Blog - Postural Restoration Institute

Select A Site:

	Blog
Course Notes - Pelvic Floor Dysfunction If patient can’t maintain re-positioning… Breathing Are they diaphragmatically breathing? Quality of respiration? Symmetry of respiration? Decreased diaphragmatic motion, increased descent of pelvic floor, altered breathing patterns associated with pelvic pain. Diaphragmatic and TA muscle activity reduced with hypercapnea. Pelvic floor depression associated with breath holding/Valsalva maneuver. Abdominals Can they isolate IO / TA? Symmetrical or Asymmetical? Palpate approximately 2 cm medial and inferior to ASIS. Slowly & gently draw in your abdominals away from your fingers. Sub maximal contraction. Change positions (supine, side lying). Monitor for substitutions. Is IO / TA activity sustained with breathing? Can they maintain IO / TA contraction with upright static & dynamic control? Pelvic Floor Can they isolate their pelvic floor muscles? Can they actively contract and relax the pelvic floor? Do they feel an up & in contraction? Are they substituting (glute squeeze, breath holding, adductor squeeze, bearing down)? Is there symmetry? Is there appropriate motor planning? Voluntary contraction of the abdominal muscles stimulates pelvic floor contraction. TA and IO recruited during all pelvic floor muscle contractions. Relaxed abdominals resulted in only 25% of maximum pelvic floor contraction. Women with stress incontinence have increased OE activity (increased OE increases IAP). Back pain more common in women with incontinence , increased probability of LBP if have symptoms of incontinence. Pelvic floor muscles are part of preprogrammed response to postural adjustment. Decreased pelvic floor strength, endurance and thickness noted in women with incontinence. Increased pelvic floor activity with postural perturbations noted with women with incontinence. Pelvic floor tonic activity at rest, with cough automatic phasic response, in women incontinence unsustained tonic pattern with asymmetrical recruitment. Timing deficit of muscle recruitment lost with women with incontinence. Higher resting tone of pelvic floor with dysfunction, need to teach down training. High resting tone does not always mean a strong pelvic floor. The pelvic floor needs to relearn how to function within a neutral pelvis. Feel the pelvic floor contract and relax. Reported cure rate of pelvic for urinary incontinence ranges between 44-69%. 30% of contractions are performed incorrectly; 50% of contraction are strong enough to increase urethral pressure. Pelvic floor muscle activity alone does not predict UI, activity related to UI needs to be considered. Isolated contraction of pelvic floor produces greatest displacement of pelvic floor. Hypermobility - But Still Have Symptoms Is there global hypermobility? There is a high correlation of pelvic dysfunction with a reduction in tissue collegan concentration. Referral Has there been trauma? Consider referral early on if patient not progressing appropriately. Patient can reposition but they still have symptoms- are they able to relax their pelvic floor? Is there psyco-social issues? Referral To If symptoms have not subsided consider referral to OB GYN/Urologists/Primary MD PT with pelvic floor specific training (biofeedback, internal evaluation, condition specific integration) Podiatry (correlation of foot flexibility and SUI) Dentist Neuro - Optometrist Posted April 7, 2009 at 6:00am by Bobbie Rappl. Categories: Courses • 0 Comments It’s Here!!!! The 2009 shoe guide that is! Before the Interdisciplinary Integration course we met with The Lincoln Running Company to hear all about the newest shoes on the market. After much conversation and a little debating, PRI and Dr. Paul Coffin came up with recommendations for the best shoes out there. Guess what shoe still tops the list…Asics Foundation! To see the entire list, click here! Posted April 6, 2009 at 6:00am by Bobbie Rappl. Categories: Products • 0 Comments Feedback from the Postural Restoration course in Woodbury, Minnesota Karen Jiran, MPT, PRC was the instructor last weekend for our one day clinical course called Postural Restoration. For those of you unaware of what this course is, this course is an individualized, one day class, that covers concepts requested by the attendees. In short, the entire day is spent reviewing concepts taught in one of our two day courses. This course happened to be organized by PRI but we often schedule the courses on request. Here is some feedback from the attendees: “Great course, Karen did an excellent job! I would recommend this class to everyone. It was a fun, dynamic learning experience!” “Excellent course, please offer more of them! It’s nice to have a small class size to have practice time!” “Very, very good! The case studies and small group discussion made the problem solving effective!” “It’s nice to have a source to get questions answered.” If you are interested in having a one day clinical course at your office, please contact us! This is a great opportunity for more advanced, hands on clinical application for you and your colleagues! Posted April 3, 2009 at 6:00am by Bobbie Rappl. Categories: Courses • 0 Comments COURSE CANCELLED The