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I had a great time this weekend teaching Myokinematics of the Hip and Pelvis at Body Dynamics in Falls Church, VA. I grew up not far from Falls Church and my college roommate lives in Rockville MD. I got to spend some time with an old friend and teach a course that I consider an old friend. Myokin is a great course to start a PRI journey and that is exactly what 90% of my course attendees were experiencing. We took an OBER and Thomas Test and turned them from orthopedic soft tissue tests to the neuro respiratory positional tests as they provide clinical evidence of an asymmetrical pattern.

There was as much fog in the room at 4:00pm on Saturday as there was on my drive up to VA on Friday night! But… by Sunday at 5pm the sun was out and the connections in their new PRI minds were clear as the weather outside!

PRI is an integrated science and Myokin of the hip and pelvis is just one piece of an integrated system. But what would a Diaphragm be without a solid pelvic base and a good appreciation of AFIR in stance and AFER in swing!

I was honored to have Dr. Felix Liao, DDS author of “6 foot Tiger in a 3-foot cage”! Dr. Liao considers himself an airway mouth dentist. He was in attendance to understand the perspective of the PRI therapist, so he can better understand the neuro mechanics of PRI and how he can better help patients integrate!

Jennifer Gamboa, Lisa Clarkson and the entire staff of Body Dynamics welcomed all of us to their clinic. These professionals all work well together and it was so fun to watch how they picked right up on PRI methods. Lisa had been exposed to PRI out in Seattle as a student. She did a great job hosting us this weekend!

This class kept me on my toes and asked awesome questions to better understands how to integrate PRI into the current practice. I always enjoy teach Myokinematics of the Hip and Pelvis. It helps further stabilize my own clinical practice and reinforce the importance of sound PRI fundamentals in my treatment plan.

We are excited to announce that next month’s Interdisciplinary Integration Symposium, “Airway Oscillation: An Interdisciplinary Approach to the Production of Voice, Airflow, and Resonance Frequency Breathing” has been approved for 15 IAOM CE hours. If you or anyone you know is a certified Orofacial Myologist, you will not want to miss this years Symposium! Please contact us at 402-467-4111 with any questions you may have, or visit our Website for more information!

It was a wonderful weekend in Roseville, CA not only experiencing balmy weather of 58 degrees (back home it was below 0) but teaching my first Pelvis Restoration course in 2019 to these professionals. Close to half of the class was experiencing their first PRI course and this group asked awesome questions. Those attending the course for the second time also really appreciated the course updates with the Hruska Abduction Lift Test and respiration concepts related to the pelvic diaphragm. I truly feel that a deep understanding and appreciation for the three Primary Courses in PRI is key for clinic outcomes. Thank you Suzi and the staff at Sutter Physical Therapy for your hospitality and to Caleb Chiu for your amazing lab assistance.

There is probably no one that has over 35 years of “breathing experience” as it relates to lower back dysfunction or chronic disease than Rosalba Courtney. I have referenced her, written about her, studied her work, and continue to read her material. She has always been a person I am mindful of when contemplating the role the ANS has on regulation and vagal tone. She was mindful of autonomic dysregulation long before the term “dysautonomia” or “persistent postural perceptual dizziness (PPPD)” became widely noted or understood. She always related neurophysiological disruption to the scientific evidenced-based perspectives of non-pharmacologic healing methods. This is what drew me to Rosalba. Her deep, deep respect for resonance and rhythmic respiration. It is such an honor to have her accept our invitation to come to Lincoln, Nebraska as our 2019 Interdisciplinary Integration Symposium keynote speaker. If there is one word that I correlate patterns and positions to, it is ‘oscillation’ largely because of individuals like Rosalba. Oscillatory activity occurs to help coordinate a system of “oscillating body systems.” After our personal conversation with her, I am sure this noted Australian will enlighten our sense of vibratory need.

To read more of Rosalba’s work, I would invite you to visit her website. What’s even more exciting is that Rosalba is no stranger to PRI, as she has attended all of the courses we have hosted in Australia in the past few years. I am very much looking forward to finally meeting her, welcoming her to Lincoln, and introducing her to more of the PRI family.

