News

Hey PRI Nation!

This past weekend I had the pleasure of enjoying teaching Myokinematic Restoration at Indiana State University. Cody Inskeep, ATC who I met originally at a Pelvis Course in Seattle invited PRI back to his stomping grounds in Indiana, and I am very glad he did! This weekend’s course was one involving learning on all fronts. We learned about muscles that move an acetabulum over a femur on one side compared to the other in the femoro-acetabular-ilio-sacro-pubic ring of bones and joints that affect position, balance normal asymmetry and allow us to optimize our gait and respiration. We touched on the fact that integration will involve muscular control of this pelvic ring to control both acetabulum and femur, what muscles in what position will assist in this venture, and toward the end of lab and lecture we discussed what we might consider learning if patients still have residual components of symptoms after acetabulo-femoral and femoral-acetabular lateralized control is established. This group was motivated and dynamic, attending for as many reasons as there were clinicians. Thanks Aaron Ford, DC and Canaan McClure for your story about why you attended your first course–a reference to PRI in a book by author Kate Bowler who noted PRI was the reason she could now fully function after a long span of ADL limitation, avoiding scheduled bilateral first rib removal. Thank you Sharon Wellbrook, DC and Tim Demchak, ATC for taking a weekend to learn principles of PRI that you can reference and teach your students in your respective learning institutions. Thank you Denny Wongosari, ATC, LMT among others for coming to learning functional strategies to allow your athletes to better perform. It was my pleasure working with all of these movement professionals as we worked to integrate Myokinematic tests, clinical reasoning and treatment strategies into their respective practices. Thank you Robert Pawlak for recognizing and initiating PRI science into your soon-to-be Orthopedic Surgery practice. Each of your stories encouraged this clinician-first faculty member with regard to the future of integrated medicine. Bravo!

 Thoroughly enjoyed lab sessions where Kelly (Kelly) Brock, DAT, LAT, ATC, Tim "The Beautiful Mess" Demchack, ATC, Wendy "PS I Love You" Schmidt, OT, former SD native Cara "Caragami" Lemon, ATC, among multiple others helped me demonstrate, nonmanual and manual techniques as well as theoretical principles to the class.

As a bonus this weekend, I got to visit the statue devoted of one of the greatest basketball players to put on short shorts–Larry Bird. The statue commemorates the 1979 ISU team that faced Magic Johnson’s MSU for the national championship game and was soul food for this old baller. Also interestingly, I learned that Larry played one game of college baseball that year in an effort to increase attendance at ISU’s baseball games–and it worked, of course. Thanks again Cody for your time, energy and for your insightful insider information on ISU history and thanks to each participant for making this course a blast!

This past weekend I had the pleasure to present Postural Respiration to a diverse mix of new attendees and "veterans" of PRI at Pro Sport in Redmond, WA. I would rename this weekend "Superior T-4 Syndrome in Seattle" considering how many course attendees presented with this patho-mechanical respiratory compensation and asked so many questions about patho-mechanical rib kinematics as it relates to this subject! We had an opportunity to demonstrate in front of class at least four students that looked like they could possibly be patho-mechanical in terms of their respiration and body type.

One take away is you may suspect a positional issue but always test and retest. Two of the students demonstrated the definitive assessment of decreased left apical expansion after a Superior T-4 manual technique. Superior T-4 came up during discussion on Saturday and was a topic that came up often during the entire weekend on how to define, assess and then treat it both manually and non-manually. One of the students that had non-manual techniques provided experienced the left side of her body in a way that she expressed with an enthusiastic smile and a new place that she could feel and find in her body! In addition, she felt a bit "unstable" when she first started walking and liked it! Welcome to variability! She not only found neutral, but she experienced transitioning right to left side and back again, alternating and reciprocating, lateralizing and realizing what tri-planer position, gait and breathing is all about. What a lesson for all to see, experience and what it means to reduce the reliance on end-ranges driven by asymmetries, respiration and patterns driven by neurology!

The enthusiasm and new awareness of Superior T-4, especially for students new to PRI, was totally fun for all involved including this instructor! Thank you PRI dedicated veterans Erin Rajca and Michael Ball, both PT’s and PRC’s, for their help and knowledge.

This course was a joy for all with them in attendance providing energy, experience and caring. Thank you Cory and Amanda for hosting at PRO SPORT and all of your hard work! And shout out to all of the students in attendance for your most outstanding questions and persistence in wanting to understand PRI principles especially regarding Superior T-4.

Saranac Lake, NY, was the site of the most recent Myokinematic Restoration class, and it was a very eventful class for a variety of reasons. One of them was the 4-6 inches that fell Sunday during the course. It was a very beautiful scene, until you realized it was April 29th.

