News

After almost a year to the day of the country shutting down, this course marked a refreshing beginning to some normalcy with teaching PRI Myokinematic Restoration again. We had at least 50 participants virtually with attendees in and outside of the U.S. ranging all the way from Canada, Slovenia, and the UK. We had 9 in person attendees that made the trek to Lincoln and served as the “models” for our myokinematic lab portion.

We began the first morning with didactic material learning all about the patterns of the L AIC. This  included non pathology and pathology discussions in relation to the compensatory demands of the femur in the acetabulum. Respiration demands, underlying neurology and asymmetry helped to shape and understand the reasoning behind the L AIC pattern.

The weekend concluded with an ample amount of lab and hands on time, learning to assess position of the hip, compensatory findings, and frontal plane performance testing with the Hruska ADDuction test and Hruska ABDuction test. The attendees then went through myokinematic techniques to restore and retrain pathomechanics of the pelvis.

We had several thought provoking questions and the enthusiasm was great from the group and could be felt even virtually!

Neal Hallinan, CSCS, LMT, PRT will join Jennifer Smart and Ron Hruska as a presenter at this year’s 12th Annual Interdisciplinary Integration Symposium. Neal has a unique understanding of the science of PRI, through his first hand experience as both a patient and a Postural Restoration Trained (PRT) provider, working with clients both locally in the NYC area and from the across the world. Although his first career began in the IT field, he sought out to find something he was truly passionate about, which was movement. Years of nagging pain led him to discover that movement could be healing. During a period of time spent living in Brazil, Neal first recognized the freedom of movement that many people living there expressed through dance. As the introduction and interest in this art of expression grew, Neal spent considerable time learning the steps and sequences of various styles of dance and fell in love with the influences of rhythm, percussion and beats that were included.

Neal began his journey with PRI in 2013, when he completed the three primary home study courses. He then went on to take many secondary and tertiary courses over the next several years, and continues to be very active within our Institute. "This was it" Neal recalls, as he had finally found answers to the patterns and positions he had noticed over time in his own body. He recalls his own personal journey changing when he could fully appreciate grounding and true sensory integration for the first time and discusses how in today’s virtual world he tries to help his clients achieve the same level of sensory awareness through the use of PRI-based principles and techniques. Neal’s interest in latin dance motion and so many other forms of rhythmic movement provided a natural fit to this years Symposium, focusing Basal Ganglia Disease and the management of kinesia paradoxica.

Learn more about Neal’s upcoming presentations below, and also check out the most recent podcast episode where Neal, along with Ron Hruska discuss how these presentations will tie into movement disorders. 

Inhibiting Inhibitions: Rediscovering Your Innate Alternating Rhythms Through Dance
-Neal Hallinan, CSCS, LMT, PRT
Dance is a fantastic way to get back in touch with the natural alternating rhythms of your body. This presentation will discuss the challenges of learning and teaching dance, how to find "the beat", and overcoming the inhibitions that hold us back. Please have space available for learning some foundational dance steps.
 

"How Do You Initiate Rhythmic Movement Provided by The Body For the Feet To Move?"
-Neal Hallinan, CSCS, LMT, PRT
Learning to dance traditionally starts with the feet. That’s the easy part. Obtaining fluidity of movement requires integrated use of the thorax, arms, and head to produce a particular "style". I will introduce common elements of styling including: spinning/turning, contra-body motion, arm movement, and Cuban/Latin motion.

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Jennifer Smart, DPT, PRC is one of three speakers for this year’s 12th Annual Interdisciplinary Integration Symposium. This symposium topic came together as a result of the extraordinary work she has been doing with those managing Parkinson’s Disease in her community, and the engaging discussions she has had with Ron over the past couple years. Jen is a clinician at heart, but also one who is current with the research and medical advancements that have been made for those experiencing extrapyramidal symptoms.

