News

Last weekend, August 5-6, at Hidef Physical Therapy in Bellevue, WA, I had the pleasure of teaching Postural Respiration to a wide range of professionals that included a chiropractic student, physical therapists, LMT’s, strength and conditioning professionals and an osteopathic physician that wanted to learn more about respiration, neurology and biomechanics.

Every PRI course that is presented is always different in terms of questions asked and what is discovered during demonstration and lab.  For example, often after re-positioning a pelvis on Day 1 with non-manual techniques, the student  will become immediately neutral to the "oohs and awes" of the course attendees.  The PRI magic seems almost easy and effortless with a technique that targets inhibition of the L AIC.
Since this course is an integrated approach to the treatment of patterned thoraco-abdominal pathomechanics, it is also likely that the PRI magic is not apparent on day 1 as the student being demonstrated on may not get neutral with any non-manual technique on Day 1 or even into the morning of Day 2.

 
This is where the process of following the guidelines on page 50 in the course manual come to life.  What if your best efforts with non-manual techniques don’t seem to be making a difference clinically?  The roadmap then takes the whole group of students through a journey of applying manual techniques to create first a ZOA, then right apical chest wall expansion.  If after doing the right apical expansion or superior T-4 manual technique does not result if all of your tests turning negative, or you have limited cervical axial rotation to the left and especially a positive left apical expansion test, then you have a definitive Superior T-4 pathomechanical respiratory process.

In every course there is someone that is Superior T-4.  In this course the students that were the demonstratees were all Superior T-4.  Much to the instructor’s relief they all became neutral after a subclavius  release and infraclavicular pump!  The most gratifying part is to walk the class through a process that they need to practice and apply clinically,  especially for the more complex cases that present to their offices.  Accessory muscle overuse, the over-reliance of end range lateralization, the inability to reciprocate and alternate side to side and especially being aware of delivery of airflow pressure sense into a chest wall for the purpose of neuro-respiratory, physiological and biomechanical variability is the heart and soul of this course.

Thank you to my most professional lab assistant Paige McNerthney, PT for all of your help this weekend and to all of the students who brought their "A" game of attention, focus and energy.  Thanks to Hidef for hosting Postural Respiration.

View Full Photo Album HERE!

Each year, this image pops up on my Facebook Memories towards the end of July, when I was working on my PRC application back in 2011. I was a full time PT at the Hruska Clinic at the time, and just two years out of PT school. I began taking courses when I was still in PT school, had an awesome clinical instructor Lori Thomsen for one of my final clinical rotations, and landed my dream job after graduation at the Hruska Clinic. I was surrounded by the best mentors ever, yet I must admit that I was a little scared at the thought of completing the PRC application and testing. However, having been on both sides (a scared and nervous applicant, now 12 years ago, and today the Director of Education and Credentialing running the show), here are some tips to hopefully ease your anxiety about the process.

Unsure about taking the next step towards PRI Credentialing? Check out what others have said about their PRC credentialing experience and PRT credentialing experience!

My Top 3 tips for preparing your PRC or PRT application:

1. Set aside larger chunks of time to work on your application.
When I first started my application, I was working on it for a couple hours at a time in the evening, or when I had a patient cancellation during the day. But, I found that by the time I would get my stuff out (all of my course binders, my case study patient charts, stacks of research articles, etc), and I mentally prepared myself to get started, I didn’t have much time to get actual work done on my application. Therefore, I found my groove when I set aside a full Saturday (which is what this picture is representing from 12 years ago). I set up a table to work, had all of my course manuals accessible and I got major work done! I did this a couple more days over the next couple months and finished the application. It isn’t too late to start on your application for this year, if you are able to dedicate a couple weekends to the process.

