spoke about PRI and his passion using Power Point slides with Polish translation.

We know that Ron was the only speaker to present to the entire congress. Can you tell us why you think he was given this opportunity?
As I mentioned before, it was the result of interest that has been growing in Poland since our last trip in March 2009 and the involvement of our friends in spreading the PRI information.

Who were the other speakers involved in this first Congress and what was their primary area of expertise?
There were few other speakers from Europe and Japan. Among them Prof. Junichi Iiyama, (Kumamoto Health Science University, Faculty of Heath Science, Department of Rehabilitation, Kumamoto, Japan), Dr. I. Lauge Johannesen, (Department of Rheumatology, Spinal Cord Unit, Viborg Regional Hospital, Viborg, Denmark), Dr. Roberto Card( from Bolonia, Italy).

How was PRI perceived? Did you receive much feedback from those in attendance?
Ron is a very good speaker, so he definitely was able to attract many of those who didn’t hear about PRI before or knew very little. Everybody was impressed with the knowledge and expertise Ron has shown during each workshop.

Can you give us a description of the attendees? (ie. Number of attendees, nationality, professional background, experience levels)
We did two 4 hour workshops attended by PTs, orthopedic surgeons, family practitioners- I do believe that at least 60 people attended those during the Congress.
On Sunday, 9/12/09 we did an MI review course for approximately 12-15 attendees who took the MI course in March 2009 offered by Michal and me.

We know it wasn’t all about work though. There where a couple days designated for “play” as you guided Ron and Jason through your native country.  Can you give us a few of the highlights of the trip?
I don’t believe that I am allowed to share too much, as the motto of our trip was the Las Vegas advertisement statement -“whatever happens in Poland stays in Poland” ☺.
On a more serious note, I was able to share with them the history of my homeland and of course, food, which became Ron’s and Jason’s favorite. Ron had been preaching about the importance of breathing for years, forgetting about the second most important aspect of our life-the second source of energy, which is food. I am sure I was able to fill the gap.  I do believe that you will see significant changes in your clinic. You will find new display cases with “artifacts” (you can’t even imagine what you will find in them) and pictures from our trip.

PRI’s exposure in Poland began with you and Michal’s first course presentation. What do you think is the next step and/or the goal for PRI in Poland?
We will continue to offer courses and presentations to those who show interest in PRI concepts. We will follow the path that PRI institute pioneered so successfully in USA.

For all of us who have never traveled to Poland, tell us what we are missing?
I am positive we don’t have enough time to describe everything.  If I had only few words to summarize it, it would be history (Poland’s origin goes back to the year of 966) and pride and faith (the history of Poland is closely related to Christian faith).  I shouldn’t also forget about women named Anna (during the classes we did a practical portion using the members of the audience – 5 of 6 women who volunteered carried that name).

Estelle completed her Master’s degree in Physical Therapy at Springfield College in Springfield, MA where she worked with college athletes.  She founded LeClair Therapy, Inc in 1997 and joined as co-owner Essex Physical Therapy in 2001.  She has studied Craniosacral Techniques with the Upledger Institute and has developed a strong background in sports medicine and overuse injuries with an emphasis in manual physical therapy.  Her practice specializes in the non-surgical treatment of back, neck, hip, knee, and headache pain, as well as post surgical shoulder rehabilitation.  Her 16 years of clinical practice in physical therapy lead her in 2007 to the designation of Postural Restoration Certified (PRC).  Her passion for Postural Restoration science and patient interventions has lead to a reputation for successful clinical outcomes and the opportunity to provide in-services to physicians, physical therapists, coaches and athletes in the implementation of Postural Restoration in their practice.  Estelle is a member of the American Physical Therapy Association.  She works with student athletes in the Essex School District and has particular interest working with soccer, hockey, golf, and baseball players, as well as ballet dancers.  Estelle lives in Essex with her husband and her three sons.  She enjoys spending time with family and friends, walking with her dog, playing women’s and co-ed soccer, skiing, snowshoeing, golfing, and traveling.

Give us a brief history of your background and how you became interested in the Postural Restoration Institute?
I began out-patient practice in 1997 and had started to see some postural patterns in the objective findings upon completing initial evaluations with my patients.  PRI was introduced to me by one of my current coworkers who had purchased a copy of one of the CD’s and printed the exercises.  I began to use the exercises (prior to attending any of the courses) with a patient who had been to therapy with several other PT’s and had not had success.  He was scheduled for a lumbar fusion and within two month of starting PRI based exercises focusing on getting him to achieve left AFIR he cancelled his back surgery.  I was hooked!

