The Postural Restoration Institute was formally founded in 2000, July of that same year you took your first Myokinematic Restoration course. How did you come to find out about the Institute and what led you to sign up for your first course?

My PRI journey actually started in 1998.  Michelin Carroll PT, ATC had taken Ron’s Protonics course sponsored by EMPI for her athletic training CEU’s.  She came back all excited about his approach to management of patella-femoral, hip, and lumbar spine dysfunctions and it was intriguing that the device was only used on the left side despite the side of pain?!?  She introduced us to some of the principles and we were all interested in hearing more.  So, that same year Ron actually came and taught a course at the clinic I was working at in Vermont.  The course was called Postural Restoration.  I was immediately inspired by what he taught. The principles made so much sense to me.

After your first exposure to PRI and your initial courses, how did it affect the way you treated patients? It is often hard for some people to incorporate this science immediately after taking a course; did you find this to be true?

It truly revolutionized the way I treated patients. I found it melded so many orthopedic, osteopathic, respiratory and neurological principles into one!! I loved the whole system approach. It was really quite phenomenal!!

I began using the PRI tests as well as traditional orthopedic tests and soon started seeing much quicker changes with my objective tests using PRI manual and non-manual techniques.  I would also use the PRI tests to validate whether various traditional therapeutic exercises were helping and the patient could see for themselves if they were not.  I would then explain why.  I still do this to some extent but now my patients accept my PRI methods since that is why they are seeing me.

It definitely took time to integrate the PRI approach but the more I used it the more confidence I obtained.  Luckily my patients trusted me. I spent a great deal of time rereading the manuals and referring to them throughout the day.  I think I was at the perfect time in my career and was ready to learn more so that exploring PRI and putting in the extra time was easy.  I also had co-workers to have discussions with, more courses to take, and calls /emails/ questions to Ron.

I had started my career working with neurologically impaired patients which I believed helped me with some of my PRI transition.  Concepts such as lateralization, facilitation, inhibition, hypertonicity, left sided neglect, righting reactions, reflexive verses volitional patterns, developmental sequencing, ambient visual issues and so forth were known to me from treating the neurologically impaired population.  I had also taken many courses over the prior 13 years including Muscle Energy, Strain/Counterstrain, Maitland and Brian Edwards’s spinal mobilization, Brian Mulligan, Upledger Cranial/Sacral etc., but I was still finding there were barriers to maintaining results with many patients.  I realized that stress was one of the barriers.   I was also a bit disappointed in the segmental orthopedic approach.  I quickly recognized the cohesion of my neuro and orthopedic manual therapy segmental training with Ron’s PRI approach and started getting lasting results!! I also began understanding more about the respiratory mechanism and how that related to the stress response and the impact on the postural muscle system.

In what ways did you initially incorporate PRI into your treatment? (Exercise Techniques, Breathing Education, Cueing….etc.) Has your method of utilizing the science changed throughout the years?

In the late 90’s early 2000’s the Protonics was used a lot.  We did not have as many of the non-manual exercise techniques we have today.   We used a lot of 90/90 exercises, some side lie and upright exercises. Brachial chain exercises were very limited compared to what we have now.  I used the manual techniques and spent lots of time teaching about proper breathing with the exercises we had at the time.  There were no other courses yet.   No Integration or Impingement and Instability!  I was still finding gaps and then out came the Cervical-Cranial-Mandibular course!!! Yaaay!!!

The method of utilizing the science has grown though the years as I have attempted to stay current with what Ron and the Institute develop.  Of course that has meant taking the courses more than once for the upgrades and to add the new ones. I have found using the reference centers and improved training from The Institutes faculty on skills/communications for finding and feeling (facilitating and inhibiting) specific muscles has helped me in more recent years.

I continue to feel inspired every day. My approach to care now is much more comprehensive than in the early years. It does get easier to recognize where to begin and why certain techniques fail to give you the results you were expecting to see. I do feel like I get successful results much sooner as I have become more fluent in PRI. I am also much quicker at recommending proper shoe wear, orthotics, dental referrals, neuro optometry referrals, or referrals to other integrative providers.

It seems like the number of professionals that are starting their own practices continues to grow. You have successfully run Cornerstone Physical Therapy for several years now. Do you have any recommendations to someone who is just starting off? What, if any influence did the science of Postural Restoration have on your private practice?

I guess my advice is to be passionate about helping others, do not be afraid to ask why if things are not going the way you expected, and be humble when searching out the answers.   I would also add that it’s important to build healthy relationships with your patients, your staff, and other healthcare providers that are like minded.  It may not be for everyone but it sure is exciting having common goals with your peers and other professionals.  Having your own practice is very fulfilling, even after 19 years!!

PRI was instrumental for me with starting my own practice. I was considering Medical or Osteopathic school. I was so passionate about PRI and how much more I could do to empower and help my patients heal that I stayed in the PT profession. I am fully committed to the science of PRI and have had a PRI center since 2007.  We have many more challenges today with reimbursement but at the end of the day I love going home knowing that I have done the very best I could to help the patients I was fortunate to treat that day.

You have taken nearly two dozen PRI courses. What drives you to continue learning? In your opinion how have the courses evolved over the years?

I may have already touched on this.  I love the science behind PRI.  It makes sense to me.  I continue to see changes that still seem magical even though I have a better understanding of why! It is so satisfying to know you have made a tremendous impact on someone else’s life.

The evolution of the courses has come from basic Myokin/Postural Respiration/ to Cervical/Cranio/Mandibular, Pelvic, I&I, Integration, Vision, Cervical Revolution, Occlusal etc.  They help you treat the patient as a whole person.  Now when I evaluate and treat a patient I can blend all the courses and use the tools/methods that are applicable.  I have been a PT for 33 years and still have the desire to learn more!  PRI fulfills my desire!!

I recently got the opportunity to see you in New York, at the Occlusal Cervical Restoration course. It was our pleasure to meet your friend and colleague Dr. Dara Chira. As our understanding of Integration and application continues to grow, how has the collaboration with a local Dentist changed your approach? Could you briefly explain how you utilize each other for patient care for anyone who is interested in working with a dentist?

I started working with Dr. Dara Chira in the early 2000’s.  I was looking for a dentist to help with my patients as recommended by Ron.  I had the opportunity to work with a couple of her patients who were referred to me by Gayle Myers MD, who practices functional medicine and biodynamic osteopathy.  Dara is an orthodontist who is not just about moving teeth!!  This is so important.

I quickly realized that Dr. Chira and Dr. Myers appreciated the relationships with airway, neutral TMJ position, occlusion, and the postural muscle systems influence.  Finding a dentist who gets this is critical in my mind.  The three of us have been a team for years now, and we all continue to learn more about each other’s profession, as well as respect the need to work together for optimal outcomes for our patients. Dara tends to be the quarterback so to speak with our more complicated team patients.  Dara understands that the restorative dentistry is the last phase of treatment. I suppose I got lucky again with being aligned with her early on in my PRI journey.

The state of Vermont was not only one of the first locations for PRI but continues to host several courses each year. What do you love most about your community and the people within it?

I am so proud of my community for embracing PRI and for searching for optimal therapeutic approaches to patient care.  We have some amazing PRI clinics in a small geographical area.  It is also so satisfying to receive referrals for “Postural Restoration PT” from physicians, dentists, orthodontists, psychologists, naturopaths, chiropractors, acupuncturists, massage therapists, yoga and  Pilates instructors , patients, the list goes on.  Our little community is so progressive!!!

You have spoken at several conferences and other events throughout the years, do you have any upcoming presentations or conferences you are interested in attending over the next year?

Yes, I have been invited to NYC next weekend to attend “Lips Rule at NYU” First annual meeting at NYU School of Dentistry taught by two other members of our team, Dr. Michael Gunson DDS, MD (Arnett/Gunson facial reconstruction surgeon for face airway and bite) and Jeffrey McClendon DMD Dental Restoration. Dara and I will be going down to the Big Apple together again which gives us time to discuss cases, learn, share and have fun!!

Dara teaches in the orthodontia program at Boston University and she and the students have asked me to come down and talk with them this fall.  I will be scheduling that soon.

I am also drooling over the Airway Summit this November in Las Vegas that Ron will be speaking at. I am not sure my schedule and resources will allow me to attend.  We will seeJ

I truly enjoy coming to Lincoln and hope to be able to attend the Symposium next year.  I am still trying to get to the Pilates course!!

When you are not seeing patients what do you enjoy doing the most with your free time?

I love this question too!!  I love spending time with my family and friends.  I have a special passion for horses.  Spending time at the barn with my horse “Alex” performing dressage training and hacking in the fields is my favorite hobby.  We compete some on a national level and just earned our USDF Bronze medal at a horseshow two weeks ago!! I also love to ski and bike!! Vermont is beautiful year round!

How did you become interested in PRI® and when did you attend your first course?

I am very much thankful to have my dear friend Kenny (Kentaro Ishii), whom I professionally “grew up with.” We’ve inspired one another and developed each other ever since we were just a bunch of geeky undergraduate athletic training students. One thing I should mention is, he was extremely good at sensing my likes and dislikes: Anything he told me that I would like (i.e. a book, a person), I actually ended up liking it.

He kept telling me that “Sayuri, you should check out ‘PRI’ – I think you will really like it” and it had been sitting in the back of my mind for a few years until, one day in graduate school, I realized that there might be a link between low back pain and the diaphragm (I saw another friend of mine manually releasing the diaphragm in a patient with LBP, which got me interested and led me to read several articles on it. A light bulb went off – it made perfect sense!).

So it finally clicked – I really should get to this “PRI” thing! It took me a few more years from there to take my actual first PRI course, which I believe was around September, 2012…and that Myokinematic Restoration Home Study course taught by James Anderson completely blew my mind. It challenged my entire belief system and it changed the way how I see a human body. Well, I think you know the rest, just a typical PRI story!

You work as an athletic trainer in the college setting, what are some of the benefits and challenges to implementing PRI with your athletes?

The benefit is that we can often catch someone’s pattern early before it manifests itself in a form of pathology or before the athlete develops a compensation out of it, but the downside is limited time, personnel and resource. It is especially difficult when you are solo, and no one else at your institution practices PRI.

What would you say to people who are considering taking a PRI class or becoming Postural Restoration Trained™?

Two things – “be patient” and “trust the process.” PRI will most likely shake your belief system because you were taught that “the sky is blue” and PRI may teach you “the sky could be green” (just a metaphor). Your first reaction may be a quick, reflexive denial because it sounds new to you, and you may even feel afraid that it could devalue what you know and who you are as a professional – it’s a very natural defense mechanism, indeed.

The good news is, you are not alone! We all have been there and felt that way. You will soon realize that this intellectual challenge is not to threaten you or your educational foundation, but to broaden your perspectives (literally, to the left) as a professional and as a person. So just sit back and enjoy the ride. Let Ron and other fantastic PRI faculty take you through this new clinical journal and allow each PRI course to gradually unfold itself. You should be proud because, without the solid education and experiences you have gained thus far, you won’t be able to appreciate what PRI has to say.

