News

We are excited to announce a Free “PRI Breathing Mechanics in COVID Times” Webinar Series beginning next week. We have been receiving phone calls and emails with questions on how the science and techniques of PRI can be applied to COVID-19 patients. What do we recommend, and why? Well, if you have been wondering the same, we will discuss all of this and more over the next several weeks on this webinar series.

As Ron discussed earlier this week in our Zoom Director’s Meeting, he feels like he has come full circle, that is 360 degrees from where he started almost 40 years ago; and where the profession of physical therapy started. Many of the first non-military patients that were treated in 1918, when the Women’s Physical Therapeutic Association was started, were children who were having difficulty breathing because of the Polio epidemic that ramped up in the United States in 1910. Chest physical therapy was well recognized by 1948 and physical therapists and physiotherapists around the world were taking responsible measures and opportunities to ‘restore lung function’ after acquiring an illness or after surgery.

In more recent years, several studies have questioned the use of intermittent positive pressure breathing (IPPB) machines and have caused many respiratory therapy departments to look to chest physical therapy as a replacement for IPPB. Respiration, ventilation and breathing are all influenced by our postural positions and patterns we are in at the time we are exchanging gas. Therefore, breathing mechanics are postural mechanics. The Postural Restoration Institute’s (PRI) concepts and scientific applications, are today used by many health care providers who collaborate with other disciplines that are mindful of the importance of keeping oral airway and lung airways open. This interdisciplinary practice reflects our early colleague’s effort in taking responsibility for the restoration of lung function through human mechanical intervention, prior to or following events that challenged lung airway position and drainage.  

Postural positioning is necessary for postural drainage, and the importance of coupling proper breathing mechanics with positioning enhances lung perfusion, expansion, and compliance to help fight off respiratory illnesses such as COVID-19 and to help acquire lung and chest wall function that speed up recovery following COVID or other viral acquisitions. This is why we are so excited to share PRI concepts, considerations and advice on how to keep your chest and lungs mechanically efficient and physiologically effective.

Just yesterday, a good friend and colleague, Cheryl Chase, PT, PRC emailed us and shared an old book that she pulled out of her desk titled “Postural Drainage and Respiratory Control, 3rd Ed”, which was published in 1971. Her colleague is going to provide an in-service on postural drainage, something that all physical therapy education programs cover, yet many PT’s have never clinically used. In the direct words of Cheryl, “I am so saddened by our current pandemic crisis, but also delighted that this current situation creates opportunities for new dialogues. It seems strangely serendipitous to coincide with the 20th anniversary of the Institute.” This message truly hit home. This is not how we imagined we would be celebrating our 20th anniversary. Yet, in some ways, it is blessing because with all of the messages and questions we have been receiving, we know that we can contribute to this opportunity for new dialogues amongst the general public and across multiple disciplines.

So, we invite you, and your friends and family to join us for this free webinar series, happening every Tuesday at 6pm CT (starting May 5th). Invite someone who has always wanted to know more about PRI, or maybe those who have questioned the “why” behind your use of Postural Restoration®. During this pandemic, we have witnessed humanity helping each other more than ever, and we are hopeful that the dialogues we can spread through this webinar will help thousands across the world.

*If you miss any of the weekly live webinars, they will also be posted to our website, so you can go back and view them later.

PRI Breathing Mechanics in COVID Times
Tuesdays at 6pm CT
CLICK HERE to register to join the webinar
*Pre-registration with your name and email will be required each week

I will be hosting a a free 1 hour live webinar next Thursday, May 7th on the use of Urban Poling with PRI activities. Please refer to the link below for more information and to register: 

https://bit.ly/2RZdBcz

You can contact me at jons@optimumperformanceptiowa.com for more info. Hope to see many of you there. Stay well PRI community.

On April 18th and 19th our Institute hosted its first live stream course on the importance of maintaining and facilitating the tone and tension needed for 30 degrees of cervical symbiotic movement. Two cortical hemispheres, two communities of inter-neuronal highways, two lateralized sets of appendages and two autonomic systems of drive, that are all associated with one “neck” of their being.  Regardless of the side of the relationship that is more dominant, or more sensed, or more patterned around a vertical axis, or more associated with emotion, fear, decision making, or physiology, both sides have to communicate with biased biologic messages going up and down through their one and only neck.

