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This past weekend, the Affiliate program got presented in the southern hemisphere as the PRI  integration for Fitness and Movement was hosted in Sydney, Australia!!  I traveled over 10,220 miles (or over 16,447 km) and the very long plane ride across the south pacific was well worth it! Sydney was such a fun city, and it was a pleasure to spend some time with the PRI Australia group.

 I am beyond grateful to have had the opportunity to share the PRI science with this area of the world.  It is exciting for me to watch attendees connect to a deeper dimension of PRI because I believe it’s in those deeper dimensions of PRI that the magic happens and gaps are bridged.  Attendees from Japan, Singapore, Malaysia, Georgia and various parts of Australia were all represented. Chiropractors, Osteopaths, Physiotherapists, Pilates, Yoga, and Exercise Specialists were all in attendance, with the class being about half and half. Half being exposed to PRI before and the other half were brand new to the science. Needless to say it was a diverse group — yet all united to learn more about the diaphragm and its influence on posture.

Regardless of credentials and training, this course is enlightening to help us all remember how to program Respiration and Alternating Reciprocal Activity to enhance Tri-Planar performance patterns (i.e “Functional Fitness”)

 We hit the ZOA hard and discussed it’s role in managing hyperactivity and unnecessary muscle tension. The exercises I introduced focused on shaping the ZOA three dimensionally with respiratory abdominals, along with promoting  expansion, movement and flexibility of the ribcage.  I then emphasized the 5 steps of programming for shaping adaptation and better integration for symmetrical compound lifts.

  The 5 steps in this course are presented to help create a framework for programming and organizing how exercises are presented to clients and patients. The 5 steps also help in organizing core stability and symmetry from the diaphragm level outward.

I loved seeing the passion and ah-ha moments as attendees connected with the material and got new resources and insights to help progress their clients and patients. I think we will see PRI quickly continuing to grow in this area of the world. Thank you to Mark Obrien and Jason Thomson for hosting. Special thanks to Mark for the hospitality and opening up his brand new facility for us to use. Fit Plus Well is such great hidden gem just south of Sydney. And Jason, thank you for sharing your passion, your insights (nuts, I will always remember your nuts cue) and helping with much of the logistics of the weekend! 

My visit to Australia was fun and I hope to get to come back one day! I could definitely live in Sydney – beaches, city and mountains were all right there. Beautiful coastline. Thank you to all who helped organize the event! Cheers!!

Boston is a city known for its innovation – ranked fifth in the world – likely due in part to the 54 colleges located within the metro area. As so it was that 50 course attendees descended upon the campus of Northeastern University to learn how to apply the innovative concepts of patterned thoraco-abdominal mechanics into their existing treatment paradigms.

Many attendees had Myokinematic Restoration and/or Pelvis Restoration in their wheelhouse, so they were excited to expand upon their understanding of how it is that the diaphragm and rib cage, via directing air flow patterns, enables us to shift our COM to from the left to the right, and back again, for efficient gait.

Discussion of the differences in the neuromuscular behaviors of the right and left hemi-diaphragms, and their profound influence on the nervous system, movement quality, and behavior, are fundamental in PRI courses. This includes the differences in the right and left diaphragm’s Zone of Apposition and its role in rib cage expansion to allow our axial skeleton shift and rotate. Arm swing, when done properly, supports this process, promoting good rib movement and hemi-diaphragm position to reduce fatigue and promote healthy air flow patterns. These concepts were brought to life by the many photos of real patients. Their backgrounds gave insight into why it is they sit, stand, and breathe the way they do.

Of course, we had our own class of individuals who provided insight. Anita Furbush, PT, PRC, and Tyler Tanaka, DPT, PRC, were instrumental in providing clinical pearls and guiding participants during lab. Johnathan Blake, CPT, Amanda Donahue, ATC, Rachel Ferrucci, DPT, Brianna Papotto, ATC, Mansi Shah, DPT, and Sean Sheridan, DPT, kept the questions coming, prompting me to clarify concepts, which benefited the whole class. Thank you to our live “case studies”: Katie Brooks, MA, CPT; Lindsey Rockett, ERYT; and Joshua Robinson, CPT, who allowed us to identify and address the different patterns of polyarticular muscle chain over-activity that a patient/client may present with. Finally, a huge thank you goes out to the folks at Northeastern for hosting: Katie Brooks, Jai Chopra, ATC, Mark Mastone, ATC, CSCS, and Dan Sanzo, ATC, CSCS. Great facility and wonderful group of attendees!

