Community News

Steps for Recovery, a Postural Restoration Certified Center and home for this past weekend’s Postural Restoration course, has offered its patients the Postural Restoration model of care for many years. Several of their clinicians, Ashley Arensdorf, PT, Lauren Cochran, OT, and Katie Stephens, PT, were in attendance to sharpen their PRI skills. In addition, nearly a third of participants were newcomers to the science of human movement. They were treated to the collective wisdom of three PRC-credentialed clinicians, who elevated the course for all: Craig Depperschmidt, PT, Lisa Mangino, PT, and Sangini Rane, PT.

Postural Respiration, the flagship course of the Institute, weaves concepts from our other primary courses, Myokinematic and Pelvis Restoration, and serves as a precursor to many other PRI courses: Cervical Revolution, Human Evolution, Cranial Resolution, Voice Box Resonation, and Forward Locomotor Movement.

Our patients/clients often are clueless about where our diaphragm is and how it moves and functions and how our rib cages become stiff and patterned. Furthermore, they often function in a state of hyperinflation, with poor neuro-sensory awareness that doesn’t allow them to get out of this state. Our thorax, after all, houses so much of our physiology and, when stiff and patterned, influences both movement and psycho-sensory processing. Want to help your patient/client with more efficient movement? Resolve headaches, shoulder, neck, and back pain and the multitude of extremity “-itis’s”? Hasten recovery from surgical procedures? Reduce anxiety, gut issues, and shortness of breath? Do you strive to elevate your practice through improved understanding of how and why our asymmetrical diaphragm becomes patterned in its position and movement? And how and why this pattern influences, for better or worse, the way we move our bodies, when upright, against gravity? Postural Restoration addresses these challenges, with multiple evidence-based research and real-life patient photos and videos and lots of hands-on lab sessions to guide the attendee through assessment and treatment.

A huge “thank you” goes out to our lab models, who gamely served as patient avatars to allow us to understand how to assess pelvis and thorax position and pathology, and how to treat what we see: Jason Adams, PT, Jason Creek, PT, Alexis Johnson, CPT, Mike Mentz, PT, River Patterson, ASCM, CPT, Kally Saffer, PT, Marcie Schwartz, PT, Lauren Shelton, PT, and James Werling, PT. Ashley, Lauren, and Katie: I speak for the class when I say we appreciated your wonderful hospitality this weekend. Thank you for inviting us in and providing a comfortable atmosphere and healthy snacks! Thank you to Katie’s Renaissance-man hubby, Josh Olinek, PT (fellow PRC class of 2011), who treated Lauren Cochran, Lisa, Craig, and I to a delicious home-cooked dinner Saturday evening!

Lastly, it was a pleasure presenting this course with fellow faculty Craig Depperschmidt, who had the class smiling with his “one-potato, two-potato…” and “pouty 5 year-old” analogy, among others. It was a delight for me to see you in action!

It was amazing to be back in Seattle to teach Pelvis Restoration.  Thank you Alpine Physical Therapy for hosting.  Eli, Jeremiah, and Murph your energy and passion for PRI is palpable.

The course participants were fabulous.  I thoroughly enjoyed the questions and intrigue into the science of PRI.  The take home message of having TWO sides of a pelvis—left and the right was a good reminder.  In addition,  the left and right hemi-pelvis need to be in a different position and alternate to gain optimal function was a huge take home message.

This video  of Reggie Bush that Jason Miller (faculty) shared with me over lunch to reinforce this need for tri-planar alternation of the pelvis was fabulous.

Thank you Jason for assisting and training with me in Seattle. Thank you course participants for your time and openness for me to “twist your brain” as we learn together how amazing the human body is.

In Missoula, Montana, a river runs through it, flowing with Postural Restoration science and application provided at Revo Training Center in the heart of town. Revo is located in a former Baptist church with stained glass windows and high ceilings inside an older brick building that makes presenting courses at this location, well, heavenly! The space has inspiring acoustics and a modern day functional gym setting that is perfect for teaching and learning.

Postural Respiration was the primary course this past weekend presented to a diverse group of fitness personnel, PT’s, a DC, an occupational therapist, and a massage therapist from Canada. For most of the attendees this was their first exposure to Postural Respiration. With so many fitness professional attendees the application to performance was emphasized as well as clinical application to the healthcare professionals and their practices.