More importantly, it was a course where we had the opportunity for as much, if not more, lab time compared to any course I have taught previously. We were fortunate to have two experienced and great lab assistants, Michelin Carroll, PT, ATC, and Sean Fitzgerald, PT, PRC. They have been in and around PRI for a long time, and having them help in lab was invaluable. My thanks to them!

We were able to delve into the differences between normal mechanics the L AIC pattern presents, as well as normal and pathological compensations that will arise. This led us into the polyarticular behavior the muscles of the pelvis and femur have on each leg as a result of the L AIC pattern. We were fortunate to have a lot of time to practice the positional assessments, as well as discuss what the positional tests indicate.

The value of the Hruska Abduction and Adduction Lift tests relative to the gait cycle and respiratory cycle was a significant topic of conversation and lab. We were fortunate to have two very good demonstrations with Matt Powers and Brendon Olsen. Matt gave us a good example of how to reposition someone who is in a L AIC pattern. And Brendon gave us a great example of how to get someone who is in a PEC pattern, and help them become inhibited enough to turn into a L AIC pattern.

My thanks to Shauna Thomas for helping us link the L AIC pattern to what she is seeing in her womens’ health population; Megan Haught for her great questions and re-states; co-workers Bill Doherty and Linda Horizny for their enthusiasm in learning this new material; and Hilary O’Connor, who is a student physical therapist attending this course.

We all need a little more "Bruce Wayne" and a little less "Batman," and we need to make sure we have the proper "boy band" in our lives!

I can’t begin to explain how much fun I had teaching this past weekend, for many reasons. One of the main reasons is the site host this past weekend was one of my very good friends, Suzie Maciel. Suzie and I went to PT school together, and we have been great friends ever since. She is responsible for PRI coming to Sacramento, as well as the success of our class this weekend. We had some IT issues, and Suzie was a real hero. My eternal gratitude, my friend!

We had a ton of great questions that helped us keep focused on our progression from normal mechanics to pathological mechanics. We were fortunate to have a very diverse class of rehab and strength professionals. It is both refreshing and exciting to have so many first-timers to the science of PRI. To have the privilege of introducing PRI to health care professionals, and sharing the ride with those eager to learn, is so enjoyable.

Our weekend started with a mechanical discussion and progressed to how patterned mechanics dictate muscular performance. We also discussed how we need to keep our muscles in the proper "Boy Band." There are times to be "Batman," and times to be Bruce Wayne. We discussed why the neuromechanics of patterned behavior leads to compensation, and how some compensation is expected, and others lead to pathology.

We were fortunate to have plenty of lab and demonstration time. My thanks to Dade Donovan, DC, for being our model for our repositioning demonstration. He has a classic L AIC presentation, and was the optimal model for our learning. , Additionally, Cole Hughlett, DPT, provided us the opportunity to learn how his testing revealed differing results when compared to Dade. We also had a great introduction to the Hruska Adduction and Abduction Lift tests, as well as how they are linked to the gait cycle. Which lead us into our discussion of how the hamstring is the gate keeper of the gait cycle. Susie Buchanan was a great model for us to learn and see how underlying every PEC is a L AIC.

My thanks to Robert "Pete" Lucente for his awesome and timely questions. Melissa Stahl, Teresa Wooden, Tim King, Joel, Smith, and Andrew Hughey kept us honest during lecture, and asked insightful questions during lab. And a huge thank you to Caleb Chiu, CSCS, PRT, for his help during the weekend. He is a fantastic lab assistant, and was invaluable in adding important points of discussion that needed to be clarified or emphasized more. An additional thank you to Taylor Lewis, MA CSCS, PRT, RKC II for his help during our labs. Having two certified individuals in the course really helped the course run smoothly and allow the first timers more access to how to apply the science of PRI from two very experienced practitioners.