Her growing interest in Parkinson’s Disease began around 2015 when her best friend was diagnosed. This was the year she completed the PRC credentialing program, and shortly after neurologist, Dr. Jay Alberts, published research showing how, when a person with PD rides on the back of a tandem that is being pedaled at a cadence of 80-90 RPM, a variety of their PD symptoms decrease. After dissecting the research, Jen bought a tandem bike, and her and her friend rode for over an hour 3 times a week at the specified cadence. Others with PD heard what they were doing, and she ended up getting several tandem bikes and set them up on stationary trainers at a local gym, where she coordinated having members of the local cycling community ride on the front to set the cadence while people with PD rode on the back. “Park’n Ride” was officially started as a non-profit in January 2015.

Based on the success of this cycling program, Jen has become a regional expert on Parkinson’s Disease, where individuals have moved to her small coastal town of Oriental, North Carolina after their diagnosis. She became certified in LSVT BIG, Parkinson’s Wellness and Recovery (PWR!) and Rock Steady Boxing, which are all evidence-based, Parkinson’s-specific programs. Jen has attended the Parkinson’s World Congress and has even volunteered for a week with Becky Farley, PT, PhD who developed LSVT BIG and PWR. In 2017, Jen received a grant from the National Parkinson’s Foundation to organize and run a two-day event, called the Parkinson’s Exercise Program (PEP) Retreat, which was designed to help both patients and medical providers better understand how to use exercise as an evidence-based treatment for PD.

In her own words, “What I have taken away from all of this training, from working extensively with this population, and from the currently exploding literature regarding the benefits of specific exercise programs for PD, is that, perhaps unknowingly, the components that make each of these treatment techniques so effective, are the components that are based on the science of PRI. People with PD, just like all of us, need to be able to rhythmically alternate, but their disease, or somewhere along their journey towards developing this disease, this ability to rhythmically alternate was compromised so they needed to develop involuntary tics, muscle spasms, tremors, restless legs, dystonia and/or postural changes to help them to get to the other side, to help them to alternate. This is now the message that I am trying to get across in both the prevention and treatment of Parkinson’s, and so many other, syndromes or diseases.”

Learn more about Jen’s upcoming presentations at our 12th Annual Interdisciplinary Integration below.

Practical Implication of Intervention and Management of Patients Who Have Been Diagnosed with Basal Ganglia Disease
-Jennifer Smart, DPT, PRC
The first half of this presentation will review a variety of diseases involving basal ganglia dysfunction, examining both their common and uniquely different motor and non-motor manifestations, while exploring not only the current and experimental pharmacological, surgical and physical treatment techniques that are being employed to treat them, but also the underlying reasoning behind each of these interventions.  The second half of the presentation will focus more on a variety of evidence-based physical treatment programs, compiling the common effective visual, auditory, postural and respiratory components from each physical activity program. Emphasis will be placed on assessing how each technique addresses the temporal, lateralization and pressure regulatory deficits seen in people who have been diagnosed with Basal Ganglia Diseases (in order to unlock, through oscillatory function, the axial skeletal system from the appendicular skeletal system in an attempt to better balance the autonomic nervous system with the central nervous system).

A Clinical Perspective on Geocentricism, Lateralized Linkages, Sleep, Timing and Weight Shifting
-Jennifer Smart, DPT, PRC
The research states that the Basal Ganglia is involved in the perception of time, but what does that clinically mean? It means that a person with a Basal Ganglia disease, such as Parkinson’s, does not know how to navigate through space since such movement is inextricably linked to time, not only for understanding when to move but also at what speed (since speed is distance per unit of time) but also for knowing where they are (“five minutes from home”) and how to integrate all their moving parts. For example, knowing when to supinate and for how long to experience appropriate weight shifting in order to avoid over lateralization relies on timing.  This presentation is going to discuss clinical ways to address the various issues involved with timing deficits, through visual, auditory, positional, and respiratory cuing, in people with Basal Ganglia deficits.