Are there other areas of PT that you specialize in besides Postural Restoration?
My best friend from PT school, Gina Kozimor, and I have attended a course together every year to allow us to spend time together but also to learn new PT techniques.  She introduced me to Craniosacral Therapy techniques with the Upledger Institute.  For the past 2 ½ years Gina has been attending PRI classes with me! 

You’ve attended several PRI courses. Can you tell us about your first course and your initial impression of the material?
I took Myokinematic Restoration in May 2003 and then Postural Respiration in August 2003.  Initially, I was a bit of a non-believer when opening day Ron said something like, “we will help you learn how to treat shoulder tendonitis by repositioning a pelvis”.  Still to this day I hear the words ischiochondylar adductor over and over as Ron had one of the participants repeat it throughout the course.  It was a great way to emphasize the importance of this muscle to achieve left AF IR.  At the time, I had been struggling for 18 months with bicep tendonitis.  Ron gave me two exercises to do while I was attending the course and by the second day I was amazed at how much better my shoulder felt.  Having had my own personal experience with the success of PRI techniques made me a believer very quickly!  I found that after the first course about 80-85% of my patients were getting better with what I had learned at the first conference.  That is when I signed up for Postural Respiration. 

In 2007, you earned the designation of Postural Restoration Certification through the Postural Restoration Institute.  What made you decide to go through this process?
When I attended the Advanced Integration course I found myself asking so many questions during the break time.  Mike Cantrell, MPT, PRC happened to be sitting nearby and he was the therapist that suggested I look into certification.  Ron said it would be a great learning experience for me and it truly was!  The preparation for the certification was by far one of the best learning experiences I could have ever had.  I just knew that this treatment approach had helped me to assist so many other people through my practice and I wanted to learn as much as possible to help my patients get the best care I could provide.

Was PRI something you were easily able to incorporate into your clinical skills?
Most definitely!  We use some piece of PRI with every patient in our practice.  We love the do’s and don’ts postural handout and give it out upon initial evaluation.  We have the file system of all the exercises which is incredibly helpful and each therapist has a binder of the exercise snippets from the CD’s.  At least half of our staff in services are PRI review sessions.  I love the fact that through the use of PRI exercises my patients are learning how to take care of themselves and to better manage their bodies.  We send everyone home with a “toolbox” of exercises to manage not just what they are currently struggling with, but we try to integrate an exercise that might be great for their current problem as well as help with the old shoulder instability issue they have that isn’t currently problematic.   

Since becoming certified, you have become interested in PRI and aquatics.  Can you tell us a little bit about your future plans with this?
I have the opportunity to co-treat with patients in the pool environment as my business associate Veronica Paquette has a pool facility just adjacent to our land office.  Veronica is a certified aquatic therapist and we have begun working together to use the aquatic medium with PRI based concepts in mind.  It is my goal to bring the Prism pool to our new facility in the Fall 2010 or Spring 2011.

Any other big projects you plan on working on in 2009?
In 2009, we began to work with Dr. Coffin on PRI orthotics for our clients and have had tremendous success with them.  Several of our clients have happy feet thanks to Dr. Coffins work.  We thank him very much for working with us. 

We are very excited to announce we celebrated our ground breaking ceremony yesterday on a new building for a second location in Essex, VT.  Our new 4000 sq ft land facility is scheduled to open in March of 2010. Our future plan includes a 2000 sq ft aquatic facility at this location to house the Prism pool.  It is very exciting to bring to our community such a great facility for rehabilitation.  I hope to become a New England host site for PRI conferences in the near future.

Oliver worked with both the general population of Waitsfield and surrounding areas, as well as the student athletes at the academy. Working in this setting, Oliver treated a wide variety of injuries from chronic back pain to post surgical ACL rehabilitation. In December of 2005, Oliver’s interest in biomechanics and movement patterns led him to become one of the first twelve therapists in the country to be certified in Postural Restoration. He has presented to physicians, rehab specialists and ski coaches on this approach. Oliver has an extensive background in alpine skiing which includes: attending ski academies in Switzerland and Norway, racing for the British National Ski Team (representing them at the 1996 World Championships) and racing for the University of Vermont Ski Team. After his racing career, he coached at the Green Mountain Valley School and provided injury care and rehabilitation for the student athletes. He has treated skiers of all ages and abilities from novices to national team athletes. In April 2007, Oliver opened Inspire Physical Therapy. He lives in Essex with his wife Jessica and daughters Anna and Sarah. He enjoys skiing, biking and most other sports.