Fellow faculty member, Jason Miller, DPT, PRC, was our lab assistant who provided a clinical dialog that added so much value and clinical experience to everyone. Since Postural Respiration integrates a big part of Myokinematic Restoration on day one, Jason was able to describe the meaning and application of AIC testing and non-manual techniques. The discussion between Jason and I included brief discussions of Pelvis Restoration and how the thoracic diaphragm and the pelvic diaphragm integrate with the form and function of both diaphragms. Jason teaches Myokinematic Restoration and will be teaching Pelvis Restoration. His presence and experience was greatly appreciated by all in attendance including this instructor.

Accessory muscle overuse is one of the main topics regarding patho-mechanical respiration especially as it applies to forward head posture and Superior T-4 Syndrome. A “nod” to Cervical Revolution was provided since respiration, in large part, determines balanced rotation and neutrality of the neck and management of the airway.

Student lab examples included one individual that became neutral in the pelvis and ribcage with only non-manual techniques, one individual that needed a ZOA manual technique to achieve neutrality and a third individual that needed several manual techniques including subclavius release but still could not achieve neutrality in terms of the ability to adduct both femurs. The clinical discussion of how to explore more detailed reasons opened the door to not only secondary and tertiary course application but the need for relaxed persistence and competence of the practitioner. That discussion between Jason and I could not have been more informative for clinical application for this group. A fourth student who played four years of college football as a lineman and strong PEC was provided a two person infraclavicular pump by Jason and myself and exhibited the ability to become bilaterally neutral with both femurs adducting as the final demonstration at 4:30 pm on Sunday afternoon! Nothing like a little PRI magic to finish a course and both instructors were happy for the result!

Thank you so much to the Revo crew including Callie, Grant, Kirsten, and Mariah for providing such a great venue. Huge thanks to my friend, fellow faculty member and colleague Jason Miller, DPT, PRC for his knowledge and experience. And, thank you to all attendees from different disciplines for traveling and sharing this PRI experience.

-Skip George

We had a great time in Lincoln last weekend. I always enjoy making the trek 500 miles east of my home town to visit with the friendly people at the Institute and in Nebraska. The whole course benefited from the 4 rock stars in attendance: Heidi, Elizabeth, Lauren, and Max.

Heidi was a perfect example of a classic left AIC patterned individual who benefited from left AF IR integration and supportive ligamentous muscle. She was a champion demonstrating challenging non-manual techniques for the camera and the folks at home online.

Lauren was an exceptional example of a bilateral AIC human trending towards swing phase of gait on both legs. We utilized a balloon to help achieve an exhalation state of the diaphragm to give her a chance to better access stance phase muscles on both sides. Something we can all likely benefit from!

Elizabeth came on day one of the course in a neutral pelvic position, thanks to seeing a PRI therapist the day before! She provided a fantastic example of what a common visit 2 PRI intervention may look like. She was neutral, so that means we can “start” our PRI intervention! We all learned how to use and interpret the Hruska Adduction Lift Test to guide our treatment progression after sufficiently inhibiting the AIC polyarticular chain of muscles.

Max also came into the course in a neutral pelvic position with strong tendencies to over-utilize his bilateral AIC muscles for forward locomotion and upright management of gravity. This provided the class an excellent opportunity to observe the importance of paraspinal and gastric inhibition towards the end of day 2.

Thank you all who joined online. It was special for me and an honor to be able to communicate the PRI science around the world. Thank you for your participation and questions as well!

I had the distinct pleasure of spending the weekend in Brunswick, Maine at Coastal Orthopedics and Sports Medicine Physical Therapy teaching Myokinematic Restoration. Much like the fall colors showing themselves on the changing leaves, we endeavored to change our perspective on the body’s musculoskeletal system. Developing an appreciation of inherent human asymmetrical patterns and their influence on achieving a “good posture” that allows the body to oscillate between two sides passing through the intersection of “neutral”.

The group did a great job engaging in discussions and asking questions throughout the weekend. Margo Goodman, DO, provided an insightful observation that her assessments of pelvic position may be skewed by the asymmetric body interfacing with the symmetric table. I had a great discussion with Kelsey Bisson, CSCS, and Beth Carlton, MS, NASM-CES, about how to integrate PRI activities in the strength and conditioning environment and the challenges faced in application. Emily Schmitt, DPT, asked great questions around the application of myokin material related to her work in pelvic health.