Clinical Case Study Presentations
-Jennifer Smart, DPT, PRC
This presentation will be a discussion of the treatment and management of several patients who have been diagnosed with Basal Ganglia Disease, either Parkinson’s Disease or Progressive Supranuclear Palsy (PSP). A few of the cases were ones in which Jennifer Smart had the opportunity to collaborate with Ron Hruska. Management discussion will include group exercise application, in addition to individual rehabilitation considerations.

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The Midwest started warming up to a balmy 22 degrees on the way to reaching almost above freezing on Saturday morning for the first Postural Respiration Live/Live Stream course this year. There were seven live attendees some of whom drove over 5 hours on slick and icy roads to take their first Postural Respiration course while almost 40 others from all over the country, and even internationally from Slovenia, attended this course. Ron and I had a discussion the day before I taught and it was a real inspiration to be able to emphasize to the new students the concepts of not just rib movement and diaphragm function but the importance of pressure and flow inside a chest wall and how that not only affects position and posture but every system in the human body. We spend a lot of time on the orthopedic consequences of neurologic patterns in this course but it is what is inside the chest wall in terms of how we direct air into chambers and how that affects whether ribs move up or move down, and torsos left or right as a critical element of Postural Respiration and all PRI courses. The Posterior Mediastinum has become more of an emphasis than ever before along with the role of the first rib in initiating the lifting of the rest of the ribs below it during respiration. This class really got the relationship between the right apical chest wall and the left posterior mediastinum with the role of how important inhibition to these chambers of the chest wall is.

One of the non manual techniques we focused on was the Standing Serratus Squat and the importance of learning how to perform it. This is one of PRI’s more difficult positions to competently perform and that there are often precursors, especially with reaching and squatting techniques, to help facilitate this most important technique. Just because it is challenging to perform doesn’t mean that students shouldn’t master it and then teach their patients. This is one of many techniques that help strengthen an individual’s diaphragm and give them a "sense", which was one of the key words of the weekend, of thier ribcage moving backwards!

And for forward locomotion, that is, to move forward, one most move a ribcage back! Questions came in fast and furious which is a delight for instructors since it helps to gauge where the attendees are in their understanding and to reinforce and repeat concepts that are needed to provide a good foundation to understand this course well enough to begin to apply. The students in this course were helping teach Postural Respiration by their re-states and questions with energy and enthusiasm. Shout out Meghann Vanslager and Jennifer Bacon who drove from Kansas then had a 5 hour drive home with work the next day! Thanks to Ian Katanec for being on a 9 hour time difference in Slovenia and everyone else that spent their weekend with us as over half of the attendees that were either brand new to PRI or first time attending Postural Respiration. Most of all, thanks to RJ Hruska who was my wingman performing audio and visual expertise with changing camera angles for lab and keeping things going smoothly during these virtual attendance times.

The updated 2021 Hruska Clinic Shoe list is out!!

Based on Postural Restoration® principles to guide our decision making these shoes are picked based on qualities that we feel may be beneficial to assist patients and clinicians narrow their choices for appropriate footwear. There are shoes not on this list that are going to be good shoes for some and not every shoe on this list is going to be good for everyone but this is a guide to help.

Listen to Lori describe the most recent updates to our list for 2021!

To get your copy of the list go to https://www.hruska-clinic.com/shoe-list/

Hope this helps you all #PRINation!

https://youtu.be/2KU7btdMfJs

There are four kinds of documentation that most of us use to change our behavior:  
1)  Learning oriented tutorials.
 2) Goal oriented how-to guides.
3) Understanding-orientated discussions.
4) And, information-oriented reference material.

Each of these four types of documentations usually have instances within the document that refers to related information elsewhere in the same document. This is important as it forms a network structure of relations that exist between different parts of data, dictionary-internal as well as dictionary-external. If the cross-reference mechanism is well designed, visibly or technically, the reader, and in this case, the course attendee, will be able to follow each and apply ‘cross-reference’ event, to the referenced content whether the content is presented visibly or technically.  