Who have been your mentor(s) in your career?

The people who’ve helped me by pulling me up are Dr. Jack Ransone, David Gish, Jason Karlik, Mary Williams, just to name a few. I also could not have come this far without my friends pushing me, Kenny (Kentaro Ishii), Aki Tajima and Keitaro Abe.

How do you go about mentoring others in your profession?

As a professor at a university, I have a large body of young athletic training students to oversee and my door is always open to anyone who is needing assistance or guidance. I may not give all the answers to them (sometimes I choose not to, and other times I don’t even know it all) but I’m rather here to teach them how to think through an issue because I believe problem-solving is one of the most important professional AND personal skills for anyone to have in life. Through in- and out-of-classroom interactions, I challenge my students to “be open” and “be skeptical” to any new or old concepts…we cannot have too many practitioners with this sort of mindset!

Who have been your mentors within PRI?

Ron, James, Mike, Lori, Jen (Poulin), Jen (Platt)…I can’t even imagine exploring the world of PRI without any of them!

What is the most challenging part about applying PRI in the athletic performance setting?

Maintaining the balance between the two opposites. SNS and PNS, on and off, activation and inhibition, going out there and fighting and coming back in here resting, taking advantage of a pattern yet not to be taken advantage by it. You definitely need both to earn success and stay in the success, but it’s so easy getting stuck in one over the other.

What is your favorite part about teaching PRI over in Japan?

Witnessing and spreading the joy of learning. This may sound weird, but this is a mental picture that I have when I am teaching PRI in Japan: Ron is the Santa Clause and I am delivering Christmas gifts he wrapped up to people in Japan. And here’s the beauty – I get to watch them open their presents! You see them get surprised, excited, smile…wouldn’t it make you feel the same? It’s been truly an honor to be able to share “Ronism” with practitioners in Japan.

I also enjoy the bonds we nurture through the process…again, all of my PRI mentors, Kenny, and the PRC/PRTs in Japan. I love that we are very much focused on sending cohesive messages across the country, across the world. I am blessed to call them my family.

Which PRI course has been the most influential in your development as a professional? 

Postural Respiration in particular was eye-opening, jaw-dropping, mind-blowing, all of the above. I’d never thought of visualizing someone’s airflow and the importance of it till I took that course. This literally added another dimension to my clinical assessment and treatment.

How did you become interested in PRI and when did you attend your first course?

This story begins in the late 1990’s.  Kyndy Boyle was a member of our year long Maitland Joint Mobilization Training group.  She took a class with a man who talked a lot about hamstrings and she found it interesting.  She shared her thoughts with our group -although we were all about joints, not muscles – and she went on to present about this new idea to our local Triangle Orthopaedic Study Group.  This was a very different approach to rehab! In 2002 or 3, Kyndy, now a professor with the new Elon University PT program, brought Ron Hruska to participate in an extracurricular Elon University program open to local PT’s.  I attended the lecture he presented and recognized then that complicated and conception challenging as it was, this was the most comprehensive, bio mechanical and holistic methodology I had encountered in some 15 years of PT experience. 

Our clinic, Advance Physical Therapy, became a certified PRI clinic in 2008 when Joe Belding, my colleague, and I both went through the PRI certification process.  This exacting process gave a quantum leap in my understanding of and ability to apply PRI concepts.  Now, 15 years later, I do not find any other rehabilitation approach which comes close to the breadth and depth and effectiveness of Postural Restoration.  It provides a constant expansion of insight, of integration and of perception of the incredible complexity of our experience of living.

What would you say to other PTs who are considering taking a PRI class or becoming PRI Certified?

Postural Restoration is at the cutting edge within the medical field, and it will continue to evolve.  Someday, this framework will be recognized for the reality it represents and asymmetry, right dominant patterned movement, and system integration will be widely accepted and utilized.  The concepts are intricate, and it takes time to shift from a one to a three dimensional, integrative  perspective.  But it is worth the effort and time, and will enhance your practice  and your thought processing in remarkable ways.

What is the typical patient you see in your clinic?

Advance Physical Therapy is a PT owned private practice.  We treat a varied patient population: from infants to the elderly, having a wide range of concerns.  Three of our therapists, me included, specialize in the treatment of scoliosis.  About 65 percent of my current patient population has scoliosis as a primary concern or as a contributor to pain and dysfunction. The patients I treat typically range in age from preteen to elderly.  A majority of our patients come to us by word of mouth.  These folks tend to be interested in their health and wellbeing and motivated to work on challenging therapeutic activities.

What sparked your fire on the research and treatment of Scoliosis (Schroth, PRI, any other Info?)

The fourth and last day of the Advanced Integration course culminates in a discussion of scoliosis.  My first experience of this conceptual coming together of triplanar lower body/upper body/ respiration and patterning was 2005.  Each year at Advanced Integration, my interest in this complex, whole body, compensatory development became more acute.

In 2006, a 14 year old girl with scoliosis came to me for treatment.  I knew at this age she was especially vulnerable for curve progression.  I also knew that our work together would affect her entire life ahead of her and I was not wanting to make any mistakes!  I sent her to Ron for consultation and followed his advice in progressing her.  Her curve reduced from 40 degree Cobb angle to 27 degree Cobb angle.  This was a heartening experience!

My German husband noticed this interest.  He learned of the German Schroth Method for scoliosis rehab, practiced in Europe for nearly 80 years but practically unknown in the United States. He encouraged me to pursue this specially by taking one of the 2 trainings available in the United States.  My colleague, Jean Massé and I attended a 10 day scoliosis specific training in the Schroth Methodology taught by Beth Janssen, PT and Patti Orthwein, PT. This course was developed by Dr. Manuel Rigo of the Barcelona Scoliosis Physical Therapy School who learned these techniques from Christa Lenhert-Schroth, the daughter of the originator of the work, Katharine Schroth.

The "3D" asymmetrical concepts we learned in this scoliosis specific course corresponded in many ways with the fundamental principles of Postural Restoration.  Although PRI was more  bio mechanically sophisticated, the Schroth Method added invaluable perspectives on evaluation of specific curvatures, clinical reasoning for treatment of these specific curve types, postural and movement precautions and an emphasis on kinesthetic self awareness of body position and breath.

Preparation for my presentation at the 2014 Interdisciplinary Symposium entitled: "The Influence of Position and Breath in Treatment of Curvatures of the Spine Utilizing PR and the Schroth methodologies" gave me an opportunity to delve deeply into these two approaches.

Shortly after this Symposium, I attended my first SOSORT meeting in Wiesbaden, Germany.  SOSORT is an international organization of doctors, orthotists and PT’s interested in the conservative treatment of scoliosis. Each yearly conference is scheduled in a different country.  Presenters share their research. My abstract was accepted for a poster presentation.  I met many interesting people and heard many interesting presentations. The highlight of this event for me was meeting and visiting with Krista Lehnert-Schroth, daughter of the originator, Katharine Schroth, and author of the book, "Three Dimensional Treatment for Scoliosis".  In 2016, I again attended the SOSORT meeting- this year in Banff, Canada.  Here I met a PT educator, author and researcher, Dr. Josette Bettany-Saltikov, who expressed sincere interest in the PRI approach.  In December of 2016, Dr. Bettany-Saltikov offered me the opportunity to write a chapter on the Postural Restoration approach for the book she was co-editing entitled, "Innovations in Spinal Deformities and Postural Disorders.  My colleagues, Jean Massé and Lisa Mangino cooperated in this endeavor.

Can you tell us something more about the chapter you authored on scoliosis.

I believe the framework provided by PRI would help many patients the world over to achieve better system balance and function. The hope for this chapter is that it will inform practitioners interested in spinal issues, including scoliosis, of a more accurate, asymmetrical model of human biomechanics than the current common assumption of human symmetry.  Basic concepts addressed in this chapter include: innate human asymmetry, the concept of neutral posture within an asymmetrical system, the power of respiratory influences, right side dominance as a result of innate human asymmetry, muscle chain activity and the left AIC, right BC pattern and the perspective ofbio mechanical  dysfunction beginning in the Sagittal plane.  These concepts are related to scoliosis issues throughout the chapter.

What areas of patient care excite you the most?

What I love most is working with others in the realm of breath and sensation.  When a patient achieves the ability to allow a diaphragmatic breath, the room becomes quiet and calm.  When a patient begins to experience movement flow/ integration – often in a "static" position, we share a feeling of satisfaction. I am grateful that as this patient is processing their sensations, I too can process my sensations.  We breathe together.

Human asymmetry predisposes all humans to have right side dominance.  Scoliosis is an extreme progression of their pattern. In PRI, we all work with scoliosis to some degree with every patient.  What is compelling to me about working with patients with diagnosed scoliosis ( greater than 10 degrees Cobb angle) is the process of their coming to understand their pattern, and finding new sensations to guide them to greater balance.  It is a total body process and breathing is a key component.

Who have been your mentors in your career?

I have many years behind me in which I learned important lessons from many people. I consider this question an opportunity for me to remember and thank my guides:

Charlotte Selver gave me embodiment and reshaped my life through her Sensory Awareness work.

Among countless gifts, John G. Bennett awakened my conscience and gave me a sense of purpose.

Irmis B. Popoff trained me to be able to meet unexpected circumstances and to serve.

Andrew McDonough at NYU communicated a love of human biomechanics.

Joy Devins and Tracy Holtzman helped me navigate hospital PT in my early days at UCSF.

Krista Clark mentored me in Maitland, gave me manual expertise and helped me start my private practice.

Kyndy Boyle led me to Postural Restoration.

My husband, Hans, has endlessly supported me and urged me to take on new challenges.

My son, Max, has repeatedly helped me formulate my thoughts and ideas.

Beth Janssen opened the doorway for me to appreciate and apply the Schroth method.

My colleagues, Joe Belding, Jean Massé, Lisa Mangino, Nancy Toole, Beth Elder, Shella LoBianco and Deana McCollum are a constant source of learning and growth, sharing and goodwill.

My patients keep my mind agile and my skills growing with their concerns and questions.

Who have been your mentors within PRI?

Despite the challenges of trying to follow the thoughts of a brilliant, integrative thinker, I am so grateful to Ron Hruska for sharing his understandings and insights. I have attended nearly every Advanced Integration course since 2005 in order to follow his evolution. Every year has been unique and revelatory. As the Institute courses continue to evolve, these extraordinary concepts continue to expand in depth and breadth.   Ron continues to push our boundaries yearly at the Interdisciplinary Symposium and through his explorations of neuro-sensory and visual realms.

How do you go about mentoring others in your profession?

I have encouraged all of my colleagues, current and past, to take on the PRI certification challenge.  We encourage all PTs who express interest in our practice to take PRI courses.  We expose volunteers at our practice to Postural Restoration treatment and encourage these potential PTs to remember the power of this methodology.  I also feel that presenting about PRI and writing about PRI are forms of mentoring.

What advice would you give to other private practice owners who want to integrate PRI at their clinic?