Fortius Sport and Health in Vancouver is not only a world class Mecca for athletes wanting to perform at the highest level and for patients recovering from an injury, but it is also a practitioners dream location for a progressive, state-of-the-art, and integrative environment to work in and hone their professional skills. Fortius was developed as an enormous community based sport rehab and facility in the suburb of Burnaby, near Vancouver, that includes several ice rinks, grass fields for field sports and a world class weight training facility including basketball courts and therapy pools. There is a vision center for concussion rehabilitation. Physical therapists, chiropractors, athletic trainers and sport performance specialists all work in an environment that is focused on mutual respect and collaboration to provide the very best in athlete/patient outcomes. Regular meetings are scheduled with all practitioners to discuss cases including having medical consultations available for athletes. This group of practitioners that attended, many of which were from Fortius, had their first introduction to PRI this weekend. One husband and wife team from the US had taken Postural Respiration through a home study course and loved it so much that they opened up their new clinic based on breathing and respiration principles. This was their first live course for Postural and having a hands-on experience was invaluable from their response. Jon Rowe, CSCS, PRT is the only PRT/PRC in Canada and drove 4 hours through the mountains to assist this weekend from a town called Kelowna. Jon is a quiet force and by Sunday was providing an amazing amount of insight and help to new students. Some of the questions that came up included what does PRI teach in terms of breathing? Well, let’s just start with an ability to exhale fully and pause before taking a full breath in. Combine that with a new neurologic and bio-mechanical re-position or non-manual technique and now unlocking the secrets to a balanced bi-lateral human being is possible. It seems simple to veterans of PRI that if you hope to master breathing, you must see for starters that a left hamstring, glute, IO/TA’s are needed to create a left (and right) ZOA of a diaphragm. All the breathing techniques in the world aren’t going to re-position, re-train or restore function and performance without this basic building block. This one concept was reinforced though out the weekend. Many thanks to Ryan Murray, DPT and Erik Torchia, DPT for hosting this weekend in such a beautiful facility, city and country.

This past weekend I enjoyed, and loved, my time with nearly forty movement scientists in the city of brotherly love. I enjoyed having a tremendously diverse group of professionals, from personal trainers like Aven Johnson, OTR’s like Wing Chin, Exercise Physiologists like Bryant Aguilar, Pilates Instructors like Susan Milosky, Inpatient Neuro PT’s like Christopher Carroll, PTA’s like Dustin Friesen, Associate Professor/ATC’s like Nicole Cattano, and PT’s like Matt Hinsey and Jessica Jennings. My time in Philadelphia and nearby suburb of Cherry Hill, NJ hosted by Jon Herting and TTR Performance was a great experience, my first at this location. Jon and his team allowed me to be dialed solely into the task of introducing nearly 30 PRI hatchlings to the science!

This weekend was especially unique because we were honored to have lab assistants Jon Herting as well as Takashi Onuki, MS, ATC, CSCS, PES, PRT, PRI coordinator in Japan and budding PRI Instructor. I had the opportunity to hang with this future faculty member and daddy of daughters who brought a great teacher’s perspective that I was able to appreciate and learn from. Thanks Takashi!

Through this course, we discussed the normality of asymmetry, the group of "amigos" that we use to oppose a right lateralized system, with some great conversation and discussion via an interactive group of professionals about how to implement PRI principles from the "it’s all neural all the time" hemiparesis client to the "it’s game on all the time" competitive athlete setting. Thank you Elizabeth Young, Ken Guzzardo, Brian Dougherty, Ray Carr, Connor "CJ" Conway, Anthony Blubello, Tara Amato, Ryan Wolff and Courtney Pierre for your assistance with demonstration of PRI techniques and treatment strategies! You all made the course real! Thank you Zach Mitchell, Colin Kidwell and Rushi Shahiwala for keeping a steady flow of good questions for discussion flowing. Lastly, thank you "table Jay", Jennifer Bolster, Jimmy Jo among many others for enjoying a laugh here and there during the course.

Overall, much was learned, and much brotherly (and sisterly) love was doled this weekend. Thanks for everything Jon and the Philly crowd!

The Institute of Community Wellness and Athletics (ICWA) hosted Postural Respiration in Albuquerque, NM Sept. 9-10. This course was a faculty member’s dream! Most of the class attendees were brand new to PRI or had only taken Myokin or a home study course previously. From the very start, the curiosity and attention was palpable and students followed closely every step of the way into a PRI weekend journey of challenge and discovery. Questions were plentiful with great re-states of concepts and honest feedback that, yes, the amount of information in this course can feel daunting for first time attendees but they wanted to hang in and work hard to really get it! The questions directed repetition from many angles that led to understanding of the basic principles of PRI. One of the many topics that vexes new attendees ( It certainly vexed me at first!) is Superior T-4 Syndrome. What helped was a strong foundation that everyone absorbed on rib kinematics driving a spinal column and that ribs are driven by respiration and respiration is driven by neurological patterns. These guys got it. What helped for the strength and conditioning group was that scalenes are like "Romanian Dead Lifters" lifting upper ribs creating a patho-mechanical pattern of respiration. Before lecture on James Anderson’s page 50 in the Appendix on Thoracic Airflow, Typical BC and Superior T-4 Syndrome, the class had had a demonstration on a "long tall Sally/Sam" that demonstrated BC testing, then manual restoration techniques including Superior T-4 technique to assess for Superior T-4 Syndrome and then identifying when and why a manual Subclavius Release is needed. Then they assessed and practiced the two manual techniques after being shown what the reasoning behind the assessment and manual approach. The lecture into Page 50 just made sense to these new students since they could apply a concept to actual experience that they just practiced in lab and could now apply since they had a better picture in their minds as to what patho-mechanical respiration is and how to identify and treat with manual and non-manual techniques. The enthusiasm, especially on Sunday afternoon after an information/paradigm changing weekend can feel over-whelming, was just great. Thank you Nathanael Smith and Jonathan Esquibel for being great site hosts and especially Jessica Kisiel, PRT for assisting! In this faculty member’s opinion, New Mexico will be a great new state for PRI and I hope to be invited back! Myokin will be there February 2018!