Can you give us a brief history of your background and how you became interested in the Postural Restoration Institute?
I first came to the US in 1998 to study PT and alpine ski race at the University of Vermont (I’m originally from England). After graduation I continued to combine these 2 passions by working at the Green Mountain Valley School ski academy in Waitsfield where I was able to split my time between coaching and working in the on-site PT clinic. After my first year, the PT clinic changed hands and was taken over by Jen Poulin who introduced me to PRI.

You’ve attended several PRI courses.  Can you tell us about your first course and your initial impression of the material?
The first course I took was the back-to-back Myokinematic Restoration and Postural Respiration in 2003. Some of my co-workers had helped me start using PRI a few months earlier and I was very encouraged with the initial outcomes, but I had a LOT of questions. I remember being challenged with the concept of tri-planar positioning and movement. When Ron was talking about an anteriorly tilted pelvis on the left my uniplanar mentality said that this should improve hip extension not limit it.  I asked the question and Ron explained that the restriction was a result of the pelvis being anteriorly tilted on the left as well as oriented to the right that caused the left hip to be positioned in relative external rotation putting tension on the left ilio-femoral ligament. This was the first time that material was presented that pulled the entire body and its multiple systems together rather than being an assortment of joints that were all supposed to co-exist independently of one another. I came back from these courses (and all subsequent courses) very excited about the new information and how it would impact my patient care. I read the manuals over and over trying to get my head around what Ron had taught.

Has PRI changed the way you practice, if so how?
Absolutely! After the first courses I took there was a period when I would treat any non-surgical patient with PRI techniques and any surgical patients with traditional stretching and strengthening. I soon found that the surgical patients would often develop “new” problems that needed to be corrected with PRI methods. Now EVERYONE gets PRI exercises. By using PRI philosophy and techniques I have enjoyed being able to give patient’s more independence in their own care. In my first year out of school I worked in a clinic that would see patient’s 2-3x/week to perform the same stretches and manual techniques over and over with very little patient participation. Now I typically see patients every 1-2 weeks and feel that I have a system in place to give them exercises that will make positive changes, re-evaluate them a week or two later and then have a clearly defined progression in place that I want to work along as goals are met. Compliance with HEP’s has also improved significantly since using PRI.  If you can explain to a patient what an exercise is for and then show them objectively the changes that it makes they will do the exercise (in most cases). This was even the case with the ski academy students, most of who were living away from home.

Who have your mentors been over the years?
After the initial few courses, my commute to work with Vance Schug (who had just taken the same courses) became a time to go over PRI material. We would go over patient cases, try to reason through our understanding of the manuals/courses and apply PRI thinking to skiing. Since certification Ron, Janie and Bobbie have been my go to people whenever I have questions. I’m very appreciative of the time and advice they give.

Which areas of patient care excite you most?
I enjoy working with back/neck pain patients and with sports injuries (particularly from skiing). Within this pretty broad spectrum of injuries I get particularly excited about working with people whose injuries have become chronic and have tried many other therapies without success.

In 2005, you earned the designation of Postural Restoration Certification through the Postural Restoration Institute.  What made you decide to go through this process?
After looking at the select list of the first therapists to become certified I felt pretty intimidated to even apply for certification. Then two of my co-workers Jen Poulin and Maura Guyer said that they were going to try to get certified and asked if I would be interested too. That was all the encouragement I needed. Certification made sense for a number of reasons: PRI is something that I am passionate about. I wanted to support the Institute and try to adhere to a set of standards that they have set. Having the PRI certification made sense for adding weight to anything I do to promote PRI in Vermont.

Has becoming certified presented any new opportunities you feel you wouldn’t have had otherwise?
It has given me more opportunities to present to others within the medical fields and has also brought in patients from further afield. Having the PRC updates are also wonderful for keeping up to date.