A few minutes ago I finished a face time conversation with Maureen Henderson PT, PRC regarding our 20th year anniversary as an Institute. She also told me she would be sending me a book written by Robin Wall Kimmer, entitled ‘Braiding Sweet Grass’.  She said the book reminded her of our relationship and the role the Postural Restoration Institute serves for masting. Mast seeding, also called "masting", is the production of many seeds by a plant every two or more years in regional synchrony with other plants of the same species. Mast seeding is an effective defense because the seed predators become satiated before all the seeds have been consumed.

On November 3rd, 2001 Maureen attended her first PRI course, Postural Restoration (the name of this course was changed to Postural Respiration in 2004) on the campus of the University of Minnesota. She reminded me that she was tired and had jet lag but wanted to go to this course because of the inter-connectedness associated with the material in a course she received from a recent course she attended on ‘Protonics’ that was taught by Karen Swanson PT, through the Postural Restoration Institute. “The core of my being is that everything is connected and meeting you and hearing you for the first time satisfied my core”, was a statement that resonated with me, because we truly have similar DNA, similar thoughts about purpose, similar respect for nature and trees… Both Maureen, and my son, RJ, know that we are all truly connected, just as all trees are.

Trees and plants talk to each other using an internet of fungus. Hidden under our feet is an information superhighway that allows plants to communicate and help each other out. Mycelial networks of fungus allows individuals (trees) who may be widely separated, to communicate and help each other learn new ways to survive, commit new mistakes, and to boost their host plants’ immune systems.  Fungi have been called ‘Earths’ natural internet (Paul Stamets 2008 TED talk on “Earth’s Natural Internet”). Both the tree trunks and our human necks need biologic tone, social tension and regional connected support that is enhanced through “masting”, so that a few of us who breathe and respect the science of PRI can further nurture the evidence behind the need for 30 degrees of cervical rest. Our “masting” effort, our inter-neuronal highways, and our interconnected hemispheres just got a huge boost from live streaming on April 18th and 19th , through the use of the internet; just like the trees we walk under that are getting a huge boost from the Mycelia fungi that never stop networking.

Full Cervical Revolution Live Stream Photo Album

Kind Regards,
Ron

Please check out this 6 minute video and accompanying blog article to learn a PRI based technique to help improve lung health amidst COVID-19.

As a result of the COVID-19 virus pandemic and having to cancel several recent and upcoming courses, we are excited to be offering our first LIVE STREAM course next month. PRI’s first live stream course will be our Cervical Revolution course taught by Ron Hruska on April 18-19th. To keep the excitement going, we will then be hosting our newest secondary course, Cranial Resolution on May 16-17th. *As a reminder, completion of the Cervical Revolution course is required to register for the Cranial Resolution course, so if you are interested in attending the live stream Cranial Resolution course in May, but you have not yet taken the Cervical Revolution course, be sure to sign up for the April 18-19th live stream event.

We are working with our AV company to set this up so that these live stream courses will be engaging, interactive and include demonstration of objective testing and/or non-manual techniques, in addition to course attendees being able to ask questions throughout the course. All that’s needed on your end is reliable internet access, a webcam, microphone and speaker (or a smart phone can be used if you do not have a computer or laptop with this capability). The course manual will be shipped directly to you, and you can still participate in a live PRI course while adhering to social distancing recommendations within your own home or clinic.

Registration for the live stream courses will be available on our website later this week! The courses will take place from 8am-5pm CT each day, and certificates of completion/CE credit will be awarded the following week after completion of the course evaluation survey and short post-test. For more information on whether your state/organization is approved for CE approval, please visit our website. And, if you have any questions, please call us.

Do you have a group of colleagues interested in participating in a live stream course together? Just like we do with our home study courses, we will be offering group discounts. If you have 2-4 individuals interested in registering, you will each recieve 10% off, and if you have 5 or more individuals, you will each receive 15% off. Please call us for more information on registering with a group!

We are grateful to be living in a timeframe where virtual learning platforms like this are available, and we are really looking forward to the opportunity to engage with #PRINation from all across the globe during these live stream courses. Together, we will continue to "Trust the Process". 

“Lots of evidence-based practice.”
“I plan to integrate the information immediately into my practice.”

Thank you to Heather Golly, ATC, PhD, Beth Marschner, DPT, and Dawn Mattern, MD, faculty at Minot State University, in Minot, North Dakota, for hosting Postural Respiration this past weekend. We were able to sneak this course in before the travel and conference bans were enacted and had plenty of hand-sanitizer at our disposal!  