Having the opportunity to reflect on some of our PRI Non-Manual techniques that originally were put together back in 2003, with the understanding, consent and support of my gracious patients is always a privilege. A proud one. These photos of patients that have now become engrained and etched in our minds were taken more than 25 years ago, and not with a cell phone. As grainy as some are, and as imperfect as some now appear, they will always be the photos the Institute will use with the respective non-manual technique they are paired with; because they are related to stories, to people with behavioral and biologic history, and to individuals with hope as they struggle to understand and appreciate the steps and desired outcome associated with the technique that they will forever be infamous for. A few weeks ago Josh Olinick PT, PRC who works in Cary, North Carolina saw a patient that came to his clinic for a PRI re-assessment and intervention program. She was seen in 2004 by myself and agreed to have her photo taken for one of the PRI techniques I designed for her and this Institute. Josh, looked at her, and said, “Don’t I know you?” After further discussion, he realized who she was and what technique she was associated with. He sent us an updated picture of her performing the same technique she has been unassumingly known for. It was terrific that she found Josh, and more terrific that he could communicate and approach her the same way that she was treated when I assessed her 15 years ago.

The other person I reflect on every time I have given this workshop (this was the third time), and every time I will give it in the future, is Bobbie Ninneman, oops I mean Rappl.  She was my “Patient Program Coordinator” back in 2003, before she became the Institute’s Clinical Education Coordinator and now our Director of Clinical Development and Public Relations. Her oversight and insight is as important today, as it was then; no matter how many children she and her husband Mark raise. Her ‘children’ and my ‘children’ are also these people and these associated techniques and wording that tie them together. They are stories, events, chapters, accounts, and initiatives that change other people’s lives and processes. These techniques will remain consistent and constant, no matter, who and how many try to change the pictures, wording or association with other activity. Evolution depends on recognition of what started the journey and these techniques make me sentimental and grateful. I am grateful for Bobbie and all the “Bobbies” of my life that preceded anyone’s use of their guidance, consistent content and hope they offer.

Dan Houglum, who knew me before I started the Institute, and is now a faculty member teaching Myokinematic Restoration, summed up his weekend like this…
"The actual activity selected is not as big of an issue as I had originally thought. The real issue is can I reference the activity properly for them so they can sense what the need to sense in that activity. It was so great to be sitting next to Dave because he pointed out that every activity has so many potential ‘referents’ and ‘references’ in them, that you can use the same activity for two different patients, but use and reference the activity completely differently for each person to achieve the necessary outcome for that individual."

A few other testimonials shared by course attendees this past weekend…

     "This course should be a requirement for people who use PRI Non-Manual techniques. This course changed how I will practice a lot. Awesome course. Thank you so much!"

     "What an amazing course! Every PRI-minded person must take this. I had no idea how some of the techniques were meant/executed. Thank you very much!"

     "The reference/referents discussion will completely change my patients’ experiences with the non-manual techniques.

If you are interested in learning more about the many ‘referents’ and ‘references’, and how to integrate them with the PRI Non-Manual Techniques, then I would highly recommend attending this workshop! It will be offered twice again in 2020 (both times in Lincoln, NE), so that I can have my side-kick, Jen Platt assisting me. Jen and I are already looking forward to it, and we hope you will consider joining us!

The Hruska Clinic’s Jason Masek will be presenting "Patterned Conditions Beyond Competitive Years: Asymmetrical Movement Pattern Considerations" at the upcoming NATA convention on June 25th, 2019.  He will be presenting about how asymmetrical patterns of movement affect athletes after their competitive years. If you are going to be at the NATA convention be sure to check his talk out! You just may learn how a race car is engineered to optimize performance and how it correlates to the human body.

The Non-Manual Techniques Collection for the Cervical Revolution course is now available for purchase as a Digital Download! The digital download collection includes PDF handouts for the PRI Non-Manual Techniques which are discussed and included in the Cervical Revolution course. Some techniques do crossover from the Primary Courses Non-Manual Techniques Collections, however many of the techniques are new to the Cervical Revolution course, and have never been available for purchase on a CD or Digital Download.

The Cervical Revolution Non-Manual Techniques Collection has three sections, and a total of 26 techniques:

• Non-Manual Repositioning (5)
• Left Sidebending Repatterning (9)
• Right Torsion Repatterning (12)

CLICK HERE to purchase the Cervical Revolution Non-Manual Techniques Collection for only $35! *Please note: you must complete the corresponding Cervical Revolution course prior to purchasing this product.

It was a humbling experience to be on the campus of the Naval Academy teaching Myokinematic Restoration the weekend following Memorial Day. It’s a weekend that will resonate with me for a long time for a variety of reasons. I have three relatives who have served in the Navy, so to be on that historical campus was truly a privilege.