You opened up your own practice a couple years ago, tell us a little bit about your practice.  What types of patients do you most often see?  Who is your primary referral source?  Are people familiar with Postural Restoration in your area?
I opened Inspire Physical Therapy 2 years ago. The majority of patients have either back/neck problems or sports injuries. Only a small group of patients have heard of Postural Restoration prior to beginning treatment. Our referring physicians however are starting to write Postural Restoration on their referral slips. There is even one doctor in town who warns his patient’s that I will give them exercises that look like they are out of a circus show, but to do them anyway because they work.

Do you have any other professional plans for this year?  Any big projects you plan to work on?
I want to make it out to the Interdisciplinary Integration course and the PRC meeting this year. Other plans would include working to make skiing a safer sport.

Can you give us a brief history of your background?  How did you become interested in becoming an Occupational Therapist?
I considered OT and PT and became an OT because there is such a wide variety of treatment settings – from cognitive rehab to sensory integration to orthopaedics.  I graduated from the College of Saint Catherine located in Saint Paul, Minnesota in 1999 and shortly after was hired by a hospital in south-central MN.  Through the hospital I was contracted into a chiropractic clinic.  The treatment team consisted of a D.C., massage therapist and myself.  This integrated approach gave me the foundation to work in a multi-disciplinary setting with complex patients.

Tell us about your current work setting.  How many OT’s, PT’s, etc…how do you integrate together?
I have worked at IMPACT Physical Medicine and Aquatic Center for 7 ½ years and currently manage the occupational therapists.  Our medical director is a PM&R physician and we have 7 OT’s, 5 PT’s, a chiropractor and a massage therapist.  We provide land and aquatic therapy at our facility with PRI principles being the primary focus of treatment.  Our commitment to PRI concepts is so strong that the PRISM pool was developed and built at our clinic.  We have had the exciting opportunity to work closely with Ron Hruska to be the first facility to fully incorporate PRI principles into an aquatic setting.

Each of the therapists, whether OT or PT, has their own specialty area; we refer to each other to make use of each person’s talents. We truly take a team approach to treatment.  For example, an OT may initiate a myokinematic program and refer to PT for PRI based orthotics in order to provide additional proprioceptive input to achieve proper foot mechanics.

Are there certain areas of patient care that excite you most?
Our clinic specializes in chronic, multi-site pain conditions.  Often these patients have had many failed attempts at therapy in other settings.  What motivates me the most is being an OT who can work successfully and have positive outcomes in such a challenging environment with complex patients.

Over the years, you’ve attended several PRI courses.  How did you first learn about PRI?
My first exposure to PRI was watching a PT treat a family member utilizing PRI techniques.  The philosophy and rationale for treatment made a lot of sense and I started re-evaluating how I was currently treating my patients.  This PT then presented a Protonics course at our clinic in 2002 and from that point on I started taking PRI coursework.

What was your initial impression of the material?
Honestly, my initial impression was, “Why didn’t I learn this in school?”  As an OT, we are taught that the entire body/system functions as a whole but the treatment approach was a very traditional orthopaedic approach that treats one joint at a time.  PRI doesn’t treat just the symptoms at the joint, it treats the entire kinetic chain and the total body system.  PRI provided me with a paradigm/model with which I could evaluate, measure and treat that total system. 

Was PRI something you were easily able to incorporate into your clinical skills?
Absolutely.  PRI is a perfect fit for an OT because from the beginning we are taught to view the body as an integrated system.  The ability to fully incorporate PRI principles into everyday treatment requires years of dedication to coursework and patient care.  I have continued to improve my depth of knowledge by repeating PRI courses and ultimately completing the PRC process. 

You were one of the very first OT’s to go through our Postural Restoration Certification process last year. How do you see Postural Restoration specifically complimenting the OT profession?
Incorporating OT’s into Postural Restoration will provide additional perspective on the implementation of PRI with ADL’s and overall function.  I believe that PRI principles provide the foundation for addressing most orthopaedic and/or neuro-muscular diagnoses.  When I train new hires and OT students, I describe PRI as “a neurological approach to treating biomechanical dysfunction.”  Combining a neuro re-ed approach with biomechanics is an easy relationship for an OT to assimilate, since OT’s are integration specialists who focus on total body function. 

Has becoming certified presented any new opportunities you feel you wouldn’t have had otherwise?
The process of certification was a learning experience for me and it provided me the opportunity to evolve my PRI skills.  I am also hoping that becoming certified will increase awareness of what an OT has to offer in this practice area. 