MSU was the host site for Myokinematics last year, so most attendees had that course under their belt.  It served as a springboard to understanding how the top half of the body, the thorax, influences and is influenced by the lower half.

Our ability to fully and properly compress and decompress our bodies – the thorax, abdominal, pelvic, and cranial chambers — in the space around us is dictated by air flow patterns provided by hemi-diaphragms that are in position to do so.  This is compromised if abdominals, which wrap around the lower ribs and shape the hemi-diaphragms within to preserve their length-tension properties, aren’t sensed and facilitated.  Therefore, training the abdominals first and foremost for respiration, not core stability, is imperative.  All our movements and physiology, from HRV, digestion, and the ability to concentrate, depend on this.

One attendee grappled with when to consider prone “I’s”, “Y’s”, and “T’s” in their program.  This led to a helpful discussion, and paradigm shift, on the need to first address thoraco-scapular mechanics, as achieved by diaphragm position, rib cage expansion, and alterations of air flow patterns, before introducing scapula on thorax activity.  Without proper respiratory mechanics in place, muscles of the scapula acting on the thorax are simply out of position and lack meaningful leverage to provide safe, effective cervical and upper extremity joint performance.

Everyone appreciated and learned from those who stepped up to demonstrate non-manual techniques and to act as patient models for lab:  Stephanie Boespflug, PTA, PRC (my fellow PRC 2011 alum), Beth Marschner, Kirk Mason, DC, Terry Quijano, ATC student, Rebekah Rye, ATC, and Shane Williams, ATC student.  They enhanced and clarified how we define R BC/L AIC patterned activity and how we differentiate this presentation and its treatment considerations from that of superior T4 and B PEC compensations. Thank you also to Kari Harris, DPT, and Heidi Folk, PT, for adding to the discussion with insightful questions and personal clinical examples. I appreciated everyone’s warmth and hospitality, North Dakota-style. Thank you all for a wonderful weekend. The Institute looks forward to bringing more courses to your neck of the woods!

 Surrounded by the tall pine trees of North Carolina and golf courses in every direction one can look, we had 2 full exciting days exploring the power of myokinematic restoration. Discussing how the acetabulum moves on the femur was an appropriate discussion in a community full of golfers when discussing rotation and the appropriate muscles of the hip complex to help achieve rotation. We learned about the inherent pattern (s) of the human body that position our pelvis and ribcage along with tests that help guide our treatment to restore these positions. We had a sharp group of attendees who remained interested and engaged through the last hour of the course which was impressive. We had attendees that made the trip from Canada which is always exciting to see the science of PRI spreading to other countries!

– Kasey Aiken

I had a great weekend hosting, teaching and mentoring Kasey at my home clinic Sandhills Sports Performance!  Kasey Aiken did a great job introducing the principles of PRI as they relate to the hip and pelvis. We discussed a dominant left AIC and patho and non-patho compensatory patterns during upright activity as it relates to the Hip and Pelvis.

We were joined by PT’s, CSCS, SPTs, SPTA, ATCs, new graduate of PT, Massage therapist and a chiropractic physician!

Our clinic was represented by Pat Tanner, ATC, Jena Landgam, SPTA, Kelsie Giannoulis, DPT, Brooke Thomas, DPT and brand new to our group Pierce Adams CSCS and Johanna Nisenholtz.  Johanna was my PT student earlier this year. It was so great to have her in her first official PRI class. We look forward to Johanna joining our staff this year!

Thanks #PRINation for growing with us!

"Watching individuals with Parkinson’s Disease participate in boxing when I spent time with Jennifer Smart in North Carolina last Fall, reminded me of the need for the human spirit to elongate appendages while concurrent body contraction occurs. The movement of flexing a shoulder as the elbow extends disengages the neck, momentarily and reflexively. It is art, it is personal, it is rhythmic and it is limited coordination done by someone, who for a moment, recognizes a functional beneficial event that required regaining balance from a floor the arm uses to “strike”. Beautiful un-timed imbalance followed by a timed balance act for regaining postural control, without needing or requiring tremor. Such a rewarding basal ganglia bi-hemispheric activity to watch, but more importantly to experience. Shortly after arriving back to Lincoln, I bought and hung a bag in our clinic. Now if I could just learn how to dance around the bag as it pushes me around when I punch it, as it punches me. I decided that it probably would be best to wait and listen to Kristy Rose Follmar, a former World Champion professional boxer, before I hurt myself."