The last example, of the four listed above, enhances usability and application of content in each of the PRI Non-Manual Techniques. Documentation or description that identifies direct reference and referent sites of consistent interest; is required so documentation that indirectly implicates cross references from these and other discrete or unconsidered sites can provide content-strategies to meet the desired needs and expectations, from both the provider and the participant.

As the author of these techniques, and as the author of cross-referencing design associated with each technique, effort to ensure that location and content of the target of the cross-reference in each technique needs to be consistent, regardless of the aptness of the provider or the participant.  

These opportunities to provide my reasoning behind each of the techniques, that were selected by this course’s participants, are not exceeded in any other course offered in PRI. Therefore, the guidance I offer to answer questions on the ‘why’s, ‘when’s, ‘who’s and ‘what’s regarding each technique’s reference’s, referent’s, and cross-reference’s content, is an absolute unique opportunity for both the author and the attendee seeking behavior modification through documentation that is resourcefully dissected at a level that is unsurpassed in this Institute.  Each technique (documentation) dissection experience is truly one of the most rewarding things I have done in my life.  And I am grateful.

 
I want to thank Dan Houglum, Torin Berge, Dave Drummer, Jen, Hannah and RJ for their assistance in making this course so enjoyable to teach and apply to “real” life limitations and likenesses.

January 25th was recorded as the second highest daily snowfall in Lincoln of all time, dropping 14.8 inches of snow at a record rate. Between phone calls and emails while working from home, all of us at the Institute were busy “Digging Out”, while at the same time being driven further into a pattern. This same system (of snow) hit much of the Midwest by varying degrees, and many of you, like me, may be feeling the effects after hours spent pushing and plowing our entries back to the outside world. There are many considerations to keep in mind while performing any repetitive, patterned driven activity, and in respect to clearing snow, they are heightened by the exertion and work needed to move the literal mass in front of you. Any activity occurring “in front of you” poses challenges in itself because of the linear forward movement which is often repetitive. Many of these activities and considerations are highlighted in our “Restoring Alternation in Your Daily Lives” Patient Guide which was published last year.

When it comes to pushing snow, be mindful of the following.

When pushing snow on a flat surface, consider first your hand placement and center of mass, in relation to the mass being moved in front of you and the ground below you. The most natural position will be for you to instantly lower your right arm nearest to the blade of the shovel, and your left arm closer to your body. This will lead to your COM to shift over your right leg causing you to work through Right AF IR, Left Trunk Rotation, and Left AF ER positioning, while further driving your pattern.

Instead, consciously start by reversing the above position, lowering your left arm further down the shovel and placing your right arm nearest your body. This will allow your COM to shift to the left, leading to Left AF IR, Right Trunk Rotation, and Right AF ER positioning, while helping to minimize the above pattern. Over time it is likely that you will naturally re-adjust back to the first position as it is what your body is asymmetrically driven to. When possible alternate between these positions as much as possible to minimize some of the common aches and pains that occur from pushing snow in a patterned position!

"The new normal."  That’s a phrase we all have heard many times during the last 10 months. As we are all adjusting to what that phrase means to us individually on a personal level, all of us are adjusting to what that means with regards to our relationships with each other as well. We are all finding new boundaries, and freedoms, associated with this "new normal."  

PRI opened the 2021 year with the newly revamped Impingement and Instability course, which introduces the concept that impingement and instability are both necessary and vital for optimal human performance. They provide new boundaries and freedoms that allow us to be able to oscillate between our two hemispheres of our body and brain. Our body needs to find a "new normal" with these new parameters in order to appreciate the left side of our body and the right hemisphere of our brain. As I reminded the course attendees, the question isn’t "are you going to get onto your left leg?", the question is "how are you going to get onto your left leg?"  

