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Advanced Integration & PRC We are busy at PRI preparing for our 4-day Advanced Integration course followed by two days of Postural Restoration Certification (PRC). Fifty-two health professionals from 17 different states will all be making the trip to Lincoln, Nebraska to attend the course. Our office will be open during the course and PRC but we will be limited in the time we’re able to respond to calls and emails. It will be business as usual on Wednesday, December 10th. Next year, Advanced Integration is scheduled only once on December 3-6, 2009 with PRC testing on December 7th and 8th. Posted November 26, 2008 at 1:33pm by Janie Ebmeier. Categories: 2009 Course Brochures The 2009 PRI Course Brochure is nearly complete! Our comprehensive booklet-style brochure with 40 different course dates and locations is sure to be a handy guide to planning your continuing education for next year. This brochure will be available for online viewing as a green alternative but if you’re hoping to receive yours in the mail this year, be sure to join our mailing list soon! If you have attended a course previously or have already requested to be placed on our mailing list, you will be receiving your brochure by the end of the year. Please remember that our brochures are mailed only once a year so be sure to keep it in a safe place for future reference. You can also receive reminders about upcoming courses in your area via email or by checking our website for schedule updates. To join our mailing list, click here! Posted November 25, 2008 at 1:21pm by Janie Ebmeier. Categories: Courses What We’re Reading The Dental Physician written by Aelred Fonder, DDS, FRSH is the newest book in PRI. Published in 1977, this book provides great insight into treating the patient as a whole “system” rather than treating “dental issues.” “Contemporary medical evidence of the unity of the human person abounds, but to present it would be to write our book in one chapter, for it is this concept which is the basic idea of the present work. The dentist is not dealing with teeth or peridontal tissue alone; he is dealing with a united soma, and more especially, he is treating the total person.” - Chapter One A decendent of the late Aelred Fonder recently responded to our request for information about purchasing this valuable book. Dr. Felker has made this book available by calling him directly at 815-625-0346. The proceeds are directed to Dr. Fonder’s wife. The cost is estimated at $100 but we’ve found the contents to be priceless. Posted November 24, 2008 at 8:25am by Bobbie Rappl. Categories: Books Gelb Splint Last weekend was the Cervical-Cranio-Mandibular Restoration Course here at PRI. Among other things, the attendees briefly covered the importance of splint therapy. “A Gelb Splint is a mandibular splint with acrylic coverage over the posteriors. A metal lingual bar is usually the major connector, which allows for plenty of tongue room. Occlusion on the Gelb splint is upper lingual cusps touching a lower flat or indented occlusal pad. This splint is usually made to a repositioned bite, bringing the mandible slightly forward.” Here is a video of a gentleman with and without his Gelb Splint. Notice his change in gait once he removes the splint and loses contact: Gelb Splint from Bobbie Ninneman on Vimeo. Posted November 20, 2008 at 9:07am by Bobbie Rappl. Categories: Videos In Case You Missed It… We recently added a new area on the PRI products page titled “Manuals”. For those of you interested in purchasing a re-print of a course you attended a few years back or for those interested in purchasing a course manual to a course you have not attended, click here! Additions and updates are continually added to all course material. If you register for a course, you will be given an updated manual at the time of the course! Posted November 17, 2008 at 2:32pm by Bobbie Rappl. Categories: Website One Day Clinical Course - Woodbury, Minnesota We have picked a date for our one day clinical course, Postural Restoration, in Woodbury, Minnesota! Mark your calendars for March 28! This one day review, demonstration, and lab course provides a number of PRI resources that are related to concepts covered in Myokinematic Restoration and Postural Respiration. Space is limited, register early! Posted November 14, 2008 at 3:35pm by Bobbie Rappl. Categories: Courses Professor Dr. Rothbart’s Site for Health Care Researchers A while back we referenced an article titled, “Vertical Facial Dimensions Linked to Abnormal Foot Motion”, by Brian A. Rothbart. I received an email from Professor Rothbart after he saw this reference and suggested we also take a look at his website. Professor Rothbart’s site has great information that is very similar to the