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Differences Between PRI and MSIA while back we received an email from someone asking “what is the difference between PRI techniques and MRI (Sahrman) techniques”? We were excited to have the opportunity to answer this question because it gave us a chance to really express why PRI is so unique! To read this email, click here or go to “Recent Emails”!
Power of Squatting
If you attended day four of our Interdisciplinary Integration course, you learned about Pelvic Floor Dysfunction and the positive effects squatting can have on treatment of this condition. Following the course, one of the attendees sent us this email that confirmed PRI’s position on the power of squatting… I wanted to share something else with you all, especially Lori and Ron. Lori highlighted the importance of squatting and it’s impact on constipation. My 3 year old, has struggled with constipation since birth. She literally will go poop once to maybe twice a week if she is lucky and it is always with tears and an all day event. We have tried everything, from suppositories, Miralax, Benefiber supplements, high fiber diet, Flax oil, Mineral oil, infant tummy massage, etc. Anyway when I got home Sunday night she was still awake. After the excitement of seeing each other again, I put her on the toilet in the squat position and she immediately started pooping! I was ecstatic! We did the same thing yesterday and today with the same results! This makes arecord three days in a row of her pooping without tears or pain! I truly feel that God brought me down to Lincoln for many reasons and this is definitely one of them. Thanks to you all for all of the work you do to help people. This simple thing will be life changing for everyone in my daughter’s life, as it was always so hard to watch her be so uncomfortable and not be able to help her. Thanks again!
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!
Technique of the Week
It’s here! We have updated the Technique of the Week from several weeks ago! To access it, click here...or go to “Technique of the Week” under Resources!
Modified Retro Walking
Joan Hanson, MPT, PRC recently sent us this email: “I was working with a patient yesterday on retrowalking. She had sufficient adductor strength to be on her feet but she locked up during retrowalking. She was turning on her TFL each time she picked up her foot to move it backwards. I therefore had her slide her foot backwards along the carpet and she was able to hold a neutral pelvis. I now call this retroslide. I realize that this patient eventually must be able to pick up her foot and keep a neutral pelvis (gait) but the retroslide will just be a precursor to the retrowalking.”
Discussion with Ron Hruska - Part TwoWhat are your favorite activities to isolate the left abdominals and to inhibit the hip flexors? 60-60 Supine Twists 60-60 Sidelying Twists Sidelying Crossovers Right Sidelying Knee Toward Knee with Balloon Left Sidelying IO/TA Foot Toward Foot Sidelying Hip Lift Sidelying Trunk Lift Left Sidelying Supported Hip Lift “These are my favorite activities to give individuals with juvenile kyphosis, scoliosis, spondylolisthesis, PEC patterns, and runners”. What is the most consistent, reinforced, feed-forward integrated muscle group in PRI? What is the most common muscle group missed in a PRI integrated program? To learn more about PRI non-manual techniques, click here!
Discussion with Ron Hruska
The abdominals have been a popular area of discussion at PRI the last few weeks. When able to catch a moment of Ron’s “free” time, I asked him a couple of burning questions… What are your favorite activities to find and feel your left abdominals and achieve a left zone of apposition? Alternating Posterior Pelvic Rotation and Reciprocal Bilateral Wall Leg Lift 90-90 Crossovers 60-60 Sidelying Twists All Four Belly Lift Wall Short Seated Left Arm Reach with Balloon Seated Resisted Bilateral Arm Pull Down with Adduction #4 “These activities are activities I would give for individuals with left rib flairs, someone who has the inability to achieve a left ZOA, for swallowing dysfunction, for PEC patients, for left unilateral neglect, for right upper trap tension and for someone who has an overactive right quadratus lumborum.” Stay tuned for tommorrow’s question…What are your favorite activities to isolate the left abdominals and inhibit the hip flexors? To learn more about PRI non-manual techniques, click here!
New Technique
Because of the importance of this week’s Technique of the Week, we have created a new activity. The “Left Stance in Right AF IR Position from the Right AIC Pattern” is the second neuromuscular activity in the PRI integrated standing activities that allows the patient to experience proprioceptive right acetabular femoral internal rotation as he/she shifts their weight from their left non-dominant lower extremity to their right while keeping his/her right leg behind the left. Click here to get a copy of this new activity!
The Importance of the Abdominals
We have all been lectured and given the lecture on the importance of our core stabilizers, the abdominals. Although everyone needs their abdominals, one patient population in particular needs an abdominal program instructed on their first visit, the PEC patient. Someone who demonstrates a PEC pattern lacks the ability to “turn off” their hip flexors which positions their pelvis forward bilaterally. A typical abdominal program would probably increase their symptoms and increase the strength of their already overdevelped hip flexors if the abdominal program didn’t first focus on pelvic position! When using integrative non-manual techniques for treatment of a PEC pattern, one must always consider choosing an exercise that isolates the abdominals and minimizes hip flexor involvement!
Seated Adductor Pull Back
When treating the geriatric population or someone with acute pain, we modify our testing and treatment all the time. You can take several of the sidelying activities and modify them to a seated position. This is an example of a modified Sidelying Adductor Pull Back. Because of the patients inability to get on and off the floor, the therapist has instructed this activity in a seated position. What’s even more beneficial to this modified seated position is the ability for the patient to isolate just the left adductors by placing her right hand medially to the left knee. With verbal cues for the patient to “press their left knee into their right hand”, they isolate just the left adductors without right adductor involvement. To access the complete handout, click here!
PRI Recommended TMJ Proprioceptive Occlusal Splints
We have updated the page discussing Recommended TMJ Splints. This handout provides a great reference for mandibular and maxillary splints and the benefits of both. We have now added discussion regarding permissive and directive splints and the considerations that need to take place before using both. To access our updated handout on PRI Recommended TMJ Proprioceptive Occlusal Splints, click here!
Moving Forward
In today’s weekly meeting between PRI and the Hruska Clinic, we discussed the importance of the PRI Left AIC Stance technique. This activity is the first activity in the standing integration section of our 2nd Edition Non-Manual Techniques CD-Rom. This activity is the beginning to all of our activities that incorporate standing left AF IR. Some patients may have Adduction Lift Test and Abduction Lift Test scores of 3 or better but still be challenged during daily gait. By placing them first in a Left AIC position, it allows you the capability to teach them how to get out of right AF IR and into left AF IR before their right foot leaves the ground. Although stair activity is a great activity to gain left AF IR during midstance, this activity helps teach the patient how to get out of right AF IR during late stance. Consider the PRI Left AIC Stance technique to transition from active right AF IR to left AF IR by transferring 50% of the patients weight through the left leg before moving forward. Many patients appreciate this activity because it gives them a good understanding of what left AF IR really is. To access the complete technique, please click here!
In Case You Missed It
These last few weeks have been filled with discussion on shoes. Now that you’ve been guided on which shoe to buy, let’s put them into use. Alternating Gait Recommendations is a handout found on PRI’s website educating patient’s on appropriate gait sequence complimenting a Right AIC pattern. This handout is a great way to incorporate PRI activity into an upright dynamic program! To access this handout, please click here!
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!
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