Postural Respiration

An Integrated Approach to Treatment of Patterned Thoraco-Abdominal Pathomechanics

Reserve your Postural Restoration course today!

Minneapolis, MN May 2017

Great course! I now understand the importance of breathing with both hemispheres of the diaphragm and how to assess and achieve this.

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Course Information

This advanced lecture and lab course is structured so that clinicians will gain an appreciation for the postural influences of: rib torsion, asymmetrical oblique strength, inconsistent breathing patterns, habitual use of accessory respiratory musculature, and a positionally restricted diaphragm. The focus of this course will be to assess and restore polyarticular muscular chain function of the thorax. Treatment interventions including manual and non-manual techniques to restore reciprocal and alternating respiratory and rotational function of the thorax will be covered. Participants will be able to immediately apply PRI clinical assessment and intervention strategies when treating diagnoses such as shortness of breath, thoracic outlet syndrome, and shoulder dysfunction.

Education Level: Advanced
Student Faculty Ratio 16:1

Cost: $495 (Early registration rate: At least 4 weeks before the course)
$525 (Late registration rate: Within 4 weeks of the course)

Postural Respiration

Course Registration

Participation is limited to ensure a low faculty to student ratio. Please register early. Courses will be canceled or rescheduled if fewer than 15 participants have registered by the early registration deadline of four weeks prior to the scheduled course date.

Cancellation and Refund Policy

Tuition is refundable less $50 if cancelled 14 days before the course date. Tuition is not refundable for registrations or cancellations within 14 days of the course. However, you may have someone attend in your place or attend on another date. If you choose to attend on another date, a $50 fee applies to transfer your registration. If you are a no show and we have no communication with you before the course you will forfeit your course tuition. PRI reserves the right to cancel a course and will refund the tuition fee only.

Date	Hosted By	Faculty	Seats	Register
September 9-10, 2017	Institute of Community Wellness & Athletics Albuquerque , New Mexico	Robert "Skip" George	43 Open	Register
September 23-24, 2017	Coastal Orthopedics and Sports Mecicine Physical Therapy Brunswick , Maine	Louise Kelley	18 Open	Register
September 30, 2017 to October 1, 2017	Fortius Sport & Health Vancouver , British Columbia	Robert "Skip" George	20 Open	Register
October 14-15, 2017	ATI Physical Therapy / Olympic Physical Therapy Everett , Washington	Louise Kelley	1 Open	Register
November 4-5, 2017	Salem Health Rehabilitation Center Salem , Oregon	Robert "Skip" George	14 Open	Register
February 10-11, 2018	One on One Physical Therapy Atlanta , Georgia	Mike Cantrell	30 Open	Register
March 10-11, 2018	Lima Memorial Wellness Center Lima , Ohio	Louise Kelley	27 Open	Register
May 19-20, 2018	Finish Line Physical Therapy New York , New York	Ron Hruska	39 Open	Register
July 14-15, 2018	University of Nevada Reno , Nevada	James Anderson	27 Open	Register
August 25-26, 2018	University Orthopedics Providence , Rhode Island	Louise Kelley	40 Open	Register
October 6-7, 2018	The Teal Center for Therapeutic Bodywork Arlington , Virginia	Louise Kelley	36 Open	Register
October 27-28, 2018	Postural Restoration Institute Lincoln , Nebraska	James Anderson	50 Open	Register

Recognize structural influences and breathing patterns of faulty postures.
Design a postural isolation and inhibition program that includes the integration of appropriate dynamics of respiration to reduce occupational, leisure, and sleep breathing dysfunction.
Release restrictive polyarticular chains and torsional patterns of the trunk through specific manual and non-manual orientation of ventilatory muscle.
Restore thoracic scapular force couples, rib alignment, and abdominal-diaphragm muscle integration for appropriate motor and sensory perceptual skill development of the upper extremities.