information presented in PRI courses. Some of this information has been referenced throughout the Impingement and Instability course and also the Cervical-Cranio-Mandibular Restoration course. To check out his website, click here! Posted November 13, 2008 at 11:29am by Bobbie Rappl. Categories: Clinicians Pec Minor vs. Pec Major With all the people studying for certification this year, we have been getting some great questions! Yesterday, I received this question: “What is PRI’s stance on pec minor vs. pec major”. When discussing the pec minor vs. pec major you have to consider the right pec minor vs. the left pec major. The pec minor on the right side in a right BC pattern acts as an internal rotator with the right latissimus. The right pec minor pulls your shoulder forward and compresses your right chest wall decreasing the abilitly to get right apical expansion. When performing a right subclavious technique, you are also trying to inhibit the right pec minor. Once you have restored right humeral glenoid internal rotation, you then retrain the right subscapularis to perform right internal rotation without compensation from the right pec minor and right latissimus. In a right BC pattern, because of the orientation of the spine, the left pec major becomes tight, pulling the sternum and the shoulder girdle together. On the left, you are working to inhibit the pec major by performing a left pectoralis stretch. What a great question! Posted November 12, 2008 at 9:22am by Bobbie Rappl. Categories: Science Physiotherapeutic Treatment for Temporomandibular Disorders (TMD) Ron Hruska has been sited again in the Brazilian Journal of Oral Sciences. “Physiotherapeutic treatment for temporomandibular disorders (TMD)” written by Grossi and Chaves discusses considerations that need to be made when treating TMD. “One of the most important approachs for TMD physical therapy treatment must be the modification of craniocervical biomechanics and its effects to posture as an etiologic or perpetuating TMD factor”. To access this complete article, click here! Posted November 10, 2008 at 3:10pm by Bobbie Rappl. Categories: Articles Right C FA IR - R C TF ER For those of you that have attended the Impingement and Instability course, you understand the concept of right compensatory femoral acetabular internat rotation (FA IR) and right compensatory tibial femoral external rotation (TF ER). Here is a fabulous video that shows this pattern! Tibial ER from Bobbie Ninneman on Vimeo. Posted November 7, 2008 at 9:39am by Bobbie Rappl. Categories: Videos Case study report: Postural Restoration We are proud and honored to share with you an article published by Holly Spence, PT, PRC. “Case study report: postural restoration: an effective physical therapy approach to patient treatment” was published in the Regional Anesthesia and Pain Management journal this summer. This article summarizes Postural Restoration as an alternative approach to physical therapy: “The purpose of this case study is to inform specialists that there are different approaches to physical therapy treatment intervention”. To access the complete article, click here! Posted November 6, 2008 at 9:30am by Bobbie Rappl. Categories: Articles Common Cervical-Cranio-Mandibular Restoration Dilemmas Today brings an end to the discussion of System Integrational Dilemmas. If you have been tuning in the last few days, we have been presenting common issues that arise with PRI programs and some things to think about when attempting to overcome these dilemmas. Today we will feature common dilemmas that arise with a Cervial Cranio-Mandibular Restoration program: 1. Can’t open mouth past 45mm - no click More than likely will need an appliance or see an orthopedic gnathologist oriented dentist. 2. Can’t open mouth without a click Treat TMCC issues, free up cervical axial limitations, restore C3-C5 lordosis and if PRI stabilization effort maintains cervical neutrality a splint or TMD treatment may not be necessary, especially if there is no associated joint pain. If joint pain, then refer to a dentist for an appropriate splint. 3. Can’t passively rotate cervical spine to the left – axially with neutral brachial chains Treat left SCM, scalenes, upper trap, anterior and posterior capitus muscles to achieve right sidebending at OA and AA. Restore cranial flexion on the right manually. Re-check after placing tongue depressor between left molars; if cervical spine resumes neutrality – refer for intra-oral appliance. If all the above fail, consider neuro-optometric treatment. 4. Can’t protrude without lateral trusion Treat left SCM, scalenes, upper trap, anterior and posterior capitus muscles to achieve right sidebending at OA and AA. Restore cranial flexion on the right manually. Re-check after placing tongue depressor between left molars; if cervical spine resumes neutrality – refer for intra-oral appliance. If all the above fail, consider neuro-optometric treatment. 