It was also a privilege to be able to deliver PRI concepts to a fantastic group of diverse movement professionals. We had ATC’s from the Naval Academy as well as from other institutions, LMT, Strength Coaches, PT’s, and DC’s. Mike Barnard, DC, it was truly an honor to meet you and I thank you for your questions and contributions to the course. With such a diverse crowd, we were permitted to expand our conversation points around many scopes of interest and practice.

Our course was held in Akerson Tower at the football field. During our course, the artificial field turf was being pulled up and removed. It was an apt backdrop for our course because, not unlike the football field, PRI was peeling off layers of preconceived notions in the minds of the course attendees. Once the truth of human asymmetry was revealed and the ramifications of it, we were able to start delivering a new layer of Myokinematic and neuromechanic foundation that they will be able to build on top of moving forward in their PRI journey.

Another unique revelation for me this past weekend occurred when fellow PRI Faculty member, Louise Kelley, and I met for dinner, and she brought her husband, Bruce. I can confirm, Bruce does exist, and we had a wonderful time Saturday night.

My thanks to Nate Nester, Jill Tender, Laurie Johnson, Ryan Carr, Greer Mackie, Vikram Somal, Christine Von Ulrich, and Johnathan Blake for their questions and their willingness to allow us to learn from them. Johnathan is going to be in attendance next weekend when Louise Kelly teaches Postural Respiration in Boston, which is going to be awesome! Cindy Anderson, PT, PRC, was invaluable during the lab portions of the class, as well as providing her valuable insight to delivering PRI concepts.

Progressing through the L AIC pattern, potential pathology that can result, and which muscles can and cannot work because of the position they are in is a lot for anyone new to PRI to digest. But we had many, many attendees who were able to digest the "why", so progressing into the testing and treatment portions of the class were relatively seamless. We were afforded a lot of time for lab, which allowed the attendees to experience getting onto their L side for the first time in a long time. This particular Myokin class will stand out for me because of where we were, the time of year, the symbolism of the football field turf being peeled away, and how stellar the class attendees were. It was a privilege to be among you.

This past weekend I spent some time at this famous institution teaching Myokinematic Restoration. I’d like to take this opportunity and commemorate a moment and talk about perspectives. The moment that I am commemorating is the weekend I got to spend mentoring Kasey Aikin PT, DPT, PRC, as she journeys toward independence as an instructor for the Institute. The perspective to which I refer is Kasey’s and mine, which I imagine will differ a bit. Kasey participated as a lab assistant along with the capable mind of THE Donna Behr PT, MS, DPT, PRC, who so many of you already know. But Kasey also had an additional task. She was not just learning or refining her PRI/Myokinematic skills, she was also learning to be an instructor, so this weekend becomes even more important for her from that perspective. As I spoke of specifics like L AF IR, the AIC, FA IR, management of specific diagnoses and refining skills like the Hruska Adduction Lift Test, Kasey was…absorbing, processing, smiling, reinforcing, thinking and determining how she could best teach the material. I admired what I saw as she worked toward her goal of being an instructor. She could, I think, have taken some of the material at any given moment and presented it. I would’ve enjoyed seeing her do it. Soon, she will. I imagine she will be quite edgy when she does but I think the class to whom she speaks will benefit greatly from her now-forming style. I invited Kasey to write about this weekend from her perspective and the ensuing words you see are from her. As for Wellesley College…put me down as grateful to have been there and I thank you Tim Snyder MS, ATC, LAT for being a great host.

From Kasey:

Walking into a PRI course as a “student” with Mike Cantrell has always been a guarantee of gaining several pearls of wisdom applicable day one while at the same time a comedy relief deciphering his southern similes and metaphors. This course was no different minus my mindset this go round as I wasn’t just a “student” anymore. The crew attending were primarily from the northeast so it’s always neat leaving the south and finding common ground with people on the other side of the country. Lab assisting with Donna Behr was awesome, she may be the nicest lady living in Boston. Seeing the light bulb moments of the attendees go off during lab is always the thrilling part of PRI and what continues to bring anyone back to PRI courses time and time again. The New York “triplets” were super enthused with the material and I’m always impressed to see strength and conditioning specialists diving into Myokin. The Maine crew had excellent questions and honed in on their testing skills. Overall, what an enriching experience while trying to navigate presenting the intricate science of PRI to do it justice. Thanks to all the attendees for the thought provoking questions and Mike Cantrell for continued mentorship and support!

We are excited to announce the release of our updated Postural Respiration home study course!