Day One

7:30am - 8:00am	Registration and Light Breakfast
8:00am - 9:00am	Overview of Anterior Interior Chain (AIC), Brachial Chain (BC) and Zone of Apposition (ZOA) Relationships
9:00am - 10:00am	Faulty Postural Influences Related to Postural Respiration
10:00am - 10:15am	Break
10:15am - 11:00am	Faulty Postural Influences Related to Postural Respiration (cont.)
11:00am - 12:00pm	Respiratory Mechanics of the Thorax: Muscle and Structure
12:00pm - 1:00pm	Lunch (on your own)
1:00pm - 2:00pm	Rib Kinematics
2:00pm - 3:00pm	Left AIC Overview and Objective Testing
3:00pm - 3:15pm	Break
3:15pm - 4:00pm	Left AIC Non-Manual Techniques (Lab)
4:00pm - 5:00pm	Left AIC Manual Restoration Techniques (Lab)

Day Two

7:45am - 8:00am	Sign-In and Light Breakfast
8:00am - 8:30am	Overview of Thoracic Mediastinum Function
8:30am - 9:00am	Brachial Chain: Muscle and Structure
9:00am - 9:30am	Postural Respiration Functional Relationships
9:30am - 10:00am	Right BC Evaluation and Assessment Demonstration
10:00am - 10:15am	Break
10:15am - 11:15am	Superior T4 Airflow
11:15am - 12:00pm	Right Superior T4 Manual Technique (Lab)
12:00pm - 1:00pm	Lunch (on your own)
1:00pm - 2:00pm	Right BC PRI Treatment Guidelines
2:00pm - 3:00pm	Right Subclavius Manual Technique (Lab) and Demonstration of Remaining Manual BC Techniques
3:00pm - 3:15pm	Break
3:15pm - 4:00pm	Left Lower Trapezius/Left Serratus Anterior Non-Manual Techniques
4:00pm - 5:00pm	Right Lower Trapezius/Right Tricep Non-Manual Techniques

Orthopedic

Yeamattanaporn O, Mekhora K, Jalayondeja W, Wongsathikun J. Immediate effects of breathing re-education on respiratory function and range of motion in chronic neck pain. J Med Assoc Thai Vol 97 Suppl. 7 2014. S55-S59.
Boyle K, Olinick J, Lewis C. The Value of Blowing Up a Balloon. North American Journal of Sports Physical Therapy (NAJSPT). September 2010;5(3):179-188.
Buford J, Yder S, Givens Heiss D, Chidley J. Actions of the scalene muscles for rotation of the cervical spine in macaque and human. JOSPT Oct 2002; 32(10): 488-496.
Flynn T. The thoracic spine and rib cage; musculoskeletal eval and treatment.1996. Butterworth-Heinemann, Newton.
Hodges PW. Is there a role for transverses abdominis in lumbo-pelvic stability? Manual Therapy. 1999;4(2): 74-86.
Hudson AL, Butler JE, et al. Role of the diaphragm in trunk rotation in humans. JN Physiol. Oct 2011;106(4):1622-28.
Kolar P, Sulc J, et al. Postural function of the diaphragm in persons with and without chronic low back pain. Journal of Orthopaedic and Sports Physical Therapy. Apr 2012;42(4):352-62.
Kouwenhoven JW, Vincken KL, Bartels LW, Castelein RM. Analysis of preexistent vertebral rotation in the normal spine. Spine 2006;31:1467-1472.
Mezieres F. “Importance de la Statique Cervicale”, Cahiers de la Methode Naturelle, No. 51, 1972.
Mezieres F. “Le Reflexe Antalgique a Priori,” Cahiers de la Methode Naturelle, No. 44, 1970.
Mezieres F. “Les Pieds Plats,” Cahiers de la Methode Naturelle, No. 49, 1972.
Mezieres F. “Methodes Orthopediques” and “La Fonction du Sympathique,” Cahiers de la Methode Naturelle, Nos. 52-53, 1973.
Morais NV, Pascoal AG. Scapular positioning assessment: Is side-to-side comparison clinically acceptable? Manual Therapy. 2013;18:46-53.
Myers T. Anatomy trains; myofascial meridians for manual and movement therapists. 2002 Churchill Livingstone, Edinburgh.
O’Sullivan P, Beales D, Beetham J, Cripps J, Graf F, Lin I, Tucker B, Avery A. Altered motor control strategies in subjects with sacroiliac joint pain during the active straight leg raise test. Spine 2002; 27(1):E1-E8.
Oda I, Abumi K, Lu D, Shono Y, Kaneda K. Biomechanical role of the posterior elements, costovertebral joints, and rib cage in stability of the thoracic spine. Spine. 1996;21(12): 1423-1429.
Rothstein JM. Editor’s Note: What we don’t know can hurt us. Physical Therapy. Oct 2002;82(10).

