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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!

Last weekend was memorable for several reasons. The first one was the new facility we were blessed to be welcomed into for the weekend. The Children’s Health Andrews Institute for Orthopedics is a new facility in Plano, TX, and it is gorgeous. It’s a relationship between Children’s Health and Dr. James Andrews, and the facility has physical therapy, EXOS Sports Performance, and is state of the art. Thank you to Alex Lopez, Brittani Cookinham, and Stephen Laplante for their hospitality and all the set up they did for us.

We had a great group of mostly first-timers to the science of PRI. And we had a great diverse crowd of athletic trainers, strength and conditioning specialists, and physical therapist/PTA’s. We even had one Physician Assistant.

Myokinematic Restoration provides a great foundational platform that allows us to explore the mechanical ramifications surrounding the hip and pelvis as a result of the dominant L AIC pattern. We were able to relate normal positional mechanics and normal compensatory patterns that occur as a result of the right diaphragm’s influence on the L AIC pattern. After that foundation, moving into pathology and Myokinematic relationships that exist due to the pattern became an exploration of polyarticular chains of muscles. These concepts allowed us to build our assessment and treatment framework for the rest of the weekend.

I greatly appreciate John Key and Katrina Earley for allowing us to learn from them during our demonstrations. There were so many great questions during the weekend, and I appreciate Paul Monje, Rayanne Garcia, Michael Wright, Joni Robertson, Andrew Gallucci, and Meka Venkatanaresh for their enthusiasm and re-states. And a special thank you to Kasey Aikin, PRC for her help assisting throughout the weekend! I thoroughly enjoyed my weekend in The Lone Star state, and the course attendees were a huge reason why. I am looking forward to seeing many of you in future PRI courses!

PRI for Pilates took the show on the road to Webster Groves, Missouri last weekend. The iconic St. Louis arch was a perfect example of  a beautifully domed diaphragm.  Participants included PT’s, Personal Trainers, Pilates Instructors and an OT. The Pilates newbies to PRI were very receptive to the new concepts and how to incorporate PRI into their Pilates practice. There was great group participation, questions and comments especially from the Laurens, Leah, Tara and Cory. 

James did a stellar job explaining appropriate diaphragmatic breathing and the the roles of the IO’s, EO’s TA’s and serratus to this group whose primary focus is the “core”. Sarah had everyone  learning to drive in the left and make legal right turns. Donna led the lab integrating Pilates and PRI techniques on the Pilates reformer. We were honored to have Jen Poulin  join us to learn how to begin to use Pilates equipment to further enhance her pelvic restoration expertise.  Shout out to our host Kelly Ruesing who jumped through many hoops to be present even though she had a music gig in Indiana the same weekend. Special thanks to Nancy Hammond PRC for igniting the interest and bring PRI Pilates to St. Louis.

Each year our Interdisciplinary Integration Symposium brings many different people and perspectives together for collegiate and collaborative discussion unified around a global topic of interest. This year, not only were we fortunate to welcome attendees from as far away as Australia, but we were also humbled to interact with attendees from at least 30 different states over the course of this two day Symposium. The variety of knowledge and unique approach that each individual brings with them, also strengthens the Symposium as a whole.

 The speaker panel this year included, Dr. Rosalba Courtney, Dr. Brad Story, Ruth Hennessy, Mandy Harvey, Dr. Howard Hindin, Dr. Ingo Titze, and Ron Hruska. Not only were their presentations perfectly in tune with the overall message, but the various backgrounds present allowed for even more resonance to occur between the speakers themselves and attendees as a whole. The power of PRI from my perspective is exactly this. The ability to bring together A Singer, a Myologist, a Physical Therapist, a Student, a Dentist, a Speech Pathologist, a Vocalist, a Optometrist, a Occupational Therapist, and a couple PhD’s in Voice Studies just to name a few. Not only does this Institute welcome all professions and mindsets, but we welcome them with the common goal of collaboration and integration at the forefront of this patient centered treatment approach.

Thank you all for contributing in your own ways, to the success of this year’s Symposium. You will continue to resonate with us all and your voices will continue to be heard all across #prination

The full photo album from these two days can be viewed HERE!

Stay tuned for more from Mandy Harvey’s presentation, and please consider joining us next year for the 2020 Symposium “Extrapyramidal Disorders: An Interdisciplinary Approach in the Management of Involuntary Movement” on April 23-24, 2020 Followed by a celebration of the 20^th Anniversary of the Postural Restoration Institute! See you there!

