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

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

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

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

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

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

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

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

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

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

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

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

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

– Jason Miller

Written By: Louise Kelley

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Congratulations to Lisa and Jean on such a deserving award!

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

PRC credentialing is the result of completing multiple advanced PRI courses, demonstrating a thorough understanding of the science through completion of the PRC application, and successfully participating in practical and analytical testing. Earlier this week, 7 clinicians earned the designation of Postural Restoration Certified™ (PRC) under the direction of Ron Hruska, Louise Kelley, Skip George, and Jennifer Platt.

The Postural Restoration Institute® established this certification process in 2004 as a way to recognize and identify those individuals with advanced training, extraordinary interest and devotion to the science of postural adaptations, asymmetrical patterns and the influence of polyarticular chains of muscles on the human body as defined by the Postural Restoration Institute. The PRC credentialing program is available to physical therapists, physical therapist assistants, occupational therapists, and chiropractors who have attended PRI courses, demonstrated a thorough understanding of the science through completion of the PRC application, and successfully participate in both clinical and analytical testing.

CLICK HERE to view the photo album.

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

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

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

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

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

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

Written By: Louise Kelley

Debbie Jung, PT, has been around PRI for a long time.  So, she jumped on her co-workers’ desire to understand and integrate the Postural Restoration approach into their practice.  Many thanks to Debbie, and to Russ Davies, Bob Fleischman, and Ryan Maxwell, all of Fluid Health and Fitness Orthopedic and Sports Medicine Center, for bringing the recent Postural Respiration course to Stillwater, MN.

Weekend discussions revolved around these key concepts:

– Movement of air into and out of an accommodating chest wall, a requirement for pressure regulation and how a person responds to gravity and navigates the space around them.

– Polyarticular chains of muscles: their purpose and propensity for over-activity.   How do they become overactive?  What movement conundrums and pathologies result from this over-activity?

– Dissecting the elements of proper air flow.  This can’t occur without the hemi-diaphragm zone of apposition, its state of rest which preserves the diaphragm’s dual roles of posture and respiration.  The oft-misunderstood “diaphragmatic” or “belly” breathing merely leads to hyperinflation and a whole host of physiologic and psychologic issues.

– Compression and decompression of the thorax, and how this creates loading and unloading of alternating sides of the body for optimal movement in any direction the owner of the thorax wishes to go.

Attendees learned the how and why of non-manual techniques, unique to PRI, that establish new, healthier patterns of movement.  We also introduced manual rib cage techniques, which brought to life the concepts of patterned air flow presented in the first half of day one.  These techniques provided the attendee, both as a giver and a receiver, with a tactile sensory experience that added further depth and meaning to didactic concepts.  Manual techniques not in your scope of care?  No problem.  Many non-manual techniques mimic the effect of manual techniques.

This course provides a clear algorithm to guide treatment decisions, applied in lab, as attendees acted as their partner’s “patient” for the weekend.  We then discussed a real-life case study to further imprint the decision-making process and answer questions such as: When do you emphasize the left low trap and serratus versus right low trap and tricep? Do you add new techniques at every session?  When is my patient in need of manual techniques?

I am very appreciative of all of the questions, comments, and requests for review.  I am so thankful to those willing to come to the front of the class so others could learn:  Russ Davies, Jessica Fee, Matt Gram, Edward Leitze, Lindsey Scott, and Samantha Zawistowski.

It’s not every day you meet someone who owns both a health and fitness clinic and a Great Harvest Bakery.  Thank you, Bob Fleischman, who wears the two hats of clinician and culinarian, for treating us to fresh-baked scones and cookies throughout the weekend!

Thank you Sid Rivera, PT, PRC, for your clinical wisdom, guidance in lab, and  lunchtime companionship.  You are a wonderful resource for these Minnesota practitioners!

It was fun spending the weekend with all of you, hearing your ah-ha moments and expressions of confidence in techniques and desire to learn more.