2. The review committee isn’t looking for perfection.

The application review is a peer-reviewed process (PRCs and PRTs). Each application is reviewed by two members of the review committee for which you are applying (either PRC or PRT), and their recommendations are provided for review by Ron and myself. Based on their feedback, we then determine if the applicant is prepared for testing, and the applicant then receives the reviewer’s feedback. None of us are perfect in what we do, and thus the review committee is not looking for perfection. Rather, they want to see your ‘thought process’ and ‘decision-making’ with the PRI concepts from the four pre-requisite courses displayed on paper throughout your application. Therefore, I would recommend that even if you look back at a case study or client program that you put together and think "wow, I would have totally not selected that technique now that I know more…." (that is fine), you can still use that case study, and at the end of your case study discussion, reflect on what you would do different now (and why….knowing what you know now, that you didn’t know then).

3. The application in itself is an educational experience.

I hear this often when people are here for PRC and PRT testing, and I felt the same way myself. I learned SO much when I was preparing my application. It forced me to review content from the courses and find answers to questions that I still had myself. I vividly remember that I didn’t fully understand the Superior T4 Syndrome until this day 12 years ago, when I went back and studied my manual, watched the home study course again and reviewed the manual techniques. I had an ‘ah-ha’ moment in preparing my application that day. The application made me reflect on my decision making process, consider what I might do different now, identify favorite techniques (which is difficult when there are so many), and it allowed me to realize how much I did know (even though there was still a lot I didn’t know). This last one is important. Preparing your application is not an easy task, and it takes a lot of time, but it should give you a little boost of confidence (you are studying for the exam while you prepare your application), and that is the hidden gem. Last but not least, the feedback from the reviewer’s is so incredibly helpful!

If you are considering applying for PRC or PRT, and you have any questions, please do not hesitate to reach out to me! The PRC application deadline (for testing in December) is September 15th and the PRT application deadline (for testing in January) is October 15th. 

I also recorded some videos a few years back, which I hope you will find helpful as you prepare your application. These videos can be found on the PRC page and PRT page of our website. 

“The stars at night are big and bright deep in the heart of Texas.” Or in this case throughout the weekend at the Myokinematic Restoration course at Elite Physical Therapy in Abilene, Texas. The attendees which were all bright made for a wonderful weekend teaching for the first time in my home state.

We started the first morning off discussing polyarticular chains of muscles with the emphasis in this course being the anterior interior chain. (AIC). We have two of these chains of muscles, a left and a right, and due to our inherent asymmetries the dominance of the left anterior interior chain was discussed in-depth throughout the weekend.

These patterns are described by chains of muscles which are neurologically driven and orient our bodies into predictable positions. In this course, we looked at the patterned relationship between the lumbar spine, (hip) acetabulum and femur. We broke out in lab with hands on learning how to identify these positions and if these prolonged positions may have caused some further undesired activity at the hip.

The group was incredibly attentive with thought provoking questions. We had a chiropractor, PTs, PTAs, a massage therapist, yoga instructors, personal trainers, and athletic trainers as well. We ended the weekend “sizzling some glutes” with PRI non manual techniques. There is nothing quite more powerful than experiencing the techniques firsthand and the immediate changes that were made.

It was an absolute pleasure teaching in west Texas, the southern hospitality always feels like home.

Wow! What an experience teaching in Munich, Germany. We had healthcare practitioners from over 10 different countries represented at the course this past weekend!!! Yes, you read that currently—10 different countries. Isn’t that amazing! What is even more impressive is that these individuals were learning Pelvis Restoration in a second language for them. One course participant told me that he had to re-learn anatomy from the English language as the translation was different for the muscles and bones. So unbelievable. It was a gift to have two days of learning and teaching and all of us being unified under the science of Postural Restoration.

I felt this group was “hungry” for more information and understanding with PRI. The energy was palpable. I greatly appreciated the lab assistance and PRI experience from Nadja and Tracy to assist me over the weekend as well.  The critical thinking, questions, and openness to the course concepts was fantastic. Thank you to this group for giving me grace with my hearing loss—I mis-pronounced names routinely and you were gracious to repeat your questions a time or two as well.

