News

The ENT Institute of Atlanta played host to the most recent Postural Respiration. This course encouraged attendees to look below the head and neck for “bottom-up” influences on the conditions you treat. What do hip pathology, low back pain, headaches, and TMD have in common? A thoracic diaphragm that is patterned in its position and activity.

We discussed how the static asymmetries of our torso lead to overactive chains of muscle below the diaphragm (anterior interior chain and posterior exterior chain) and above the diaphragm (brachial chain). These chains create dynamic patterns of breathing that become entrained in our nervous system and that can restrict healthy alternating, reciprocal movement when upright. Numerous videos were presented that reflect how patterned breathing influences walking: poor posterior right arm swing, reduced thorax rotation and center of mass shift onto the left leg, and waddling, to name a few. Our stronger, better leveraged right diaphragm creates twist and torsion of the airway which, in turn, promotes inefficient strategies to pull air in, including belly and neck breathing, with their associated forward head posture, hyperinflation, and overly extended thoracic spine and rib cage. Neurologically-driven patterns of airflow define how we sense ourselves in the space around us, how we move through it, and our vulnerability to pain and injury.  

Many thanks to Kaitlin Blankenship, ATC; Jose Crespo, PT; Mischelle Hardwick, PT; Allison Robbins, PT; Tre Tate, CPT; and Adria Wofford, PT for volunteering to model the tests and techniques.    

Kristen Spencer, PT, PRC, was invaluable in assisting with lab and adding clarity to questions and concepts.  

The practitioners at ENT Institute did an awesome job of accommodating us guests: Jose; Ann Gerber, PT; Jennifer Hansen, PTA; Mischell; Jennifer Harrell, PT; Deisy Nunez Aguirre, PT; Allison; Olivia Terrell, PT; and Cristen Walker, PTA.   

I hope you get the chance to host again. If so, Cervical Revolution would be a natural fit for your caseload.  You will learn about the influences of an additional chain of muscles, the temporal mandibular cervical chain. You will gain an understanding of how the concepts of Postural Respiration and patterned air flow apply to the cervical spine and cranial patterns and their potential to create malocclusion, TMJ dysfunction, headaches, and visual-vestibular disturbances, all of which you routinely address in the clinic.

The first Cervical Revolution course of 2023 was presented at the Postural Restoration Institute to an international group of students. Attendees present were from all around the globe including China, Japan, Singapore, Canada, England, Ireland, Germany and Bulgaria as well as from every part of the U.S.A.  Professions included physical therapists, chiropractors, strength and conditioning professionals, an osteopath and a medical doctor to learn PRI concepts of the cervical, cranial and occlusal system.

Cervical Revolution is the introduction to the PRI concept of "top down" while acknowledging that "bottom up" is always at play since humans need to manage upright posture, gravity and gas! One of the biggest topics is that if you lose the floor then a new ground up into the cervical spine, cranium and even jaw will occur. When this over reliance on the neck occurs, cranial torsion or pathology is almost certain. This course unlocks the path into the cranium and a deeper dive into neurology which is then presented in tertiary PRI courses.

During the weekend, PRI examination of the cervical spine was then integrated with repositioning techniques that addressed position of the cervical spine, occiput, sphenoid and temporal bones all at the same time. This is part of the magic of this course in understanding how to integrate many parts to restore alternation of the whole with oscillation of atlas and occipital bones, freedom of a sphenoid, wobble of temporal bones and jaws that can freely swing or truse! Louise Kelley, PT assisted me greatly in this endeavor with lab exam, PRI techniques and answering tough questions from curious students.

For over a year, Louise Kelley, DPT, has been training with me to teach Cervical Revolution. This past weekend was her last training course as she will be "flying solo" in May to teach this course on her own. During this time working with Louise I have been so impressed by her knowledge and dedication to the science of PRI. Over the weekend and over the past year I have watched her grow into becoming a stellar faculty member especially in her understanding of PRI principles as well as describing and breaking down techniques to restore alternating cervical and whole structure alternating function. I will miss spending time with Louise and she will be a brilliant Cervical Revolution teacher! 

I felt right at home with the clinicians at Finish Line Physical Therapy, all seasoned runners. Photos of their and their patients’ running accomplishments, all smiles at the completion of a race, adorn the space – and make for the perfect back-drop to discuss the impact of undesirable airflow patterns, habitual use of accessory muscles of breathing, and a restricted diaphragm on movement.

