An Integrated Approach to Treatment of Patterned Thoraco-Abdominal Pathomechanics
An Integrated Approach to Treatment of Patterned Thoraco-Abdominal Pathomechanics
Atlanta, GA Feb 2018
Posture and breathing have always been important. This gives me a new, better conceptual framework that addresses asymmetry.
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)
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 |
---|---|---|---|---|
May 5-6, 2018 | PRO Sports Club-Willows Road Redmond , Washington | Robert "Skip" George | 4 Open | |
June 2-3, 2018 | Aurora St. Luke's South Shore Milwaukee , Wisconsin | Louise Kelley | 16 Open | |
July 1-2, 2018 | Tel Aviv University PT Department (Assaf Harofeh Medical Center) Tel Aviv , Israel | Mike Cantrell | 40 Open | |
July 14-15, 2018 | University of Nevada Reno , Nevada | Robert "Skip" George | 23 Open | |
July 14-15, 2018 | Florida International University Miami , Florida | Louise Kelley | 31 Open | |
August 4-5, 2018 | Finish Line Physical Therapy New York , New York | Ron Hruska | 22 Open | |
August 25-26, 2018 | University Orthopedics Providence , Rhode Island | Louise Kelley | 39 Open | |
September 22-23, 2018 | Complete Fitness Results St. Louis , Missouri | Mike Cantrell | 50 Open | |
October 6-7, 2018 | The Teal Center for Therapeutic Bodywork Arlington , Virginia | Louise Kelley | 31 Open | |
October 20-21, 2018 | Lindebergs Academy Munich , Germany | Michael Cantrell | 27 Open | |
October 26-27, 2018 | Postural Restoration Institute Lincoln , Nebraska | James Anderson | 50 Open | |
November 3-4, 2018 | DIAKADI San Francisco , California | Robert "Skip" George | 38 Open |
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 |
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
Patient lies in supine with knees flexed to flatten the lumbar spine. Passively take the patient’s arm into horizontal abduction while securing the shoulder joint with one hand and maintaining forearm supination with the other hand.
A positive test is indicated by limited horizontal abduction of one extremity when compared to the other. Less than 30° is considered limited.
Patient lies in supine with knees flexed to flatten the lumbar spine. Position the patient’s bent arm at shoulder level. Stabilize the shoulder by placing firm pressure on the anterior shoulder joint. Passively rotate the patient’s arm toward the mat as far as it will go. Repeat the test on the opposite extremity. A positive test is indicated when the patient’s arm will not fully rotate towards the mat or table.
Patient lies in supine with knees flexed to flatten the lumbar spine. Patient inhales through nose, upon exhalation guide left rib cage down. Hold ribs down as patient attempts to fill opposite chest wall. Repeat on opposite side.
A Positive test is indicated when the patient is unable to draw air into the right thoracic chest wall as easily as on the left, through patient report or tester observation. Limitation in expansion of the right thoracic-apical chest wall reflects right rib internal rotation orientation with accompanying left rib external rotation orientation secondary to possible compensation of thoracic rib cage to the left as a result of thoracic “spinal” orientation to the right.
Newton A. Breathing in the gravity field. Rolf Lines Fall. 1997;27-33.
Coughlin KJ, Hruska R, Masek J. Explore. 2005 Sept;1(5):377-379.
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.
Chaitow L, Bradley D, Gilbert C. Multidisciplinary approaches to breathing pattern disorders. Churchill Livingstone. 2002.
Reid WD, Dechman G. Considerations when testing and training the respiratory muscles. Phys Ther. 1995;75:11.
Mead J. Functional significance of the area of apposition of diaphragm to rib cage. Am Rev Respir Dis. 1979;11:31.
Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine. 2004;7:34-41.
Fried R. Breathe well, be well. John Wiley & Sons, Inc. 1999.
Physical Therapists and PT Assistants
Occupational Therapists and OT Assistants
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.
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 look into applying for CEUs for Chiropractors (upon request).
Athletic Trainers & Athletic Therapists
Strength and Conditioning Coaches
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.
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.
Missoula, Montana, March 2012
Thanks for your teaching energy/changing how I think has made a huge difference in my PT world
Missoula, Montana, March 2012
This was my first ever CEU course and it was great choice. I hope to make it to others to make more connections.
Missoula, Montana, March 2012
Overall, course was very good. Integrated the AIC material from prior course – I understand the whole body pattern much better.
Missoula, Montana, March 2012
Was very informative and an awesome (and legitimate) new way to see/think about neck/shoulder/back pathology.
Missoula, Montana, March 2012
Very informative, really enjoyed the speaker’s enthusiasm and helpfulness.
Urbana, Maryland, February 2012
Great learning experience!
Urbana, Maryland, February 2012
Very good experience with this course. Mike was a fantastic speaker!
Urbana, Maryland, February 2012
Very informative, enlightening, helpful and beneficial to further and help my career as a trainer.