Rosalba’s presentations at our upcoming sympoisum are titled:

Oscillations and Resonance Frequencies of the Breath and the Body- Part 1     
Our bodies live in ever changing conditions. For health and homeostasis to be maintained successfully we need to constantly adapt to constant change. Oscillations occurring within the functions of our various body systems help these systems to co-ordinate their functions so that they can work together to optimally react to change and maintain homeostasis. Breathing is an oscillating system that can influence the function and co-ordination of other oscillating body systems, particularly the autonomic nervous system, the cardiovascular system and the digestive system in ways that enhance or interfere with the function of those body systems. Every oscillating system has one or several resonance frequencies where unique capabilities emerge. Resonance frequencies of breathing can be used therapeutically to assist a range of health conditions including depression, anxiety, panic disorder, dysautonomia, asthma, fibromyalgia, chronic pain, functional gastro-intestinal and cardiovascular disorders.

Optimizing the Healing Effects of Breathing Rhythms, Frequencies and Oscillations- Part 2
The healing and homeostatic effect of breathing oscillations can be optimized by improving the functionality of breathing. People with dysfunctional breathing have difficulties harnessing the healing powers of resonance frequency breathing. We well explore how 1. psychophysiological, 2. biomechanical and 3. biochemical dimensions of breathing functionality affect the breaths ability to heal and restore homeostasis and learn some techniques for assessing patients for with tools that can measure these various dimensions of dysfunctional breathing. We will then explore ways of modifying the practice of resonance frequency breathing to assist functionality in these 3 key breathing dimensions.

The early registration deadline for the Interdisciplinary Integration Symposium is this Friday. CLICK HERE to register today!

One of the more rewarding aspects of teaching PRI to movement professionals who are new to the science is their transition from initial shock, to their minds being blown a little (or a lot), to when it starts to click for them and start to see the PRI picture.

This past weekend was one of those classes where the overwhelming majority of the attendees were new to the science of PRI. But it was also one of those classes where the overwhelming majority of the newcomers left understanding and appreciating how PRI, while challenging them in a good way, is an exceedingly necessary clinical tool for them. I have heard from several individuals in the days following the course as they express their gratitude to PRI for opening their mind and challenging their clinical perspective.

Myokinematic Restoration is a great entry point to start one’s PRI journey. We started our weekend by laying out the mechanical ramifications of the L AIC pattern, and how pathology may not be far behind. We then started our deep dive into neuromuscular behavior the Left AIC pattern puts us in, and how to get out of it.

One of the main points of emphasis we have been attempting to drive home in this course is not only how to perform the positional and functional testing, but to understand what the tests mean. And, more importantly, what to do with that information in order to properly decide which PRI non-manual activities to choose. As a result, we constructed our lab time to reflect that concept. We were very fortunate to be able to spend at least half of Sunday in lab. The feedback we were getting was that participants could still feel their L IC Adductor and R Gluteus Max on Monday! That sensation is very helpful for them as movement specialists in order to feel those muscles and how that made them feel as a result.

My thanks to Holli O’Kelley for her willingness to be our host. Her questions during the course were very helpful as well. My thanks to Barak Pearson, Kyle Sammons, and Young Filer for their interest and questions. My special thanks to Mary Faulk and Loren Johnson. Thank you for your openness and willingness to explore different treatment options. Thank you to Betsy Baker-Bold, PRC, for her assistance with our labs. The Seattle area has been growing rapidly in PRI interest over the last several years, and Betsy is one of the main reasons for that growth. This weekend reminded me how grateful I am to PRI, and how humbling it is, as an instructor, to help fellow clinicians explore this new science.

It was a very cold weekend here in Lincoln Nebraska, and as a result of the weather and having a weekend off from course instruction, I had the opportunity to read, reflect and integrate. Therefore, it was a great weekend. This morning, I am reflecting again on material I read and perused, some of which was written by our speakers who are coming to Lincoln in April for the Spring Symposium. It is difficult to focus on what I need to do this week, because of my excitement for this collaborative event. Each of the speakers I have met and talked to in one form or another, and they all are people that have so much in common and so much to offer because of their dedicated work and dedicated pursuance of advanced work that is built off of integrative collaboration. I look forward to you meeting them and learn how they will help you advance your effort with airway oscillation, incorporation of glottal alignment and regulation of vibration in treating conditions associated with postural asymmetry.

After spending a day with Ruth Hennessy and some of her vocal clients a few days ago, while in NYC, I received this text message from Ruth. “I have a voice student I Skype with in Australia who has, for several years, been telling me about her amazing osteopath and how we are so on the same wavelength. Yep, it’s Rosalba Courtney! My student has taken some of her breathing classes in Sydney. Small world!”