I have already said it multiple times: this is the most effective evaluation and treatment modality I know of in Physical Therapy.  It is well worth the investment of course work.  As the clinicians understanding grows so do effective interventions.  Patient success rates increase, so do word of mouth referrals.  It is a good business decision to begin the process of becoming a certified clinic.

What types of activities do you enjoy doing in your free time?

Before I started PT school (age 34), my early experience was shaped by the work of Charlotte Selver, J.G.Bennett, and Irmis B. Popoff.  I learned deep sensing of fundamental forces in myself: gravity, support, energy; how one could relate to others, to the environment, how to listen.  I learned about self-study, meditation, movement practices, how to work with others for a greater good. I was exposed to big ideas of the world and our place in it. These teachers and experiences were transformative on all levels and continue to be my touchstone.

How did you become interested in PRI and when did you attend your first course?

Actually, I stumbled onto my first PRI course the fall of 2002.  Twice a year, the Nebraska Physical Therapy Association offers a variety of courses for continuing education.  I happened to choose the course entitled "Myokinematic Restoration – An Integrated Approach to Treatment of Lower Half Musculoskeletal Dysfunction" with instructor Ron Hruska.  He was describing me with my mild scoliosis and movement pattern.  I had chronic neck and back pain all through high school and college.  I struggled with exercise induced asthma during basketball and track season.  I had frequent headaches and the dreaded migraines started in college.  This course was enlightening! After 6 years practicing therapy and previous continued education courses, this was the only course that left me with a desire to know more about a specific treatment method in physical therapy. 

Within that same year of taking my first PRI course, I attended Postural Restoration (Hybrid class before Postural Respiration).  Because I own my practice, I did not feel restricted in trying something different from traditional physical therapy.  I began to integrate the PRI approach with my patient load. I would offer free therapy with nursing staff and friends to hone my PRI testing and techniques.  It was both rewarding and frustrating at the same time.  Rewarding in the fact that I witnessed immediate results in treating patients and I knew that this PRI approach was undoubtedly a method I wanted to pursue.  Frustrating because I didn’t have another PT to collaborate with.  Because I was a sole practitioner going through the PRI concepts, at times I found it difficult to thoroughly interpret and apply the best treatment plan. 

In 2009, I opened a second clinic and Ben Sudbeck, DPT, came on board.  He had practiced with PT’s who attended PRI courses and was vaguely aware of the science. Together we began our endeavor to attend PRI courses, taking in as many as possible.  And so, we both continued to expand and improve our PRI knowledge together. 

It became increasingly evident to me that the basic understanding of PRI principles was just a small part of the broader science behind PRI.  The secondary courses, affiliate courses, PRI Vision and the annual symposium have been vital in my growth and understanding in effective treatment of patients – how to get to the root cause of symptoms quickly.  

What has been the biggest challenge with having your own practice?

The biggest challenge is relaying what we do that is so different.  Because of PRI, we are operating in a niche market that is saturated with physical therapy clinics. Because of PRI, we are different than the norm.  As a business owner, it’s not always comfortable being ‘different’.  My husband and I own the clinic together and we have had many late-night discussions on the direction of our clinic. I was determined to have PRI as our primary focus of the clinic.  I wanted to set ourselves apart from traditional physical therapy.  As we started to market our business, the challenge was explaining PRI in print and radio ads. How do you explain to doctors and other healthcare professionals that we integrate with dentistry or optometry?  

Somewhere in the process, I stepped over the line to become fully invested in PRI. There was no looking back.  We brought on our three physical therapist assistants through the PRI journey and they began to quickly recognize the direction our clinic was taking. The heavy use of modalities became days of the past.  We no longer treated the right shoulder like the left.  We were able to relieve neck tension by addressing a respiratory system or left leg awareness.  Therefore, having like-minded employees jump on board with PRI was easy. It would be a challenge to bring on an employee that wasn’t open minded in trying something different.  Even bringing on another PT to the clinic would be a challenge if they didn’t already have a taste of PRI.  The PRI approach is a continual learning process over several years of courses and clinical experience.  Therefore, there’s a challenge of surrounding yourself with other likeminded therapists who are willing to do something that can be difficult and outside the norm.

What would you say to other PT’s who are considering taking a PRI class or becoming Postural Restoration Certified?

Words cannot describe how valuable PRI has been to us. Not only am I being recognized nationally but also internationally. The problem with PRI is that it can take a physical therapist out of their comfort zone.  It takes work…a lot of work.  Each patient has a very specific treatment plan and no two patients are the same.  For the typical patient in our clinic, PRI is successful and results oriented with sports rehab, musculoskeletal pain and post-operative rehab. But, if I neglect a patient’s pes planas (flat foot) then my treatment plan will not be effective…if I neglect a patients occlusal bite (how teeth touch) then a patient can lock back into their strong pattern of movement or pain…if I didn’t have an understanding of how both eyes need to work together for particular patients, then all my efforts to help these patients are unsuccessful. 

The entire staff at the Postural Restoration Institute, the practitioners teaching the courses, the like-minded therapists and medical professionals all are wonderful people to know and work with.  The Institute is willing to help you through the process and they truly care.  You will learn how to reach out and integrate with other professionals, like a dentist, within your community. There are many therapists and medical professionals who reach out to each other in a PRI group email.  The PRI website is a great source of information as you go through your leaning process.

The ‘find a provider‘ link on the institute’s website has been a great tool for doctors to refer their patients to us. Even our local health professionals will write on the script ‘PRI eval and treat’.  Patients will tell us their doctor recommended PRI therapy because of the results and not to expect the same physical therapy from past experience. 

Completing advanced training and coursework to become a PRC is highly recommended.  The primary and secondary courses are a fraction of the integral coursework of how all systems are connected in treating each and every patient. Ron Hruska is passionate in providing a strong institute of excellence. The process to complete your certification could be intimidating, but I gained an enormous amount of confidence and a deeper understanding of PRI. 

What is the typical patient that you see in your clinic (if there is one)?

The typical patient tends to be a musculoskeletal strain, sprain or repair.  But with PRI, I am able to take that to another level with more success than traditional PT.  What’s more enjoyable is treating that same patient’s underlying symptoms that are directly related to their initial complaint.  For example, I am able to teach the patient how a particular exercise will not only address their knee pain, but how that same exercise also addresses their chronic low back tightness and headaches.   

What areas of patient care excite you the most?

I enjoy the younger patients only because their pattern is easier to change and address before the symptoms are ingrained.  I am amazed at how many kids come in with strong cranial torsion. If we are fortunate enough, we see them before permanent teeth are removed or before braces. It is a blessing to validate these kids’ chronic complaints using PRI intervention. They present with real struggles that no kid should have to go through. They have a range of symptoms that we take very seriously such as; panic attacks, difficulty swallowing, migraines, EIA (exercise induced asthma), shortness of breath, chronic joint pain, poor sleep patterns and daytime fatigue.  They honestly don’t know what ‘good’ feels like. It is a blessing to have these kids come into our clinic before they go further down this strong cranial torsion or strain. I am ever more grateful to integrate with dentists who are able to help these kids as they progress through PRI rehab.

The other patient I get excited about are the ones who have been everywhere and tried everything.  These patients come in to our clinic and are desperate for help.  Oftentimes they are told that we are ‘different’ than any previous physical therapy experience.   They have tried A, B C and completed X, Y, Z without lasting results.  Often these patients have a long rap sheet of symptoms and quite honestly, they just want their life back.  Occasionally I will need to integrate with the PRIME program, PRI Vision, my local dentist or a dentist that is able to assist with cranial torsion.  Because we are so close to Dr. Paul Coffin, there are certain times I will have a patient drive to Sioux City versus doing the impressions here for PRI orthotics.  I am grateful for the trust placed in me when a patient will need further intervention that is not covered by medical insurance.   

Who have been your mentor(s) within PRI?

There are so many…I strongly feel that anyone going through the PRI process needs another therapist to bounce ideas off.  My coworker, Ben Sudbeck DPT, PRC has been by my side through the ups and downs of understanding PRI.  Without a doubt, there were times when we would take two steps forward and one back as we both pursued our PRC.

As a clinician progressing through PRI coursework learns how to quickly and effectively treat a patient, there will be times that you have a piece of the puzzle, but not the whole puzzle.  Fortunately, I live 2 hours away from the Hruska Clinic. It was there that I worked with PRC’s Jen, Dave, Torin, Jason, Lori, Ron and Dr. Heidi Wise in finding that missing piece to the puzzle.  Because of the amazing mentoring of these clinicians, I have exponentially gained a wider skill set to treat my patients.  I can now recognize when a like-minded dentist or optometrist is needed to integrate with a patient’s plan of care, sooner than later.  

How do you go about mentoring others in your profession?

A doctor’s office once warned us that there were other clinics promoting PRI therapy. I think they were expecting me to be concerned that this clinic would be encroaching on my practice.  Instead I replied how beneficial it is to have more therapists learn and integrate PRI techniques in their practice. I would enjoy to having more PRI clinics around our area.

I thoroughly enjoy planting the PRI seed with undergraduates applying for PT school.  By showing the benefits of PRI on themselves and with current patient load, they can see and feel the changes instantly. Most of these students are needing to meet the required observation hours in a variety of physical therapy settings. Once they see what we do differently, or better yet experience PRI on themselves, they want to know more. We talk about the process of PT education and the all-important continuing education after graduation. It’s easy to tell which students ‘get it’. They ask all the right questions and I keep feeding their inquisitive minds. They often come in for more observation beyond what is their required hours in applying for PT school.  I find that these students have watched PRI videos, they’ve been on the website, they have tried the exercises and can feel the results. Those are our future PRI therapists.  The sooner you plant the PRI seed and make them aware of this asymmetrical system and how we treat that pattern, the sooner we will see our profession recognize PRI.

What types of activities do you enjoy doing in your free time?

My family is my free time. We enjoy summer nights in the backyard by the fire.  Making meals together with a dose of healthy conversation is now a very cherished commodity as the last two kids are in high school and the oldest will soon be married this summer.  As with most families, we are on the go with the kids’ extracurricular activities.  I am a baseball mom who probably cheers too loud.  I am a horse mom who loves to get up at 4 am to assist my daughter at horse shows on minimal sleep. I am a soon to be mother-in-law, looking forward to little ones running around.  I used to enjoy running until I fractured my left heel (in the PRI world, that is critical).  I download books and sneak in casual reading over lunch, at the ball field or at a horse barn.  And very recently, I’ve discovered a new love for history and politics. 

How did you become interested in PRI and when did you attend your first course?

I first heard of PRI during some conversations I had with some participants during the DNS certification programs. They kept saying once you get DNS that I should really look into PRI. I took Postural Respiration home study in the Spring of 2014, and even though it seemed “out there” it also made a lot of sense. The home study courses are great, but its not the same as being there. I fortunately live in an urban area where courses are offered a few times a year, so I was able to attend the other courses in a short period of time, and now am in the process of repeating some of them. Every time I attend a course, even the second time, there is so much to learn and I keep picking up stuff.