Neurology

Bagesteiro L and Sainburg R. Handedness: dominant arm advantages in control of limb dynamics. J Neurophysiol 88: 2408-2421, 2002.
Barnes M, Crutchfield C, Heriza C. The neurophysiological basis of patient treatment. Volume II, Reflexes in motor development. West Virginia, Stokesville Publishing Company, 1978.
Bertherat T, Bernstein C. The body has its reasons; self-awareness through conscious movement. Healing Arts Press, 1989.
Brunnstrom S. Movement therapy in hemiplegia. New York, Harper and Row Publishers, 1970.
Day LB, MacNeilage PF. Postural asymmetries and language lateralization in humans (Homo sapiens). J Comp Psychol. 1996 Mar;110(1):88-96.
Fiorentino MR. Normal and abnormal development. The influences of primitive reflexes on motor development. Springfield, Charles C Thomas, 1972.
Gabbard C, Hart S. Effects of standing and sitting on finger-tapping speed in healthy adults. JOSPT. Oct 2002; 32 (10): 525-529.
Hodges PW, Butler JE, McKenzie DK, Gandevia SC. Contraction of the human diaphragm during rapid postural adjustments. Journal of Physiology (1997), 505.2, pp.539-548.
Hodges PW, Heijnen I, Gandevia SC. Postural activity of the diaphragm is reduced in humans when respiratory demand increases. Journal of Physiology (2001), 537.3, pp. 998-1008.
Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. Physical Therapy. 1997; 77(2):132-144.
Hodges PW, Richardson CA. Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement. Exp Brain Res (1997) 114:362-370.
Kenyon CM, Cala SJ, Yan S, Aliverti A, Scano G, Duranti R, Pedotti A, Macklem PT. Rib cage mechanics during quiet breathing and exercise in humans. J Appl Physiol. 1997 Oct;83(4):1242-55.
Leonard C. The neuroscience of human movement. 1998. Mosby, St. Louis.
Porac C and Coren S. Lateral preferences and human behavior. Springer-Verlag New York, 1981.
Previc FH. A general theory concerning the prenatal origins of cerebral lateralization in humans. Psychol Rev. 1991 Jul;98(3):299-334. Review.
Shumway-Cook A & Woollacott M. Motor control; theory and practical applications. 1995. Williams & Wilkins, Baltimore.
Tokizane T el al. Electromyographic studies on tonic neck, lumbar and labyrinthine reflexes in normal persons. Jpn J Physiol 2:130-145, 1951.
Volkmann J, Schnitzler A, Witte OW, Freund H. Handedness and asymmetry of hand representation in human motor cortex. J Neurophysiol. 1998 Apr;79(4):2149-54.