If someone were to ask me to describe the ideal setting, attendees, topic, and timelines for a PRI Course that I would want to organize and create, I would have responded the following way.   First, I would truly like to instruct and teach in our PRI home, our Institute, our place of study, work and fun, our resource center, our reference center, and our service center where we can serve nourishment both in the form of food and didactical discussion.   Second, I would invite a mix of course attendees and disciplines that were new to PRI; and some that took the first offered PRI courses offered years ago. (Joan Hanson and Lori Thompsen you will always remain young in my heart and mind).  Third, I would limit the class to 20 attendees to maximize the individual interaction and participation.  Fourth, I would want to have lunch with all of them and talk about things that they wanted to talk about with me. Fifth, I would pick objectives and subject matter related to the head, neck, teeth, vision, and neuro-patterning.   Sixth, I would hold the course on a Friday and Saturday and I would do it at the astronomical beginning of spring in the Northern Hemisphere or mid-March.   And finally, I would like to participate with some professionals that I work with in this community, since I lecture and talk to so many attendees, that work in different disciplines and also in different communities.   Pat Brinkman-Falter BSDH, MS, RDH,CO,  Susan Christiansen DDS,  Janae Greer PT, DPT,  and Charissa Johnson PT,ATC, thank you for coming to this community educational course.   I respect and appreciate you all so much.   I look forward to each and every course that is hosted here in Lincoln Nebraska, home of the PRI minds.  

Jen Poulin, one of PRI’s veteran faculty members, told me that this group of attendees would be great to present to. She was spot on and this group assisted by Carolyn Weber, PT, PRC and Holly Spence, PT, PRC was most engaging and enthusiastic . There were physical therapists that either worked in a hospital setting, private practice or with local ski teams. Former ski racers, now turned physical therapists and mentors that were new to PRI got the concepts immediately and could see applications for their athletes as well as general populations. As always, the questions asked were intelligent and challenging backed by a strong drive to learn and explore new concepts and practical applications of a previously unknown science to many in the room. Also in attendance was a DC/PT, athletic trainers and strength and conditioning professionals. Vermont has a great audience and already has another PRI course scheduled for next year. Many thanks to the staff at Northwestern including Karen Staniels and Christy Cushing. Thanks again to Carolyn and Holly for your help!

Go Cats Go!! What fun this course was for me! But I guess they all are in one way or another huh? But… 25 years ago this May I graduated from the University of Vermont as a bright eyed and bushy tailed PT ready to take on the world. It is so nice to still be so bright eyed about my profession. Vermont, as most of you know is special to me, not only because I graduated from UVM, BUT both Chris (my husband) and I grew up in VT so going here to teach is also going home. I enjoyed a beautiful spring weekend. The trees were budding and so was the interest in learning about PRI. I had a great time with this group of PT’s, ATC’s, Strength Coaches, Massage Therapists, Wellness providers and one very special DC that I only wished I had more time to talk to about PRI.

I had the privilege of working with two friends and fellow PRC’s Holly Spence and Cory Healy as my lab assistants. These two are Pros and made my time that much more enjoyable.

What was even cooler was 3 soon to be DPT’s ready to graduate from UVM in just a few weeks were in the front row!  See “The Future of PT” and me pictured below.  Good luck to Johnny, Kathleen and Natalie from the Class of 2016! 

The UVM Athletic Medicine staff is also dear to my heart as my husband is a former consultant and teammate of the current staff.  Many a nights were spent cheering on the Catamounts. I was so thrilled to meet their new staff and see some familiar faces. Looking forward to helping the UVM staff take their student athletes to new heights with PRI in the mix. 

I just returned from our largest state, where I thoroughly enjoyed my time with a group of energetic learners.  Joy, Katie and Tracey at The Physical Therapy Place were tremendous hosts on all fronts!  This class had a great discussion about integration of femurs and a thorax by way of establishing frontal plane control of the inlet and outlet of the pelvis for our clients in various settings.  Control the pillars, inhibition tools plus integration atop said inhibition were a couple of the topics we enjoyed discussing as part of this course.  There were so many people who I enjoyed the process with this weekend!  Thank you Alaska folks for proving to be a very inviting group of learners for this instructor from the “outside!”