This weekend of cogitation has reminded me of how small of a world it really is, when you reflect on how our interpersonal lives are really tied to those with similar adventures, study, interests, habits and relationships. All of this year’s Symposium speakers have two things in common, breath and body position. And I can’t wait to see and hear them interact with each other and with you in the SAME room.   If you have not decided yet on whether or not to come to this opportunity, reconsider what I reflected on this weekend; this unique personal connection of our ‘small worlds’ WILL NOT happen again like it will on April 11^th and 12^th. For those of you coming, I am eager for you to meet these speakers and experience the energy they will bring you, and your clients or patients through this assembly. Over the next few weeks, I will expound on my personal reasons for asking them to participate, and expand and consolidate our ‘small worlds.’

I had a great time with Brian Benjamin, DPT, PRC and the team at ProActive Physical Therapy teaching the new and improved Postural Respiration course. It was great having a number of experienced PRI clinicians present in the class to set the tone and help guide the new attendees, like Lisa Kelly, PT, PRC, and both Joshua Merrick, DPT and Rachel Kroncke, DPT, who have each attended 9 previous PRI courses. Those with experience were helpful for the 12 first time attendees in many ways, asking appropriate questions, providing guidance in the lab and overall just helping to make it a fun and rewarding experience for everyone.

The new research articles and references included in this course really made the first part of Day 1 interesting and educational. It was powerful to take a close look at the important relationships between static asymmetry, dynamic respiration and patterned respiration. Experienced PRI clinicians as well as the first time attendees really benefited from the discussion with the material organized in this way. It was nice to redirect the focus back to the classic PRI concept of Left Posterior Mediastinal Expansion, something that has been a priority at this Institute for years, but can be overlooked if we’re not careful.

Other highlights of the course include the new explanatory sections for the AIC and BC tests, as well as the new Posterior Mediastinum Respiratory Reach Test. It was good to clear up the details of why we use a balloon for respiratory training with the new Standing and Seated PRI Balloon Techniques. It was also good to spend time with each of the newly organized Inhibition sections, for the Right Intercostal, Left Pectoral, Paravertebral, Anterior Neck, Right Latissimus and Left Posterior Mediastinum. And besides the Right BC Treatment Guidelines training, it was nice to have 2 full case studies in the appendix to help with practical application of the material.

Overall a great weekend in a beautiful place focusing on PRI fundamentals, as I was honored to teach the flagship course of this Institute with a great group of professionals. It was meaningful for me to strengthen old relationships as I built new ones with some amazing people, who I am now grateful to call friends and associates.

There probably is not a place on the body that I want to put my hands and eyes on more than the neck. It tells me so much about the neurologic state of the body, the position the body resides, the pattern of respiration placed on the thoracic diaphragm and the anterior neck muscle, the appendicular compensatory probability, the demands placed on dental occlusion, the manner of visual and auditory processing, the pharyngeal airway limitation and the voice habilitation existence. Our character and personality is refined and reflected by our cervical function, or lack of.

Quite frankly, I can look at someone’s neck and become oriented to their orientation and probable individual needs for and from Postural Restoration integration and application. Our synergistic patterns of behavior are defined by the dimension and displacement of the vessels and their lumens and the string-like fiber of muscle, tendons, fascia, and nerves of the neck.

Last weekend’s instruction and interaction with Skip George DC, PRC, who will be teaching this class with me on April 27-28 in Holland Michigan, allowed us to fully examine patterns of functional behavior that corresponds with limitations of cervical lateral flexion and axial rotation. I want to thank Alicia Ferriere DPT, PRC, Darlene Kalinowski PMA-CPT, Laura Paley PT, DPT, Yohei Takada DPT, CFMT, OCS, SCS, CSCS, Catherine Coelho PT, and Daniel Buron MS, CSCS for helping out with lab demonstration and class participation. I always enjoy having Michael Zhao BS, CSCS in my classes. His brain-centric view of the importance of including physiological, environmental and biologic political determinants in assessing synergistic patterns of behavior enlightens me. Thank you Michael for your ongoing participation and attendance after taking 17 PRI courses. Lastly, thank you to Finish Line Physical Therapy for your ongoing support of PRI and continuing to host several courses a year in NYC, my home away from home. 

I am excited to introduce "The Postural Restoration Podcast" with #PRINation! Many of you may be familiar with our featured interviews, and you may have even been highlighted on one in the past. We will now be using this Podcast for our Featured
Interviews as a way to better familiarize the general public with not only our Faculty but also our Certified Providers. Check out the description of the first episode below, and I promise that not every episode will be this lengthy!

PS. Make sure to check out the History of PRI – The Foundation of the Postural Restoration Institute (August 2008) written by Ron in 2008, to discover how far we’ve come over the past decade!