If you ordered this online home study course in the past 6 months (while we were editing), we would like to offer you 2 weeks complimentary access to view this updated version. Please check your email for more information on how to begin your complimentary access.

This new version is co-taught by James Anderson and Ron Hruska (and their pal SYMBA – the rib cage model), and features over 17 hours of content, including case study discussions. Over the past year, our faculty and staff worked together to update the content, structure and flow of this course, and we hope you enjoy the finished product as much as we have!

*Please note that we are still waiting to hear back from a handful of states on CE approval for this updated version of the home study course, so please be sure to check the up-to-date list of Accreditation/CE approval on our website, and contact us if you have any questions about whether the updated course is approved in your state.

Ahh Seattle… How I missed you! I had the absolute pleasure visiting one of the most beautiful places I have ever had the privilege to teach PRI. I flew in early this time and was able to finally scratch my bucket list line item of going up the Space Needle! I visited the Pikes Place Market, took in an Underground Walking tour and learned all about how the Pioneers developed the city of Seattle. I ate my fair share of seafood and fueled up for the weekend ahead.

10 years ago, I assisted James Anderson in teaching the very first PRI course in Seattle. PRI has grown so much in the last 10 years, but nothing like the firestorm that hit this area. Seattle has so many amazing clinicians that have really grabbed hold of the science and ran with it.

I had the help of my PRI friend Zac Hawthorne. Zac did a great job helping during lab, sharing his insights with our class and answering questions.

This weekend I taught Pelvis Restoration at Pro Sports in Redmond, Washington. The staff Amanda, Cory, Siera, and Nathan made me feel so welcome, it hardly felt like I was working.

Pelvis Restoration is a great first course as it allows for a nice blend between Myokinematics of the Hip and Pelvis and concepts introduced in the Postural Respiration course. My attendees ranged from 8 “Newbies” to experienced PRI clinicians. This was a nice mix for learning and integrating effective evaluation tools and treatment interventions. I hit home the concepts of Respiration and Gait as it relates to the inlet and outlet and how that presents in patients suffering from diagnosis of Iliosacral pain, pelvic floor conditions, lower back pain and pubalgia.

My own recent course attendance at I & I, the Non-manual technique workshop and PRI for Pilates really helped me teach Pelvis concepts this weekend. I did my best to keep to the Pelvis concepts but relevant to the science taught in other courses. The integration of outlet and mediastinum inhibition using the objective tests such as how a PADT and posterior medisatinal outlet expansion tests, bridge the gap between the pelvis and thorax.

Special thanks to Taylor, Anna, Lisa, Jake, Elena and Steve for helping with lab demonstrations this weekend. I will now take a much needed rest and look forward to being back on the road in September in the Big Apple!

Until then PRINation… #trustthebreathe

Who knew that following Ron’s advice many years ago to find a dentist who appreciates the influences of airway, neutral TMJ position and occlusion would take me to Vilnius, Lithuania?  I have had the privilege of working with a multidisciplinary team of dentists, Dara Chira DMD orthodontist, Jeff McClendon DMD restorative dentist, and Michael Gunson DDS, MD orthognathic surgeon for the treatment of complex TMD, Airway and Occlusal patients.  We have been invited to speak at various dental conferences on our multidisciplinary approach to care (Lips, Teeth, and Tongue to Toes).  Most recently we spoke at the Baltic Sea Community on Orthognathic Surgery and Orthodontics Spring course on “The Gravity of Temporomandibular Disorders Treatment “in Vilnius, Lithuania. 

The conference opened with dental radiologist Dania Tamimi BDS, DMSc presenting on radiographic evaluation of the TMJ.  I just about fell out of my seat when she showed a left cranial side bend and how it affects the TMJ, mandibular position and occlusion!! This made my discussion of the RTMCC so much easier for the participants to understand. There were lectures by orthodontists, and orthognathic surgeons as well.  Dr. Mariano Rocabado DPT presented arthrokinematics of the craniovertebral and craniomandibular areas with the influences of manual therapy on the cervical spine and its impact on neutral TMJ.  All the lectures and especially Dania and Dr. Rocabado’s lectures were a perfect set up for our team to close the meeting with how we work together to achieve balance for our patients on so many levels.  My part was very well received as I was able to develop the PRI concepts from an Advanced Integration approach including LAIC, RBC, RTMCC, muscle chains, forward head posture, asymmetrical patterns and the importance of the diaphragm and attaining proper breathing mechanics and ZOA with its influences on temporal and mandibular position and function.  It was great fun demonstrating a balloon technique to 230 participants from 30 different countries!!! I am very excited about the feedback we got after and how open minded the group of dentists were to the idea of occlusion being more than just about the teeth!!! They really do like looking at teeth though!!!!

