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In 1848, a gold nugget was found in the Sierra foothills of California at a place called Sutter’s Mill that started what would be famously known as the “Gold Rush” where thousands flocked to find their fortune. Last weekend in Sacramento, CA at Sutter Health, a class of nearly all new to PRI or Postural Respiration students enthusiastically discovered new nuggets of insight into posture being delivered through air pressure sense into a thoracic wall and how that influences patterns, position and dynamic posture of the entire axial skeleton.

This course was what I would consider very homogenous since more than 85% of the students had never taken this course. Breaking down digestible pieces for everyone new to PRI can be a challenge since all of our courses have the potential to be a significant paradigm shift in reasoning and application.

The similarities of the attendees were that most were new to PRI while the differences included PT’s, a DC, an OT, massage therapists and strength and conditioning personnel . Not only were those professions represented, but a dentist was present who is taking a more broad or holistic approach applying PRI principles to his practice from what we mention as a stomatognathic perspective in Cervical Revolution and our Occlusal course. Sharing how occlusion, respiration and mandibular appliances integrate was an advanced discussion with him that was professionally stimulating and confirming!

As the weekend progressed and students began to sense changes in themselves after non-manual and manual techniques were practiced and applied, the enthusiasm for these first timers to PRI began to build. For one OT, her response to PRI was essentially “where has this been my whole career?” When new students ask which course they should take next or what is the process for PRC or PRT certification, it is a good sign that curiosity and motivation is significant!

One of the questions was how does a tricep influence the position of a scapula, especially the right side? How is it that it is like a left hamstring on a left ilium?

When the right arm is extended and in a fixed position, especially with an active left abdominal wall resulting in a left ZOA, the static contraction with a right arm reach has a positional effect resulting in posteriorly tilting a scapula much like a left hamstring has the potential to posteriorly tilt or reposition a left ilium. This can be seen in the non-manual technique, “Left Stance in Left AFIR Position from the Left AIC Pattern with Right Upper Extremity Resisted Reach.”  Or in a “Paraspinal Release with Left Hamstrings”, it can clearly be seen that the tricep is engaged positionally to posteriorly tilt a scapula. Both of these techniques are in the Right Lower Trapezius and Right Tricep section of the manual and since the long head of the tricep attaches to the infraglenoid tubercle of the scapula and then to the olecranon process of the ulna, not only does the tricep extend a humerus or ulna, but it also has the potential to position a scapula from a fixed position of the hand and forearm.

Many thanks to all of the students, including one of my patients who is a massage therapist and flew in from Salt Lake City, that attended with much enthusiasm and attention to this course. Thank you to Taylor Lewis, Ph. D once again as my faithful lab assistant. Thank you much to Anne, Erin and Susie at Sutter Health for providing such a professional location and facilitation of Postural Respiration and future PRI courses. It is the behind the scenes facilitation of location, food and a learning environment that enhances everyone’s next step into their PRI journey  and makes the job easier for  PRI faculty.

– Skip George

Written By: Dan Houglum

Impingement and Instability is my favorite course to attend and teach. It’s a bridge between the PRI Primary courses and the rest of the PRI Secondary and Tertiary courses. We discuss the application of the science of PRI in a clinical manner. My goal in teaching the course is to help you leave a better clinician.

We had a great group of attendees for the most recent version of I & I. This course is continually evolving and changing based on feedback we get, as well as the questions we get during the course. We had a great mix of very experienced clinicians, several PRI certified attendees, and several other who are relatively new to the science of PRI. It is a wonderful challenge to present the material that can be absorbed by someone who has taken the Primary courses, and go deep enough into the clinical weeds to satisfy those who have attended many PRI courses and have been using PRI clinically for many years.

This course is laid out to specifically address the thing that the body responds to the most: pressure. We go through the wealth of research behind the science of PRI, as well as lay out how and why the brain learns new movement strategies. We take the concepts from the PRI Primary courses and expand on them by linking them to pressure management. We spend a lot of time going through ground-based pressure management, as well as how to manage all of the human’s floors.

It was a pleasure to spend time with Loc Rao, PRC, Cody Gilliss, PRC, Alan Lee, PRC, and Jarrett Kolich, PRT. These are all great people, and I was honored to have them attend. Their questions were exceptional and helped drive the course. I really appreciate Rhiannon Dickison, DC, Elizabeth Markous, PT, Tara O’Brien PT, Daniel Loub, CSCS, and Nikki Smith, PTA. Their questions were vital to help us understand and re-state concepts for all of us. Thank you for slowing me down and helping all of us learn.