Asymmetry is the rule of the body and brain. As such, humans, by design, exhibit a right-sided preference, which is reinforced by a culture that favors sitting and a lifestyle made easier by technology. The result is a form of “hemi-neglect” of left sided muscles of grounding – hamstrings, gluts, and abdominals – needed for weight-shifting. Rib cages remain under the influence of muscles that don’t promote alternating internal and external rotation and the associated sense of expansion and recoil. The result is a form of left or bilateral COPD, with its distinctive hyperinflation.

   
Stiff, patterned rib cages and abdominal oblique disuse cause the diaphragm to undergo twist and torsion that, in many cases, cannot get out of. This twist of our respiratory system is a significant mechanism underlying the many syndromes and injuries that we confront in the clinic.

Many thanks to our weekend avatars, whose willingness to demonstrate and receive techniques enabled us all to better understand PRI concepts: Patrick Cronin, PT; Laura Gibbons, PT; Laura Loftus; Iris Platt, PT; RikkiLynn Shields. Thank you Yohei Takada, PT, PRC and Andrew Xenophontos, CSCS, PRT for your tremendous help in lab, coaching the attendees in the nuances of the manual and non-manual techniques, allowing them to experience the power and influence of these techniques on the neuro-muscular system. Finally, thank you to the physical therapists at Finish Line PT for being gracious hosts: Mandy “I WILL blow up a balloon” Fox, Connor Hesselbirg, Jaclyn Massi, Ryan Matisko, Timothy Waanders, and Jimmy Williams.

 
Finish Line PT is a clinic for runners and triathletes, people who strive to be their best selves. To all of the course attendees, I hope the material you learned this weekend will help take you to new heights in your careers and shift your stride to a new way of looking at, and improving, movement.  

Thank you Elizabeth Makous for the invitation to come to the Henry Mayo Fitness Center to present Pelvis Restoration this past weekend. Southern California saw snow, rain, and hail Friday and Saturday, but it didn’t stop the quest for learning in this group!!!  

I truly enjoyed teaching this past weekend with this group of clinicians. The questions, attention to detail, and intellect was fabulous and assisted the whole class in learning the material. We went into the "weeds" to understand the pelvic inlet and outlet position influencing neuro-muscular need for inhibition and facilitation of muscle for ascension and descension of the respiratory and pelvic diaphragms. This is desired for internal compression and decompression for forward movement. This material can be complicated, but worth the journey for improved patient and client outcomes.

Loc, thank you for being an amazing lab assistant. Thank you to all the course attendees spending a weekend with PRI and learning new concepts and being open to them. Again, thank you to Henry Mayo Fitness and Elizabeth for hosting.

I should note–I did return home to Nebraska to blue skies, sunshine, and 60 degrees!!!

Join us for the second webinar of the 3 part MANDIBULAR Temporal LATERO-Rotary Movement Infleunces series on Friday, March 10th at 1pm CT. This free 90-minute webinar will include time for questions at the end. If you are unable to join us live, the webinar will be posted to the Webinars page on our website.

This webinar is titled “MANDIBULAR Temporal LATERO-Rotary Movement Influences on the ANKLE and FOOT”.

If you missed the first webinar in this series, which was titled “Mandibular Temporal Latero-Rotary Movement Influence on Palatal, Occlusal, Glossal and Podal Orientation”, you can click here to access the recording and handouts.

Please feel free to share this information with other colleagues who might be interested in attending.

I enjoyed teaching from the Postural Restoration Institute and in my hometown, Lincoln, NE this past weekend.  I want to thank Alex, Carlos, Allison, Paul, Becky, Lee, and Jordan for attending in person and allowing me to demonstrate on you and to let your fellow colleagues learn from you during our lab time.  Also, a huge shout out to those in Zoom (too many names to list) for spending two days with me as well.  I thoroughly enjoyed teaching you all and appreciated the questions and participation.  

The Pelvis Restoration course goes into the weeds of AFIR (IPIR/IsPER) and AFER (IPER/IsPIR) positioning of the pelvic inlet and outlet.  It is a lot of information, but clinically it can be a game changer to assist your patients. The pelvis is like the foundation of your house—it’s positioning can affect the rest of the body.  The pelvis integrates the thorax and hip and foot/ankle, which allows our patients to be grounded and regulate airflow/pressure needed for forward movement.  The IO/TA’s, Glute Max, and Glute Med play in an important role with pelvic inlet positioning as the Hamstrings, I.C. Adductor, and Obturators for the pelvic outlet.  One course participant stated “this course connected so many dots for me.”  It was a wonderful weekend, thank you for allowing me to be a part of your PRI journey.