On Sunday the group joined me in celebrating the NY Yankees first playoff win of the season, a welcome surprise being this far north in Red Sox country. The day was spent dissecting the Hruska Adduction Lift Test, nailing down the technique, scoring, and interpretation of the results, then using those test results to guide our activity selection. There were a few “holy cow!” exclamations (no doubt a nod to the historic Yankee great and announcer Phil Rizzuto) as we worked through activities and had the opportunity to experience and practice the non-manual techniques.

A big thank you to Jeff Eckhouse, PRT, CSCS, LMT, for coming up from Portland to assist with labs and add his valuable insight and queries to the weekend. I am no longer surprised, but remain consistently impressed with the knowledgeable and kind folks I get to meet throughout the PRI community.

Thanks to Brian Bisson, DPT, the course went off smoothly and with everything we needed. Coastal Ortho was well represented with six members in attendance, thank you Patrick Nelson, PT, Amin Saab, PT, Lisa Burdick, PTA, Kelsey, and Beth for all the work it takes to host and for your interest and questions throughout the weekend.

Las Vegas was the location for Pro Sport Chiropractic’s annual conference Oct. 3-5, 2024, and was a combination of rehabilitation, sport performance and a 21^st century application of chiropractic manipulative skills and research.

I had the opportunity and privilege of representing PRI with the topic of “The Asymmetrical Diaphragm and It’s Role in Sport Performance”.  Respiration is a hot topic in rehabilitation and human  performance and understanding asymmetrical airflow pressure sense in a chest wall as it relates to lateralization and variability in human gait and forward locomotor movement, on and off the playing field, is critical for the sports performance professional.

This conference had so many knowledgeable speakers including on day one Christine Foss, D.C., M.D. who presented on injury recovery of the hip and kinetic chain management.  Her topic and experience was inspiring and educational.  Deed Harrison D.C., who has extensive peer reviewed research on posture relating to the cervical spine from a Chiropractic Biophysics perspective presented some of the best chiropractic evidence for restoring normal lordotic curves with corresponding improvement of movement and function.

Bill Parisi, BBA, CSCS, founder of Parisi Speed Schools,  had a superb presentation on Fascia Training in Athletic Performance.  I have seen Bill at Perform Better Summits, and his presentations are always inspiring and a must attend especially for anyone working with youth sports development specializing in speed and agility.  Bill, with his associate and top Strongman competitor Chad Coy, and I,  had an extensive discussion after hours on the role of the diaphragm and sport performance.

Tim Brown, D.C. presented on SPRT Soft Tissue Therapy in breakout sessions and is always a pleasure to listen and learn from.  He works with world class surfers and volleyball players and has extensive knowledge in soft tissue sports management.  Seth Forman, M.Ed., LMT, CSCS presented Clinical Challenges with athletic movement and exercise solutions, and it was a pleasure meeting Trent Nessler, PT, DPT as well discussing his product lines and working with elite MMA fighters.

Dan McClure, D.C. and his team including his son had an amazing  demonstration and lab for extremity adjusting with practical application and practice.   Kelly Lange, D.C., CCSP, ICSC had a breakout presentation focusing on lower extremity manipulation which included demonstration and lab and was simply fantastic.

I haven’t seen Sue Falsone, PT, DPT in several years and it was great to see her again in this venue.  What a wealth of knowledge and competence Sue brings to the subtleties of dry needling and all of the physiological benefits and biochemical responses of dry needling.

I first met Spencer Baron, D.C.,DACBSP an American Chiropractic Board of Sports Physicians Summit in San Diego in 2009 where I first made my entrance into being a speaker at a large professional venue.   This weekend he was the Master of Ceremonies at Pro Sport Chiropractic and kept the weekend on time and inspiring all with our purpose as chiropractic sport physicians.  It was great to reconnect with him this past weekend and share stories of life and professional topics.

I want to give a big thank you to John Pecora, D.C who invited me to present what I consider to be a vital topic called the diaphragm and respiration.  Thanks John very much for considering this topic and I hope to return to provide demonstration and lab during breakout sessions next year!