I know you work with amputees and Paralympic athletes, how does your exercise selection change for these athletes?

The Riekes Center became a designated US Paralympic Committee Sport Club 5 years ago. My first Paralympic athlete, was Sharon Kelleher, a 2 time Paralympian in wheelchair tennis. It was really intimidating at first, because I felt really lost training her. Then after a few sessions, we had this conversation, and it was like, lets just throw preconceived notions out the window, and lets come up with our own way to train. I tribute Sharon,and the other Paralympic athletes myself, or my staff train, with allowing us to just take it and run with it. They have been so incredibly open. As far as PRI use with the Paralympians, it would come as no surprise to Ron, but you still see the same compensation patterns, they just may be harder to find. A colleague and myself were doing a gait analysis on our gold medalist sit volleyball player, who is a below the knee right leg amputee. We thought "now there is no way, she is going to be right side dominant in her gait”. Sure enough, you could see her just hanging out in right hip during gait. Another one of our wheelchair athletes who took 5th in the 1500 in Rio, sure enough, right posterior rib hump with left anterior rib flare. The others we work with show the same compensatory patterns seen in “able bodied” clientele. The challenge comes in adapting points of reference. It’s often a question of “how far down can you feel?”. Finding left heel or back of right hip, may not be possible, so you have to come up with reference point that works for them, and sometimes that means palpating to find it. None of our wheelchair athletes expect to be able to jump out of their chairs and walk again, and we’re not looking for that either, however, it has been amazing how much more they can do now. It might be just bending over to touch the floor and being able to come all the way back again on their own, or it may just be “finding left oblique” while establishing a zone of apposition, when they never could feel left oblique before. I am also blessed to work with the super elite of the Paralympic community. They are so willing to try anything.

Can you talk about the Riekes Center and some of the services you provide?

Its so difficult to describe the Riekes Center. I always tell people just go to www.riekes.org. We are a nonprofit mentoring organization that provides programs in Nature Awareness, Creative Arts and Athletic Fitness. My immediate supervisor, Gary Riekes, wants us to provide the best services possible. He has been incredibly supportive of me going as far as I can professionally, which included PRI, and expects all of our staff to be the best they can be. I come from a social work background, so the idea of providing services to everyone regardless of ability to pay is huge for me. For example, Stanford University may refer underinsured patients to me. We can scholarship them, and while I am working with that patient I can communicate with their PT at Stanford so continuum of care is provided. The patient gets to continue their care at a reasonable fee with us, and the Stanford PT is freed up to work with other patients. Its become a win/win situation for many of our clients. Riekes Center has this knack for taking students that are in very difficult situations and using all 3 of our program areas (Athletic Fitness, Nature Awareness, and Creative Arts) and creating a customized program that works for that particular individual. Its very unique, and the community is very supportive due to the success we’ve had.

What would you say to other CSCS that are considering taking a PRI class?

As a CSCS I can say that unfortunately many in the strength and conditioning field are still stuck in a methodology that is outdated. Its a competitive field, and we are working with athletes that need any type of advantage, so get out of the comfort zone and try something different. PRI is where strength and conditioning and elite athletic performance is headed. Learn it now or get left behind.

What is the typical client?

I really don’t have a typical client. Each day is incredibly diverse. In one day I could see a Stanford professor dealing with a knee injury; a Paralympic athlete in a wheelchair; an executive from Google; a TBI referral from Palo Alto Medical Foundation; a high school athlete coming out of PT; a group of high school athletes getting ready for college; and Olympic caliber athletes looking to fine tune; etc. etc.

What areas of client training excite you the most?

I have really gotten into training the TBI patients. Its a challenge because the cognitive ability to remember and repeat patterns may not be there, so you have to help them find correct movement patterns that might have “gotten lost” with the TBI, or create new ones that will “stick”. Clients really bought into PRI are also wonderful, and its fun getting the high school and college kids ready for their season .

Who have been your mentors in your career?

My career mentors come from way back during my days as a social worker, dealing with inner city gang members and pregnant and parenting teen age girls that were wards of the state. My daughter Becky, is named after one of my former social work supervisors. They work for so little pay with the marginalized of society, and go unnoticed for what they contribute to society.

Who have been your mentors within PRI?

I have great admiration for Ron Hruska for the way he runs PRI. The PRI instructors I have had are wonderful- Jesse Ham, James Anderson, Skip George, and Mike Cantrell who we discovered we were acquaintances at Emory University in the late 1980s while I was in seminary and he was in PT school. Sometimes its the 2 minute conversation that makes a difference. Instructor Jesse Ham and PRT Matthew Uohara were the first ones to encourage me to apply to the PRT program. PRT Caleb Chiu is local and very open to discuss when needed, as is PRC Keren Cahn, and there are several other local PT’s that have taken several PRI courses, so there is a PRI community here. Maybe its not so much mentors, but people around that understand PRI.

How do you go about mentoring others in your profession?

The Riekes Center is a nonprofit mentoring organization, so mentoring is built into our philosophy. We are expected to share what we know with others, so its a natural part of our day. I’ve also had interns come from Japan and Mexico and we expect our international internship program to grow.

What types of activities do you enjoy in your free time?

I am a single parent, so I place a ton of value on my time spent with my daughters, and seeing them at their various sporting events. I do a variety of workouts, mostly at Riekes center. Caleb introduced me to MovNat which is really cool. Preparing for my visits to Mexico also is something I enjoy and that takes a lot of time. I also play saxophone a few times a week and play at the Riekes Center recitals when needed.

We know you have done lots of education in Mexico. Could you expound on your experiences in this country and how you see PRI being appreciated in Mexico?

I lived in Puebla,Mexico 1994 to 2000 and worked and coached for 4 years at the Universidad Popular Autonoma del Estado de Puebla (UPAEP) and 1 year at Universidad de las Americas (UDLA). Both are top notch universities. Many of my former players are now coaches or administrators at other universities or for professional teams, so a few years ago they started to invite me back to help out their teams or universities in Puebla, Mexico City, Chihuahua, Sinaloa, Quintana Roo and other places some times as much as 3 times a year. I’ve also done Spanish language webinars that have been broadcast throughout Mexico, and I’ve been told to Colombia, Argentina, Peru and Panama also. My trips to Mexico can be very overwhelming. Thanks to the success of the teams I coached in Mexico and to my former players, conferences I give in Mexico can be really big. I had 300 show up 2 years ago, and this past week every session averaged more than 100. There’s the homecoming part of seeing my former players who are now married, have children, and successful careers. It’s so great to see them. There’s the strength and conditioning side of presenting concepts to coaches who have grown up learning a Cuban style of methodology, so concepts we take for granted can be very new to even very good experienced Mexican coaches. There is the language side of presenting in Spanish and I have to make sure I am getting my point across accurately. Then anytime you cross the border, you go from representing yourself and/or your organization to, like it or not, representing your country. I was just in Mexico last week during the transition of the US government. You have to make sure you’re not coming across as a condescending know it all American, and I probably had to be even more sensitive to it this time. This last trip I had 170 students from the physical therapy department during one of my presentations on TBI/PTSD. I mentioned PRI to them and asked if they wanted to see the Intro to PRI powerpoint, which is provided to all PRCs and PRTs (I translated it into Spanish) and go through some of the basic concepts, which they of course agreed to. Like most people in sports performance or PT, they were really blown away by the PRI concepts. After the talk, about 10 students stayed an extra 30 minutes just asking more questions about PRI and PT in the US. PT in Mexico tends to be applying modalities and maybe doing some exercises in sagittal plane, so it kind of opened up a whole new world to them, and I was just sharing basic concepts. PRI has massive opportunities to make a huge difference in developing countries precisely because it doesn’t rely on expensive treatment devices and or medications. The reach and effectiveness can be enormous. This is what really excited me about PRI since the beginning, and its something I hope to work with PRI staff on. Then there is just the logistics of being a presenter, which I am sure PRI staff and others who present can relate to. You may have just presented 3 hours of intense material and are dying to go to the bathroom or grab a bite to eat, and during your 15 minute break 5 people want to come up and discuss their particular issues. Thats just part of  presenting that you need to anticipate. I’d love to talk more to the PRI presenters at conferences during breaks, but I refrain from doing so as I know how valuable those breaks are.

I also want to thank Ron and PRI for allowing me to indirectly be part of such a wonderful, ethically run organization. My professors in seminary said they felt I was best suited for a career that “involved healing the body” (which is why I didn’t continue in seminary) and during my over 10 years in social work and international development, I always felt there was so much more organizations could do to improve the health of their communities. The Riekes Center provides me a place where we can make this happen, and PRI has been such a wonderful complement to the services we provide.

How did you become interested in the PRI and when did you attend your first course (you can also talk about your educational/professional history that led you to PRI)? 

I first became interested in the PRI when I was in Arlington, TX working at a PT clinic. My good friend and fellow ATC, Kentaro Ishii, who is now PRI faculty, introduced me “Hey Takashi, this is an awesome course to take, they think the body is asymmetrical!” I attended Myokinematic Restoration in Fort Worth, TX which was taught by James Anderson. I still remember lots of smoke coming out of my head at the first break of the course!

Since I came from Japan where asymmetry is a beauty, I thought that the idea of asymmetry somehow made sense to me (which I definitely regretted at the first break of the Myokin course).  I was looking for deeper thought processes since it had been 4 years since I graduated grad school and I was finding that my techniques were missing something.

What does a normal day look like and how do you integrate Postural Restoration into your training facility?

I usually see people at a “medical fitness gym” type of place where older populations get treated or trained. These people have not been exposed to intense training, and PRI exercises are great to start with. So I do a quick assessment and have them perform PRI non-manual exercises. Most clients have some issues such as back pain or knee pain. I also see some athletes, mostly baseball players and golfers.

What are some of the main differences between the training and rehab that you see in Japan vs the US?   

The biggest difference I see is people’s perception to exercises. Japanese people know stretching a lot, but no one trains or uses muscle activation since they still don’t feel like using muscles will fix their issues. Only 3% of our population has a membership to some sort of fitness clubs, whereas in the U.S. 17% of the population has a membership. There are over 40,000 bone-setter or judo therapist clinics in Japan and those places are the first of their choice of treatment. I think that number suggests people here are well treated, but it’s a passive way. An active way of treating themselves is needed to improve our health. We are No. 1 in life expectancy in the world, but healthy life expectancy (life expectancy without counting years being in bed or needing support) is 10 years less than the regular life expectancy.

What is your favorite part of the job as our Education Coordinator in Japan?

To see the 40 seats sold out in 9min after we open registration…just kidding. When I get a “Thank you” message after a course!

What would you say to people who are considering becoming Postural Restoration Trained™? 

Oh, I would really recommend going through the PRT process! It’s not just a PRT exam held in Lincoln, but the entire process is a learning process (the application, article reviews, case study preparation). Then the exam process takes the whole process into the next level!

Who have been your mentor(s) in your career?