This course was re-written several years ago to better align with the neurological concepts of the rest of the PRI secondary and Tertiary courses, in addition to the Postural Respiration course. If you have taken the three Primary courses and want to learn how to apply PRI concepts at a more advanced level, then this course is for you. It is a gateway to the PRI Cervical Revolution, Cranial Resolution, Forward Locomotor Movement, and Voice Box Resonation courses. I hope to see you at Impingement and Instability later this year!

We are looking to hire a PRI-minded Physical Therapist in Austin, TX. 1:1 treatments and must have a desire to grow, new grads considered on a case-by-case basis, athletic background preferred.

Please apply here: https://www.mindbody-physiotherapy.com/careers

Job Title: Performance Physical Therapist

Job Summary:

Seeking a highly skilled and compassionate Physical Therapist to join Mind Body Physiotherapy. In this role, you will provide expert care to patients with general orthopedic conditions. Your proficiency in assessing, diagnosing, and treating will be instrumental in helping patients regain balance, reduce pain, and improve their overall quality of life.

Responsibilities:

• Conduct comprehensive evaluations of patients including thorough assessments of medical history, symptoms, range of motion, balance, and functional limitations.
• Develop personalized treatment plans based on individual patient needs, utilizing evidence-based interventions and techniques.
• Implement therapeutic exercises, manual therapy, and modalities to address pain management, restore joint mobility, and improve muscle strength and coordination.
• Educate patients about their conditions, treatment options, and self-management strategies to promote long-term recovery and prevent future complications.
• Collaborate with a multidisciplinary team, including orthopedic doctors, dentists, orthodontists, neurologists, and other healthcare professionals, to provide comprehensive care and optimize treatment outcomes.
• Regularly monitor and reassess patients’ progress, adjusting treatment plans accordingly and documenting findings accurately.
• Stay updated with the latest research, advancements, and best practices incorporating new knowledge into clinical practice.
• Participate in continuing education opportunities, professional conferences to enhance clinical skills, and workshops to educate other providers about the physical therapy profession, and stay abreast of emerging trends.
• Adhere to ethical and legal standards in patient care, ensuring privacy, confidentiality, and informed consent.

Qualifications:

• Doctorate in Physical Therapy from an accredited program.
• Valid Texas state licensure or eligibility to obtain licensure as a Physical Therapist.
• Interest in Temporomandibular Joint Disorders (TMJD), Vestibular Therapy, Pelvic Health, or a background with Runners is a plus but not required. In-house training will be provided.
• Strong experience in fitness and exercise programming
• Proven experience in evaluating, diagnosing, and treating patients with general orthopedic conditions.
• In-depth knowledge of the anatomy, physiology, and biomechanics of the temporomandibular joint and the vestibular system and its disorders.
• Familiarity with various treatment modalities, including therapeutic exercises, manual therapy techniques, pain management strategies, and functional dry needling.
• Strong interpersonal and communication skills to establish strong relationships with patients
• Ability to collaborate effectively with a multidisciplinary team.
• Compassion, patience, and the ability to provide empathetic care to individuals experiencing pain, functional limitations, dizziness, and imbalance.
• Must be detail-oriented and willing to learn.
• Commitment to ongoing professional development and staying updated with the latest advancements.

Compensation:

$73,300 base yearly

25-30 patients/week

Bonus structure – make up to $85,300 yearly

1:1 patient care without overlap

Flexible schedule

PTO

Emphasis on work-life balance

Join the Mind Body Physio team and significantly impact the lives of patients seeking to improve their quality of life and return to doing the things they love while maintaining work-life balance. New grads will be considered on a case-by-case basis.

Are a dedicated and skilled Physical Therapist ready to change the face of healthcare? We invite you to apply.

Job Type:

Full-time

Salary: $73,300.00 – $85,300.00 per year

Benefits:

• Continuing education credits
• Flexible schedule
• Health insurance
• Opportunities for advancement
• Paid time off

What a great weekend in Albuquerque, NM. Albuquerque is really my home away from home. My wife is from Albuquerque and we have spent winter holidays with family down in the great state of New Mexico. Family, sunny skies, and amazing cycling have given Albuquerque a special place in my heart. It was so nice to grow my PRI family this past weekend in Albuquerque with such a great class.

Everyone seemed excited and ready to learn about patterns, positions, and posture. We learned how a left hamstring will help oppose the dominant neurological patterns and positions that have been our default as human beings. We learned how to engage a left IC adductor, a left anterior glute med, and a right glute max to balance out our “pickles” and provide a recipe for forward locomotion in a less dangerous and pathological way. Albuquerque is famous for balloons, so a PRI class in New Mexico would not be complete without utilization of PRI balloons to inhibit an AIC chain.

