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Orthotics May Not Be Appropriate for EveryoneOver the last few years we have been fortunate to develop a strong relationship with Paul Coffin, DPM. His monthly visits to the Hruska Clinic have provided us a great avenue to learn about him, his practice and his amazing knowledge of the foot. As time goes on, we are getting better at determining when PRI activity will succeed without Dr. Coffin’s expertise and when a referral to him is necessary. Last night when I got home from work I was greeted with the warmest welcome I have ever received from my adorable dog, Miles. As I sat my things down and began to walk to the bedroom, his habitual behavior of following my every step ceased. Ignoring this bizarre behavior I continued my path to the bedroom. Once I opened the door, I realized why my shadow had chosen to stay 10 paces behind me. Although my experience with orthotic referrals is elementary, I am fairly confident that he will not be able to help me?
Top 10 Recommendations for the Office
Lori Thomsen, PRC has given several community talks around Lincoln, Nebraska. One popular topic of interest is office ergonomics. In the world of Physical Therapy, office ergonomics, is a trendy topic covered by many clinics and organizations. Here at PRI, we have taken your typical office recommendations and applied PRI related concepts to them. Along with a list providing you with the top ten recommendations, there is also a coordinating image. To access the Top Ten Office Recommendations, please click here!
Standing Right AF ER with Right Glute Max
While working with a patient who lacked right glute max activity in a standing right AF ER position, we came up with a new activity. This new activity not only places the patient in standing right AF ER, activating the right glute max, it also provides resisted right FA ER. This is a great activity to promote left AF IR with concomitant right AF ER / FA ER activity. To access the complete exercise, please
Class is always in session
Providing patient care is not only a learning experience for the patient but also for the therapist. Each patient has taught a lesson, sent a message and left an imprint that has helped develop our approach to treatment. This week Ron Hruska was working with a patient who had seen another therapist at the Hruska Clinic prior to this visit. She mentioned that a specific cue from Lori Thomsen made all the difference in her ability to breathe into her right chest. Lori asked her to “breathe into the heel of my right hand” during an Infraclavicular Pump and Subclavius technique. Ron brought a couple of us into the treatment room to feel the upper right ribs externally rotate upon inhalation using this particular cue. The next time you perform these PRI Manual Techniques consider using this instruction to maximize your patient’s ability to achieve right apical expansion. Contact us to share your own patient-directed discoveries!
CCMR Supportive Literature
For those therapists doing cranial work, you’ll want to read these latest articles supporting our CCMR course. Orthodontics in a Quantum World I: The Rationale for a New Approach by Gavin James, MDS, FDS, D. Orth. Abstract: Advances in physics and cell biology are changing how science views studies about the body. The first part of this article is an overview of these advanced. The second part is a working hypothesis as to how these changes could affect orthodontic diagnosis and treatment. An example is given of how this thinking might apply. To access the entire article please click here or contact us! Orthodontics in a Quantum World II: Cranial Movement and Parafunction by Gavin James, MDS, FDS, D. Orth. Abstract: Maintenance of brain vitality is the most important function of the body. Several oral behaviors are involved in this process. Typical facial characteristics and intra-oral change can result from this. Symptomatically, the response can resemble a temporomandibular joint disorder. An integrative systems approach gives a basis for understanding and treating the condition. To access the entire article please click here or contact us!
More Summer Reading
Recent articles printed in The Journal of Manual & Manipulative Therapy further support Postural Restoration Institute methods for management and treatment of SI pathology. Three-Dimensional Movements of the Sacroiliac Joint: A Systematic Review of the Literature and Assessment of Clinical Utility by Goode et al, offers a review of current literature that sheds light on the need to consider re-organizing and retraining neuromotor adaptation patterns rather than mobilizing or manipulating the SI joint. To read the article click here. Go here to read the Letter to the Editor and here to read the Author Response. The second article, Variation in Pelvic Morphology May Prevent the Identification of Anterior Pelvic Tilt by Preece et al, discusses how angle of pelvic tilt and sagittal plane orientation may be morphologic. To read this article click here.
Functional Squat Test
In addition to the Hruska Adduction Lift Test and the Hruska Abduction Lift Test, we have created the Functional Squat Test. Similar to the tests mentioned previously, The Functional Squat test is graded by levels. Level 1 is the inability to perform the test and level 5 represents maximal performance. This test helps the clinician determine whether the patient demonstrates hyperactive hip flexors, back extensors, and femoral rotators. It also helps establish whether or not the patient has the ability to perform a posterior pelvic tilt and if they can achieve maximal AF IR. To view the complete Functional Squat Test, please click here!