This upgraded course introduces the neuromechanical concepts to answer the question of "how", as this course serves as a gateway into the other PRI Secondary and Tertiary courses, such as Forward Locomotor Movement. This is the material Ron was looking to introduce 20 years ago, and it is my honor to be able to help provide the neurological answers to the question "how are you going to get onto your left leg?" As we discussed during the entirety of the weekend, the how is rooted in one’s ability to compress, or impinge, certain areas of the body, and decompress, or destabilize, other areas of the body. In order for the brain to appreciate these novel concepts, we need to provide the cortex of the brain with novel reference centers for proper inhibition of functional cortical dominance.

As we embarked on our "new normal, " not only in 2021, but in our cerebral cortical function, this course has now become much less of the orthopedic course it had to be several years ago, but has progressed into the neuromechanical blueprint for behavior modification that Ron had intended from Day 1 of the Institute. This course has always been my personal favorite of all the PRI courses offered because it is a clinician’s course as it provided me a more integrated manner to apply the information I had learned in the three PRI introductory courses. My appreciation for this course has grown dramatically due to the necessary evolution from an orthopedic delivery to a neuromechanical, cohesive, and expansive delivery of PRI concepts. As the attendees of the course can attest to, Impingement and Instability helps our body’s ability to appreciate the "new normal" from the inside out.

We are excited to introduce and congratulate our Postural Restoration Trained (PRT) Class of 2021! PRT is the result of completing multiple advanced PRI courses, demonstrating a thorough understanding of the science through completion of the PRT application, and successfully participating in practical and analytical testing. This past weekend, five professionals earned the designation of Postural Restoration Trained (PRT) under the direction of Ron Hruska, Dan Houglum and Jennifer Platt.

The Postural Restoration Institute® established this credentialing process in 2011 as a way to recognize and identify individuals with 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 PRT credential is available to Certified Athletic Trainers, Certified Athletic Therapists, Exercise Physiologists and Certified Strength and Conditioning Specialists who have completed the course requirements, application and testing process. With the addition of this class, there are now 59 PRT professionals throughout the U.S and Internationally.

To view/download the photos click here.

Back Row (L to R): Ron Hruska, Philip DeNigris, Jarrett Kolich, Dan Houglum;
Frong Row (L to R): Jennifer Platt, John "Amos" Mansfield, Diane Banderas, Yoshikatsu Abe

Happy New Year!

As we approached this New Year, I reflected on the the year that was 2020. As I transitioned into this new role of Executive Director at the beginning of this year, I could have never imagined the challenges we would be facing in just a few short months. I think most people would agree that 2020 was a year that none of us could have ever predicted, but even with the challenges presented from COVID 19, we were determined to make the best of it. And that’s just what we did! The events of 2020 really encouraged us to explore new ways to expand our ‘reach’. Although we already had our primary courses available online, we transitioned quickly to live stream virtual courses for our secondary, tertiary and affiliate courses, and this allowed us to reach interdisciplinary professionals from all over the world. Several live stream courses were sold out with 100 attendees, and many had at least a dozen countries represented. We are grateful that we were able to continue to reach you through PRIVY and podcasts, in addition to some new projects geared towards expanding our reach to the general public, including the ‘Restoring Alternation’ Patient Daily Living Guide. We also took advantage of the circumstances and reached thousands with our ‘PRI Breathing in COVID Times’ 9-week webinar series, which was (and still is) available online for both the general public and healthcare & fitness professionals. The word ‘reach’ has always been a staple of our Institute, and for those of you who are familiar with the PRI non-manual techniques, you have undoubtedly experienced the power of a reach. While our ability to reach you over this past year has been primarily through digital formats, we are excited to get back to reaching (with) you at our live in-person courses. We will be forever grateful for all of you who allowed us to continue to reach you during this crazy, uncertain past year that was 2020. It’s a year that we will never forget, but due to the circumstances that were presented, we now have many new means in which we plan to continue to reach you in 2021 and beyond.