Respiration

Barral JP. The thorax. 1991 Eastland Press, Seattle.
Bertherat T & Bernstein C. The body has its reasons; self-awareness through conscious movement. 1989 Healing Arts Press, Rochester.
Boyle K, Olinick J, Lewis C. The Value of Blowing Up a Balloon. North American Journal of Sports Physical Therapy (NAJSPT). September 2010;5(3):179-188.
Bordoni B, Zanier E. Anatomic connections of the diraphragm: influence of respiration on the body system. Journal of Multidisciplinary HealthCare. 2013:6 281–291.
Bradley H, Esformes J. Breathing Pattern Disorders and functional movement. The International Journal of Sports Physical Therapy, Feb 2014, 28-38.
Buchholz I. Breathing, voice, and movement therapy: applications to breathing disorders. Biofeedback and Self Regulation.1994;19 (2): 141-153.
Chaitow L, Bradley D, Gilbert C. Multidisciplinary Approaches to Breathing Pattern Disorders. Churchill Livingstone. 2002
Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine 2004; 7(1): 34-41.
Courtney R. The functions of breathing and its dysfunctions and their relationship to breathing therapy. International Journal of Osteopathic Medicine. Elsevier 12 (2009) 78-85.
Fried R. Breathe well, be well. John Wiley & Sons, Inc. 1999.
Gilbert C. Hyperventilation and the body. Journal of bodywork and movement therapies. July 1998.
Hodges PW, Gandevia SC. Changes is intra-abdominal pressure during postural and respiratory activation of the human diaphragm. J Appl Physiol. 2000:89:967-976.
Hodges PW, Kaigle Holm A, Holm S, et al. Intervertebral stiffness of the spine is increased by evoked contraction of transversus abdominis and the diaphragm: in vivo porcine studies. Spine. 2003:28:2594-2601.
Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine. 1996;21:2640-2650.
Hodges PW, Richardson, CA. Transversus abdominis and the superficial abdominal muscles are controlled independently in a postural task. Neurosci Lett. 1999;265:91-94.
Homma I, Hagbarth K. Thixotropy of the ribcage respiratory muscles in normal subjects. Journal of Applied Physiology 89:1753-1758, 2000.
Hruska RJ. Influences of dysfunctional respiratory mechanics on orofacial pain. Dental Clinics of North America. April 1997; 41(2): 211-227.
Izumizaki M, Shibata M, Homma I. Factors contributing to thixotropy of inspiratory muscles. Respiratory Physiology and Neurobiology 140:257-264, 2004.
Layachi L, Georges M, et al. Diaphragm pacing failure secondary to deteriorated chest wall mechanics: When a good diaphragm does not suffice to take a good breath in. Respiratory Medicine Case Reports 15 (2015):20-23.
Lomax M, McConnell A. Ispiratory muscle fatigue in swimmers after a single 200 m swim. Journal of Sports Sciences, 2003, 21, 659-664.
Newton A. Breathing in the gravity field. Rolf Lines Fall 1997; 27-33. Available online.
Obayashi et al. Effects of respiratory-muscle exercise on spinal curvature. Journal of Sport Rehabilitation, 2012, 21, 63-68.
Priyanka P Ostwal, Wani SK. Breathing patterns in patients with low back pain. Int J Physiother Res. 2014; 2(1):347-53.
Puliti B. Resistive Breathing Influence on Performance. Advance Aug 2007; 13-15.
Snosek M, Tubbs RS, et al. Sternalis muscle, what every anatomist and clinician should know. Clinical Anatomy. 2014;27:866-884.
Wilson R, Legrand A, Gevenois PA, DeTroyer A. Respiratory effects of the external and internal intercostal muscles in humans. Journal of Physiology 530.2:319-330, 2001.