In March, you attended a four day Interdisciplinary Integration course.  One of those four days covered Vision Vestibular Integration.  From what I understand, this is an area that was covered in your OT course curriculum.  Can you elaborate on this a little more?
We are introduced to vision rehab in school as related to a neurological event and taught how to assess, retrain &/or accommodate the person or environment.  Vision rehab is a very specialized area of OT and is not utilized in all settings.  We also have a background in sensory integration in which our role is to assess and provide proper integration of sensory input – which includes the vision and vestibular system. 

Is the material presented during this course going to be something you can use in your current clinical setting?
After attending the Interdisciplinary Integration course, I was able to add some of these principles to my previous knowledge base.  The next week I had a patient who had received vision-vestibular rehab previously and achieved a certain level of success.  By incorporating PRI principles with her vision program, she experienced a new level of challenge she had not previously had.

Another benefit of the Interdisciplinary Integration course was meeting with other providers who appreciate a neurological approach, including optometrists, dentists and a podiatrist.  We returned to our clinic with hopes of networking with these professionals to build collaborative working relationships.

Do you have any other professional plans for this year?  Any big projects you plan to work on?
I will continue to mentor OT students in order to gain awareness of OT in this non-traditional setting.  I’m planning to establish a role in the academic arena by presenting information re: OT and PRI concepts to students and faculty.

Later this fall, our OT group is presenting at MOTA (Minnesota Occupational Therapy Association) on OT and incorporating PRI concepts into treatment.  Two years ago we presented and the material was well received by the audience.

Michal graduated with a Master’s Degree in Physical Therapy from the Academy of Physical Education in Warsaw, Poland in 1992.  Prior to starting the Physical Therapy Center of Horseheads in 1996 with Joyce Wasserman, Michal worked as a physical therapist for the Arnot Ogden Medical Center.  In 2007, Michal earned the designation of Postural Restoration Certified (PRC).  He then returned to Poland to introduce concepts of Postural Restoration to hundreds of students and physiotherapists.

Can you give us a brief history of your background and how you became interested in the PRI?
In 1990 my best friend died in a car accident. While struggling with this loss I became involved with sports activities for the disabled. One of my colleagues created a fencing program for people in wheelchairs and invited me to collaborate in this effort. My engagement with this program provided me with the opportunity to become the director of a rehabilitation center for the disabled at the Academy of Physical Education in Warsaw where I received my MPT degree in 1992. The sports program for the disabled grew to eventually include 6 sports and a curriculum for all physical therapy enriched by active rehabilitation through ADLs.

While I did not know it at the time, my first experience with the theories associated with PRI occurred in my junior year of study in a Pathobiomechanics class taught by Professor Seyfried. In this class he assessed a woman with chronic right knee pain. After observing her gait he requested that she remove her right shoe and then asked an assistant to place tissue paper under her right metatarsal head. As a result the patient was immediately able to walk pain free. This experience was the first hint to me that there was more to physical therapy than what I knew at the time.

In 1994 I moved to the United States with the anticipation that I might find progressive physical therapy methodologies. I quickly realized that physical therapy in America centered on the conventional and conservative approach of treating symptoms which I now call the 2D (2-dimensional) approach. I began to ask myself: what is fundamental to human function? What are the principles associated with walking, standing, running, etc?  What then are valid functional tests?  And, ultimately, how do I define physical therapy? These questions invigorated me.

Finding the answers to these questions brought me to PRI.

You’ve attended several PRI courses.  Can you tell us about your first course and your initial impression of the material?
In 1996, Joyce Wasserman and I opened the Physical Therapy Center in Horseheads, NY. While looking for a knee table for quad sets a representative from EMPI showed us Protonics and allowed us to test the device for ten days. We quickly realized the effectiveness of the Protonics device and inquired with Inverse Technology regarding the history and origin of this product. They invited me to a weekend seminar in Rome, NY where I met Ron Hruska. In meeting Ron, I found an individual who had been asking the same questions that I had been asking. But more importantly, I found somebody who had revolutionary answers. By the end of the weekend I was convinced that the PRI curriculum would provide me with the methodologies to practice the type of physical therapy that would take me to from 2D approaches to “integrated 3D (3-dimensional) therapies”.

