Postural Respiration

An Integrated Approach to Treatment of Patterned Thoraco-Abdominal Pathomechanics

Atlanta, GA

"Posture and breathing have always been important. This gives me a new, better conceptual framework that addresses asymmetry."

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Course Information

This advanced lecture and lab course is structured so that clinicians will gain an appreciation for the patterned respiration influences on: rib torsion, asymmetrical oblique strength, costal and crural function, 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 both hemi-lateral thoraxes and their respective pleura. 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 that are related to undesirable airflow patterns, 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)
$545 (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.

Special Needs Requests

If you have a disability and require accommodation in order to fully participate in this course, please contact us at least two weeks prior to the course date or prior to purchasing any online home study course so that arrangements can be made.

Course Completion

The course must be attended in full, and a course evaluation summary completed in order to receive a certificate of completion for 15 CE hours. If you arrive late, or leave early, your certificate of completion will be adjusted for the number of CE hours you were in attendance.

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
January 19-20, 2019	Prevail Conditioning Performance Center Santa Barbara , California	Robert "Skip" George	34 Open	Register
February 2-3, 2019	Mizzou Therapy Service Columbia , Missouri	Robert "Skip" George	29 Open	Register
February 9-10, 2019	HealthSource of West Norman Norman , Oklahoma	Louise Kelley	30 Open	Register
February 16-17, 2019	Renew Physical Therapy Covington , Louisiana	Mike Cantrell	35 Open	Register
February 23-24, 2019	ProActive Physical Therapy & Performance Center Fort Collins , Colorado	James Anderson	29 Open	Register
March 16-17, 2019	Canton Physical Therapy Canton , Connecticut	Louise Kelley	34 Open	Register
April 6-7, 2019	Alta Bates Summit Medical Center Oakland , California	Robert "Skip" George	37 Open	Register
April 27-28, 2019	Adirondack Health Rehabilition and Sports Medicine Saranac Lake , New York	Louise Kelley	27 Open	Register
May 4-5, 2019	Finish Line Physical Therapy New York , New York	James Anderson	35 Open	Register
June 8-9, 2019	Northeastern University Boston , Massachusetts	Louise Kelley	30 Open	Register
August 17-18, 2019	Cantrell Center for Physical Therapy Warner Robins , Georgia	Robert "Skip" George	25 Open	Register
September 14-15, 2019	Rosencutter Ultra Fitness Greenfield , Wisconsin	Robert "Skip" George	44 Open	Register
September 21-22, 2019	Charles George VA Medical Center Asheville , North Carolina	Louise Kelley	35 Open	Register
October 26-27, 2019	Motus Integrative Health Crown Point , Indiana	Louise Kelley	34 Open	Register
November 2-3, 2019	University of Arizona Tucson , Arizona	James Anderson	45 Open	Register
November 9-10, 2019	Robbins Rehabilitation Easton , Pennsylvania	Robert "Skip" George	40 Open	Register

Recognize relationships between static asymmetrical respiration, ideal physiologic respiration, and patterned respiration.
Identify how to restore restrictive polyarticular chains and torsional patterns of the trunk through specific manual and non-manual orientation of ventilatory muscle, and thoracic osseous structure.
Recognize how to maximize thoracic scapular force couples, rib alignment, and abdominal-diaphragm muscle integration for appropriate motor and sensory perceptual skill development of the upper extremities.
Outline how to design a postural isolation and inhibition program that promotes integration of appropriate hemi-thoracic airflow to reduce occupational, leisure, and sleep breathing dysfunction patterns.