And last but not least, thank you Brenda Ellis for having me speak this year and all the staff at Pro Sport Chiropractic that made this happen.  I believe this was the 31^st year of this event and the level of professionalism made this conference a must event for our profession.

– Skip George

I recently had the opportunity to teach Cranial Resolution in Virginia Beach. Only one person in attendance had previously taken the course, and that person was Julie Blandin, PRC. Julie graciously offered incredible insight and experience regarding the material and techniques, especially during the final four hours of the course, which were exclusively devoted to clinical application. I cannot thank Julie enough for both hosting the course and for all that she brought to it.   

The other attendees, who were all Cranial newbies, seemed to grasp the concepts remarkably well. It was gratifying to witness more than a few ah – hah moments . . . and to field questions that clearly illustrated that people were starting to understand the difference between ANS tension and CNS tone, what neutrality really means, why we need to insure (and help guide) clients to be able to functionally cycle sensory afferentation, and grasp the reasoning behind the unique thoracic cranial techniques for which this course is known.  Since I am first and foremost a clinician, I loved making this brilliant, yet sometimes seemingly esoteric material, more user friendly.   

To me this course serves as a bridge, a bridge that connects neuro and physiological adaptations to predictable orthopedic compensatory patterning. It was therefore very appropriate to be able to look out from where I was staying on the shore just north of Virginia Beach and see the 17.6-mile Chesapeake Bay Bridge Tunnel. It was an awesome sight, especially at night when it was all lit up . . . just like those bridges in our brains.  

When you have a client or patient in your care, are you thinking about where they’ve been? How they may have developed? What experiences they may have or have not had? Do they understand what it feels like to push and to pull at the same time? Do they have competence with LE extension? Did they drop off previous patterns to attain new ones? Are they grounded and how did they attain that sense? Does their posture or their gait demonstrate that they have interferences with one or more of their senses? Is their sense of cortical, functional, hemispheric activity balanced?

These are some of the questions we discussed last weekend in the latest live stream offering of the PRI Human Evolution course. Understanding the 10 critical components in a sensory motor developmental sequence (SMDS) and how they cross reference with 7 particular sensory systems can help the clinician, personal trainer, or movement specialist deliver developmentally informed care for optimal outcomes. Because, let’s face it… we’ve all gotten to the place we are today by overcoming challenges, by compensating, by adapting, and by evolving over time. The remedy for improvement of our patterning depends on this history of experiences for patients and clients at any current age.

-Lisa Mangino

Central Massachusetts Physical Therapy, host of the most recent Postural Respiration course, has a wonderful clinic culture.  Its clinicians provided an enthusiastic learning environment, where half of the attendees experienced a PRI course for the first time, and plenty of Dunkin Donuts coffee and bagels.  Thank you to Mark Howard, Morgan Bronk, Brian Crowe, Micheal Curnen, Margret DiPlato, Connor Dougherty, Amanda Guavin-Valenta, Robyn Hillard, Tarandeep “TJ” Jaidka, Katherine Jones, Chloe Lal, Donna Layman, Megan McGuiness, Connor McLaughlin, Matthew McLeod, and David Urella for your efforts in set-up, take down, tech support, food, and interest in the science of PRI.

Attendees of various backgrounds (PT, OT, DC, PTA, massage, strength and conditioning) hailed from clinics with varied patient populations.  That provided us an opportunity to touch upon the challenges inherent in patients with scoliosis, history of open heart surgery and stroke, and the movement maladies associated with advancing age.

I am very appreciative of all of the questions, comments, requests for review of concepts, and several “this is what I heard you say” moments.   Thank you to those who elevated the learning experience for all by willing to be models for assessments and treatments: Morgan Bronk, Keith Donato, Gail Fennell, Jeanne Halloran, Jennifer Harris, Robyn Hillard, Rachel Medvedev, Alex Papanastassiou, Ruth Sunshine Wagner, Donna Waldrop, and Nathan Wright.

Thank you also to Tyler Tanaka, fellow PRC, for your help in explaining and demonstrating tests and techniques throughout the weekend.  You and Michal Neidzielski, PRC, were so gracious to share your perspectives on certain concepts and patient application.

Postural Respiration takes a comprehensive look at the thoracic diaphragm anatomy and function, most-notably its role in providing compression and decompression, the origin of all movement. This course  is lab-intensive, enabling attendees to achieve competence in performing objective tests and manual techniques and in coaching of non-manual techniques to prepare the attendee for Monday’s real-world patients.