The best moment of my PRT exam was that two of my mentors were in the same class, Ryan DiPanfilo and Nate Shaw from the Arizona Diamondbacks. Those guys taught me a lot not only about techniques and knowledge, but also how to be a true athletic trainer and a leader. I cannot thank them enough and I am so proud of myself becoming a PRT with them the same year.

Regan Wong, PT and Dr. Keith Meister from TMI Sports Medicine, Arlington TX have also been mentors in my career. I spent most of my time in the US there and they built a solid foundation for my career. As I started working in Japan, I had so many opportunities to work with baseball players and the things I learned from them can save bunch of shoulders and elbows in Japan too!

Who have been your mentors within PRI? 

Most recently as my role as an Educational Coordinator of PRI Japan, Jennifer Platt and Ron Hruska have both been my mentors too! I love their passion for doing the right thing, and I feel very comfortable learning from them since I feel like I’m part of PRI family.

Kentaro Ishii and Sayuri Abe have also been my mentors even though they are younger than me. They are extremely hard working. They have put so much time and effort into learning the material in English and translating into Japanese to teach in Japan. They also coordinated all of the logistics before I was the education coordinator here in Japan. We are now a great team working to spread PRI science to Japanese health care populations. I love sharing ideas and learning from them! 

Which PRI course has been the most influential in your development as a professional?

I have to say Myokinematic Restoration and Postural Respiration if I have to pick…all were great and the idea of Postural Restoration itself changed my career development, but those two courses are really a fundamental part of it and the more basics I know, the better I can explain to my clients.  

What kind of growth do you expect PRI to have in Japan in the next couple of years?

Lots of people are starting to realize the importance of asymmetry and respiration which will hopefully keep the upward trend of course attendance! We recently had 130 people sign up in 17 minutes!  We hope to have Ron over to Japan sometime in the next couple of years!  

How did you become interested in PRI® and when did you attend your first course? 

My first course was Myokinematic Restoration with James Anderson in Arlington Virginia in April 2010. I vividly remember the shock and excitement I felt at being presented with a major paradigm shift after 25 years of “traditional” clinical practice.  James had added a whole different perspective to the way I pictured the body working – and I wasn’t sure where in my brain to put it. I have always loved the biomechanical basis in which my PT studies were rooted – and now here I was listening to a new, yet totally sensible approach to kinematics where it’s a given that muscles are positioned differently on the right vs. the left.

I went to this course thanks to my dear friend Karen Taylor Soiles whom I first met in September 1979 when we were freshman PT students at Northeastern University. Karen and some colleagues were hosting the Myokin course and she told me that I absolutely had to come and hear what the Postural Restoration Institute was all about. I guess the rest is history!

What has been the biggest challenge with starting a new practice?

The first challenge was to change my mind-set. I had never imagined myself NOT being an employee in an established institution where I was surrounded by extraordinary colleagues, thriving on the clinical conversations and friendships that were part of belonging to a department. Leaving this sense of stability and security was not easy.

But the time came last year when I craved the autonomy to create my own space for practicing physical therapy. It became apparent that I needed more time with clients in a quiet environment in order to enhance and optimize their experience of PT and PRI work.  My practice has totally changed as I developed a deeper awareness of our bodies’ patterns in 3D (ingrained preferences, influences of sensorium, tone, and reflex).  As I learned how to manage my own body, I became more passionate about wanting to pass that knowledge on to my clients – and to altering the positions and habits that they use for movement and rest to achieve powerful results.  The best path I saw for doing all this was to start my own practice.

So I started my practice in December 2015 – with all the trepidations you’d expect (will I have clients? will it make money? will it be weird being alone?).  Thankfully it has worked out well so far thanks in large part to the fact that my clinic is a recognized Postural Restoration Center (the first and only one in southern New England at this time) – so people find me through the PRI website.

What would you say to other PTs who are considering taking a PRI class or becoming Postural Restoration Certified™? 

I recommend entering into the world of PRI courses with an open mind. You need to be open to the paradigm shift that you will be presented. PTs are used to continuing education courses that are organized around a series of techniques, so one expects to simply be adding more to one’s tool box. PRI courses provide this, but to me the greater value comes in understanding the evaluation framework. It can take some time to really appreciate this difference.

A common question is which course to start with. For PTs who work with a varied client base, I recommend starting with “PRI Integration for the Home”.  After having taken all of the primary courses, my Massachusetts General Hospital colleagues thought that this would have been the best starting point rather than any of the primary courses. The affiliate courses summarize the science of PRI into a rich 1/2 day presentation followed by evaluation and treatment techniques that are easier to teach to a wider variety of patients, making it easier to put into practice. That said, the course is as integrated as I&I.

When I first took Postural Respiration, the speaker asked who in the audience had taken this course before. A few participants raised their hands. I thought it odd that one would take the same course more than once, which is now very ironic given that I have become a PRI course junkie. Taking the time for multiple courses has given me the knowledge to pursue my PRC, continue to strengthen my understanding, and to develop a wonderful network of like-minded colleagues.

What areas of patient care excite you the most?

I get most excited about modifying how people envision their bodies and teaching them how they can positively affect their physical well-being. My clients tend to be ones who have tried more “traditional” therapies and are looking for different strategies. These clients come to therapy feeling that their body and pain/symptoms have taken over and that they have lost control. I love changing that mind-set using PRI.

Who have been your mentor(s) in your career?

I met my first true mentors when I was enrolled in the PT Masters Degree program at the Massachusetts General Hospital (MGH) Institute of Health Professions.  My two program and thesis advisors were Daniel Dyrek and David Krebs.  They provided me with a taste of the huge impact that great mentoring can have. Dan and Dave helped me appreciate the value of greater depth of analysis about what my clinical input was affecting. Through them I also had the opportunity to participate in clinical research and to co-author some work. Dan has continued to encourage and support me through my career development in many ways. Most recently, he helped me with my transition from hospital to private practice. Sadly, Dave Krebs passed away a few years ago. Those of us who had him as a research advisor were very fortunate.

During the 10 years prior to opening my practice, I worked in an out patient satellite clinic of MGH. My supervisor, Jane Loureiro, has the most amazing skills in observation, palpation and manual treatment. She taught me many things about being a better clinician, and helped introduce PRI methodologies to our MGH colleagues by understanding how to integrate them seamlessly into her own practice first. She had noticed elements of PRI patterning in her patients for years, and embraced the unique ways PRI could approach these issues.

 Who have been your mentors within PRI?  

First of all, let me thank all the people in the PRI network who kindly answer my phone calls and emails. For me, not having another PRI-trained therapist nearby has been the biggest challenge in my process of studying and applying a PRI approach to my patient care. The wisdom of the Institute in allowing certified therapists to retake courses at a discount and to participate as lab TAs has also been incredibly valuable.  The time spent has allowed me to develop a network of friends and colleagues who I can call to brainstorm and to share patient successes and frustrations. My first and most dear PRI colleague is Karen Taylor Soiles. Jen and Chris Poulin have opened their home and practice to me so that I could see how PRI can be integrated into many layers of care. Mike Cantrell must have the most patience of all and I truly appreciate every question answered and PDF shared. It’s amazing how many questions are answered by “side lying hip lift”! And then of course there’s Ron for whom I have the utmost appreciation for being willing to share his ideas and be a supportive friend to all of us.  Thank you Ron!

How do you go about mentoring others in your profession?

Being the only PRC in Massachusetts has its pros and cons. The greatest benefit is that people interested in PRI call me when they want to observe treatments and geek out. I have had the privilege of being visited by PTs, strength coaches, personal trainers and all sorts of students. My clients enjoy learning from a wide variety of practitioners, as we discuss their case. When I was at MGH, we hosted 3 PRI courses. In addition, I have been a lab instructor at courses hosted by Northeastern University and Central Mass PT.  I have also been invited to present PRI topics at the sports performance departments of local universities.

What types of activities do you enjoy doing in your free time?

Besides going to PRI courses and reading manuals? I absolutely love to hike in the White Mountains of NH year round. The views from the high peaks are spectacular! I also enjoy kayaking, bike riding, skiing, quilting and cooking. Ah yes, and the value of an afternoon nap.

How did you become interested in PRI® and when did you attend your first course (you can also talk about your educational/professional history that led you to PRI)?

It’s a funny story, really. It starts with the fact that I am kind of a CE nerd; I always wanted to continue to be the best PT I could be, so I was always taking CE courses, and my focus for many years was getting certified as a manual therapist, so a lot of my training was with the North American Institute of Orthopedic Manual Therapy. I received my certification and got my OCS from ABPTS.  Our company, Olympic Physical Therapy had a strong reputation in the area for high level therapists, and we were always hosting CE courses. Somehow (I can’t remember how it got on our radar) in 2010, we got signed up to host Myokin and as usual, I signed up to take the course (being the CE nerd I was..). The week before the course had been a stressful one and the day before class started, I said to myself, “I need another hip/lumbar spine course like I need a hole in the head. I’m beat; I don’t want to go.. but I’ll go and if it’s lame I won’t go back on Sunday”. Well, needless to say it was Myokin with James and Jen and it blew my mind. It was such a refreshing paradigm shift for me, I had to go back for more. I came back after that class, and told all of my staff that they needed to take the classes…and the rest is history! We are the first, and only, Postural Restoration Center in Washington state!

I know you work as a clinic director, what are some of the benefits and challenges to getting your staff and other clinics in a corporate structure to get on board with PRI?

The biggest challenge is recognizing the importance of investing in sending support staff to CE/PRI courses. We often utilize support staff who have 4 year degrees in Exercise Science or Kinesiology to help PT’s with patient in exercise instruction. I feel it is crucial that these care extenders are on the same page with us. And while we do a lot of training in house, nothing compares to a course. When I was an owner of Olympic PT, I budgeted and paid for my staff to attend CE courses. Kudos to PRI to making their coursework open to allowing them to attend!

What would you say to people who are considering taking a PRI class or becoming Postural Restoration Certified™? 

For people who are considering taking a PRI course, be prepared to have your paradigm shifted a little (or a lot, depending on your background). The first course, I always say, is like drinking from a fire hose. It can seem overwhelming as you try to adjust your thinking. Sometimes just grasping the big concepts takes a lot of attention, so you miss some things. After a few classes, it starts to feel like you can actually drink from the hose, and after a few more, you begin to realize the water has a bit of flavor to it. And prepare yourself to have an open mind, and consider that you may want to take the courses more than once. I think I have taken Myokin about 6 times, including the times I have been a teaching assistant.

Who have been your mentor(s) in your career?

I have had a couple of mentors, but many inspiring minds. As a business owner and clinician, my first mentor was Craig London and his wife Marty. They are who truly shaped me as a clinician and a manager/business owner. Craig was always very eclectic in his treatment approach, which opened my perspective to a variety of treatment options. He was also our CE coordinator for the company, so he brought in a variety of schools of thought to make sure we had skilled, well rounded PT’s in the company. My business partners at Olympic Physical Therapy all contributed to my growth, and I have a friend and accountant named Tom who has always been a great business advisor. 