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	Static Structural Asymmetry and Dynamic Respiratory Influences on Hemi-Diaphragm and Hemi-Thorax Function
10:00am - 10:15am	Break
10:15am - 11:00am	Patterned Respiration and Associate Airflow
11:00am - 12:00pm	Anterior Interior Chain: Muscle and Structure
12:00pm - 1:00pm	Lunch (on your own)
1:00pm - 2:00pm	Left AIC Objective Testing (Demonstration)
2:00pm - 3:00pm	Left AIC Non-Manual and Manual Techniques (Demonstration)
3:00pm - 3:15pm	Break
3:15pm - 4:00pm	Left AIC Manual Techniques (Lab)
4:00pm - 4:30pm	Brachial Chain: Muscle and Structure
4:30pm - 5:00pm	Overview of Thoracic Mediastinum Function

Day Two

7:45am - 8:00am	Sign-In and Light Breakfast
8:00am - 8:30am	Postural Respiration Functional Relationships
8:30am - 10:00am	Right BC Objective Testing (Demonstration and Lab)
10:00am - 10:15am	Break
10:15am - 11:00am	Right BC PRI Treatment Guidelines
11:00am - 11:30am	Superior T4 Airflow
11:30am - 12:00pm	Right Superior T4 and Right Subclavius Manual Techniques (Demonstration)
12:00pm - 1:00pm	Lunch (on your own)
1:00pm - 2:00pm	Right Superior T4 and Right Subclavius Manual Techniques (Lab)
2:00pm - 3:00pm	Left Low Trap/Left Serratus Anterior Non-Manual Techniques
3:00pm - 3:15pm	Break
3:15pm - 4:00pm	Right Low Trap/Right Tricep Non-Manual Techniques
4:00pm - 4:30pm	Inhibition Considerations for the Right BC Pattern
4:30pm - 5:00pm	Case Studies

Dynamic Function/Posture

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, Yoder 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.
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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).
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.

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.
Ben-Dov I, et al. Diaphragmatic paralysis: a clinical imitator of cardiorespiratory diseases. Israel Medical Association Journal. 2008; 10(8-9):579-583.
Bertherat T, Bernstein C. The body has its reasons; self-awareness through conscious movement. Healing Arts Press, 1989.

Bordoni B, Marelli F, et al. The five diaphragms in patients following cardiac surgery in sternotomy: An observational study. Int J Complement Alt Med. 2017; 7(6):00245.
Bordoni B, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. Journal of Multidisciplinary HealthCare. 2013:6 281–291.
Bordoni B, Zanier E. The continuity of the body: Hypothesis of treatment of the five diaphragms. The Journal of Alternative and Complementary Medicine. 2015; 21(4):237-242.
Brunnstrom S. Movement therapy in hemiplegia. New York, Harper and Row Publishers, 1970.
Cherniack NS, et al. Responses of upper airway, intercostal and diaphragm muscle activity to stimulation of oesophageal afferents in dogs. The Journal of Physiology. 1984; 349(1):15-25.
Corda M, et al. Proprioceptive innervation of the diaphragm. The Journal of Physiology. 1965; 178(1):161-177.
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.
Henderson AT, et al. Effects of rib raising on the autonomic nervous system: a pilot study using noninvasive biomarkers. J AM Osteopath Assoc. 2010 Jun; 110(6):324-330.
Hjortskov N, et al. The effect of mental stress on heart rate variability and blood pressure during computer work. Eur J Appl Physiol. 2004 Jun; 92(1-2):84-89.
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.
Khedr EM, Trakhan MN. Localization of diaphragm motor cortical representation and determination of corticodiaphragmatic latencies by using magnetic stimulation in normal adult human subjects. Eur J Appl Physiol. 2001; 85:560-566.
Leonard C. The neuroscience of human movement. 1998. Mosby, St. Louis.
Malik M. Heart rate variability – standards of measurement, physiological interpretation and clinical use. Task Force – European Society of Cardiology and The North American Society of Pacing and Electrophysiology. Eur Heart J. 1996; 17:354-381.
Niedringhaus M, et al. Dorsal motor nucleus of the vagus: a site for evoking simultaneous changes in crural diaphragm activity, lower esophageal sphincter pressure, and fundus tone. AM J Physiol Regul Integr Comp Physiol. 2008 Jan; 294(1):R121-R131.