I had a wonderful time teaching and exploring the cultures in both Austria and Germany. We live in a beautiful world, and I am grateful to had gotten to explore more of it, but more importantly I was blessed to have gotten to teach and meet 38 Healthcare workers who have a passion to learn and undeniable compassion to assist their patients to reach their full health care potential and see that it’s possible with the science of PRI.

Thank you, Lindebergs Academy! You were gracious hosts.  

Postural Respiration was presented at the Postural Restoration Institute May 28-29 to a large zoom audience of students as well as live participants. It is always a pleasure to have students from around the world in different time zones staying up late or getting up early to participate in this flagship primary course. There were students from Australia, Europe and coast to coast from North America and a large percentage of students were first time attendees to a PRI course, and for the majority of students, first time to Postural Respiration.

Delivery of air pressure sense and its effect on pelvis, ribcage and diaphragm shape, form and function are central themes that are returned to over and over in this course as it relates to neurology and ultimately biomechanics.
I taught Postural Respiration two weeks before in Chandler, AZ and there were similarities in terms of lab and demo with one student in each course presenting with almost exactly the same exam findings and same treatment guidelines as defined in this course for Superior T-4.

Often this patho-mechanical compensation can seem daunting to identify and treat, however, in both courses with both attendees, following the course guidelines with a detailed and repetitive description of both non-compensatory respiration and contrasting with patho-mechanical respiration made this difference very clear. Both students remained positive in their PRI testing on day one even after non-manual and manual AIC treatment regimens.  Then, on day two following Page 50 guidelines to determine if these individuals were in fact presenting with Superior T-4, a subclavius release with infra-clavicular pump was performed and all tests became negative with both cases.  No pressure, but the instructor is always relived when this occurs!

The overuse of accessory muscles of respiration became very clear to all attendees in both classes knowing that scalenes, for instance, need to act more like initiators of the first rib to signal rostal to caudal sequential rib elevation and not become primary rib lifters attempting to direct and deliver air inappropriately  into a right chest wall. Superior T-4 became very clear as to just one more step in the treatment guidelines for effective and balanced delivery of airflow pressure sense. This allows then alternating and reciprocal function into the entire physiological, neurological and biomechanical systems.

All in all it was a wonderful course especially the time and attention all of the students provided and "spot-on" questions that were asked. Thanks to all of our students especially on zoom from  different continents and time zones.  And the course was facilitated so well by RJ Hruska as he makes the process go so easy for students and instructors!

An enjoyable weekend was spent with a fantastic, energetic group at Thrive Proactive Health in Virgina Beach. Thrive has hosted numerous PRI courses, and its clinicians were ready to take their PRI knowledge up a notch with Cervical Revolution.

As in every PRI course, the concepts in Cervical Revolution are rooted in our neurological propensity to be oriented in right stance, a dilemma that manifests itself in the neck and cranium. Our right atlas, in particular, remains oriented over the right foot and under a right occiput, creating a highly influential “floor” for the cranium. A cervical pattern is established, resulting in tonicity of a chain of muscles known as the temporal mandibular cervical chain, or TMCC. Much like the left AIC and right BC chains, the right TMCC may become over-referenced during upright function. And just like the sacrum in the pelvis and the sternum in the thorax, our third “S” bone, the sphenoid, may become patterned in its position and movement.

The effects can be profound. Consider the vital openings associated with the neck: the foramen magnum and the pharynx. Malposition and narrowing of these openings effect nervous system and visual and vestibular function, cerebral spinal fluid flow, circulation to, and drainage of, the brain, and airway, swallow, speech, and chewing patterns.

We practiced objective tests, unique to this course, that assess loss of cervical and mandibular motion and the likely presence of two common cranial positions (called “lesions” by osteopaths): left sidebending and right torsion. We presented multiple photos of faces, with facial characteristics that reflect these two positions, and discussed the impact of these positions on symptoms that we commonly treat: neck pain, headaches, dizziness, and TMJ pain and dysfunction.