What a fun weekend of teaching Pelvis Restoration this past weekend in Lancaster. Nearly 3/4 of the class was attending their FIRST PRI course. I know many individuals have opinions what primary course attendees should attend first and many think Pelvis should be the last to attend of the the three primary courses. That being said, these professionals were amazing with understanding new concepts, looking at the pelvis in the detail of position, muscle facilitation/inhibition, and application of PRI tests needed for treatment. Yes, it’s a lot of material, but one must understand it’s the integrator between Postural Respiration and Myokinematic Restoration. If you don’t have a pelvic inlet you won’t get a ZOA needed for trunk rotation (Postural Respiration). If you don’t have inlet and outlet frontal plane control you won’t manage a hip (Myokin). My fellow course participants got it and did amazingly well. What an awesome weekend, learning shouldn’t stop in our careers! Thank you for being open minded to new concepts and I hope you all come to love PRI as much as I do.

A shout out to Cathy Ingram and the rest of the staff at Lancaster for hosting this past weekend. Lancaster had 15 participants from their staff alone attending the course this past weekend. Thank you so much for the set up, tear down and organization. Most importantly, thank you for your passion for PRI.

Also, a huge thank you to Frank Mallon for being a wonderful lab assistant. Frank is humble, approachable, an amazing clinician with a strong passion for learning and PRI.

What a group of course attendees that came to Postural Respiration hosted by Alta Bates Summit Physical Therapy in Oakland, CA! First timers really shined in terms of curiosity and questions to absorb the foundations of PRI. There were students that traveled as far away as Alaska, Hawaii and Washington State. The course started out with definitions. What is posture and how do you define it? What is neutral rib alignment in a dynamic, tri-planer context? What does respiration have to do with posture and alignment?

The veterans with PRI were exposed to the new and revised Postural Respiration course and the feedback from them was really enthusiastic. One of the new attendees wanted just a little more lab time so he was chosen as the subject of a review of all of the AIC/BC tests Sunday afternoon. Non-manual and single person manual techniques did not get him inhibit is neurological system and at 3:45pm on Sunday, a little PRI magic had to appear! After all, it was the bottom of the ninth, nearly 40 pairs of student eyes are watching and is the student going to experience what it is like to be neutral for perhaps the first time since he was an infant? Taylor Lewis, PRT, a veteran lab assistant (And great guy who uses PRI with Cystic Fibrosis patients) assisted with a two person infraclavicular pump. This young athletic man who was demonstrated on was also a prime example of what one would imagine as having perfect posture on visual inspection (could even win an award for it!) standing nice and tall. Problem was, all of his PRI tests were positive and he was neurologically extended head to toe! After this two person manual technique was performed, all PRI tests became negative, much to his delight including class attendees and maybe even the course instructor! He sat up and said “I feel sooo good and relaxed!”.

Lab this weekend with testing, non-manual techniques and manual techniques was totally fun for everyone and was a great balance to didactic learning going from concept to experience and then having this last lab to send everyone home with as to what is possible when you just keep exploring treatment options with PRI techniques. Thank you Taylor Lewis, PRT, Keren Cahn, PT, PRC as my lab assistants but also thank you ,Tim Dempsey, PRT, for attending while also helping as a third assistant over the weekend. These courses take a lot of work by the host site. Thank you Shaun Buchanan, PT, Marcela Larrondo, PT, Joan Sheppard-Mellows and the rest of the supporting crew from Alta Bates Summit Physical Therapy.

I had a great weekend in Milwaukee! Nick Rosencutter and his staff were so welcoming. The last time I was in Wisconsin, Nick helped me reinforce the concepts of autonomics as he did the “Ice Bucket Challenge” in a proper Left Stance position of AFIR. He managed to find the video to show this class. Super fun to meet new people and then reconnect at PRI courses!

We once again had a diverse group of clinicians from PT’s, ATC’s, and Strength and Conditioning specialists. The course attendees were mostly new to the science of PRI and taking their first PRI course. Myokinematics is a great first course for clinicians to introduce PRI concepts. I enjoyed integrated discussions about respiration and gait as it relates to an A on F vs. FA activity. I spent Sunday a.m. teaching both the HADLT and HABLT and tying together Saturday’s passive positional tests to help these new clinicians begin their PRI clinical journeys. It is so great to have so many new clinicians and wellness professionals interested in learning PRI. Overall I am proud of my course attendees for opening their minds and practices to the science of PRI!

Just wrapped up a thoroughly enjoyable weekend at the beautiful Minot State University in Minot, ND teaching Myokinematic Restoration. Thank you to Minot State faculty Dr. Heather “Rockstar” Golly and the Beth Marschner “twins” for their help in coordinating this course at their gorgeous third floor facility with a view of the campus. The Minot State team made me feel like family from start to finish. This class included an interdisciplinary group of movement scientists including Maci Severson, ATC, Holly Thompson, PT, Kevin Melby ATC, PTA, Dawn Mattern, MD among others in a largely new to PRI crowd. Many thanks to newly minted PT, PRC Bridget Anderson, who did a great job as lab assistant throughout the course.