Pickering M, Jones James FX. The diaphragm: two physiological muscles in one. J. Anat. 2002; 201: 305-312.
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Redding G, Song K, et al. Lung function asymmetry in children with congenital and infantile scoliosis. The Spine Journal, 2008; 8(4):639-644.
Shumway-Cook A & Woollacott M. Motor control; theory and practical applications. 1995. Williams & Wilkins, Baltimore.
Terada M, Kosik KB, McCann RS, Gribble PA. Diaphragm Contractility in Individuals with Chronic Ankle Instability.
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.
Vrijkotte TG, et al. Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability. Hypertension. 2000 Apr; 35(4):880-886.
Young RL, et al. Sensory and motor innervation of the crural diaphragm by the vagus nerves. Gastroenterology. 2010 March; 138(3):1091-1101.

Respiration

Barral JP. The thorax. 1991 Eastland Press, Seattle.
Basu S, Kakade PP, et al. Influence of abdominal and hamstring muscle activation exercises over iliotibial band stretching on a positive Ober's test in subjects with low back pain. Global Journal for Research Analysis. May 2017; 6(5):704-705.
Beeckmans N, Vermeersch A, et al. The presence of respiratory disorders in individuals with low back pain: A systematic review. Manual Therapy. 2016;6:77-86.
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.
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.
Calais-Germain B. Anatomy of breathing. Eastland Press, Inc. Seattle. 2006.
Carreiro JE. An osteopathic approach to children, 2^nd ed. Churchill Livingstone. 2009.
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.

De Troyer A, Wilson TA. Action of the diaphragm on the rib cage. Journal of Applied Physiology. 2016; 121(2):391-400
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.
Hellyer N, Andreas N, et al. Comparison of diaphragm thickness measurements among postures via ultrasound imaging. PMR. 2017;9:2-25.
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.
Kolar P, et al. Analysis of diaphragm movement during tidal breathing and during its activation while breath holding using MRI synchronized with spirometry. Physiol. Res. 2009;58:383-392.
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.
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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.
Russell MEB, Scott AB, et al. Inclusion of a rest period in diaphragmatic breathing increases high frequency heart rate variability: Implications for behavioral therapy. Psychophysiology. 2017; 54:358-365.
Snosek M, Tubbs RS, et al. Sternalis muscle, what every anatomist and clinician should know. Clinical Anatomy. 2014;27:866-884.
Tatsuya Hirasawa and Shigeru Kuratani A new scenario of the evolutionary derivation of the mammalian diaphragm from shoulder muscles.
Wallden, M. The diaphragm – more than an inspired design. Journal of Bodywork and Movement Therapies. 2017 Apr; 21(2):342-349.
Wilson R, Legrand A, Gevenois PA, De Troyer 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.
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Flynn T: The thoracic spine and rib cage. Musculoskeletal evaluation and treatment. Butterworth-Heinemann, Newton, MA. 1996.
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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.
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Hruska RJ: Management of pelvic-thoracic influences on temporomandibular dysfunction. Ortho Phys Ther Clin North Am 11:2, 2002.
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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.
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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
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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 Codes)

