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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.
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.
Success with Postural RestorationMegan Bollinger, MPT of Peak Performance in Bemidji, MN was kind enough to share with us her patient’s account of treatment with Postural Restoration. 45 Years of Chronic Pain—Then Postural Restoration Crossed My Path When I was about 5 years old, I fell off a chair and had a brain concussion that affected my vision. I still remember what it looked like to have triple vision, then everything being all white, then all black – all the while feeling nauseous and having a pounding headache. The following year I was riding on the rock wagon in our farm field, kicking at the wheel (which I knew I wasn’t supposed to do), when it caught my foot and the next thing I remembered was seeing the sky come into view as the wagon rolled across my left hip. The field was just plowed, so I was pushed down into the dirt when I was run over, and walked away with just scratches and a tire track across my upper thigh. Read More…
Compensatory FA ER…The other day we received a great question… In Myokinematic Restoration I understood that the left femur is in flexion, external rotation, and abduction (Left AIC pattern). I understand this as being positional AF ER. But I think I learned somewhere that the left leg is oriented in internal rotation and adduction because of the “pull” of the left ilium as it rotates anteriorly in the transverse plane. When I look at my Impingement and Instability manual I see that the left hip can be oriented in internal rotation and compensatory external rotation. Is external rotation a function of position, compensation, or both? You are not wrong in identifying that these concepts are presented differently depending on if you go to Myokin or Impingement. In a Left AIC pattern the femur will be internally oriented and adducted. This is described in Impingement and Instability. This is an assessment made through upright / dynamic evaluation. In Myokinematic Restoration, the femur will be in external rotation and abduction with respect to the acetabular position because of the position you and the table placed them in. When you place the patient on a table to measure ER/IR values, the patient’s lower extremity is positioned by the table and the examiner, not by the acetabulum. So theoretically, this is not a compensatory activity, you passively placed them in that position. Left FA ER is only considered compensatory when it is dynamic. We can’t go into discussion that the femur is actually in an internally oriented and adducted state in Myokinematic Restoration because the attendees taking this course are learning what PRI means by “neutral” and “position”.
PRC Therapist - Christel Parvey
Christel was recently recognized by her company for her achievement of PRC. Crookston, MN – RiverView Rehab Services physical therapist Christel Parvey recently earned the designation of Postural Restoration Certification (PRC). Postural restoration is a physical therapy technique that aims to restore a more neutral posture for individuals. Parvey is one of only 40 physical therapists in the nation to achieve this certification.
Latest InterviewBe sure to check out our first interview of 2009. Lori Thomsen, MPT, PRC will be speaking at our Interdisciplinary Integration course in March covering the topic of PRI and pelvic floor integration. Click here to read her interview!
Julie’s StoryRon Hruska recently received the following email from a PRI trained therapist: When I told Julie I had been to another of your courses, she asked if I had thanked you for fixing her headaches and jaw pain! I admitted that I had not, so now I will.
Postural restoration is going to the major leagues!
Elizabeth Wheeler recently shared with us some good news! Liz is a PT who has attended PRI courses and implemented the techniques with great success. Congratulations, Liz! Postural restoration is going to the major leagues! I have been named the PT for the Washington Nationals baseball team! I will be going down to spring training in Florida and have been asked to do PRI assessments on all the baseball players. I have put together a patient questionnaire (including dental & optical history), a list of desired pictures (to compare before and after - upon completion of the season and postural restoration rehab), and a general PRI assessment form. I would like your input as to what else to include. This information could be a golden opportunity for a ton of objective PRI info….. that I hope to turn into a published paper. - Liz Wheeler To read this article, click here!
Congratulations to the PRC class of 2008!
The Postural Restoration Institute™ proudly announces that the following therapists have earned the designation of Postural Restoration Certified (PRC): Lisa Bartels of the Hruska Clinic in Lincoln, NE; Joe Belding of Advance Physical Therapy in Chapel Hill, NC; Kyndy Boyle of Northern Arizona University in Flagstaff, AZ; Mara Brandsoy of Impact Physical Medicine & Aquatic Center in St. Paul, MN; Susan Henning of Advance Physical Therapy in Pittsboro, NC; Jill Honermann of Sanford Health/Sanford Spine Center in Sioux Falls, SD; Kim Keyser of Duke University Medical Center in Durham, NC; Minh Nguyen of The Rejuvenation Center in Omaha, NE; Bobbie Ninneman of the Hruska Clinic in Lincoln, NE; Gregory Parfianowicz of Corning Hospital in Corning, NY; Christel Parvey of RiverView Rehab Services in East Grand Forks, MN; Gayla Pleggenkuhle of OSI in Maplewood, MN; Sangini Rane of Apex Physical Therapy in Apex, NC; Deborah Reagen of Deb Reagen PT in Woodbury, MN; Jane Stanley of Sioux City Physical Therapy in Sioux City, IA; Tina Straub of Brookings Avera Medical Clinic in Brookings, SD; and Joyce Wasserman of Physical Therapy Center of Horseheads in Horseheads, NY. Certification is a result of advanced training, extraordinary interest and devotion to the science of postural adaptations, asymmetrical patterns and the influence of polyarticular chains of muscles on the human body as defined by the Postural Restoration Institute. The certification process of both clinical and analytical examination took place on December 8th and 9th at the Postural Restoration Institute™ under the direction of Ron Hruska and James Anderson. We congratulate these therapists on their outstanding achievement! Forty therapists nationwide are now recognized as Postural Restoration Certified.
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!
PRC Therapists know SquatDuring the 1st annual PRC conference that took place in Minneapolis, Minnesota, Mike Cantrell, Holly Spence and Jen Poulin took a break from the action and happily demonstrated their ability to squat! We are so proud of them on so many levels…especially Level 5!!
CAREERS
Re-locating or looking for a change? Be sure to visit our “Careers” page to find a listing of employment opportunities specifically for PRI trained therapists nationwide. Go to Find a Therapist and click Careers!
No Measurement Needed!
Recently, a therapist at The Hruska Clinic had a patient in the office with complaints of low back pain. All of the objective measurements taken were reflective of a Left AIC, Right BC pattern. When the patient was positioned in supine, the apical expansion test wasn’t necessary in determining whether or not this patient could apically expand on the right. His prominent left rib flair paints the whole picture!
Where’s the Evidence?
We are often asked for evidence based articles supporting PRI. The “evidence” is there, but going to all the sources as they presently exist, hasn’t been put together for the general public…yet! A while back, upon request, Ron Hruska wrote an explanation on his view of evidence based material as it relates to PRI. Please read!
PRC Applications Have Arrived!
Thank you for sending your applications for 2008 Postural Restoration Certification. Applications will be checked for completeness before they are sent on to our PRC Application Review Committee. This revolving committee is comprised of four therapists from across the country who have completed the PRC process. They will thoroughly review all material submitted and provide feedbackand suggestions to assist the applicant in preparing for the educational process of PRC. The application review will be completed by October 15th at which time applicants will be notified of the reviewer’s comments in preparation for analytical and clinical testing scheduled on December 8-9. PRC intentionally follows our four-day Advanced Integration course in Lincoln, Nebraska. Thanks again for submitting your application and look for your complete review after October 15th.
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