Episode 1: The Foundation of the Postural Restoration Institute

"Welcome to the first episode of the Postural Restoration Podcast! In this Episode, I am joined by Founder and Director of the Postural Restoration Institute, Ron Hruska. The foundation of the Postural Restoration Institute resulted from many years of Clinical Practice and a strong interest in the patterns and positioning that at the time seemed to be the cause of many patients’ pain and dysfunction.

Ron discusses his time in Graduate school pursuing a Master’s in Public Administration after receiving his Physical Therapy degree from the University Of Nebraska Medical Center. His time working at the V.A. Medical Hospital as well as his eventual role as Director of Physical Therapy at St. Elizabeth’s Hospital in Lincoln, NE both played roles in his desire to look at and treat the human body through a multidisciplinary, systematic approach.

This led Ron to create other ways of treating patterned dysfunction, initially through the use of the first “Re-Positioning” device called Protonics. Although Protonics looked and seemed to function to many in the orthopedic world as a Patello-Femoral “Brace”, it was actually much more. Using this device allowed him to "Re-Pattern” bi-lateral chains of muscle and look at orthopedics from a Femoral-Patella lens.

Eventually this device left Ron with the desire to move into the private practice setting, in order to dedicate more time to roles with the APTA Association, and more time dedicated to learning and discovering further ways to develop his ideas. Protonics allowed him to connect with and teach other clinicians, including some of the first PRI Faculty members. Following the creation of the Hruska Clinic, Restorative Physical Therapy Services in 1999, Ron worked with fellow Physical Therapist Jason Masek and others to create some of the earliest PRI Non-Manual Techniques.

As this science continued to grow, PRI Director Janie Ebmeier was put in charge of helping to develop what would become the first Postural Restoration course which would later be renamed to “Postural Respiration”. With the foundation of the Postural Restoration Institute in 2000, other courses including the "Influence of the Pelvic-Femoral Complex" which was later called Myokinematic Restoration was a quick addition. We now are proud to offer more than 15 different courses, which have been developed to build upon these three Primary Courses

I welcome you to join us on this journey as we continue to explore how the creation of this science has changed the way coaches and clinicians approach the treatment of the human body."

The Postural Restoration Podcast
 

We were excited to see a newly published article this past week titled "Effects of Two Different Recovery Postures during High-Intensity Interval Training". This study was performed at Western Washington University, and includes PRC therapist Wren McLaughlin as one of the authors. While on faculty at Western Washington University, Wren was instrumental in sharing some PRI concepts with her colleagues and students. This study examined the effects of two different recovery postures, hands on head (HH) and hands on knees (HK) as a form of immediate recovery from high-intensity interval training. The researchers wanted to explore the effects of maximizing a diaphragmatic zone of apposition (ZOA) through a flexed spinal posture (hands on knees) rather than an extended posture (hands on head), during recovery breathing.

The results of their study indicated that the hands on knee posture significantly improved HR recovery, tidal volume, and carbon dioxide elimination in comparison with the hands on head posture. Thank you Joana, Lorrie, David, Wren and Dylan for your work on this study, and for publishing these results for the world to see. You have provided such valuable data that will hopefully result in a new recovery position (and a deeper understanding of its benefits) for clinicians, coaches, athletic trainers, strength and conditioning coaches, personal trainers, and athletes around the world!

I spent my February 20th to the 22nd in Chicago at the American Equilibration Society. A long-standing congress that found me surrounded by about a thousand dentists. A convention that caused me to realize that I had come to the right place. Elizabeth Caughey DDS, with whom I work, implored me to come and…learn. Multiple topics were covered including: bruxism and sleep disordered breathing, occlusion and TMD, mentoring (a strong Ron Hruska point), pediatric airway orthodontics and I even heard a physical therapist speak of PT and TMD! Multiple topics moved my learning forward and caused me to repeat the phrase that I’ve said many times: my learning will never stop. I have no doubt that PRI will one-day be on the docket at this fantastic convention and until then I will continue to expand my learning. Thank you to Ron Hruska for compelling me to get out there and take courses “outside the box” of PRI. I am strengthened and I am excited.

After much deliberation the new 2019 Hruska Clinic Shoe List is available for anyone who is interested in seeing how we look at shoes and how they can influence a PRI program.  We feel footwear is an important factor for a lot of patients, especially those struggling to progress through an upright PRI program. Feel free to use the list as you would like, but please keep the name "Hruska Clinic" on the list.

To get a copy of the list and to watch a video from Lori Thomsen, PT, PRC which describes a little about the history of the list, some tips for patients and for PRI practitioners, as well as some good information on several of the shoes that have changed on the list, check our website HERE.  Feel free to contact us if you have any questions!