Course participants engaged in discussions about PRI theoretical principles, scientifically based rationale for testing and treating the normal asymmetry seen and learned special tests to assess acetabulum and femur relationships. Course participants like Kevin Melby, Micki LaDage, Jodi Swedlund, Samantha Brizee among others volunteered to participate in lab activities to practice PRI special tests and how to use PRI techniques to develop a treatment plan with progression. Thank you to all who helped during lab time by allowing course participants to see examples of normal polyarticular chain patterns of muscle and inhibition techniques that affect them!

A lively, thoughtful and robust group, it helped me really enjoy my time in the “sister state” of North Dakota this weekend. Thank you each for adding to PRI nation and for jumping into the science of PRI with candor and zest!

“That’s another course, for another time.”

According to Kristi Jagels MS, PT, PRC this is a statement that I have made at many of the past courses she has attended. And I believe she is correct. 

Cupidity, or the intense desire for possessiveness, acquisitiveness, and avidness, usually interferes with our respect for the process that clarifies our appreciation for incessant curiosity and pedagogic gratification. We all need to struggle with novel approaches, new relationships and unfamiliar applications. There were thirteen PRI certified and trained clinicians in this course, as well as many more attendees, who have remained altruistic and content with familiar application of PRI principles and were, hopefully, ready for “this course, at this time”. 

More importantly, they hopefully appreciate that this PRI course, which is about human dysfunctional oscillatory patterned behavior, would not have resolved their discipline outcome based discontentment, without trusting a thalamic process that was outlined by PRI objectives offered by previous courses that were required for this course attendance. The tag line following the title of each of those required courses, as well as this course, is “An Integrated Approach to the Treatment of…”  An appreciable understanding of human patterns is helpful in building a cognitive framework for the interplay between Autonomic and Central Nervous system integration in “treatment”. 

I believe the framework offered by the PRI Primary and Cervical Revolution courses guides this interplay. Clinical “integration” of the Autonomic Nervous System and the Central Nervous System, using PRI based concepts, can have a significant influence on clinical interdisciplinary design and outcomes. After reading the comments from these course attendees, I believe they have gained a better understanding of the magnanimity associated with the words “that’s another course, for another time”.

Cranial Resolution IS that course, and worth your time!

To see more photos from this course CLICK HERE

Paula Webster, PT, invited us into her Canton, CT, clinic for the weekend to host Postural Respiration. This was one of the most unique clinics I’ve seen: a renovated 1812 home, with its original bee hive fireplace, whose previous owner was involved in the abolitionist movement.

 This was the first PRI exposure for close to half of the participants. It was also a first for me to have a gastroenterologist in attendance, Dr. Kiran Sachdev, who provided insights into the connection between GI issues and patterned respiratory mechanics.

 Discussion opened with the asymmetrical diaphragm and its role in patterned lumbo-sacral-pelvic mechanics below and rib and humeral-glenoid mechanics above, driving us into L AIC and R BC patterns that direct air flow patterns and influence every physiologic system in the body.

As always, the concept of the Zone of Apposition, as needed on the left, was thoroughly defined. This left ZOA indicates left lower ribs that are held down, in, and back to lateralize the body to the left and enable healthy air flow directed into the left posterior mediastinum and right apical areas. With a sufficient ZOA, the left hemi-diaphragm is able to regulate and balance thoracic pressure and abdominal pressure so that its dual roles of respiration and stabilization are preserved.

 We emphasized the three-dimensional function of the abdominal-pelvic and thoracic cavities, and discussed numerous examples of “deflated, converged” cages and thoracic flat back posture, presentations that require over-activity of necks, bellies, and backs to breathe.

Then it was off to the gym for lab time, to practice PRI’s objective tests, including the new "posterior mediastinum respiratory reach test", along non-manual and manual techniques. Attendees put their hands and minds to work to facilitate and experience the powerful sense of rib cage expansion and freedom. How apropos to sense this freedom within a former abolitionist’s home!

Thank you to Paula’s Canton PT colleagues, Jeanne Daubert, DPT, Heather Mogielnicki, OT, and Shanya Stearns, DPT, for welcoming us into your clinic and tending to the nitty-gritty to help the course run smoothly. Thank you to Robert Barksdale, DScPT, FAAOMT, for your crucial A-V assistance. I also appreciate the willingness of everyone to act as models for various demonstrations. You were a fun group to hang out with all weekend!

We are beyond excited to have Mandy Harvey as our Featured guest for this years Interdisciplinary Integration Symposium!

Mandy will be presenting, “Sensing the Rhythm: Exploring Music without Hearing”

I encourage you to read more about Mandy and all the incredible endeavors shes a part of on her Website!

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