We were able to stay a few extra days and tour Lithuania and Latvia which included a tour of a 14^th century castle on Trakai Island, Riga, Hill of Crosses and The Rondale Palace!! The trip was absolutely extraordinary!!!

I am so grateful for all the continued education and support that Ron, Jen, Jason, RJ and many others have had over the years in helping me understand the science of PRI, the application of PRI for better patient outcomes and for helping me with spreading the word to other professionals on how important it is for patients to work with a PRI minded clinician.

Sitting in the “audience” and listening and reacting with fellow faculty is such a wonderful time, opportunity and fulfillment for me. To do this with a host site that is as welcoming and friendly as a site could possibly be,  makes it very special.  Thank you Nate Dykema DPT, Kelly Marsman PT, DPT, Kevin Proctor DPT, and Craig Stasio PT so much!   To do this with a faculty member, whom I have developed so much respect for over the last few years, is even more life-affirming.  Skip George DC, CCSP,CSCS, PRC has been preparing and “dreaming” about teaching this course since he became a PRC in 2014. He has talked to  Mike Cantrell MPT,PRC , and me, about the course content and delivery of material since he learned he would be teaching it.   He has applied and postured himself, in my opinion, to do this type of work early on his career.  He has been a speaker for the Postural Restoration Institute since 2016 and has been so well received by his Postural Respiration course attendees.  I asked Hannah Janssen, our Education Coordinator, how would Skip’s course attendees describe him.  She quickly responded by saying, “ they feel that Skip works hard at making things understandable and he is passionate about the science and application of PRI”.   I agree with her so much. As a chiropractor he understands universal mindsets and applications.  We are so fortunate, as an Institute, to have him help us move forward these universal messages in the professional and personal manner he uses.  

I believe our understanding of the cervical relationship to pattern development, dominance and dysfunction of the cranium and thorax will be satisfactorily broken down from a PRI perspective by Mike and Skip.  They both have been instrumental in the present design, material covered and the flow of the delivery the last few months.   If there was an ‘Impingement and Instability’ course for the neck, it would be, in my mind, this one.   And both of these speakers integrate pertinent PRI universal concepts of vision, teeth, tongue, and the feet at understandable and applicable levels.   I am so grateful for this.

If you have not taken this course, and have met the requirements, consider taking it.  If you have taken this course and I was the presenter, consider taking it again from one of these two speakers.  The perspective and the manner in how it is presented will be worth your repeated time and expense.

It’s not often that I look out the window at the end of April and see snow falling, but here in beautiful Saranac Lake, NY, this is pretty typical! Matt Powers, DPT, and his team at Adirondack Regional Hospital hosted the updated version of Postural Respiration. This was the second PRI course for many, and they were eager to both expand upon and consolidate PRI concepts they learned in Myokinematics last year.

PRI is a broad science, and this course focuses on polyarticular muscular chain function of the thorax and how it contributes to patterned respiration and patterned movements, as evidenced by neck and belly breathing, rib torsions, asymmetrical abdominal oblique activity, and asymmetrical air flow patterns. Patterned activity can be a good thing. After all, it allows us to avoid an on-coming car as we cross the street, creates the beautiful music of a skilled musician, and gives the appearance of effortless movement in a professional athlete. However, the inability for the nervous system to shut off overly-patterned activity becomes a mechanism for chronic back and neck pain, shoulder and hip pathology, shortness of breath, anxiety, etc.

This course has plenty of lab time devoted to assessment and treatment of compromised diaphragm position and polyarticular muscle chain overactivity. Lab time provided many “aha” moments as attendees saw in their partners, and felt in themselves, improvements in air flow patterns and tri-planar motion immediately following non-manual and manual rib cage techniques.

Ann Marenick, Sara Goldfine, and Brendon Olsen were our class demonstrators of several repositioning exercises and a few challenging lower trap, tricep, and serratus non-manual techniques. Ann was able to move her left shoulder and Sara was able to turn her neck, with greater ease and without the tension and resistance they had felt just minutes before. Brad Collins was the recipient of a 2-person manual technique. Christine Hill and I worked together to help Brad bring his rib cage on both sides into a state of more internal rotation to establish ZOAs and chest wall mobility. Upon getting up off the table, Brad smiled and said, “I feel looser all over.”

Special thanks to Matt and Brendan, who came to the rescue following my rental car fiasco. I enjoyed the one-on-one time hearing about your families and your love of life in the Adirondacks. I’ll be teaching next at Northeastern University in Boston on June 8-9. There are a few seats available, so sign up now!