Anna helped us all appreciate some internal obliques and transverse abdominals to prevent us from being alligators. Jayson saved the day with an emergency trip to Office Depot for an essential projector cable. The “hamstring” of the projector! Caroline provided a pleasant southern twang narration while being a great example of a common left AIC presentation. The “Work Wives” up front were a joy to have in the front row and their excitement for the material was contagious. The “Sams” in the back contributed to fantastic dialogue and thought processes. I am excited for them for their PRI journey ahead. Hannah reminded us all of the importance of shifting left and right and why the patterns are not a bad thing. Patterns are our “friends” as long as we can alternate and reciprocate!

A big thanks to all who attended, especially the Presbyterian Healthplex “family” for being so welcoming, friendly, and allowing me to grow my New Mexico family of clinicians.

The ENT Institute just north of Atlanta was the location of the latest Cervical Revolution presented to a curious, question asking and enthusiastic group of PT’s, athletic training, fitness and soft tissue professionals.
One major emphasis of Cervical Revolution is on the brainstem specifically nerve and CSF flow at that highly neurologic articulation located at Atlas and the occipital bone.  When a neck is unable to maintain neutrality and oscillating function, especially at the craniocervical articulation or the occipital atlanto joints, a wide range of symptoms are likely to occur.  These symptoms can include hypotonia affected by the fusimotor system, neuralgia, inflammation, tinnitus, dizziness and hypertonia especially with stiffness of cervical musculature and headaches.

This is a short list of symptoms that can also mimic Chiari-like symptoms that can include all of the above with sleep apnea and sleep disorders.   One goal of this course is to identify and restore normal spinal coupling of the cervical region through testing and non-manual techniques for proper tri-planer function of the neck, cranium and occlusal system.  In this course, the neck is the primary driver of cranial strain patterns that can appear in a non-pathological or pathological presentation.  The cervical spine has a direct relationship with osteopathic descriptions of cranial position including temporal bone influence on the jaw.  The occlusal system also has a strong influence of not only the cranium and neck but the entire body. This is known as the stomatognathic system, and it has a significant influence on the entire axial skeleton.

The staff at The ENT Institute was so excited about attending this course since they see so many patients with the symptoms previously mentioned and can see the application of PRI into their daily practice.  It is always a pleasure for a faculty member to have so many intelligent questions and see so many “ah-ha” moments from students eager to learn a detailed, and at times, challenging to assimilate course!

Thank you very much to the staff at The ENT Institute including Allison, Jennifer, Niah, Miscelle, and Ann.  Thank you to Tassie for driving up from Warner Robbins, Mary Beth for all the great questions, Andy for your continuing journey, Danielle, Meghan, Roberta for your energy and last but not least, Kaitlin, for participating so well during lab.

I had the distinct pleasure of presenting Myokinematic Restoration at the home base in Lincoln. Honestly, standing at the front of that room still feels a bit like getting to take batting practice at Yankee stadium. Only this time, it was game day!

I was joined in this endeavor by a healthy live stream audience and three hearty souls in bodily attendance. A big thank you to Mike Hammond, CSCS, Whitney Rubendall, PTA, and Janna Vavra, DPT for their willingness to help me teach and demonstrate the material to our virtual attendees.

The group as a whole joined me in our mantra for the weekend, “Questions are catalysts”, and provided insightful queries and observations that propelled us all forward. One of the questions I enjoyed the most was from Susan Peterson, DPT when she asked, “Should I assume that the L AIC pattern is present in all my patients?”. Such a great question! My answer was a resounding “NO!”.

I would ask that none of us assume, that we use the tests and the material presented to confirm. The tests and the ability they provide to apply an A-B-A single subject experimental design to our treatment sessions are the foundation of successful PRI application.
Quoting Lucy Yu, DPT from her excellent document included in every primary course on evidence based practice and PRI:
“The A-B-A design as a clinical decision making tool allows for systemic, objective testing and retesting to be conducted during daily clinical PRI practice in order to rule in and rule out causes of pain and dysfunctional movement. The results can be immediately applied to direct a treatment plan that addresses each individual patient’s specific needs.”
If you haven’t had an opportunity to read through Lucy’s document, I highly recommend it.

Our journeys’ through this process of life long learning at times meet with challenging information that may conflict with how we were taught and understand the human body. PRI is not here to knock down anyone’s foundation, that is where we come from, but it is no where near our ceiling. We are all incomplete and evolution requires openness, humility, and drive. Thank you to this group for helping me on my own path, my greatest hope is that our time together can serve as another rung onward.