Zone of Apposition

Bacci I, Richman M. Fibromyalgia: a new paradigm for its origins and treatment. ADVANCE for Physical Therapists and PT Assistants. Dec 3, 2001:31-32.
Bartels L. Rib cage influences on the volleyball players shoulder. Performance Volleyball Conditioning. 2007;13(7).
Boyle K, Olinick J, Lewis C. The Value of Blowing Up a Balloon. North American Journal of Sports Physical Therapy (NAJSPT). September 2010;5(3):179-188.
Boynton B, Barnas G, Dadmun J, Fredberg J: Mechanical coupling of the rib cage, abdomen, and diaphragm through their area of apposition. J Appl Physiol 70:3, 1991.
Buchholz I: Breathing, voice, and movement therapy, applications to breathing disorders. Biofeedback Self-Regul 19:2, 1994.
Cassart M, Pettiaux N, Gevenois PA, Paiva M, Estenne M. Effect of chronic hyperinflation on diaphragm length and surface area. Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):504-8.
Clanton TL, Diaz PT: Clinical assessment of the respiratory muscles. Phys Ther 75:11, 1995.
CliftonSmith T, Rowley J. Breathing pattern disorders and physiotherapy: inspiration for our profession. Physical Therapy Reviews. 2011;16(1):75-86.
DeTroyer A, Estenne M: Functional anatomy of the respiratory muscles. Clin Chest Med 9:2, 1988.
Estenne M, Derom E, DeTroyer A. Neck and abdominal muscle activity in patients with severe thoracic scoliosis. Am J Respir Crit Care Med. 1998 Aug;158(2):452-7.
Flynn T: The thoracic spine and rib cage. Musculoskeletal evaluation and treatment. Butterworth-Heinemann, Newton, MA. 1996.
Goldman M, Mead J: Mechanical interaction between the diaphragm and the rib cage. J Appl Physiol 35:2, 1973.
Hodges P, Gandevia S, Richardson C: Contractions of specific abdominal muscles in postural tasks are affected by respiratory maneuvers. J Appl Physiol 83:3, 1997.
Hruska RJ: Influences of dysfunctional respiratory mechanics on orofacial pain. Dent Clin North Am 41:2, 1997.
Hruska RJ: Management of pelvic-thoracic influences on temporomandibular dysfunction. Ortho Phys Ther Clin North Am 11:2, 2002.
Hutt D, Parisi R, Edelman N, Santiago T. Responses of diaphragm and external oblique muscles to flow-resistive loads during sleep. Am Rev Respir Dis. 1991;144(5): 1107-1111
Ishida H, Watanabe S. Changes in lateral abdominal muscles' thickness immediately after the abdominal drawing-in maneuver and maximum expiration. Journal of Bodywork & Movment Therapies. 2013;17:254-258.
Kolar P, Neuwirth J, et al. Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment. J Appl Physiol. Oct 2010; 109(4):1064-71.
Lando Y, Boiselle PM, Shade D, Furukawa S, Kuzma AM, Travaline JM, Criner GJ. Effect of lung volume reduction surgery on diaphragm length in severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999 Mar;159(3):796-805.
Maskill D, Murphy K, Mier A, et al: Motor cortical representation of the diaphragm. J Phys Great Britian 443:119, 1991.
McKenzie DK, Gandevia SC, Gorman RB, Southon, FCG. Dynamic changes in the zone of apposition and diaphragm length during maximal respiratory efforts. Thorax. 1994;49: 634-638
Mead J: Functional significance of the area of apposition of diaphragm to rib cage. Am Rev Respir Dis 11:31, 1979.
Nason L, Walker C, et al. Imaging of the diaphragm: Anatomy and function. Radiographics. 2012;32:E51-70.
Petroll WM, Knight H, Rochester DF: Effect of lower rib cage expansion and diaphragm shortening on the zone of apposition. J Appl Physiol 68:2, 1990.
Reddy V, Sharma S, Cobanoglu A: What dictates the position of the diaphragm – the heart of the liver? J Thorac Cardiovasc Surg 108:4, 1994.
Reid WD, Dechman G: Considerations when testing and training the respiratory muscles. Phys Ther 75:11, 1995.
Valenza MC, et al. The immediate effects of doming of the diaphragm technique in subjects with short hamstring syndrome: a randomized controlled trial. Journal of Sport Rehabilitation. June 2015.
Vostatek P, Novak D, et al. Diaphragm postural function analysis using magnetic resonance imaging. PLOS ONE. 2013;8(3):e56724.
Vleeming A, Mooney V, Dorman T, Snijders C, Stoeckart R. Movement stability and low back pain. The essential role of the pelvis. Churchill Livingstone, 1997.
Walpin L. Sitting: there is more to it than meets the eye…or seat. Physical Therapy Products. Sept 1996: 64-67

Anatomy

Anterior Interior Chain (AIC)
Muscles: Diaphragm, Psoas, Iliacus, TFL, Vastus Lateralis, Biceps Femoris
Opposition Muscles: Hamstrings, Gluteals, Internal Obliques
There are two anterior interior polyarticular muscular chains in the body that have a significant influence on respiration, rotation of the trunk, ribcage, spine and lower extremities. They are composed of muscles that attach to the costal cartilage and bone of rib seven through twelve to the lateral patella, head of the fibula and lateral condyle of the tibia. These two tracts of muscles, one on the left side of the interior thoraco-abdominal-pelvic cavity and one on the right, are composed of the diaphragm and the psoas muscle. With the iliacus, tensor fasciae latae, biceps femoris and vastus lateralis muscles this chain provides the support and anchor for abdominal counter force, trunk rotation and flexion movement.