How do you go about mentoring others in your profession?

I feel my responsibility as a manager and a clinician is to lead by example and respect the individuality of each colleague and employee. We all are inspired by different things, learn different ways, and have different priorities and perspectives in life. Having a genuine respect for that, while eliminating judgement and getting to know people helps to be a more effective mentor. I try to be authentic in my interactions with others and show my passion for what I do, and if they are interested I help teach them in a way that they can learn. Taking time to practice techniques, talk over lunch breaks, teach study groups and inservices, provide resources, etc.

What were your problems with bringing PRI into an area that is so traditionally an orthopedic manual therapy part of the country?

It has grown so much in this area, I don’t think there were many problems!  I think the people who were open to a new perspective from our traditional treatment approach, really embraced it. Some were quicker than others, and some just didn’t find it to be their ‘cup of tea’, which is fine. To be honest, I think PRI is an amazing adjunct to orthopedic manual therapy! I blend them all the time together. I strongly feel that being a physical therapist with a large “Tool Box” allows us to adapt and treat a wider array of patients. There can be a place and time for all of it, which is why I loved being a CE nerd and have a long list of varied CE courses I have taken, from David Butler to Strain Counterstrain, to Manual Therapy and Taping, to Energy Medicine and Hellerwork, in addition to PRI.  Some people are just happy with their level of expertise as orthopedic manual therapists and aren’t into PRI. And that’s okay; they just refer their patients to me and my staff when they get challenged with their patients. They often can see when someone needs a PRI approach, and they appropriately refer out. The same way I refer out if someone needs a skill that I can’t provide. We all have the best interest of our patients in mind, not our own egos (hopefully!).

Which PRI course has been the most influential in your development as a professional? 

That’s a hard one. Because if I hadn’t taken Myokin to start with, I wouldn’t have started down this worm hole. But in terms of expanding my expertise, I would have to say Cervical Cranio Mandibular Restoration back in 2012. It has opened up the type of patients that I can successfully treat, and has expanded my referral base and professional network to dentists and orthodontists and sleep specialists and beyond. But I have to say, the first time I took Advanced Integration, my ability to synthesize PRI really came together. So all of those courses, for different reasons.

How did you become interested in PRI and when did you attend your first course? 

I first learned of PRI in the summer of 2006 from my friend and colleague Paul Meier, who at the time was the athletic trainer for the US Men’s Alpine Ski Team. He had a difficult time articulating the information to me that he had just learned at the Myokinematic Restoration course he had just taken, and I had a hard time comprehending the concepts, but he was very adamant that it made sense to him and that he had gotten some quality outcomes with the skiers he was working with since taking the course. This piqued my interest and I was signed up for my first PRI course (Myokinematic Restoration) that I attended in January of 2007.  

What do you enjoy most about working in professional baseball?

I think I enjoy working in professional baseball because it gives me an arena to connect and work with some pretty special people, both from an athlete standpoint as well as professional colleagues. There is a lot of travel associated with a 162 game MLB regular season, but it also allows me to connect with friends and colleagues across the country to talk shop, exchange ideas and visit different training and rehabilitation facilities throughout the year.

What would you say to other ATCs who are considering taking a PRI class or becoming Postural Restoration Trained™? 

I would highly recommend a PRI course to any performance or allied healthcare professional. I don’t think you can find a better educational value for your money when it comes to continuing education courses. It was really the first continuing education course that I took that helped me gain an appreciation for the interplay and integration of all of the systems of the human body. I also highly encourage athletic trainers and performance professionals interested in the PRI science to go through the PRT process. The combination of the application process, case studies, testing process, and roundtable conversation make for a great learning experience.

How do you integrate PRI Principles or exercises into your athletes daily routines?

There are a number of ways we integrate PRI exercises and concepts into the athletes’ routines. Some players will do PRI exercises as part of their routine prior to beginning weight room and/or baseball activities. Other athletes will have certain PRI exercises prescribed based on problems, conditions or patterns that they are currently working on managing. Other athletes will also perform some PRI exercises at the end of their day to help from a rest and recovery aspect. Another way that we will utilize PRI is when an athlete approaches us explaining certain activities that they have pain or perhaps challenges performing and this gives us the opportunity to educate the athlete on patterns and positioning. These types of scenarios breed an environment of “motivation through education” where the athlete will be more inclined to follow a program if it has been conveyed to them how it will help them in the areas they are seeking to improve.

Who have been your mentors in your career?

Throughout my career I have had a number of professional mentors who have helped shape me into the professional I am today. One mentor in particular that sticks out is Ken Crenshaw, the Head Athletic Trainer for the Arizona Diamondbacks. I had the great fortune of working with Ken for 8 years. He is a very mild mannered and selfless guy whose actions speak louder than his words. He leads by example and is the epitome of service, humility and integrity. He always speaks in “we’s and us’s” and not “I’s and “my’s” and the staff and athletes he works with always know that he has their best interest in mind. I owe a lot of my personal and professional growth to Ken.    

 Who have been your mentors within PRI? 

I met James Anderson and Allen Gruver in January of 2007 when Allen hosted a Myokinematic Restoration course that James taught in Chandler, AZ. I have maintained a great relationship with both James and Allen ever since. I have also had the pleasure of working with Ron Hruska over the years by taking a number of classes that he taught as well as working on a couple of special projects and programs that we have collaborated on over the years. Their guidance over the years has been invaluable in my continual appreciation for the science and application of PRI.

How do you go about mentoring others in your profession?

I firmly believe in a “pay it forward” philosophy. I have had the great fortune of having great mentors in my life, and I feel as though it is my obligation to share and pass on information with other inquiring professionals. I enjoy sharing my thoughts and experiences and exchanging ideas with other professionals that I work with or with colleagues who I connect with while traveling throughout the season. I also enjoy introducing young professionals to PRI because I would have done anything to be exposed to some of these concepts and courses earlier on in my career. I feel like I get as much out of these hands on shop talk sessions than anything else.      

What types of activities do you enjoy doing in your free time?

My hobbies include reading, mountain biking, hiking, backpacking, stand up paddleboarding, and traveling. I also enjoy spending as much time as I can with my wife, Laura, and my daughter, Liv.

In The News: SportsRehabExpert.com Teleseminar Discussing DNS and PRI

How did you become interested in PRI® and when did you attend your first course?  

I remember in 2001, very soon after moving to Maine from San Francisco, looking up information on the internet on breathing and the “core”.  I had been working with my patients for a few years on the work of Jull, Hodges, Richardson on their concept of “drawing in” to help recruit the deep abdominal muscles to help improve segmental spinal stabilization and biasing some of my intervention strategies on this approach.  However, I struggled with how to cue them on when and how to breathe when performing some of the activities, and “just breathe naturally” wasn’t cutting it.  I came to the Postural Restoration Institute’s website and saw pictures with balls and bands resisting different legs in different positions and some articles which I struggled a bit to follow.  I remember talking with one of my co-workers at the time and saying “I’m not exactly sure what it’s all about, but they are on to something”.  I took my first course, Myokinematic Restoration, in 2002 which was taught by Ron Hruska, and, much like most people, was blown away by the information and paradigm shift in mindset it produced. I haven’t looked back since.

How do you integrate Postural Restoration within your practice?  

Great question and certainly one I actually receive regularly from people—and one I remember clearly asking others early on.  For starters, it is the lens I look through when observing and assessing the human system and a strong basis of my evaluations with either rehab patients or training clients.  I have to develop a good idea of how patterned, compensated or pathologic they are….or are not.  I know this will influence how much tone they will be carrying, aberrant muscle activity they likely have, how it affects their movement patterns and so on.  
I also can’t not think this way anymore either as I have seen too many people over the years and had too much success with components of this science to not feel like it is a significant driver in people.  Much like I remember hearing Ron say years ago:  “Guilty until proven innocent”.  I have really developed my peripheral vision over the years as I am constantly watching my patients and clients and how they orient themselves, subtle shifts in movements, what their loading response is, etc. and this also helps a fair amount in helping determine how patterned they are, are they more of a top-down or bottom-up driven individual and other such concepts.  
Every person I see gets “The Talk” on breathing mechanics, some training and activities on proper breathing sequences, and I also educate them on the influence it has on movement and position.  I then work on getting them to be better positioned for the things I want them to do, through manual or non-manual techniques, depending on their needs.  For example, do they need to perform more supported activities early on to get going, can they start further up the hierarchical chain from an intervention strategy standpoint, or can they progress more from treatment to training.  While there certainly is a significant amount of overlap between rehab and training concepts, people are also at different places functionally, have problems or conditions which will affect what they can do, and also have individual goals that have to be taken into consideration.  That’s where the art plays a bigger role than science. 
I feel fortunate in having developed good manual skills over the years as well from a number of different approaches.  It has been quite successful in helping a lot of different problems people come to see me with and introducing the Institute’s manual interventions on top of this skillset has only helped me that much more.  Any hands-on activity I do is incredibly more successful, with better carry-over, and requires less work, when the person has a ZOA and is more neutral.  Period.  It’s a game-changer.
I also like the roadmap that PRI provides to the areas of the body that need to be better managed with an activity.  It provides a number of different things to look for and cues to use to empower the person to help them manage areas where they might be compensating or things they really should focus on more (reference centers, position changes, muscles to “find and feel”).  These extra tools are incredibly helpful and are quite powerful in the influence they have on results.  The educational aspect of a session with people is a critical aspect of carry-over and providing continued success in someone’s program.

It’s actually an interesting time for me professionally as I have moved away from the out-patient orthopedic physical therapy environment I have been in for the past 25 years and started a company called Integrative Rehab Training LLC (Facebook Page), where I am an independent contractor providing Fitness Rehab and Clinical Athletic Trainer services at two different facilities.  I share that because it has changed how I integrate PRI into practice.  I have complete autonomy in the services I now offer and as a result, have been better able to develop how I assess and provide intervention strategies.  For a long time, I often had to work to either treat someone more towards the traditional model or do some kind of hybrid intervention as my co-workers were not as familiar with—or familiar at all with—PRI.  Since I would be co-treating patients with others, I didn’t want to give patients mixed messages.  Now I am able to utilize all the different things I have learned, and work with patients one-on-one, to really create Integrative Rehab & Training.

I know that you also have a passion for writing and teaching, how do the concepts that you learned through PRI affect those two portions of your life?

Significantly.  I have been very fortunate over the years and learned some incredible things in this field from some amazing practitioners from a number of different disciplines and approaches.  This has given me an improved understanding, a well-rounded background, a solid set of strategies and an appreciation for the complexity that is the human system.  Because of different environments I’ve been exposed to, I’ve had to be able to speak to professionals with little to no exposure to PRI and therefore have had to develop an ability to have dialogue on a more common level.  This has carried over to my writings and lectures in that I can vary the depth of the information based on the audience I am trying to educate.  Introductory PRI concepts with less of the language or more in-depth concepts if the audience has some background.  I truly enjoy educating others and sharing things I’ve learned and PRI offers a lot more variability in information I am able to provide.