5. Can’t decrease a cant (bipupilar plane, otic plane, transverse occlusal plane) Will more than likely require palate expansion for system unlocking and possibly orthodontistry to ‘stabilize’ neutral cranium with proper occlusion. Posted November 5, 2008 at 2:40pm by Bobbie Rappl. Categories: Courses Common Postural Respiration Dilemmas Yesterday I highlighted common problems that may occur when initiating a Myokinematic Restoration program. Today I will cover common dilemmas in a Postural Respiration program: 1. Can’t reduce left rib flare Open right low back – inhibit right quadratus lumborum. Right Superior T4 manual technique or two person Infraclavicular Pump with emphasis on proprioceptive integration of inhalation on right and exhalation on left. 90-90 abdominal integration without use of hip flexors. 2. Can’t realize 70-80% of passive right HG IR Restore left horizontal abduction and cervical axial rotation to the left. Guide right humeral internal rotation with hand placement on volar forearm to inhibit HG ER guarding. Supine Resisted Right HG IR with Left HG ER to fatigue right teres minor and infraspinatus, followed by Supine Resisted Right HG IR with Weighted Left HG ER. Two person Right Subclavius manual technique. 3. Can’t achieve 45% of left upper extremity horizontal abduction Supine Hooklying T8 Extension Paraspinal Release Standing Hip Flexor Stretch Sternal Positional Stretch 4. Can’t expand right chest with left chest wall resisted expansion Improve right thoracic rotation with technique that places a rolled towel along the left paraspinals when in supine. PRI Supine Weighted Punch (right serratus anterior) with Right Apical Expansion and (left latissimus dorsi) Left Resisted HG IR. Two person Superior T4 with right arm distraction from mid range flexion to full flexion (end range) during inhalation. 5. Can’t blow up a balloon without pinching balloon neck Allow patient to blow balloon and pinch neck during inhalation at first. Then practice tongue up during pinch. Then attempt again normal balloon process with epiglottis sealed by tongue. Can they perform Supine Hooklying Restorative Synchronized Resisted Glute without arching back? Consider blowing up a balloon correctly in seated position first to allow for posterior mediastinal expansion. Then go back to supine hooklying position. Tommorrow we will end this series on Common Dilemmas with a Cervical-Cranio-Mandibular Restoration program! Posted November 4, 2008 at 3:31pm by Bobbie Rappl. Categories: Courses Common Myokinematic Restoration Dilemmas For those of you tuning in the last few days, we have been discussing common dilemmas that occur with a PRI program. Today we will highlight dilemmas that occur when instructing a Myokinematic Restoration program and offer suggestions on how to correct the dilemma: 1. Can’t find and feel left hamstring In a 90-90 position use the isotrainer ledge or similar set up to disengage paravertebrals Blow up a balloon in a 90-90 position with right arm reach and toes off the wall Protonics 2. Can’t find and feel left adductor Allow the patient to ‘roll’ entire torso and hip back upon Right Sidelying Left Adductor Pull Back during inhalation. Upon exhalation, contract the left abdominals - left knee into right thigh or ball Right Sidelying Knee to Knee – we often forget about this co-contraction adductor technique Left Sidelying Knee Toward Knee with Left Trunk Rotation – move knee with left abs on and during state of inhalation 3. Can’t find and feel right glute max Single Leg Wall Left AF IR with Right Glute Max Standing Supported Right AF ER with Right Glute Max Left Retro Stairs with left AF IR Stance, left foot one step higher than the right. Focus on right AF ER / glute max facilitation 4. Can’t abduct right leg without right low back activity Un-Resisted Single Leg Lateral Dip - emphasis on simultaneous right cervical and left thoracic abduction Sidelying Swiss Ball with Passive Apical Expansion - focus on contracting left IO/TA’s upon inhalation, hold and then attempt to raise right leg with hip abductors Standing Resisted Adductor Pull in -left leg in left thoracic abduction 5. Can’t inhibit left TFL or left hip flexors Single Left Leg Kneeling with right hip flexion Right Sidelying Left Glute Med in Hip Extension - push left knee into the wall above Right Sidelying Left Anterior Glute Med with TFL Inhibition - push left thigh into post Tommorrow we will highlight common dilemmas that take place with a Postural Respiration program! Posted November 3, 2008 at 11:21am by Bobbie Rappl. Categories: Courses Page 1 of 1 pages More blog entries can be found in the archives...