Brachial Chain (BC)
Muscles: Anterior-Lateral Intercostals, Deltoid-Pectoral, Sibson’s Fascia, Triangularis Sterni, Sternocleidomastoid, Scaleni, Diaphragm
Opposition Muscles: Triceps, Lower Trapezius, Abdominal Obliques
There are two brachial polyarticular muscular chains lying over the anterior pleural and cervical area. These chains influence cervical rotation, shoulder dynamics and apical inspirational expansion. They are composed of muscle that attaches to the costal cartilages and bone of ribs four through seven and xiphoid to the posterior, inferior occipital bone, anterior, inferior mandible and coracoid process of scapula. These two tracks of muscles, one on the left side of the sternum and one on the right, are anterior to the medial and upper mediastinum and upper thoracic cavity and are composed of the triangular sterni, sternocleidomastoid, scalene, pectoralis minor, intercostals and muscles of the pharynx and anterior neck. They provide the support and anchor for cervical-cranial orientation and rotation and rib position. The right brachial chain muscle is opposed by the right posterior back muscles (PEC), lower trap, serratus anterior, and external rib rotators, in addition to the left internal abdominal obliques. The brachial chain muscle on the left is opposed by the left posterior back muscles (PEC), lower trap, serratus anterior, external rib rotators, and right internal abdominal obliques.

Posterior Exterior Chain (PEC)
Muscles: Latissimus Dorsum, Quadratus Lumborum, Posterior Intercostals, Serratus Posterior, Iliocostalis Lumborum
Opposition Muscles: Abdominal Obliques

Terms

Upper Half Examination Tests

Recommended Reading

Physical Therapists and PT Assistants

Occupational Therapists and OT Assistants

Classification Code

Athletic Trainers

Strength & Conditioning Coaches

Other Healthcare Professionals
PRI welcomes any interested healthcare professional to attend our courses. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to registrants upon completion of this course or any of the other PRI courses.

Accessible Learning Environments
All participants in Postural Restoration Institute™ (PRI) continuing education courses are entitled to an accessible, accommodating, and supportive teaching and learning environment. Participants have the right to request accommodations and the responsibility to provide disability documentation that supports those requests. PRI has the right to establish eligibility guidelines in accordance with both law and policy regarding disability and provide those accommodations that appropriately provide equal access to the programs and activities it sponsors.

A Certificate of Completion for 15 contact hours is awarded to attendees upon the successful completion of this course. Before attending a course, please verify CEU acceptance with your profession’s regulating body.

Physical Therapists and PT Assistants

In the states where PRI is sponsoring courses and where approval through state American Physical Therapy Association (APTA) or licensing agencies is required, PRI will apply for approval for CEUs for Physical Therapists and Physical Therapist Assistants.