Who have your mentors been over the years?
When I was in high school I was generally more interested in sports than academics.  One of the topics that I was the least interested in was physics. A family friend, Mr. Chabik, who was a college physics teacher, took it upon himself to show me how physics impacts our lives every day. He taught me to look at problems in their entirety, to uncover what is important first, and to direct problem solving at the causal agents not at the symptoms. The seed that was planted by Mr. Chabik was cultivated during my time at the Academy of Physical Therapy in Warsaw with Professor Seyfried, this continued to grow during my years in the US and finally came to fruition after meeting Ron Hruska and my colleagues at PRI. Today, I consider integrated physics and more specifically “integrated 3D therapies” as the cornerstone of my physical therapy practice.

Which areas of patient care excite you most?
Like many of you, I am energized by making a difference in someone’s life. One of the truly unique benefits of the physical therapy occupation is the opportunity to make profound and lasting changes in your patient’s health and well-being. I consider this to be the reason that my work motivates me every day.

In 2007, you earned the designation of Postural Restoration Certification through the PRI.  What made you decide to go through this process?
Both my initial and subsequent interactions with Ron opened my eyes to the possibility of teaching PRI methodologies. Certification was the key milestone in this endeavor.  The curriculum also allowed me to deepen my knowledge related to biomechanics and osteopathy. 

Has becoming certified presented any new opportunities you feel you wouldn’t have had otherwise?
Yes, first I would suggest that completing the PRI curriculum broadened my understanding of physical therapy implications to areas beyond what I believed to be the more typically accepted limits of our field. In addition, completing the PRI curriculum has given me the chance to teach Myokinematic Restoration in Poland this March.

In March you and Gregory Parfianowicz are scheduled to teach the Myokinematic Restoration course for the first time ever in Poland.  How did this opportunity come about?
I introduced Gregory to PRI and he quickly developed a strong interest in the curriculum. Working with Ron, Gregory and I built a project plan with the objective of introducing PRI concepts to Poland. Our first step involved introducing PRI through a set of four seminars conducted in March 2008 in four different Polish cities. This March we will conduct the first module of our Polish PRI curriculum. Our hope is to follow up with annual offerings that will allow participants to become fully certified in PRI. Ultimately we hope to create a European center for PRI. 

What do you ultimately hope to see as a result of all your work in Poland?
We see the potential for European universities to be early adopters of PRI studies and methodologies. As this occurs we would further anticipate the need for ongoing European research to study PRI concepts. The European adoption of PRI will build exposure through research publications and increased graduate representation in our field.

Do you have any professional plans for this year?  Any big projects you plan to work on?
Right now Gregory and I are highly focused on the delivery of the Polish curriculum and the development of the European center. Our efforts after March 2009 will be focused on the March 2010 course offering.

Lori completed her Bachelor of Biology degree from Nebraska Wesleyan University in Lincoln, Nebraska and her Master of Physical Therapy from the University of Nebraska Medical Center. Her 11 years of clinical experience has resulted in a strong passion for the Postural Restoration science and patient interventions. Lori has recently moved back to the Lincoln area from North Dakota where she enjoyed providing in-services to physicians, chiropractors, physical therapists, coaches and athletes in the implementation of Postural Restoration in their practices. She currently practices at the Hruska Clinic, Restorative Physical Therapy Services in Lincoln, Nebraska.  Lori has earned the designation of Postural Restoration Certified (PRC) as a result of advanced training, extraordinary interest and devotion to the science of postural adaptations, asymmetrical patterns, and the influence of polyarticular chains of muscles on the human body as defined by the Postural Restoration Institute™.

During your career as a physical therapist, in what types of settings have you practiced?  How did you become interested in the Postural Restoration Institute?
I have practiced in acute care, rehabilitation, home health and out-patient physical therapy.  I had a strong interest in geriatrics and wound care when I first got out of physical therapy school.  I first got interested in PRI after moving up to North Dakota.  I was practicing in out-patient after having been in home health care for five years.  I wanted to get to a course to update my skills in the out-patient arena as I was feeling a bit rusty being out of this environment.  I had heard of Ron having practiced in Nebraska prior to moving to North Dakota.  A Myokin course was being offered in the Minneapolis area and after that first course it changed my career path and how I practiced dramatically.