The evolution of the human being from an infant to an upright, alternating adult is a complicated and multifaceted, sequential, unstable, patterned process, requiring stages, challenges, and self-actualization for optimization.

From infants learning to roll, to toddlers walking behind a push toy, to a competent upright human walking down the stairs backwards (yes, backwards), we presented a 10-component, cumulative Postural Restoration Developmental Sensory Motor Sequence supported by 9 carefully chosen and explained Sensory Integration Principles that support attention to 7 Postural Restoration Developmental Processes. Incorporation of sensory awareness of these processes into the treatment of human beings, fortifies the sensorimotor outcomes that every parent, clinician, and human hopes to experience.

In front of an engaged audience of 7 in-person and a whopping 60 faces on the live stream, comprised of 17 PRC’s and 3 PRT’s, PT’s, ATC’s, personal trainers, massage therapists, an osteopath, an acupuncturist, a health coach, a yoga instructor, lots of familiar faces as well as welcomed new ones, from 9 different countries (Taiwan, Germany, Singapore, Ireland, Japan, France, Poland, Canada, and China), Ron Hruska and I presented the second offering of the Human Evolution course and the first live stream. We enjoyed the enlightening discussions fueled by insightful questions from the audience and I think it’s fair to say we ALL came away from the weekend with a little more to think about in our attempt to better understand the complexities of the developing human being.

‘Understanding how underlying developmental processing of information contributes to the development of sensory motor sequencing and the ‘sense of self’, will enable the caregiver to optimize the use of movement instabilities, without developing overdependence on the respiration or primitive adaptive motor ‘patterning’ for stability’ at any age.

Personally, I’d like to sincerely thank Ron Hruska for his gracious mentoring and for trusting me to deliver this complex and valuable information. (I could go on and on…) Further, Jen Platt was instrumental in assisting with content organization, publication, and is a technological whiz for ensuring we were on the same page, slide, and that the almost 100 videos came through clearly. RJ and Hannah were spectacular from behind the scenes and nothing short of enthusiastically supportive! THANK YOU!

Thanks to all of the attendees for your attention, contributions, thoughts, smiles and ‘thumbs up’ from zoom land. It sure was an honor, a timely opportunity and a very fulfilling experience to be with you all!

Until we meet or meet again….

Lisa

Welcome to 2023! It’s hard to believe that we have moved into an entire new year. With the turn of the calendar to a new year, we kicked off 2023 with the first PRI course of the year. Impingement and Instability has had a relatively new re-write a few years ago, and it is now a great introduction to other PRI Secondary and Tertiary courses, as well as being a clinician’s course. It provides the clinician with integration strategies and lays a neurophysiological framework for why PRI is so effective as a science.  

We were fortunate enough to have 53 people join us for Impingement & Instability, which is an astounding number for the first course of 2023. Our first several hours are spent delving into the neurological aspects of how and why PRI does what it does, and why it works. Since this is no longer a specific orthopedic-driven course, we started making integrated connections between the foot and scapula within the first 30 minutes of the course.  

This course has evolved, not only in the last few years, but in the last several times I’ve taught this course. We’ve added more demonstrations and explanations of how to use the reference centers to change the emphasis of a non-manual technique, depending on what the client of patient requires to reduce their functional cortical dominance.  And there are four unique non-manual activities that are discussed in this course and are not found in any other PRI course.

We had a great group of movement specialists from several countries. It was great to have Dana Hirsch, DC, Logan Thomas PT, Minh Nguyen OTD, PRC, Kurt Van Kuiken, ATC, Ryne Gioviano, CSCS, and Nora Harris, yoga instructor in attendance. We had so many great questions and participation from our live stream crowd.  My thanks to Collin Kidwell, CSCS, Nick Rosencutter, CSCS, and Jack Wong, DPT for their attendance in-person and their willingness to help with our demonstrations. And thanks again to RJ Hruska for his exceptional assistance with the production of course. And on his birthday weekend, no less!

We are excited to introduce and congratulate the Postural Restoration Trained™ (PRT) Class of 2023! PRT is the result of completing multiple advanced PRI courses, demonstrating a thorough understanding of the science through completion of the PRT application, and successfully participating in practical and analytical testing. This past weekend, five professionals earned the designation of Postural Restoration Trained™ (PRT) under the direction of Ron Hruska, Dan Houglum and Jennifer Platt.

The Postural Restoration Institute® established this credentialing process in 2011 as a way to recognize and identify 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 PRT credential is available to Certified Athletic Trainers, Certified Athletic Therapists, Exercise Physiologists and Certified Strength and Conditioning Specialists who have completed the course requirements, application and testing process. With the addition of this class, there are now 68 PRT professionals throughout the U.S and Internationally.