-Ron Hruska

Kristy Rose Follmar, ACSM, CPT, EIM is a 2003 graduate of Ball State University, with a degree in Telecommunications/Marketing and Sociology, a certified fitness professional and a retired World Champion professional boxer. Follmar was approached in 2006 by Rock Steady’s founder, former elected Indianapolis Prosecutor Scott Newman, to help build Rock Steady Boxing, a non-profit exercise program dedicated to help ease the progression of Parkinson’s symptoms.

Newman, a young on-set Parkinson’s sufferer, discovered that intense exercise using a non-contact boxing-style training regimen was slowing down the progression of his symptoms. Follmar understands through her experience as a professional athlete the benefits that boxing style training can bring to people with Parkinson’s in addition to Parkinson’s specific exercise.   

Kristy Rose Follmar is one of the architects of The Rock Steady Boxing Method, a curriculum that combats the physical and emotional effects of Parkinson’s. Follmar uses her experience of professional boxing and formal education in the fitness industry to design curriculums specific to varying levels of Parkinson’s disease.

Kristy’s presentation is titled “Rock Steady Boxing: The Fight Against Parkinson’s & Community-Based Medical Collaboratives”. This presentation will cover our history and an intro to Rock Steady: our story, our methodology and message of Hope to help people with Parkinson’s Fight Back against their disease.  Also, a discussion about how Rock Steady has developed a community-based collaborative between local healthcare professionals and community-based Rock Steady programs.

If you have not registered for the 12th Annual Interdisciplinary Integration Symposium, be sure to register soon. The early registration rate of $525 ends on March 26th!

Jennifer Smart, DPT, PRC is the headliner for our 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.”

Ron had the opportunity to spend a couple days with Jen in her hometown a few months ago, and had this to say about his experience, “Jennifer is probably one of the most, if not the most respected, individuals in this community. Everyone who lives there knows how much she cares about humanity in general, and how much she dedicates herself to each individual specific needs and limitations. Her compassion, her wealth of knowledge on Parkinson’s Disease, her multi-level of experience, and her successful outcomes are immediately recognized by anyone who observes her classes, talks to her patients or witnesses the respect wherever she goes in this community. I am humbled by all of this and my admiration for her selflessness is unsurpassed.”

Read more about Jen’s upcoming presentations at our 12th Annual Interdisciplinary Integration below:

An Overview of the Science of Movement Disorders as They Relate to Sensory Input and Autonomic-Driven Postural Compensations
This presentation will review various types of movement disorders, examining their association with each other and with other non-motor symptoms, which may appear independently or as prodromal symptoms for various movement disorder syndromes, such as Parkinson’s disease. Current theories as to the causes of movement disorders will be explored, including evidence supporting basal ganglia oscillatory dysfunction, how and why this dysfunction may occur and techniques that are being employed to influence it, including pharmacological, surgical (especially the use of deep brain and/or implanted spinal stimulation) and physical activity interventions. Emphasis will be placed on the evidence supporting how intrinsic oscillations are being altered by afferent stimulation.

Afferentation Techniques and How to Clinically Incorporate Them into the Treatment of Movement Disorders
This presentation will be more clinically applicable, providing information about the current, evidence-based programs that are being used for people with Movement Disorders, examining their common effective elements regarding the movements involved in the activity, the dosage (time and intensity) of the activity, and the auditory, visual and tactile cues that are being used during the activity.  Emphasis will be placed on using specific afferentation techniques during these activities in order to alter the need to use pathological postural compensations, or movement disorders, to create a sense of stability and/or a method of mobility.  

A Review of Perspective and Progression Influences on Treatment and Management of Patients with Parkinson’s Disease
In this presentation, Jennifer Smart and Ron Hruska will discuss treatment and management of patients with Parkinson’s Disease and review several cases in which they have had the opportunity to collaborate together. Management discussion will include group exercise application, in addition to individual rehabilitation considerations.