You’ve attended several PRI courses.  Can you tell us about your first course and your initial impression of the material?
I attended my first course in the fall of 2003 in Minneapolis.  I remember the fall as there was a Husker football game that Saturday.  I was quite distressed with the inability to watch it on TV and called to get score updates during the breaks. :0)  I also remember passing this vital information along to Bobbie and Janie at the time.  Okay, I regressed here a bit.  Myokin was my first course.  I remember feeling behind the first hour of the course. Ron was talking about shifting into a hip and left AF IR and everyone in the room seemed to be following him, but me.  I remember staying up late and studying the first day (skipped watching more football on ESPN) to try to catch up but still felt behind.  I went to the course early the next day in hopes that Ron would be there to answer my questions…he wasn’t but Karen Jiran was.  She sat next to me in the front row.  She answered my questions, gave me her e-mail and phone number and I wasn’t shy about using them!  (See question 3)  After that first course, I studied the material and exercises in the evenings after work and after a couple of weeks I started implementing the material into my patient care.  The outcomes were amazing and I couldn’t get to the rest of the courses fast enough.  I finally felt like I was practicing physical therapy.  The human body made sense.

Who have your mentors been over the years?
I have had a lot of help over the years with PRI.  I don’t feel that I have been shy to ask questions, admit that I didn’t understand or ask for further explanation when I have been stumped with patient care or with the material.  I have made mistakes with my patients, however I have learned the most from those patients.  Ron Hruska, Jason Masek, Bobbie Ninneman, James Anderson and Carrie Langer all have assisted me throughout my PRI path.  I would say however, that Karen Jiran is my mentor.  After that first course, she spent hours on the phone and e-mail to help me.  It was amazing!  I was by myself in a clinic doing PRI trying to explain it to co-workers, physicians, and the community.  Karen taught and helped me a lot.  I feel indebted to her for all that she has done for me.

Which areas of patient care excite you most?
I am passionate about all things PRI.  I particularly have an interest in PRI in its application with scoliosis and the pelvic floor.  I do also enjoy working with runners.  I was an injured runner for 5 years.  When I was first learning about PRI, I was also getting ready to run a marathon.  After I finished that marathon my hip hurt worse.  That is when I decided to see Ron as a patient and found relief from my hip pain for the first time.  I now run faster and pain free.  I want other runners to have the same opportunity I had. 

You are very active in education outside of clinic hours. Tell us a little bit about the other areas you have become involved in. 

I have done a lot of talks over the years about PRI to chiropractors, physicians, the community, running groups/clubs, running camps, coaches/trainers, and businesses. I have also written several articles about PRI regarding the asymmetrical pattern, cycling and squatting.  This year I am doing a talk to around 125 runners in February and will be assisting with the Integration Course in March teaching with Heather Engelbert on integration between PRI and the pelvic floor.

You’ve been asked to present at the Interdisciplinary Integration course in March of 2009 on Women’s Health.  What is your background in women’s health?
I would not consider myself a “guru” in Women’s Health.  I initiated an incontinence program at a rehabilitation facility that I worked in when I first got out of school.  I feel that all PRI therapists treat the pelvic floor whether they realize it or not.  My clinical experience over the past several years with PRI has offered success with many women who were seeing me for SI, low back or hip pain and would report to me that their incontinence or painful intercourse was also gone as a benefit from PRI.  I was doing PRI work with these individuals, not teaching them kegals or having them keep a bladder diary.  I’m not saying that these aren’t important, but what a fun thing to see the power of PRI.  I noticed relationships with these patients with urge and stress incontinence.  In the Interdisciplinary course, I feel my expertise in PRI will be my strength in application to the pelvic floor.  I will be teaching this course with Heather Engelbert from Minneapolis who has a lot of years of experience in the Women’s Health arena coupled with PRI.

Who have you studied on this topic?
I have taken a course from Kathe Wallace and Holly Herman.  I have read articles and books by Janet Hume, Diane Lee and Paul Hodges.  I will be attending a Paul Hodges course in February. 

How do you plan on incorporating PRI into the discussion of women’s health?
It is going to be fun to integrate PRI and the pelvic floor.  We have one day to cover a lot of information regarding anatomy, PRI tests, hierarchy of treatment, introducing new and current PRI exercises for treatment,  abdominal integration and integration with PRI and other professionals.  Heather and I are excited about this opportunity.

Do you have any professional plans for the year 2009?  Any big projects you plan to work on?
The Interdisciplinary Integration course is a huge project for 2009, however, I have other things I would like to pursue.  I want to write an article to Runner’s World about PRI, write up a case study and present a video/article to a shoe line production.  The running shoes with lack of arch support and lateral calcaneal support is driving me nuts!  A lot to promote and do with PRI!