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, 2019– February 17, 2022.
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 March 24, 2018 – March 24, 2020. Approval #63908TX.
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 #1748. Approval valid January 1, 2019-December 31, 2019.
Approved by the Maryland Board of Physical Therapy Examiners for 1.5 CEUs. Approval valid February 25, 2016-February 25, 2020.
Approved by the Illinois Physical Therapy Association for 15 CE Hours. Approval valid January 1, 2018-January 1, 2019. Course Approval #205-7026.
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 Connecticut Physical Therapy Association for 15 CEH. Course #CT-16-12-1. Approval valid February 16, 2017 - for 1.5 CEUs. February 16, 2021.
Approved by the Wisconsin Physical Therapy Association for 15 contact hours. WPTA Approval #17348. Approval valid January 19, 2019 - January 19, 2020.
Approved by the Pennsylvania State Board of Physical Therapy for 15 Gen Credits. Course Approval #PTCE012991. Approved January 13, 2018 - December 31, 2018.
Approved by the California Physical Therapy Association for 1.5 CEU's. CPTA #18-429. Approval valid January 13, 2019-January 13, 2020.*Approval valid only for courses offered in the state of California. If you attend this course outside the state of California, you will need to submit an individual CEU approval application with the CPTA.
Approved by the Ohio Physical Therapy Association for 15 CEU's. Approval #18S0340. Approval valid March 10, 2018 - March 10, 2019.
Approved by the New Jersey Board of Physical Therapy Examiners for 15 continuing education credits. NJBPTE course approval #1712-88. Course approval expires January 31, 2020.
Approved by the Florida Physical Therapy Association for 15 CE hours for PTs and PTAs. Approval valid January 1, 2018 – December 31, 2018. CE Broker tracking #20-628590. FPTA approval #CE18-628590.
Approved by the Nevada State Board of Physical Therapy Examiners for 1.5 clinical units. Approval valid February 8, 2018 - July 31, 2019.
Approved by the American Physical Therapy Association of Massachusetts for 15.0 Continuing Education Hours. Approval valid February 26, 2018 - February 26, 2019. Course #MA18-01-04.
Approved by the Arkansas State Board of Physical Therapy for 15 hours. Date of Approval 6/21/18. Approval does not expire, provided the course does not change.
Approved by the Louisiana Physical Therapy Board for 15 clinical hours. Approved for the 2019 calendar year.

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. This course awards 1.5 AOTA CEUs/15 Contact Hours.

Chiropractors

In the states where PRI is sponsoring courses and where approval through state licensing agencies is required, PRI will look into applying for CEUs for Chiropractors (upon request).

Approved by the California Board of Chiropractic Examiners for November 3, 2018 – November 4, 2018. 8.75 Hours of Category B - Physiotherapy, CA-A-18-11-11093. Approved by the California Board of Chiropractic Examiners for November 3, 2018 – November 4, 2018. 6.25 Hours of Category B – Diagnostic Testing, CA-A-18-11-11092.
Approved by the Minnesota Board of Chiropractic Examiners for 15 regular units of instruction for 2018 course dates.
Approved for 15 hours by the New Mexico Board of Chiropractic Examiners.

Athletic Trainers & Athletic Therapists

Postural Restoration Institute (BOC AP# P2376) is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. This program is eligible for a maximum of 15 EBP Category hours/CEUs. ATs should claim only those hours actually spent in the educational program.

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

This course is approved by the Collegiate Strength & Conditioning Coaches Association (CSCCa) for 7.5 CEU's.
Since continuing education courses are not required to have pre-approval through the National Strength and Conditioning Association (NSCA), this course is not currently approved through the NSCA. NSCA certificants interested in completing this course may contact the NSCA to inquire about CEU eligibility.

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.

Learned more than ever in a Con-Ed course.

Providence, RI August 2018

I was able to blow up a balloon for the very first time in my life at 32 years old!!

Providence, RI August 2018

The course was excellent. The Abundance of materials to read independent beyond the course is appreciated.

New York, NY August 2018

Overall great course and great learning experience to supplement my experience in PT school.

Philadelphia, PA April 2018

Posture and breathing have always been important. This gives me a new, better conceptual framework that addresses asymmetry.

Atlanta, GA February 2018

Wonderful content, excellent speaker, very helpful and educational.

Seattle, WA, October 2017

Louise was the best instructor I have had out of the 3 courses I have taken. Great listener, observer, great review throughout, calm, very hands on, professional. Thank you!

Seattle, WA, October 2017

Mind-blowing. New respect for ribs and the diaphragm.

Albuquerque, NM September 2017

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.