– Jason Miller

Written By: Louise Kelley

We were honored this past weekend to present Cervical Revolution to attendees from multiple disciplines across the country and world wide.  Eleven countries were represented, reflecting the growing strong interest in Postural Restoration!

Cervical Revolution introduces to the attendee the immense impact that position and triplanar movement of the cervical spine and the occipital-atlas articulations have on the efficiency of movement patterns, such as walking and chewing, and on the patency of the foramen magnum, ensuring unimpeded flow of nerve tracts, blood, and cerebral spinal fluid and the health of the cranial nerves housed within the brain stem.

We introduce a new chain of muscles, the temporal-mandibular-cervical chain (TMCC) that, like the anterior chain and brachial chain, becomes overactive on one or both sides. Typically, activity of the right TMCC is in cahoots with the left AIC and right BC, further driving us to our right side for safety when upright against gravity.  Right TMCC overactivity is reflected in asymmetrical cervical test findings and asymmetrical faces and bites.

We spent extensive time discussing and coaching non-manual techniques (and one manual technique), some unique to this course and others borrowed from our primary courses, allowing us to appreciate their impact on the neck and cranium, not simply the pelvis and thorax.

We are grateful to those who asked questions and provided feedback following technique performance.  A special thank you to Ashley Kaploe, DDS, who offered her dental expertise to the occlusion discussions.  And thank you to our in-person lab avatars who greatly enhanced our understanding of tests and techniques: Kentaro Ishii, ATC, PRT; Ashley Kaploe; Emily Schulz, DPT; Kyle Shunkwiler, DC; and Shinri Suzukawa, PT, PRP.

It is my sincere wish that all attendees now have the confidence to begin assessing necks, faces, and smiles.  Your patients-clients will be the better for it!

The temporal bones mirror the ilia of the pelvis and should exhibit alternating internal and external rotation, depending on the leg you’re standing on.

Earlier this month, at our annual Advanced Integration course, we presented the PRI Director’s Dedication Award to two very deserving individuals who have had such a positive impact on our Institute. The PRI Directors Dedication Award was established in 2012 to recognize individuals’ ongoing dedication to their advancement in PRI. Susan Henning and Joe Belding were the very first recipients of the PRI Director’s Dedication Award, back in 2012. And this year, we were so honored to present the PRI Directors Award to two of their colleagues, Lisa Mangino and Jean Massé. To date, we have presented this award to 20 individuals and an award recognition plaque, which is pictured above, is displayed at the Postural Restoration Institute® in Lincoln, Nebraska, recognizing each of the PRI Directors Dedication Award recipients.

Lisa Mangino and Jean Massé are physical therapists and colleagues, in Chapel Hill, NC. Lisa began her PRI journey 14 years ago, taking her first course (Myokinematic Restoration) in 2009 at the University of Duke, where she was employed. Not long after, in 2010, Jean Massé, who was influenced by co-workers and PRC therapists Susan Henning and Joe Belding at Advance Physical Therapy, completed her first PRI course. She went on to complete PRC credentialing in 2013.

Jean is a nationally recognized Board-Certified Orthopedic Clinical Specialist (OCS) through the American Physical Therapy Association, since 1999. She continues to be a regular speaker at the UNC Chapel Hill Department of Physical Therapy on the subject of scoliosis and chronic pain.

She and Lisa obtained the preliminary C1 and Advanced C2 Schroth scoliosis certification in 2013. They have been treating young and older people with scoliosis since.

Lisa completed PRC credentialing in 2014, the same year that she began working at Advance Physical Therapy in Chapel Hill, with Susan, Joe and Jean. And, they have all worked alongside each other for the past 10 years.

Lisa’s passion is working with children, and as a pediatric therapist at Advance Physical Therapy, and the University of Duke Medical Center, she has touched the lives of so many children and families in her career. Her dedication to treating the child with neurological impairments led her to pursue certification in Neuro-Developmental Treatment (NDT), in 2009. Lisa obtained national recognition with her certification as a Board-Certified Pediatric Clinical Specialist (PCS) by the American Physical Therapy Association, in 2010.

Over the years, Lisa and Jean have attended 10+ Advanced Integration courses. In 2017, they began teaching day 4 of the Advanced Integration course, on Curvature of the Spine, alongside colleague and mentor Susan Henning. And it was such an honor to have them here teaching day 4 of this course again this year!