What would you say to people who are considering taking a PRI class or becoming Postural Restoration Certified™ or Postural Restoration Trained™?

I am certainly a bit biased, but I would definitely say go for it!  The information and education I learned early on in my career was very valuable in providing a baseline of understanding of the body and different assessment and intervention strategies.  It got me going so I could then go out and grow more in the field.  The Postural Restoration programs are an important part of that growth in order to get an improved understand of how all the systems work together.  While I feel strongly it would be beneficial for this information to be part of many health science’s curriculums, the courses offer a great educational opportunity to become better aware of the influences that are affecting our bodies.
With respect to someone getting their PRC or PRT, again, I would definitely recommend it.  When they feel they have a good understanding of the tenets and guiding principles of the Institute and they have had the opportunity to apply the different strategies for awhile, then absolutely they should go through the process.  The application and certification process in and of itself is an amazing learning opportunity.  For me, it also helped me gain more confidence because it made me recognize that the Institute felt I had an appreciation of the science to then go out and utilize it and educate others on it.

Who have been your mentor(s) in your career? 

At the very beginning of my career, there was an orthopaedic surgeon I worked with in New Hampshire named Jim Vailas who was instrumental in helping me recognize and respect the important aspects of being a health professional, working as part of a team, taking time to freely exchange information in our fields and how to be an important part of the community you serve.  
When I moved to San Francisco in the 90’s, I was the Coordinator of Rehab Services for an orthopaedic surgeon named Kevin Stone who had a fairly prestigious practice.  It was here that I learned a lot about surgical techniques and post-op care, cutting edge intervention strategies, publishing articles and doing research, working with high-level athletes and well-known people and organizations, and the multiple ways to help market a practice.  
Both of these people and the opportunities these environments provided were incredible times of growth for me early on, but the list of others whom I have learned from over the years is endless.  Whether it is through personal exchange, taking courses or reading information from them from different sources, there are a number of MD’s, DO’s, PT’s, OT’s, ATC’s, massage therapists, performance coaches, administrators, facility managers, front desk people, etc. that have all helped shape me professionally.

How do you go about mentoring others in your profession? 

There is actually a few different ways I go about doing that.  I am on Clinical Adjunct Faculty at the University of New England and have had an intern with me most semesters for the past 10 years from the athletic training department who are looking for a rehabilitation internship.  They definitely leave with their world a little shaken up with the paradigm shift they experience.  In an effort to teach, it’s kind of fun when they leave with concepts like:  “When you are taking your boards, this is the answer to this question, but the reality is that it really means this.”  I also lecture regularly at UNE for the athletic training students in the rehabilitation classes, in the physical therapy program and in the university’s dance classes.
I get together with people whenever I can, wherever I can, in small groups, one-on-one, have them come and observe me at my work and in other similar formats.  I like to think that the lecturing I do at different conferences, symposiums, and half- to one-day programs I teach also helps in that regard.
I also work very hard to make myself available to others through e-mail, phone, social media, etc. who might have questions or want some insight into something professionally.  It means the world to me to know I may have had a small influence on someone being better able to understand a concept or improve their skills.

Which PRI course has been the most influential in your development as a professional?  

Yikes!  Not sure I have an answer to that one as they all have their benefits and can all be taken multiple times and one leaves with a lot more insight each and every time.  I lab assist for any of the local primary courses I am able to and still learn things each time I am part of that.  Certainly the secondary courses really help further build and develop one’s understanding of the science that much more and tie together concepts from the primary programs.  They are also great opportunities to spend time with those who are a little further along their PRI journey so the dialogue and exchange of information is really exciting.

I know you love to be outside and active, what activities do you enjoy doing in your free time in Maine?  

Another long list, but certainly time with my wife Kay and my children Mitchel and Natalie tops the list.  I like to cycle, alpine and nordic ski, weight train, paddleboard, run, hike, snowshoe….essentially, I like to play.  I enjoy the ocean, lakes, mountains, city and all four seasons which is why Maine totally suits me because it has all of that!
 

How did you become interested in PRI® and when did you attend your first course?  

In early 2012 I was at a Craig Liebenson, D.C. seminar in Scottsdale, AZ.  when he  mentioned PRI as a powerful tool emerging in rehabilitation and sports performance.  I was intrigued to learn more about PRI!  I attended my first course taught by James Anderson in Scottsdale and quite frankly it “rocked my world”.  That course, Postural Respiration, changed my paradigm on rehabilitation, sports performance and my entire approach to chiropractic.  I discovered that PRI was actually more “chiropractic” than I could ever imagine considering its approach to neurology, alignment, posture and position of the human body.   PRI was really a breath of fresh air since I was able to drop some stagnant ideas and approaches that I had learned long ago and needed to replace.  I wanted to become and stay more relevant in this new world of rapid changes in healthcare and innovative approaches like PRI.   

How do you integrate Postural Restoration within your chiropractic practice?

 First, I think that the more tools any practitioner has in their toolbelt the better.  This is the 21st century and the advancement of sports and rehabilitation science is growing faster than anyone can imagine.  I am well versed in some of today’s most contemporary approaches to rehab and performance. From my perspective, PRI is the most powerful model for integrating  biomechanics, respiration and neurology.  I integrate PRI into an assessment program that tells me the unique issues a particular patient has then I provide a precise prescription for a technique that provides a specific solution.  This fits perfectly with a chiropractic practice.  In a short amount of time time you can gather a lot of information and provide treatment that will help not make your adjustment technique easier to administer but make it last  longer and more effectively. 

How do you use traditional adjustments that you learned in school?

I still adjust patients but with more ease and effectiveness when used with repositioning techniques with PRI.  PRI is just pure logic and observation based with tests that provide a baseline to guide treatment that the patient is involved with.  I prefer having my patients take an active role in their care vs. a passive one that just relies solely on manual therapy or adjusting.  
How much time do you spend with each patient?  It depends on the need.   I may spend as little as 10-15 minutes with a few of my patients but mostly up to an hour with many patients depending on their unique issue.  Having a powerful tool like PRI enables me to practice the way I want to and I am not dictated to by the insurance companies.  Patients have no problem paying out of pocket for comprehensive competent care.  I think this is the model that makes most sense moving forward for any practitioner, DC or PT.    

Do you do more exercise program than manual?

I use more exercise programming now, specific to that patient, than ever before. For instance, I am formally full body certified with ART but use much less manual therapy because of the effectiveness of PRI.  In addition, and this is just my personal experience, it is much easier on my thumbs and hands than using manual therapy!

I know that you are also a CSCS along with your Certified Chiropractic Sport Practitioner (CCSP). What kind of athletes do you specialize in training with your sports performance training?

 Pee-Wee  sized to professional athletes come into my practice with a large sprinkling of weekend warriors and aging baby boomers that want to move well and feel as good as they can!  I think my favorite athlete is at the high school level where the chance for good biomechanical coaching can be provided early enough in their lives and sports careers to make a difference.  Once a patient has been healed from a biomechanical issue or injury, I like to provide specific strength/functional training to provide a more solid base for prevention and durability.  I have learned more about identifying movement “faults” with PRI than any other approach I have used especially with athletes that have extension or rotation movement pattern issues (Which almost every athlete has!).

What would you say to other chiropractors who are considering taking a PRI class or becoming Postural Restoration Certified™?

Times are changing rapidly in the healthcare field.  We have a great profession with a lot to offer but after 35 years of practice I can say from a “chiropractic veteran’s” perspective we need to step up to the latest, most effective technology and science available and not be afraid to challenge every status quo and outdated notion in our practices or profession.    PRI is leading the way in rehabilitation and sports performance science and provides a scientific approach to treatment .  I have developed a deeper and more sophisticated appreciation for spinal, rib and pelvis mechanics which are driven by the diaphragm and nervous system than ever before.
The best career advice I can offer is to become a master at your craft and develop as much competence as you can by keeping up with a 21st century approach while letting go of old ideas from the last century!  PRI provides a perfect link of neurology, respiration and biomechanics of the spine and entire body that fits perfectly with chiropractic philosophy.  The PRC or Postural Restoration Certification is now available for those practitioners who have a passion for learning and want to be excellent and caring about their own competence and the wellbeing of their patients.  One more thing.  PRI is a science that takes time, energy and attention to be proficient.  Every step of the process is challenging and totally fun.  I challenge anyone that wants to have satisfaction on a deeper level and a more solid job security in their practice to attend a PRI course and pursue becoming Postural Restoration Certified.  

Who have been your mentor(s) in your career?

My first mentor is my lifelong friend Bob Sleight, D.C. who suggested I go to chiropractic school.  He was like an older brother who got me two great jobs in college.  He had a physical and mental toughness that I respected and admired.  I have never met anyone who read Dorland’s Medical Dictionary cover to cover and remembered it!   One of the jobs Bob got me was managing “Vince’s Gym” in the San Fernando Valley, CA.  He was leaving Vince’s and  he handed me over his post.  For anyone who remembers Vince Gironda, or the “Iron Guru”, it was a memorable experience that has lasted a lifetime!
The next job Bob also got me and introduced me to my next mentor, Dr. H.J. Terwilliger or “Doc.T”.  I interned with him my two last years in chiropractic school.  Doc T.  was generous with providing me with a salary that enabled me to work my way through school and showed me how to create a professional and friendly rapport with patients.  Dr. T was part of the “Greatest Generation” that came back from the World War II grateful to survive and eager to work.  In addition, he had a terrific sense of humor and I still use some of his “quips” today.  He had the attitude that you never stop learning your entire career and I am eternally grateful for the privilege of knowing him.  
Craig Liebenson, D.C. was instrumental in introducing me to Janda’s work and my friends Jeff Tucker, D.C., DABCR and Richard Cheung, D.C., ATC have been two key people in helping chiropractors become PRC’s.  Gray Cook, P.T. and Lee Burton, Ph.D provided me the opportunity to teach FMS to chiropractors and chiropractic students.  

Paul Hatherley Ph.D has been a friend and mentor for 35 years and has been vital in my success personally as well as professionally balancing the internal with the external aspects of career and living a meaningful life.  

How do you go about mentoring others in your profession?

I get many emails from not only D.C.’s but P.T.’s and ATC’s with questions about PRI, how to set up a practice in today’s healthcare environment and how to integrate PRI into a busy practice.  I hope that becoming the first chiropractor to “PRC”  inspires a whole generation of chiropractors to whole-heartedly put their professional efforts into the work of always expanding their “toolbox” starting with PRI.  If you are a team chiropractor for any sports team, amateur or professional, PRI is absolutely necessary for providing sound movement and durability. 

Who have been your mentors within PRI?  