Day one is devoted to understanding how our natural, normal human asymmetries drive us into patterned activity by overactive chains of muscles:  namely the left AIC, right BC, and, in some individuals, the bilateral PEC.  We learn first how to inhibit these chains of muscle, to disengage our patterned postures, and follow this with facilitation of under-sensed muscles that oppose and subdue the overactive chains.  The result: a sense of the ground and compression through the left side of the body, a right rib cage that is free to expand, and a thorax that can flex to enable rotation to either side.  Sounds like efficient walking, doesn’t it?

Day 2 is devoted to how to implement the treatment algorithm so that attendees can confidently apply the material.  This includes significant lab time performing and interpreting tests and practicing non-manual and manual techniques. We also thoroughly define Superior T4 Syndrome, how it develops, its impact on movement, and how to treat it.  Comments following non-manual technique practice included: “My neck tension is gone.” “I feel lighter.”  “I don’t feel the impingement in my hip anymore.”

Throughout the weekend, we dissected numerous photos and videos of typical humans with typical jobs and hobbies, to answer these questions:  How does hyperinflation restrict our movement from side to side?  Why do we emphasize arm reaching in our techniques?  How does arm reaching influence diaphragm position, thoracic flexion, and shifting of our COM when we walk, move?  How does right arm reach differ from left arm reach in its effect on position and movement?  How do the normal, natural asymmetries of the human species – i.e. a powerful thoracic diaphragm that has greater leverage on the right and a brain that has differing functions on the left and right – impact an individual who sits for a majority of the day, walks over hard, level surfaces, and rarely reaches with their arms?  The answer: a high susceptibility to the head-to-toe syndromes that we treat.

Remember, the Institute is here to support you as you continue your PRI journeys.  Please reach out with questions that arise.  I’m looking forward to seeing all of you at future courses!

-Louise Kelley

The Cantrell Center in Warner Robins, GA, has long been a PRI facility under the long-time leadership of Tassie Cantrell. For me, it was a full-circle moment. In 2006, after taking a few years to study PRI concepts, and my first course to get back into PRI was at the Cantrell Center. The course was Postural Respiration with Ron as the instructor. And from that point forward, PRI has been an exceptionally rewarding professional and personal journey. So it was not lost on me that nearly 20 years later, I was teaching the same course in the same facility that jump-started my professional relationship with PRI.

This course was a wonderful mix of PRI veterans and those new to the science of PRI. The labs were wonderful, with the help of Samantha Anderson, PRC. There is so much lab on the second day of this course, and with Samantha’s help, everyone had the opportunity to experience the manual and non-manual techniques. This course has been tweaked and massaged several times since the first time I took this course in 2004, most recently in 2022. If you haven’t taken this flagship course of PRI, I would encourage you to do so as this course is the gateway to Cervical Revolution, Cranial Resolution, Impingement and Instability, Human Evolution, Voice Box Resonance, and Forward Locomotion Movement.

Day One of this iteration of Postural Restoration is designed to provide hard evidence and rationale for how and why the rib cage needs to move backwards and in alternation. The thorax and rib cage movement necessary for acquisition and maintenance of a Zone of Apposition is the recurring theme of Day One. We present exhaustive peer-reviewed literature evidence of why the ZOA is the body’s best opportunity for proper use of the diaphragm for inhalation.

Day Two is primarily lab so the attendees have the opportunity to experience the manual and non-manual techniques recommended by the science of PRI to achieve and maintain a ZOA. For many years, Superior T4 Syndrome was a mystery to me. So I do my best to flush out how this course has evolved to hopefully remove the mystery of what Superior T4 Syndrome is, how to identify it, why it occurs, why it is problematic, and how to manage it. There are a few “deal breakers” in PRI, and Right Superior T4 Syndrome is one of them.

My thanks to the Cantrell Center and specifically the staff that were in attendance: Johnathan, Maria Christina, Samanatha, Erin, Linda, Braxton, Dina, Elizabeth, Keeley, and Cindy. And Sunshine was the perfect host as she attended to all of our needs during the course. It was also so great to reconnect with PRI veterans Karen Warren, PT, Mary Beth Verlander, PT, Melissa Baudo PT, and Angela Nelson, LMT. Hope to see you at the new and improved Postural Restoration!