Approved by the Arizona Board of Physical Therapy for Category A credit via approval of other state PT associations.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2016 – February 17, 2019.
Approved by the North Carolina Board of Physical Therapy Examiners via approval by other states.
Approved by the Texas Board of Physical Therapy Examiners as meeting continuing education requirements for PTs and PTAs. Approval has been granted for 15 continuing competency units (CCUs). Approved October 24, 2015 – October 24, 2017. Approval #60504TX.
Automatically approved by the Office of Professional Regulation for Vermont Physical Therapists by approval of other State Chapters of APTA.
Approved by the Minnesota Board of Physical Therapy for Category 1 continuing education credit for 15 hours. Course approval #9273. Approval valid January 1, 2017-December 31, 2017.
Approved by the Kansas Physical Therapy Association for 15 CEUs. Course approval #CEUL003152. Approval valid February 27, 2016-Febuary 28, 2017.
Approved by the Maryland Board of Physical Therapy Examiners for 1.5 CEUs. Approval valid February 25, 2016-February 25, 2020.
Approved by the Alaska Physical Therapy Association for 1.5 CEUs. Course approval #AK-04-01-16-03. Approval valid April 3, 2016 - April 3, 2017.
Approved by the California Physical Therapy Association for 1.5 CEUs. Approval valid August 20, 2016 - August 20, 2017. CPTA #16-120.
Approved by the Nevada State Board of Physical Therapy Examiners for 1.5 clinical units. Approval valid April 26, 2016 - July 31, 2017.
Approved by the Illinois Physical Therapy Assocation for 15 CE Hours. Approval valid January 1, 2017-January 1, 2018. Course Approval #205-6649.
Approved by the Mississippi State Board of Physical Therapy for 15 CC units. Approval valid July 1, 2017 - June 30, 2018.
Approved by the New Mexico Board of Physical Therapy for 15 contact hours. Approval valid September 9, 2017 - September 9, 2020.
Approved by the Minnesota Board of Physical Therapy for Category 1 continuing education credit. Course approval #9273. Approval valid January 1, 2017 - December 31, 2017.
Approved by the Connecticut Physical Therapy Association for 15 CEH. Course #CT-16-12-1. Approval valid February 16, 2017 - February 16, 2021.

Occupational Therapists and OT Assistants

The American Occupational Therapy Association (AOTA) recognizes PRI as an Approved Provider of continuing education. AOTA Provider #6596. Please note that the assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.

Chiropractors

In the states where PRI is sponsoring courses and where approval through state licensing agencies is required, PRI will apply for approval for CEUs for Chiropractors.

Approved by the California Board of Chiropractic Examiners . Approved for 15 hours Category B, Course approval #CA-A-16-11-12859. Approval valid November 1, 2016 - October 31, 2017.
Approved by the Minnesota Board of Chiropractic Examiners for 15 regular units of instruction for 2017 course dates.
Approved for 15 hours by the New Mexico Board of Chiropractic Examiners.

Athletic Trainers & Athletic Therapists

PRI is recognized by the Board of Certification, Inc (BOC) to offer continuing education for certified athletic trainers (#P2376). This course has been approved for a maximum of 15.0 hours of EBP Category continuing education. EBP Provider # P2376-2031. Approval valid August 20, 2015 - December 31, 2017. Certified Athletic Trainers are responsible for claiming only those hours actually spent participating in the continuing education activity.
This course is approved by the Canadian Athletic Therapists Association (CATA) for 6 CEU's. Approval valid November 10, 2016 - November 10, 2018.

Strength and Conditioning Coaches

Since continuing education courses are not required to have pre-approval through the National Strength and Conditioning Association (NSCA), this course has not been approved by the NSCA for 2017 course dates. NSCA certificants interested in completing this course in 2017 may contact the NSCA to inquire about CEU eligibility. This course was however approved by the National Strength and Conditioning Association (NSCA) for 1.5 CEU(s) or 15 contact hours for all 2014 and 2015 course dates (Approval #J1072).
This course is approved by the Collegiate Strength & Conditioning Coaches Association (CSCCa) for 7.5 CEU's.

Massage Therapists

PRI is approved by the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) as a continuing education Approved Provider. Provider number 451877-12. *Approval not valid for New York licensed massage therapists.

Other Healthcare and Fitness Professionals

PRI Welcomes any interested healthcare or fitness professional to attend our courses. Attendees are responsible for following their state statues regulating their professional practice as they integrate interdisciplinary PRI concepts.

Some of the most intriguing material I’ve ever had in my educational process.

Kearney, NE June 2017

Great course! I now understand the importance of breathing with both hemispheres of the diaphragm and how to assess and achieve this.

Minneapolis, MN May 2017

Jesse, you're a great person and a great instructor. Thanks for working to become a high level teacher. This course has the best inhibition section and great clarification on inferior R glute max stretch.