To prepare for their Monday morning patient/client, participants experienced techniques designed to restore cervical neutrality, a sense of the left OA floor, lateral shifting of the mandible, alternating cranial expansion of the temporal bones, and sphenoid orientation.

Finally, we discussed patient examples in which “orthotics for the mouth” — dental splints – were combined with a PRI program, resulting in beautiful therapeutic outcomes. I hope that those attendees who haven’t yet established a relationship with a dentist are now inspired to make that happen. Mark Ragusa, you have Howard Hindin, DDS, right in your neighborhood.

Laurie Johnson, see you on the next zoom course😊 Mark Pedersen, wishing you all the best as you begin your physical therapy studies. Takumi Sakabe, safe travels back to Japan. You have a wonderful PRI cohort that will take you in with open arms. Thank you to everyone in attendance for your questions and insights and to the clinicians of Thrive for hosting and keeping the discussion light and lively!

For a number of years, the Postural Restoration Institute® offered an annual Interdisciplinary Integration Symposium. Each of these symposiums was designed around a theme that we felt best represented the present mindsets of those applying PRI course material as well as our own interest in exploring pathways of collaboration for advancing PRI concepts.

We are excited to announce that beginning in 2024, we will begin offering an annual PRI Interdisciplinary Studies Summit. The word ‘interdisciplinary’ reflects activity that analyzes, synthesizes, and harmonizes links between disciplines into a coordinated and coherent whole. Or, simply put, it means “relating to more than one branch of knowledge.” This annual Summit will not be centered around one topic or theme, but rather will offer two days of presentations on multiple areas of study, for attendees interested in PRI who want to explore how multiple areas of study intersect with one another.

This Summit will allow those with common interest to come together from any field and converge on shared research, a common problem, or professional experience. It will provide opportunities for interdisciplinary collaboration, dialogue, and connection across the PRI community. Not only is this an opportunity for you to be involved in the learning and application of PRI supportive, evidence-based practice in novel settings, but this Summit will also provide you the opportunity to present on a specific topic for the PRI community.

Opportunities for social interaction have been few and far between over the past few years, and to say that we have missed seeing you in Lincoln is an understatement. We look forward to bringing together the PRI community again for an annual in-person event, where PRI interest can be intersected at this PRI Interdisciplinary Studies Summit. A time to connect, learn, and socialize with one another. *Please note that this annual Summit will be in-person only and will not be available via live stream. Social events will be scheduled each evening. 

Are you interested in presenting on a topic that interests you?

We encourage you to submit an abstract!

Presentation topics should be relevant to the interest of the PRI community and must fall within one of the five summit sub-categories (see more the presentation guidelines).

Speakers do not need to be PRI Credentialed Providers, and PRI welcomes interdisciplinary professionals (i.e. dentists, optometrists, massage therapists, psychologists, etc.). A presentation may include up to two speakers, and interdisciplinary teams (i.e. PT and Dentist) are encouraged to submit an abstract.

Abstracts are due no later than July 15th. To learn more about submitting an abstract, please visit our website and review the presentation guidelines!

If you are interested and you have any questions, please reach out to Jennifer Platt at platt.jennifer@posturalrestoration.com or 402-467-4111.

The Therapy team environment is fast paced and well organized in taking care of the needs of our orthopaedic community.

Our top priorities are focusing on patient safety as well as patient satisfaction.

Teamwork is paramount as we are dedicated to Always True in promoting trust, respect, understanding and engagement with all team members.

If this sounds like the type of team and environment you want to be a part of apply today!