To view/download the photos click here.

Back Row (L to R): Dan Houglum, Colby Mamigonian, Joshua Elleman, Colin Kidwell
Frong Row (L to R): Ron Hruska, Nick Rosencutter, Aleena Kanner, Jennifer Platt

On November 4-6, after a few years of break, the Postural Restoration Institute primary courses returned to Poland. The first module, “POSTURAL RESPIRATION – An Integrated Approach to Treatment of Patterned Thoraco-Abdominal Pathomechanics”, led by Michał Niedzielski, was held in Warsaw. The course was implemented over 3 days with a greater focus on practical activities. Course participants had the opportunity to get acquainted with the foundations of the PRI concepts, therapeutic tools, and learn about diagnostics that will increase their effectiveness in their office work. In addition to physiotherapists, many athletic trainers also attended; training-medical professionals who use specific, targeted movement while working with people with ailments and pain. This fact is pleasing, because the PRI method is excellent complementing conscious, effective training.

On February 4-5, 2023, the next module from the series of Postural Restoration Institute foundation courses will take place in Warsaw, Poland – “MYOKINEMATIC RESTORATION – An Integrated Approach to Treatment of Patterned Lumbo-Pelvic-Femoral Pathomechanics”. It will be held in two-day online sessions.

More information on Polish PRI method courses taught by Michal Niedzielski can be found on this website. 

To view photos from the Postural Respiration course held in Warsaw, CLICK HERE. 

‘Timing’ means something a little different to all of us. Some look at time as it relates to acceleration, movement through space (speed), or muscle activation to name a few. But these biometrics often dominate the actual relationships at hand. These relationships are exactly what we at the institute spend our time reflecting on throughout the year. The best time to introduce a new technique, the amount of time needed to achieve a full exhale, the amount of time spent in one hemisphere, the best time of year to host a specific course, the timing of speaker availability to teach said course, the last possible time that the manuals must be shipped to host sites or your homes…….. and the time goes on.

In cyclical fashion this yearly passing of our daily expenditure of time, ends in 4 days, 30 hours or 1,800 minutes of Advanced Integration discussion. Reflecting on exactly how we spend our time rotating, reaching, reacting to, respiring, repositioning and hopefully resting, throughout our daily lives. The biometrics of it all are covered in depth, building upon the concepts discussed the days and months before. And by the last day, in the final hours, it is always hard to believe how fast our time together really occurs.

That’s the thing about time, it may seem daunting, sometimes nonexistent, or even endless at ‘times’, but until it has passed, until we are able to sense something new at its conclusion, we have no comparison, no metric, of how much of it was truly spent. As our time this year and every year concludes, it is this event that provides us as a PRI community with the sense of our time, being well spent, on and for, others in our lives.

Thank you to all of you who have spent time alongside us this year. And to our faculty who dedicate much of their time to help you, and us, fulfill ours. We look forward to spending renewed time with you all in the year ahead and are excited about the many opportunities available to do so.

May this time of year bring you and your loved ones, peace, rest and well-being.

To view the full photo album, CLICK HERE

W dniach 4-6.11 do Polski po kilku latach przerwy wrócił kurs metody
Postural Restoration Institute. Pierwszy moduł, jaki odbył się w
Warszawie, to Oddychanie Posturalne, prowadzony przez Michała
Niedzielskiego. Zrealizowany został w innowacyjnej, 3-dniowej formule,
zwiększającej ilość ćwiczeń praktycznych. Uczestnicy kursu mieli
możliwość zapoznać się z fundamentami koncepcji PRI oraz poznali
narzędzia diagnostyczne i terapeutyczne, które zwiększą ich efektywność
w pracy gabinetowej.

Poza fizjoterapeutami, na szkoleniu licznie stawili się także trenerzy
medyczni, którzy ruch wykorzystują w pracy z osobami z dolegliwościami
bólowymi. Ten fakt cieszy, ponieważ metoda PRI stanowi doskonałe
uzupełnienie świadomego, efektywnego treningu.
Już 4-5.02.2023 odbędzie się kolejny moduł z serii podstawowych kursów
Postural Restoration Institute w języku polskim – Miokinematyczna
Odbudowa Wzorców Kompleksu „Lędźwiowo – Miedniczno – Udowego”. Będzie on
realizowany w formule dwudniowych zajęć online. Więcej informacji na
temat polskich kursów metody PRI znajduje się na stronie
https://inspirowaniruchem.pl/kurs-pri/

zdjęcia