Urbana, Maryland, February 2012
Absolutely amazing; brilliant. I would take this course over 3 more times if Mike spoke.
Clearwater, Florida, January 2012
Mike was enjoyable to listen to and his enthusiasm made the time pass quickly.
Clearwater, Florida, January 2012
Mike was amazing!
Clearwater, Florida, January 2012
What I learned what that I need to learn more
Clearwater, Florida, January 2012
Mike did an excellent job of explaining everything-especially the biomechanics of what we were going to be seeing.
Lincoln, Nebraska, October 2011
Very happy with the speaker! As a PTA, I was able to understand.
Lincoln, Nebraska, October 2011
Great speaker, very fun and made it very interesting! Thanks!
Lincoln, Nebraska, October 2011
This course has changed the way I look at everything! This could be the beginning of a whole new career in physical therapy!
Hayden, Idaho, May 2009
Instructor was fabulous and wonderful at explaining and applying the material!
Rockville, Maryland, February 2009
This course filled in many “blanks” about the myokin course. We will be much better prepared to eval, treat and educate our patients. Thank You!
St. Louis, Missouri, September 2008
Ron’s compassion for the subject matter is unmistakable. This course does a great job of filling in the upper quarter puzzle and emphasizing the importance of respiration- thank you!
Lincoln, Nebraska, January 2008
Best series of courses I’ve ever taken, including Upledger and Myofascial Release courses. The most comprehensive approach I’ve found.
Portland, Oregon, July 2007
Just wanted to share a success story with you after the course this last weekend in Lincoln. I have a patient who is s/p mva some 6 weeks ago, severe pain cervical/thoracic/and lumbar; very guarded and flexed posture. We had seen her maybe 6 times prior to the course last weekend, and hadn’t made any progress. She was very guarded and we could not release any tension with massage, modalities, and ROM. I performed the manual AIC technique taught in class, restored her ZOA and got the rib cage to move, and the results were amazing. The patient was so excited her burning pain in her mid-back was gone, she broke down in tears. And my 2 PTA’s started to cry with her as they had seen how much pain she was in, and now was feeling relief. Just wanted to relay that story and to say thanks. Your class was amazing. And after 2 days in the clinic, I’ve already seen amazing results. I want to encourage you to keep on empowering therapists as you have me. Thanks again.
Lincoln, Nebraska, October 2006
Thanks for “re-booting” me, giving me belief back in my profession, and hope for relieving my pain. You just changed my life and the lives of my patients.
Crookston, Minnesota, March 2006
Ron has revolutionized the way I treat my athletes. He is the most passionate speaker I have ever had the privilege of hearing.
Omaha, Nebraska, August 2005
I doubt I will attend any other continuing education course besides PRI or something related to.
Omaha, Nebraska, August 2005
Ron was very dynamic in introducing this concept and treatment techniques. This method of PT really makes sense. Finally an approach that ties it all together and help for those people who haven’t been able to be helped yet!
Sioux Falls, South Dakota, May 2005
This material is based on a paradigm that includes the whole body and its interconnections unlike anything else in our training.
Sioux Falls, South Dakota, May 2005
This is my 5th PRI class. As always, they are life changing as my understanding deepens. I am grateful for this approach! It is evidence based, makes sense, can be validated by objective tests and readily applied in the clinic. It has changed the way I practice and made my career more satisfying.
Bloomington, Minnesota, October 2004
I want to thank you for another great class. The responses we get from patients is probably the most rewarding I felt in the 30 some years I have been practicing, and I thought we were doing a good job then…
Bloomington, Minnesota, October 2004
Absolutely outstanding! Excellent course and instructor. He had complete command of the material. A master expert clinician. Thank you for putting the human body back together again and integrating all systems of the body.
Elon, North Carolina, May 2004
You are an innovative thinker, thanks for opening my mind, broadening my horizons and enabling me to better treat my patients.
Elon, North Carolina, April 2004
Awesome course and information. Will incorporate this info in our practice. The lab was great and very beneficial in actually seeing it put into action.
Sioux City, Iowa, December 2003
Thanks for a fresh, common sense approach to biomechanics of the body. Thanks for affirming that there is a lot more to physical therapy than stretching and strengthening.
Sioux City, Iowa, December 2003
Early Registration Fee: $495
(4 or more weeks prior to course)
Late Registration Fee: $525
(within 4 weeks of course)
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.
Those who have earned the designation of Postural Restoration Certified (PRC) or Postural Restoration Trained (PRT) are eligible for a 50% discount. Students are eligible for a 25% discount if they are currently enrolled as a full time student at the time of the course. You may be asked to submit your official course schedule to verify student status.
*Discounts exclude Occlusal Cervical Restoration, Non-Manual Techniques Workshop, Interdisciplinary Integration Symposium, PRI Vision Courses, and PRI Affiliate Courses.
(This is not the homestudy)