Myokinematic Restoration course scheduled in Syracuse, NY this weekend has been cancelled. If you are registered to attend, please give us a call for more information. Posted April 2, 2009 at 5:35pm by Janie Ebmeier. Categories: • 0 Comments The Brain that Changes Itself The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science written by Norman Doidge is a highly recommended PRI reading! This book was discussed throughout our Interdisciplinary Integration course this past weekend and it was decided that this book is a must have!! To learn more about this book, click here! Here is what the New York Times had to say about it! Posted April 2, 2009 at 12:34pm by Bobbie Rappl. Categories: Books • 0 Comments For those of you that couldn’t make it… to our first Interdisciplinary Integration course, you missed out on a fantastic weekend! Let me give you a quick overview on each day… Day one which covered Podiatric Integration started out with information covering gait analysis and it’s relevance to PRI related treatment. It was a great overview of the reciprocal process that takes place as our body moves through the motion of gait and what PRI considerations we should keep in mind as we are treating different phases of gait. The afternoon carried on with information regarding orthotics and what purpose a PRI orthotic serves in reducing neuromotor pathomechanics provided by Dr. Paul Coffin. The day couldn’t have ended better than with Ann Ringlein, from the Lincoln Running Company, covering proper shoe wear. Here are some comments from attendees of day one: “Excellent clinical application I can use immediately.” “Fantastic, fascinating guy; we could learn a lot more from him!” “Excellent information and application for our clinic.” “The videos and pictures of those walking was so helpful!” Day two was devoted to Dental Integration provided by Dr. Mike Hoefs. The entire day was spent by a passionate, enthusiastic dentist talking about the importance of position and maintaining cranial symmetry. Dr. Hoefs is one of the few dentists in our country treating craniofacial pain and dental discrepancies through gnathic orthopedic positioning. The highlight of the day was when he took our very own, Lisa Bartels, DPT, PRC, and placed a twin block ALF appliance in her mouth in front of the whole class. It was incredible to see the postural changes that took place immediately following the application of this appliance! Here is what others had to say about the day… “Interesting, informative and very helpful for understanding when and how to refer to an appropriate dentist!” “This was such an eye opener; I really appreciate all the information given!” “The demonstrations used during this course were very applicable for use in the clinic.” “Wow, Dr. Hoefs is the Ron Hruska of dentistry! He is such an innovator!” Day three was spent on Vision Vestibular Integration. The first part of the day covered optokinetic learning taught by Ron Hruska, MPT, PT. We learned all about vision and its influence on balance and the vestibular system. The morning provided an excellent overview on how to integrate and communicate with optometrists. Dr. James Nedrow discussed his expertise in neuro-optometry and the treatment of visual midline shift and post traumatic visual dysfunction. Here is what others had to say: “I have a better idea of when to request optometry and neuro optometry.” “Both the morning and the afternoon came together for me and showed me where to look to study and begin tying things together. The whole day was fascinating!” “This course opened my eyes to the importance of treating the entire system.” “Wow, this course definitely helped clarify the relationship of the vision-vestibular system and posture. Ron and Dr. Nedrow did a great job of presenting this information and demonstrating the importance of interdisciplinary integration.” And finally, day four! Pelvic Floor Dysfunction was the topic of this day given by Heather Engelbert, PT, PRC and Lori Thomsen, PT, PRC. What an incredible day covering the importance of establishing a positioned pelvic floor, before addressing pelvic floor dysfunction. Not only was pelvic asymmetry discussed but also covered was the importance of the respiratory system and its influences on the pelvic floor! The afternoon was spent on treatment techniques for pelvic floor dysfunction and we were given several new activities to use with our patients. Here is what other attendees had to say about it… “Great explanation of the Left AIC pattern and how it affects pelvic floor dysfunction. I loved the “egg”, pelvic floor and diaphragm diagrams; it helped me to understand position of the pelvic floor and the pelvic diaphragm.” “The clinical application with treatment strategy and reasoning behind these strategies was one of the best discussions I have ever heard!” “This was a wonderful way of improving my understanding of how to fit the pelvic floor in the PRI picture.” “This course exceeded my expectations; I now know what is going on at the bottom of the egg and what to do about it!” Posted April 1, 2009 at 9:35am by Bobbie Rappl. Categories: Courses • 0 Comments Page 2 of 2 pages < 1 2 More blog entries can be found in the archives...