Although we didn’t print a brochure this year, you can see that ‘reach’ would have been the theme carried out within the pages of our Programs and Courses brochure. Please visit our website over the coming year for the most up to date schedule of our programs and courses. In addition to returning to hosting courses across the country this Spring, we are excited to be offerering over 20 live stream courses this year, and we will also have limited in-person attendance available for each of the live stream courses held in Lincoln, Nebraska.

We hope we have the opportunity to reach you, in one way or another, in this New Year!

Every December I reflect on my past year personal and professional activities, a few days before beginning the Advanced Integration course.  My inner wellness usually transforms during these four days because of the way I feel connected in real time with real bodies, who have real interest in how our bodies transform by revolving and evolving around axial sagittal verticality and appendicular horizontal integration.  I need this eye-level connection with other people to complete my year and to advance myself, as well as the science I am so obsessed with.  This past year, as challenging as it was, advanced all of us because we needed to connect with technology in ways that we never have before; to revolve, evolve, and transform with other people.   

Technology is value neutral. It becomes value non-neutral, depending how one uses it.  The amount of time I spent this last year in some virtual space, or in the space above my neck, by observing bodies above the neck, is overwhelming.  However, because of my need to connect with real people, real bodies with real interactive interest, I had to do so with eyes primarily, that were all at eye-level with mine. Body language became eye language.

This opportunity to interconnect, virtually, reduced my isolation and actually advanced me in so many ways.  I have never been more prolific or productive, in my life, like I have been this year. New courses composed, books  read, research reviewed, interdisciplinary collaboration, etc. all reduced potential obsolescence because of technology.  Who would have thought a little virtual reality would advance us, like it has.  

Therefore, it just seemed natural, that after a year of virtual wellness, we would host an Advanced Integration course with 11 people (PRC applicants) actually sitting to the left and in front of me and 100 people sitting in a ‘Hollywood Squares’ box, slightly to the right and also, in front of me.  It advanced all of us who were in attendance.  We received the best of two worlds of advanced postural restoration presence.  This advanced technology seemed so value non-neutral challenging, so futuristic, so non-elementary, so alive and yet so unimaginable, because we were all not in the same room and breathing in the same space.  Everything we did the year before, now feels so retro.

This December my inner wellness rose to a new, novel and an unnatural high. And I am sure all of the future December PRI Advanced Integration course attendees will reflect on the how “real”, integration feels during these four days, in real time, with real bodies on one side of the room and real faces on the other, all because of value non-neutral technology.

I want to thank Dan Houglum, MSPT, ATC/L, PRC, Lori Thomsen, MPT, PRC, Jean Masse, DPT, OCS, ATC, PRC, Lisa Mangino, DPT, PCS, C/NDT, PRC and Jen Platt for making this course so connected and so advanced, in a time where there is so much uncertainty.  

We are excited to announce and congratulate the Postural Restoration Certified (PRC) Class of 2020! PRC credentialing is the result of completing multiple advanced PRI courses, demonstrating a thorough understanding of the science through completion of the PRC application, and successfully participating in practical and analytical testing. This week, 11 clinicians earned the designation of Postural Restoration Certified (PRC) under the direction of Ron Hruska, Lori Thomsen, Dan Houglum, and Jennifer Platt earlier this week.

The Postural Restoration Institute established this certification process in 2004 as a way to recognize and identify those individuals with 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 PRC credentialing program is available to physical therapists, physical therapist assistants, occupational therapists, and chiropractors who have attended PRI courses, demonstrated a thorough understanding of the science through completion of the PRC application, and successfully participate in both clinical and analytical testing. To date, 226 professionals have earned the designation of Postural Restoration Certified (PRC).

To view/download the photos click here.

Back Row (L to R): Ron Hruska, Tracey Blain, Molly Miller, Brad Gilden, Amy Brown, Yohei Takada, Dan Houglum;
Front Row (L to R): Jennifer Platt, Corina Carlson, Danielle Cardinale, Deanna Elliott, Danielle Juckett, Nicole Davison Moore, Paige McNerthney, Lori Thomsen