And The Winners Are…
Last week we brought you the shoe list provided by The Lincoln Running Company. This week we are providing you with the favorites chosen by Dr. Coffin and PRI! With so many choices in footwear it’s hard to decide which is best. The shoes listed are not only the most appropriate footwear biomechanically they are also the best suited to compliment PRI orthotics. 1. Asics Evolutin
Going Up or Going Down?
Retro Stairs has been a popular activity for the last decade of PRI. It is one of the first upright activities given to patients when teaching them how to achieve left AF IR. During the dawn of the squat program, taught in the Impingement and Instability course , we have found other great ways to utilize the stairs. Heel Stair Descents is a new activity designed to eccentrically lower your self down the stairs. This activity is an excellent way to activate the quads, promote controlled hip extension and inhibit the gastrocs. To view the complete technique, click here!
Food for Thought
The newest journal article being passed around PRI is “The contractile field – A new model of human movement – Part 3”. This article written by Phillip Beach and published in Journal of Bodywork and Movement Therapies discusses embryology and evolutionary biomechanics as they relate to ‘contractile fields’. “Tuning between muscles within a contractile field, and tuning between fields, shapes movement patterns”. To access the entire article please click here or contact us! Beach P. The contractile field – A new model of human movement – Part 3. J of Bodywork & Movement Ther. 2008; 12:158-165.
PRI Recommendations for a Right TMCC Pattern
If you have been to the Cervical Cranio Mandibular Restoration course you are aware of the recommended activity for limited opening of the jaw, hypermobility of the jaw, and anterior disc displacement. Most recently, we have updated these guidelines and added a new section titled, “PRI Recommendations for a Right TMCC Pattern”. These recommendations will help guide clinicians on teaching patients about tongue position while at rest to promote proper maxillary position. To learn more about the Right TMCC pattern please look at our Cervical Cranio Mandibular Restoration course (please note that in 2009 this course will be offered as an introductory course with no pre-requisite). To view the recommendations for a Right TMCC pattern, please click here!
Postural Restoration Presented at NATA Annual Meeting
The 59th NATA Annual Meeting & Clinical Symposia was held June 18-20 in St. Louis, MO! University of Tennessee’s Assistant Baseball Trainer, Jeff Wood, presented “Exercise Programs to Protect Baseball Pitchers Arms from Overuse Injuries”. The majority of the content presented in this lecture was based on PRI principles. Jeff utilized his personal knowledge and experience with PRI as well as articles that have been written by PRI faculty and certified therapists to outline his presentation. To view the complete presentation, please click here!
“If The Shoe Fits, Wear It”
Last night was the annual gathering between The Hruska Clinic, Dr. Paul Coffin and The Lincoln Running Company to discuss what’s new in shoes! The Lincoln Running Company is a local shoe store in Lincoln, Nebraska who works closely with the staff at The Hruska Clinic assisting patients in finding appropriate footwear that compliments PRI concepts and PRI orthotics. Dr. Paul Coffin is a podiatrist from Sioux City, Iowa, who evaluates patients of The Hruska Clinic twice a month and assesses their need for customized PRI orthotics. To see the new 2008 shoe grid, provided by the Lincoln Running Company, please click here!
Impingement and Instability Course
Thinking about attending our upcoming Impingement and Instability course in Lincoln? Don’t wait - Register now! Due to our low number of current registrants this course may be cancelled, however, only a few more registrations are needed to avoid canceling. Don’t miss this opportunity to benefit from a small course size and advance your clinical skills in the treatment of hip impingement, patellar instability, calcaneal instability, shoulder impingement and many other diagnoses! Registrations will be accepted until Monday, July 7th - at which time we’ll be making the big decision! Register now!
Core Balance Offers Postural Restoration
If you live in the Flagstaff, Arizona, area or are planning a summer vacation there, let Core Balance Therapy Services take care of your Postural Restoration needs. Kyndall Boyle recently joined the staff at Core Balance and brought with her the PRI approach. She is the only therapist on staff practicing this “unique approach to rehabilitation.” To read more about Kyndy and Core Balance Physical Therapy, please click here!
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