Cervical Revolution is a highly integrative secondary course that blends physical therapy, chiropractic, osteopathy, dentistry and a whole lot of neurology with arthrokinematics to provide a detailed understanding of how critical the cervical spine is especially at the atlas and occipital articulation.

An international group, as well as attendees from the US and Canada, experienced Cervical Revolution in Lincoln, NE Sep. 13-14, 2024. There were 14 live participants including two dentists and even a DVM who performs chiropractic manipulation and acupuncture to small and large animals and sees similar patterns in animals and humans!

This international group included PT’s, DC’s, strength and conditioning personal and an LCSW who is integrating PRI with her holistic practice. The students attending from Taiwan, Japan, Australia, China and South Korea were staying up all night their time to attend and the students from the Netherlands, Poland , Germany, Norway, Italy, Slovakia, Spain and even Iran were up into the late night participating with tons of energy and great questions with all helping to teach this course with discussion and dialog that provided clarity and understanding of this information dense and detailed course.

Every course in PRI has more detail in the course manual than can be covered in one weekend and the material presented is often experienced as being “fed by a firehose” of information! This is especially true for this secondary course called Cervical Revolution where defining and exploring the cervical, cranial and occlusal system in two days.

The big picture of this course is that it is a right stance course that primarily relates to and starts at the atlas and occipital bone with the right atlas being in a position of flexion in relationship to the occipital bone. Inside the cranium, where the occipital bone connects to the sphenoid, right cranial extension occurs. This cranial position drives right temporal bone internal rotation that results in a protruded jaw on the right and a retruded jaw on the left with a mandible positioning more left! (If the mandible positions right this could indicate a compensation or pathology) The opposite occurs on the left side and this course is designed to identify this pattern and position, inhibit it, shift to the other side and then alternate back and forth. This variability of alternation is essential for upright human beings and whatever the feet, pelvis and ribcage are doing (Refer to the three primary courses), the neck knows it! Simply put, the goal is to achieve right A/O extension, left A/O flexion and go back and forth as if you are walking! (Because you are!)

This big picture description succinctly describes the basics of this course and then add the five cervical revolution tests with repositioning and then alternation techniques and the basics are covered! As with any course in PRI, day two adds a dimension that is considered pathological from the basic dominant pattern and position and for this course it is called right torsion. Right torsion is essentially torsion and stress located in the cranium that may result in neurologic symptoms including headache, ataxia, vision disturbances, dizziness and TMJ disorders to mention a few.

With the basic big picture reinforced and repeated a complex subject with the basics provided as a foundation helps to provide application on Monday morning and beyond. This weekend all of the students maintained an energetic focus throughout and now have not only more tools for patient care but a pathway to tertiary courses that include occlusion, cranium and the new vision course!

– Skip George

This was my 2nd time teaching in Valencia at the Henry Mayo Fitness and Health Center. Just like before, the staff and facilities are top notch and very welcoming to myself and the attendees as well. There was a mix of PRI experience among the attendees with half being their first PRI course and others that have multiple courses under the belt including Yoshi Fujii PT with 17 courses in his history. The local Californian, Locatelli Rao DPT, PRC, was my trusted lab assistant and he knew half the room. His insights clinically helped throughout the weekend and I’m grateful for his presence. This goes to show that reviewing primary course material is always still beneficial even after years of practicing PRI. We had a handful of chiropractors, PTs, PTAs, personal trainers, a chiropractor student, yoga and Pilates instructors, and overall an eager room of attendees. We began the morning with the didactic material and discussing the common pattern, the left anterior interior chain, and how it becomes dominant as we as humans center our body over our right half more often due to neuro respiratory demands and asymmetry of multiple systems beginning with the brain. After a morning of sitting, we hopped into lab and found some “money muscles” to help reposition the pelvis to close the day out. The second day was majority of lab and mastering the Hruska Adduction lift test, which we dove into being a gait assessment test. A humbling test for most but I saw all the wheels turning and improvements in test scores after we completed our treatment lab. Overall, a fantastic weekend and a good one to be inside as that part of California was in a heat wave. Being from Texas, I know heat, and it was HOT! Thanks to all who traveled and made it a memorable weekend of learning for me.

– Kasey Ratliff