In addition to their involvement with day 4 of the Advanced Integration course, they also co-authored Chapter 7 titled “Postural Restoration: A Tri-Planar Asymmetrical Framework for Understanding, Assessing, and Treating Scoliosis and Other Spinal Dysfunctions”, in the InTech open access book, “Innovations in Spinal Deformities and Postural Disorders”, back in 2017 with Susan Henning. And a couple years later, Lisa, Jean and Susan founded STRATER Scoliosis Institute, where they are dedicated to the education of physical therapy professionals for safe and effective treatment of scoliosis. Over the past 5 years, they have worked closely with PRI to receive permission to teach PRI copyrighted material in the STRATER level 1 and 2 courses. Katie Piraino, who is a PRC therapist, attended the STRATER level 2 course last month and emailed me shortly after. Her exact words were, “I just took the Strater Scoliosis 2 course. Only 15 participants, there should be 100’s they are so good!”

In addition to this dedication and involvement with education related to PRI and scoliosis, Lisa has spent hundreds, if not thousands of hours on course development over the past several years, including the former PRI Integration for Pediatrics affiliate course, and today’s Human Evolution course, which was taught for the first time in September 2022….and although it’s a relatively new course, it is already catching fire with PRINation.

In 2020, Lisa was also invited as an adjunct faculty member at High Point University, to teach a semester long selective course for Physical Therapy students titled, “Postural Restoration® – An Overview of Asymmetrical Human Movement”.

Congratulations to Lisa and Jean on such a deserving award!

We are excited to announce and congratulate the Postural Restoration Certified™ (PRC) Class of 2023! This was a special week for us as we conducted PRC credentialing for our 20th year! From the first class in 2004 to this most recent group of clinicians, we have had 250 clinicians complete PRC credententialing, spanning 38 states and 7 countries. You can search PRI credentialed providers on our Find a Provider map.

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. Earlier this week, 7 clinicians earned the designation of Postural Restoration Certified™ (PRC) under the direction of Ron Hruska, Louise Kelley, Skip George, and Jennifer Platt.

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.

CLICK HERE to view the photo album.

Back Row (L to R): Skip George, Alan Lee, Timas Peteraitis, Justin Baird, Brandon Le Burkien
Front Row (L to R): Louise Kelley, Greer Mackie, Diana Lee, Steven Blair, Ron Hruska, Jennifer Platt

They say the third time is a charm! I think we’ve been planning to take the “old Peds course” and now the new, remastered “Human Evolution” course to Alpine PT in Seattle WA three times, and in October, we finally did it, barring surgery and COVID! From my perspective, it was well worth the wait. Christopher Murhpy, Jeremiah Ferguson, Eli Zygmuntowicz, and Eva Bilo were the most gracious hosts and hostess. It was so great to have met you after hearing so many good things about you and your clinic.

We took a journey through the development of a human, highlighting critical sensory motor milestones, reviewed the literature supporting why these human developmental principles are important and connected it all with a description and application of 7 specific developmental processes. With over 100 videos of clinicial application through the lifespan, we were “in the clinic” with 8 patient cases for all of Day #2, from 15 months old to 70 years old.

We had an important conversation about the overwhelming benefits of crawling on hands and knees, and how important this skill is to painfree, grounded, postural development and walking as we age. This skill (at any age, really) brings sensory attention to all of our bases of support (right and left, front and back), helps to use and to integrate primitive tonic neck reflexes, provides a sense of upper extremity self-referencing on the maturation of cephalic-caudal independence, allows us to feel a grounded sense of gravtiy in a primitive form of forward locomotor movement, AND to explore our worlds from a new visual persepctive for cognitive processing!  And that’s only one of the 10 milestones we recognized.

A couple of the attendees came up to me and said, “As you were talking, I was writing patients names down because this course applies to so many of them”. We might not be crawling for locomotion as adults, but as we are cleaning out a bottom cabinet, gardening on hands and knees, pushing a grocery cart in the grocery store, rolling over in bed, lowering ourselves to play with our pets or children, or walking upstairs (or downstairs backwards – WHAT?), we are using the skills that were hopefully laid down in the developmental years. If these skills were not wired developmentally, or if an injury or insult changed that developmental fortification, there’s a good chance one might be pursuing PT, which is why your patients might be in your clinic. This course was created to help us all better understand these cross-referenced connections for better patient outcomes.

I hope to see you in one of 2 live stream offerings in January or September of 2024, or maybe I’ll get to shake your hand in person in Malvern PA in April. Thanks again to the fine folks at Alpine PT, and to everyone who attended, nodded, questioned, and participated. Your presence was enriching to me and to the group’s learning. I appreciate you all!