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Comment from a PatientA course attendee who has been practicing PRI for years sent us this email from a patient he recently saw… “I just wanted to again express my sincere thanks for your help with my back issues! I continue to make progress each week but most notably with a couple items. Driving for an extended period of time has killed my back for the past several years. My last trip which was 6 hours one way was the most comfortable in many years. Also, my right calf (since I ruptured my right achilles about 15 years ago) has looked like it belonged to a child despite much physical therapy and work on my own to bring it back over the course of time. I finally gave up on it a few years ago. It has fired more and developed more muscle tone in the last 5 weeks than at any point since I blew it out. This may not sound like a lot but to me it has been life transforming. I will forever be indebted to you both.”
Great Picture!
Ron taught Cervical-Cranio-Mandibular Restoration in Loveland, Colorado this past weekend. The great people at Rebound Sports and Physical Therapy gave him this x-ray image. What a great picture of left anterior innominate rotation with compensatory left femoral acetabular external rotation!
What a great way to end the week!We received this from a therapist practicing PRI in Colorado: “Hi all, I wanted to send along some information that I was amazed by. I have integrated the PRI concepts into my practice over the past year and have been thrilled with the results that I have seen. I recently treated a 13 year old female that came to me with right sided low back pain and a 17 degree scoliotic curve. After working with her over the course of 5-6 sessions, she returned to her M.D. for a follow up and x-rays, only to discover that her scoliotic curve decreased to 14 degrees. She has overall decreased pain and improved alignment. Thank you for giving us the tools to help people like this! It makes my job so much more rewarding to be able to effectively treat patients.”
A Peripatetic Perspective from Ron Hruska
It’s raining here in Nebraska and as I walk on the slippery, wet surfaces I can’t help but reflect on how our patient’s must feel when they can’t feel their heels strike or sense what centering over a lower extremity is all about, because of uni-planar learned behavior and lateralization in their attempt to move without falling. What a difference left heel strike made on the waterlogged path I was on this morning. I could walk from place to place and dodge the wettest surfaces without locking up my back, my knees or my spatial perspective. I feel blessed to understand the importance of left AF IR and right trunk rotation so that my reciprocal respiration and peripheral vision can remain peripatetic.
Success Story from Jennifer Poulin, PT, PRCI have been working with this patient on a PRI plan of care to address left lower extremity radiculopathy following a back surgery. We might refer to this as “failed back syndrome”. She had plateaued in her program and was getting frustrated with her lack of progress. She was wearing some good shoes consistently and I did not see major foot and ankle concerns initially. This is a patient who is dedicated to her rehab plan of care so I knew compliance was not an issue. We spoke at length about the benefits of a PRI orthotic and I finally convinced her to give them a try. She returned this week after wearing the orthotics for only two weeks and was thrilled with her immediate changes. I asked her to put it in writing so we could share with others. I know the orthotic is an investment for many, but the return on this investment is well worth it! I especially thought Ron and Dr. Wise would be interested in her visual changes! Jen
I want to thank you and the person you worked with on my new orthotics—they’re wonderful! I started seeing changes immediately upon inserting them into my shoes:
Beyond the immediate changes, I’ve also had some additional successes with the orthotics:
I am thankful for the improvements I’ve seen over the past couple of weeks, and I appreciate all the two of you have done to improve my quality of living.
A story worth sharing…I wanted to share a very cool story about a patient I just recently saw… A 65 year old female comes in and sees me with a complaint of right-sided lateral and medial elbow pain. She has a 3-4 year history of symptoms. Patient has received 4 cortisone injections with min-mod relief (symptomatic relief has decreased with each injection). Patient has had PT at 2 different locations with no success. During PRI exam, she is identified as a PEC. She is repositioned during PT session and is sent home with Paraspinal Release program 2x/day. Comes in 7 days later and hasn’t held her correction. She corrects with a Superior T4 manual technique and continues Paraspinal Release program. I also placed a medial longitudinal arch pad in her right shoe in an attempt to hold her correction. Comes in 10 days later and has not held her correction. On her third visit, I use a tongue depressor on her left molars and re-check her PRI tests (HG IR, passive HG flexion, Adduction Drop, Extension Drop) and it does nothing. So, I ask the patient when the last time was that she had an eye exam (she wears glasses – and I used to make glasses to help pay my way through PT school, so, I can tell that she has a pretty strong prescription). She says she has been due to get her eyes checked. I explain that I believe she has something going on with her eyes and that is causing her inability to hold her corrected posture. I ask her to see an eye specialist and I send a note to that specialist explaining my findings. The patient calls me after her visit and is crying. She has cataracts in both eyes and needs emergency surgery!!! She would have never have found out if it wasn’t for me. And, I would’ve never checked if it wasn’t for PRI…a home run all the way around. Mike Dixey, PT, Cert MDT, CSCS
Comments following Skype sessionLast week, Ron Hruska and Oliver Hall treated a patient using Skype. Here is what Oliver had to say about it: The consult was awesome. This is a girl that I have been looking at for a while, seeing what she can do in my confined clinical environment and trying to correct the imbalances that I saw and found. The way that Ron was able to look and think beyond the clinical environment, find out about 3 concussions and explain things to Jenn in such functional terms as “you need to feel like you are walking or riding up hill” – which ultimately lead to Jenn saying, “actually my horse is built downhill and I started riding her shortly before my hips started to hurt” was incredible to watch and listen to. All of the pieces were made to fit together. My wording of “you need to be able to flex more or turn on your abs more so that you can squat”, did not give her the same functional understanding of the problem so we never put the pieces together. Also the way that Ron narrowed things down: can she shift in stance, can she shift to the left with either eye closed, does she have frontal plane control, does she lose frontal plane control with her left SCM on, can she feel prisms shift her weight forward or back, how does her seated FA ER strength change between sitting normally versus sitting in a flexed position while trying to find her abs really added a whole new dimension and method of application to the basic PRI tests that I am so familiar with.
What do you see?
The day I was treating this patient I thought this looked like a type I right shoulder blade and a type III on the left. After I got home, I’m wondering if it is a Type II bilaterally and I didn’t see it correctly? Can you tell by looking at the picture? You were right the first time…she is a Type I on the right and a Type III on the left. She is in IR on the right and ER on the left. She doesn’t have a lot of upper trap and mid trap hyperactivity to be considered a Bilateral Type II.
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