The Center for Medicare & Medicaid Services (CMS) requires all healthcare workers, as well as individuals who interact with healthcare workers in a work setting, be fully vaccinated against COVID-19 as a condition of employment unless a medical or religious exemption is approved. At this time, fully vaccinated means that an individual is at least two weeks past their final dose of an authorized COVID-19 vaccine regimen. Final candidates must be fully vaccinated as of their first day of employment. As a condition of employment, newly hired team members will be required to provide proof of their COVID-19 vaccination or apply for a medical or religious exemption.

Position             Full-Time           

Shift                  Days 

FTE / Hours      1.0 / 40

Schedule          Mon – Fri  8a – 5p 

Department/Position Details/Duties:

Deliver high quality clinical care and customer service

Establish goals and treatment plans in collaboration with the patient, family members and healthcare team.

Provide treatment services in order to restore, maintain or improve patient functions.

Promote and advance the hospital’s vision to be the BEST through department initiatives and community outreach.

Develop and enhance the vision of the department with an emphasis on growth and program development.

Promote collaboration with referring physicians.

Offer clinical instruction to physical therapy and physical therapy assistant students.

Must be able and willing to collaborate with others as demonstrated by good listening skills, honest and respectful communication, and engaging in the process of reaching consensus when making decisions.

Displays flexibility and adaptability in order to provide patient education regarding their specific physical therapy treatment needs.

Ability to problem solve with patients, team and other departments within OrthoNebraska.

Position Requirements:

 Education:

Graduate of an APTA approved program for physical therapy

Fully licensed to practice physical therapy in the state of Nebraska.

Basic Life Support (BLS) required within 60 days of hire.

Advanced clinical certification is a benefit

 Experience:

Experience in orthopaedics required.

 Physical:

This position is classified as Medium Work in the Dictionary of Occupational Titles, requiring the exertion of 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. Physical Demand requirements are in excess of those for Light Work. 

https://orthonebraska.com/careers/ 

Postural Respiration was presented April 15-16, 2023 at Spooner Physical Therapy in Chandler, AZ to an enthusiastic mix of PT’s, Chiropractors, OT’s and fitness professionals. There were students from Alaska, California and Idaho that made the trip to AZ. Dr. Victor Elmurr, D.C. was the motivating force in contacting the staff at Spooner several months ago and facilitated the return of PRI to the Phoenix area.

Among the new attendees to PRI, most of the students were new to Postural Respiration and their purpose was to understand and integrate delivery of airflow into the thorax with their knowledge of pelvis, lumbar spine and femur myokinematics. The response from them, and understanding that this course is the flagship of PRI, was that this course completes a picture of diaphragmatic function and how it affects not only delivery of air pressure sense into the thorax but the position, posture and movement of the entire axial skeleton.  

Since posture is not a static concept often thought of in a normal sense, the dynamic, tri-planer function of air flow pressure and sense allowing alternation, reciprocation and variability were all defined and experienced by every student.

As with every Postural Respiration course, Superior T-4 is the patho-mechanical portion of the weekend that is explored in detail on day two.  Rhythmic airflow and it’s physiologic effects are discussed on day one in terms of dynamic airflow considerations.  Next, the importance of the first rib, especially on the right, is discussed in this context of rhythmic airflow and the first rib being an "initiator" of rostal to caudal rib movement.  With overuse of accessory muscles like the scalenes, the first rib will be lifted out of "sync" with the ribs below leading to patho-mechanical respiration as described in this course.

One of the students was used as a "demo" on the first day of the course for PRI exam, NMT and then a left ZOA manual technique. The inability to adduct a femur along with positive BC testing after NMT and manual techniques on the first day lead into day two of the course to explore if this individual was a Superior T-4. With definitive testing and after following the treatment guidelines on page 50 in the course manual, his Superior T-4 was discovered, treated and resolved for everyone to experience the progression to resolve patho-mechanical respiration considerations.

This course was such a pleasure to teach and thank you to the staff at Spooner especially Jessica who got there early and stayed late to lock and clean up. Thank you also to Carly, Sarah and the rest of the Spooner crew and thank you Ben for allowing us to share PRI with your clinic and the community.