If there are three bones that have always had an impact on my course of study as related to respiration, airway, occlusion, oral function, head and neck position, speech, vocal cord dysfunction, tongue compensation, nasal flow, autonomics in general, auditory sense and the soft and hard palates, it is the temporal and occipital bones. Three very important nerves go through the most infamous foramen of mankind, the Internal Jugular Foramen (IJF). When the lumen or congruence of this foremen is challenged our bodies know it. Cranial mal-position and underlying associated predictable human torsional constraint increases the need for compensation and  work around this malpositioned set of paired bones, on an accompanying occiput bone that orients and houses the medulla and brain stem in off-centered state of un-rest. This positional state of unrest feeds neurologic information to our mid brain and associated cortices that are directly associated with my course of study, outlined above.   

Re-orientation of these two paired IJFs can have a major impact on ANS, SoNS and CNS function and behavior, secondary to the compression or lack of compression on these three nerves. The glossopharyngeal nerve innervates the stylopharyngeus muscles, the vagus nerve innervates the levator veli palatini, the salingopharyngeus, the palatoglossus, the palatopharyngeus, and the pharyngeal constrictor muscles, and the accessory nerve innervates the trapezius and the sternocleidomastoid muscles. I will not go over these three nerves sensory innervation, but these nerves are instrumental in how we physically, physiologically and psychologically behave and operate. Cranial mal-guidance provided by the calvaria, temporal and occiput bones and their associated torsional patterns of function can be resolved through PRI based sacral cranial repositioning and through PRI based thoracic cranial resolution, that incorporates cranial oscillatory alternation. Having the opportunity to outline and teach the reasoning behind these PRI techniques and considerations, offered by this unique course, through the involvement of the sinus cavities, the palatine bones, and the pharynx, is as fulfilling for me as any course I have ever written, designed or taught.

I would like to thank Amy Goddard PT, DPT, OCS, CSC, PRC and her staff, once again, for hosting another PRI course at her expansive and accommodating facility. Gail Kaiser PT, OCS, thank you for your willingness to participate in my demonstration autonomic orthotics. And Stephanie Irizarry Pt, CLT-LANA, PRC your presence is always welcomed because of your love for Pantone 269 C (purple), your predictable body performance through autonomic filtering, and your on-going smile. Jennifer Bullock PT, DPT, OCS, PRC your input, discussion and feedback was so invaluable. I honestly believe, this is ‘your course’ if there ever was one offered by PRI. I truly love everything you stand for and represent.  

A fantastic time was had at the annual Arizona Athletic Trainers’ Association (AzATA) Winter Symposium that took place in Mesa, AZ  from Feb 8-9, 2020. Kelly Boyce, Mike Powell and I were gifted the opportunity to present to local athletic trainers of all settings in both lecture and lab formats. Big shout outs to Casey McKay and Suzie Squires with the AzATA Professional Education Committee for organizing and our teammate Jon Herzner for connecting us. The 45-min lecture presentation entitled “The Fundamentals of PRI: A Diamondbacks Perspective” covered the origins of PRI in addition to “big rock” concepts such as asymmetry, PRI-defined polyarticular muscle chains as well as reciprocal and alternating function. In addition, basic assessment and treatment approach concepts were discussed. For the lab portion, detailed demonstration and further explanation of the Adduction Drop Test, proper breathing mechanics and the application of basic repositioning techniques were provided. Due to the interest of the attendees and the leadership of Kelly and Mike, the lab portion was a fun and engaging experience for all!  Thank you again to the AzATA for the opportunity to serve and thank you to the Institute for all the support!

We are just a couple weeks away from the Postural Restoration Trained™(PRT) application deadline for summer testing. PRT summer testing is available once every 3 years to help accomodate Athletic Trainers and Strength and Conditioning Coaches who have expressed an interest in completing the PRT credentialing program, but due to the schedule of the teams that they work with, are unable to get away to attend the annual testing date in January.

PRT applications for the summer testing date are due on March 15th, and testing will take place on July 17-18th at the Postural Restoration Institute in Lincoln, Nebraska. Please note that there will not be an Impingement & Instability course offered in conjunction with this testing date, therefore all applicants will need to take this required course elsewhere prior to testing.  

Postural Restoration Trained (PRT) is a credential available to Athletic Trainers (with Certification through the BOC), Athletic Therapists (with Certification through the CATA), Strength and Conditioning Coaches (with CSCS Certification through the NSCA or SCCC Certification through the CSCCa, Certified Special Population Specialist (with CSPS Certification through the NSCA and completion of a Bachelor’s degree or higher degree), and Exercise Physiologists (with Certification through the ACSM). For more information on the course requirements and to download the application, CLICK HERE!

If you are planning to apply for PRT, and have any questions, please email me!