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What do you see?Mike Cantrell, MPT, PRC recently sent us a video of a patient he is treating. Here is what he had to say about her: “I have been treating this patient for bilateral knee pain. Her right knee pain has decreased but the left still persists. She is in a set of PRI orthotics and wearing appropriate shoes. She had a significant ankle sprain back in the fall of last year and it continues to hurt. She is an Irish dancer and feels knee and ankle pain when dancing. She is not sure if ankle bracing helps or hurts the knee. Hruska Adduction Lift scores are excellent, she has full HG IR and FA IR/ER. Here is a video of her gait pattern.”
After looking at the video you will see that this patient still has no control of her left glute med. She collapses with gait and falls to the right. She will need to be on a program where she feels her left adductor co-contract with her left glute med.
Squatting
Lori Thomsen, PT, PRC recently wrote an article on the importance of squatting in the Performace Conditioning magazine. This short article does a great job highlighting PRI’s view on proper squatting techniques. To read this article, click here!
Curricular Considerations - Day Four
Day Four...What’s new in the PRI curricular future? The pelvic floor- like never discussed before. Heather Engelbert, PT, PRC and Lori Thomsen, PT, PRC will bring you up to date on the importance of establishing a well-positioned pelvic floor, before addressing pelvic floor dysfunction. Ironically, the timing of my pregnancy fit perfectly with our need for a PRI model for this course so you’ll be seeing me in many of the ‘new’ PRI pelvic floor non-manual techniques. Applying a PRI myokinetic format to the pelvic floor anatomy is exciting in itself, but to integrate these concepts with the respiratory system is even more rewarding. What an uplifting way to end the four days!
Curricular Considerations - Day Three
Day Three...how about going back to school to learn about vision and its influence on patterned balance and the vestibular system? Ron Hruska will start off by giving an overview on how working with optometrists has helped him establish timely, good neuro-mechanical postural change, complimenting Postural Restoration Institute goals of improving reciprocal balance and function. A didactic day of functional optokinetic learning. Learn about associated vision and vestibular patterns of people who rely on back and neck extension, and their right extremities. Dr. James Nedrow’s discussion about neuro-optometry in the treatment of visual midline shift and post traumatic visual dysfunction will enlighten any professional who treats patients with dizziness, headaches and perceptual issues. Both Dr. Nedrow and Ron are members of NORA, the Neuro-Optometric Rehabilitation Association, and see eye-to-eye on the need for increased vision-vestibular integration in the future of orthopedic, neurologic, pediatric and geriatric treatment programs. What an ‘eye-opening’ day!
Curricular Considerations - Day Two
Day Two...you can expect to hear a passionate dentist talk about the importance of temporal mandibular disc position on maintaining cranial symmetry. His unique approach to treating craniofacial pain and dental discrepancies through a gnathic orthopedic positioning approach has complimented Ron Hruska’s approach of reducing neuromuscular patterns of the ‘head, neck face’, through integrative muscle and respiratory re-positioning. The two have been working together for over two years and have successfully integrated unconventional cranial and postural methods to maintain a cranial, occlusal and cervical-thoracic lumbar stability. I see this as a great opportunity for a physical and occupational therapist and podiatrist to recognize the opportunities and the rewards of working with dentistry in establishing postural alignment or neutrality of the head, neck and trunk. Dentists should feel more comfortable working with physical and occupational therapists and podiatrists, knowledgeable about the Postural Restoration Institute philosophies, after taking this course. What a ‘team’ day!
Curricular Considerations - Day One
As the Interdisciplinary Integration course approaches, I thought I would provide some timely input and updates. Our speakers are excited about this event and are working on each of their presentations and trying to condense their material down to one day. Since there will be a different speaker each day, I thought I would provide some insight on how each unique day will “feel”. Day One...could be compared to our ‘Technique of the Week’. If you are interested in why an orthotic is important for challenging habitual postural and gait patterns, or what purpose a PRI orthotic serves in reducing neuromotor pathomechanics, or when should you consider using specific orthotics and muscle integration to establish PRI outcomes, or who specifically should experience specific support from a specific appropriate footwear, you should think about where you are going to be that day. Dr. Paul Coffin, Ron Hruska and Ann Riglein have been working together for more than 8 years, what more can I say.
Technique of the Week OverviewFor those of you that have had the chance to read the technique of the week I thought I would share my discussion with Ron Hruska. I’ll be honest, at first I was a little puzzled when he started discussing GH movement and upper trap contraction promoting GH abduction? After we talked about it, I was able to visualize the glenoid being similar to the acetabulum. I was able to pull together the muscular influences of FA and AF in comparison to GH and HG. After more discussion I realized that this technique could quite possibly be a functional upper extremity test similar to the Hruska Adduction Lift Test. If the patient can’t perform this technique without activating on their neck, they still do not have their frontal plane. You, as a clinician would need to go back to the integrative sidelying techniques that incorporate a left internal oblique with right thoracic adduction and left femoral adduction before your patient is capable of performing a Sidelying Hip Lift. It took me a while to absorb the complexity of this technique and I’m still not 100% there, but I now have a better understanding of the integrative tri-planar control this technique offers our patients and the objectivity this technique offers us as clinicians in assessing and progressing our patient’s programs!
New Technique of the Week!We have posted a brand new Technique of the Week! We realize that it is long overdue, however, we promise you won’t be disappointed! This technique is comprised of seven hand written pages and is said to be by the author, Ron Hruska, ”the best sidelying activity that incorporates the inhibitory processes needed to reduce Left AIC / Right BC tone in the upright individual”. To read about the Sidelying Hip Lift, click here!
Why Does the Lung Hyperinflate?
Why Does the Lung Hyperinflate, written by Gary Ferguson is the most recent article being filed in PRI. This article discusses the effects of hyperinflation on COPD. “Hyperinflated lungs can produce significant detrimental effects on breathing, as highlighted by improvements in patient symptoms after lung volume reduction surgery”. To access this article, click here!
Great Example
This picture is a great example of an individual who appears to have a lot of right FA ER but when you sit them up to measure their ROM, they have limited right FA ER. They have actually subluxed their right hip because of the position of their pelvis. Even though this patient visually appears to have a lot of FA ER, they actually need a right glute max program to stabilize their right pelvis and help maintain pelvic neutrality and right AF ER so that appropriate, non hip flexor oriented, hip rotational strength can occur.
Rehabilitation of the Spine - A Practitioner’s Manual…
...written by Craig Liebenson is the latest book being passed around PRI. This book is a compilation of interdisciplinary treatment approaches to improve clinical outcomes. With our first annual Interdisciplinary Integration course soon approaching, this book couldn’t have fallen into our hands at a more appropriate time! Also, we were delighted to find that in Chapter 17 of this book, Rehabilitation of Breathing Pattern Disorders, Ron Hruska was referenced. In addition to Hruska being referenced, many other familiar references were used to complete this book…Hodges, Chaitow, Janda, De Troyer, Travell, etc… There are several websites that sell this book, we feel it is definitely worth having around! You can preview some of the pages from this book by clicking here!
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