San Francisco, CA February 2017

This course definitely changes the way I think now. I can think outside the box now, and I feel like I have a good understanding of respiration and how it's the foundation of treatment.

Philadelphia, PA November 2016

Great, ahead of a lot of thinking out there.

Minneapolis, MN April 2016

Best CEU course I've taken in my 6 years of being a PT.

San Diego, CA February 2015

James, your knowledge comprehension of this subject matter is fantastic, as well as your ability to transfer that to me.

Las Vegas, NV September 2014

This has been the best course I have ever attended! Excellent content and game changing material.

Boston, MA, June 2014

Great course! Each course builds on one another to develop a complete picture of how the asymmetrical human body works.

Stanford, CA, June 2014

Amazing! James was a terrific presenter and teacher. I am very motivated to pursue other courses offered by PRI.

Stanford CA, June 2014

I was highly skepical of PRI before the course. With several videos and seminars under my belt. I was highly engaged in this course. Now, on to the challenge of implementing it... before my next course!

Indianapolis, IN, March 2014

I loved it. I love everything about PRI and what it stands for. Thank you, thank you, thank you!

Indianapolis, IN, March 2014

James was great, as usual! The information is so incredibly relevant. Before PRI, I have never been to a more relevant course(s). Love it.

Portland, OR, February 2014

Thank you! These classes have completely changed how I approach and treat patients with pelvic dysfunction. I has completely filled the hole that I had in my practice – which was the neuromuscular piece!! Much thanks!

St. Louis, Missouri, January 2013

Great job Mike. Thanks for all the work you’ve in in by yourself over the years where others can benefit in 2 days!

St. Louis, Missouri, January 2013

Taking it for a second time was very enjoyable. I could really listen and take it all in!

St. Louis, Missouri, January 2013

Thanks – I will use this tomorrow in the clinic. I want to learn more!!

Sioux Falls, South Dakota, January 2013

I just had an AMAZING morning in the clinic thanks to what I learned in class this past weekend. I blew through L AIC and brachial chain problems like a breeze today. I’m sure humility will come, but I am going to enjoy the great morning I had.
I think that was the best PRI class I have EVER been to. You made it crystal clear and applicable to the cinic the entire time. You also made it fun which helps with retention. The emphasis on treatment is much appreciated and played out this morning in the clinic.
So Mike, YOU are THE BOMB! (I never heard that phrase until I went to Georgia).

Minneapolis, Minnesota, October 2012

I took this course 3 years ago – and it is so much better now. Same theory, but much easier to follow and integrate immediately into practice! Thank you

Phoenix, Arizona, May 2012

Great job James at presenting info. You transfer your passion! I’m hook on PRI techniques! Best explained, and understandable course I’ve so far!

Phoenix, Arizona, May 2012

BEST speaker of any of the 100 different courses I have been to over 20+ years.

Phoenix, Arizona, May 2012

Mike was great! Awesome teacher and speaker. Very motivating and give practical examples and ways to easily incorporate new info into patient care.

Houston, Texas, June 2012

Mike went above and beyond with answering questions and taking time with everyone. Also personalizing various issues/test results.

Houston, Texas, June 2012

Very good. Ron always does a great job. I learn new idea every time I take a course, no matter how many times I have taken it.

Lincoln, Nebraska, June 2012

I appreciate thoroughly explaining the important topics more than once to be sure we understood before moving on!

Lincoln, Nebraska, June 2012

It was great! Thanks so much I’m excited to review and incorporate.

Lincoln, Nebraska, June 2012

Thanks for making the “older” PTs feel welcome. I haven’t always felt that way in other courses. This was an eye and mind opening experience to look at anatomy, physiology/neuro from a different, flip side of the coin way. Thank you.

Lincoln, Nebraska, June 2012

I really want to thank you for your expertise, knowledge and relief that you provided for me. I know you have heard this many times but I feel so blessed that you have changed my life. I have for the past year changed my practice techniques and achieved more success. I will be in contact. Thank you.