My first contact with PRI was James Anderson and I must say that being in a class or talking with him about PRI is inspiring.  I heard him talk about this guy Ron Hruska who created the science of PRI and I thought who is this guy?  Is he a wild professor who is a creative genius?  Well, he is and Ron is the most friendly ,warm guy with a great sense of humor that you will ever meet.  Talk about a “teddy bear” of a great guy who is not only really smart but totally relatable as a human being!  Ron is a friend who is always interested in everyone he meets.  He has an innocent curiosity and warm sense of humor that is infectious!  
 Jennifer Platt has been a huge mentor for me in this PRI journey.  She has really helped with any and all questions, always returns a phone call and has tirelessly helped to bring chiropractors to PRI as well as everyone else.  She has guided me through the PRC process and is the behind the scenes force in PRI and everyone knows she is a major part of the glue the binds the success of PRI.  She has been one of my biggest supporters to help me become certified with the institute and further my career as a faculty member.
 I mention Mike Cantrell now simply because of the order of meeting my mentors in PRI.  Mike is one of the most talented people I have ever met and has helped me to grow in PRI knowledge in ways that would have not been possible had it not been for him providing long hours of breaking down slides and PRI concepts with me even when he was exhausted from teaching a course all day or travelling several weekends in a row.  I appreciate and respect his dedication to this work and am grateful for his friendship. 

As a chiropractor, which PRI course has been the most influential in your development as a professional?  

Wow that is tough since every course has had a huge impact on me.  Postural Respiration, when I first took it, intimidated me since it just shook up how I viewed the human body!  To think that the diaphragm and management of air affected every joint and every move one makes was such a revelation.  Myokinematics took me over the edge!  Those two courses spoke loud and clear to me that this is a significant science that has such an impact on patient care.  I also was a little sad!  I wished I had this knowledge when I first started practice years ago!  I didn’t want any more time to pass before I learned and understood more PRI principles.

You are currently training to teach Postural Reparation next year. What have been some of the highlights you have experienced in this training process?

 Another wow!  How about having Mike Cantrell, James Anderson and Ron Hruska as mentors in this process?  This is been a privilege that few people can imagine.  What I love about this process is that PRI brings professionals from so many disciplines and it is a big tent for us all.  It doesn’t matter what initials you have behind your name since everyone is simply there to learn from each other and share this science.  The big highlights have been getting to know some really smart, dedicated and super friendly human beings that care about being the very best at what they do.  What could be better?

What are you looking forward to most with teaching this course to health care and fitness professionals alike?

 Making a real difference for everyone I meet that improves their professional competence and personal satisfaction.  It is really satisfying to see the impact PRI has on practitioner and patient/client in terms of healing and performance results.   And, I want to share a “paradigm” shift with my profession to help chiropractors fulfill more of their potential by expanding their ability to be more masterful at providing the latest technology for patient care.  I also look forward to learning more from everyone that comes to a course, student or instructor.  I will always be a student even if I am teaching.  Again, what could be better?  

What activities do you enjoy doing in your free time in sunny San Diego?  

When I get a chance I like to go surfing at one of my favorite spots.  Hiking Torrey Pines is a must or going east to the mountains about an hour to hike in the “high country” is a favorite.  

Julie, tell us about the evolution of your career and how you ended up becoming so passionate about PRI.

It’s interesting for us to reflect back and try to remember where we used to be. The evolution of my career is a bit much so I apologize for my lengthy answer. My career has evolved through 3 states – PA, VA, and CA and I’ve had to pack up and start over 4 different times due to my husband’s military career and regional relocations.  Each move was a big transitional point for me to learn about myself, new cultures and meet new people who influenced my career path.

My career started off in the fitness industry, passionate about training and Pilates. I went through a phase were I was neurotic about my physique and worked out a bit obsessively. Resources I remember pulling from at that time were primarily the internet, magazines, NSCA publications and other general text books. These were fun years as “I didn’t know what I didn’t know”. I understood muscle actions and basic movement patterns, and was able to choreograph a creative work out as a Personal Trainer and Pilates instructor.

My understanding of the human body progressed as I worked various sports as an Athletic Trainer.  As an Athletic Trainer I started to get into Gray Cook’s Athletic Body in Balance, Stuart McGill’s work, and NASM’s publications.  These helped me get some strategic frameworks in place for looking at movement and doing assessments.  Being an ATC locked in my love for working with athletes. 

Physical Therapy school of course added to helping me understand the body in more depth and how to do assessments. Since becoming a PT in 2004, I’ve held various practitioner and management positions in both small private practice and corporate physical therapy outpatient clinics. I’ve always demonstrated clinical leadership and had an entrepreneurial spirit. I was in a clinical lead or director role since 2006 and I had my own business twice – one concentrated on training youth athletes in speed and agility programs and the other offered restorative and performance training and rehab services out of the Pebble Beach Resort – Beach and Tennis Club in CA. Currently I’m a regional manager for a large healthcare system and look after 4 outpatient clinics and 30 employees. These past 18 months in this role have given me a new perspective on leadership and mentorship, which I will be forever grateful. However, anybody that knows me knows I have always had a strong commitment to clinical care. I am looking forward to getting back into that full time and soon will be going through another transitional point in my career.

I was lucky to know early in my career that I wanted to specialize in sports medicine. I’ve recovered from 2 ACL surgeries, one tore playing high school basketball and the second tore years later playing beach volleyball. These injures shaped a lot of my learning and dedication to understand human movement. Both times traditional ortho rehab failed me. I remember being in my young twenties not being able to run without right knee pain. I was also having neck problems, and thinking “I’m way too young for this”. I was in great shape, lifting legs specifically to keep my legs (i.e. “knee”) strong 2-3 times a week, had “great flexibility” and “fabulous posture” as I taught Pilates classes a couple times a week… it makes me giggle thinking about the strong beliefs I had as a young professional, meanwhile I couldn’t run or turn my neck fully to drive… so embarrassing. But working with a lot of athletes and myself, I realized a lot of my patients were strong, had good mobility, and the dysfunctions causing their pain weren’t always that obvious. I needed to learn how to assess the body and movement at a deeper level.

Thankfully, I’ve always been a continuing education junkie. I thirst for new ideas and knowledge and drive my husband nuts with how much I like to push the educational envelope and spend on learning new things.  If there was a course series out there I’ve probably taken at least one of the courses from that series. And if I connected with what they were saying I’d take them all and repeat the courses until I fully grasped the material. Besides PRI, I did this with several other methodologies which I continue to incorporate into my practice today – various manual techniques, functional movement impairments, kinetic chain reactions, and other neuro based movement philosophies.  Ever since I can remember I’ve been the type that loved to learn and absorb as much information as possible. I’m attracted to difficult and challenging endeavors, which is probably what I found attractive about PRI – it wasn’t easy to learn.

Early in my PT career, after taking a few manual therapy courses I was determined to get a manual certification and become a “spine specialist”. I began to label myself as a hands on manual therapist. At the time, I felt extremity rehab was too easy for me and the advanced concepts taught in osteopathic manual medicine were new to me and challenging. Plus learning more spine rehab correlated well with my Pilates background. It was fascinating the improvements I could get quickly with manual medicine, but studying osteopathic manual therapy didn’t teach me much about movement and muscle function. I remember thinking at times I should have been a chiropractor. To help me understand movement better I dove into Shirley Sharman’s work and went to a bunch of movement analysis courses. I became fascinated doing gait analyses and saw the same dysfunction over and over again in these runners but didn’t really understand why.

A friend from Nebraska asked me to attend a PRI course with her. I didn’t know much about it, and it sounded interesting so we drove up to DC to attend our first course. James taught that course and I’m pretty sure I was lost 80% of the time. But as a committed learner, everything and anything I learned I would try to spend time applying it right away in the clinic with my patients and clients. In doing that with all the courses I went to, nothing rocked my world as much as PRI. I saw things happen that I couldn’t explain. Joints and mobility were unlocking without my mobilization. PRI was challenging me and making me think and apply anatomy and biomechanics very differently and strategically.  

Even though I liked PRI from the start, I wouldn’t say I applied it correctly right away. It was defying many of my beliefs and how I was taught and currently practicing at the time. I was intrigued to keep learning more about it but didn’t understand how it was going to fit in my practice style. The main components of PRI I started using daily were the manual techniques because I had considered myself a “manual therapist” and it was easy for me to incorporate those techniques into what I was already doing. It wasn’t until after several PRI courses that I became fully devoted to diving into the material and trying to figure it all out. The more I started putting the courses together, the more devoted I got to the material and realized how I was over utilizing manual techniques. When I did PRI with the patients, I could empower them to get more involved and less dependent on me. I liked that.  After a couple years of practicing PRI I saw the true value in it and enjoyed how it was piecing together relationships that I had intuitively figured out and saw doing manual work. PRI was also helping me understand the whys and how certain patterns were developing in people which I had been seeing repeatedly for years. The more I learned about PRI, the more fascinated I became in understanding the system fully.

Something some people may find interesting is, I remember going through a phase constantly failing at incorporating PRI into treatment programs successfully. I remember getting frustrated daily and wanting to abort PRI because I felt my life was so much easier before I ever learned it.  The more I tried to ignore the patterns the more they haunted me and kept showing up. I literally knew just enough to drive me crazy. One of my employees recently told me about this quote “Nobody changes until the pain of staying the same, becomes greater than the pain of change” and this describes this part of my life well. The pain caused me to push harder trying to figure out what I was missing and why this PRI stuff wasn’t working for me. Looking back I can tell you it was because I couldn’t let go of some of the traditional beliefs that had been pushed down my throat for years. I was trying to mix PRI in with too many of my current practices, and I was trying to rush the “fixing” of the injury. I was not addressing the whole person, their behaviors, and habits that were driving the imbalance in the first place.

Since 2008 I have attended over 30 PRI courses and PRI is the main objective framework I use today to evaluate anatomical relationships three dimensionally. Even if the patient or client is not a candidate for traditional PRI activities I still use the tests to help me understand their biomechanical patterns and muscle balance and may incorporate PRI principles into their treatment while using other theories, modalities and interventions. It took me at least 4 years to get to the unconscious competence level of using it and that continues to be fine-tuned today. I believe once you understand the patterns and their deviations, it’s virtually impossible to look at the human body the same. Additionally, once you become good at understanding what the tests mean, it makes evaluations and screening people more efficient and effective — so much easier on you as a clinician!! PRI gives me direction and helps me identify where and what to concentrate on first. This is one of the reasons I am so passionate with sharing the material.  I believe it truly makes our jobs easier once you get through the tough stages of learning it.

What are the principles that have guided your professional development at each phase in your career?

Keep learning. The more you learn about the human body, the more you should feel like you don’t know. We are so much more than an orthopedic system of bones and muscles. The neuro system always wins, and the only system that has a chance to compete with it is the respiratory system.

Good posture is not about standing up tall. Posture is dynamic, three dimensional, and an interconnected linkage of parts and relationships. What happens in one area, has to produce an opposite reaction somewhere else. Learn the relationships and patterns associated with the three planes of movement and stop chasing pain.

It’s ok to be different. Be true to yourself and don’t worry about pleasing everyone else and fitting in with the mainstream crowd. You just need one person to believe in you and help you through adversity. If you figure out what your personal values and beliefs are and get yourself grounded in those, you will start attracting likeminded people into your life who you can team up with – which makes practice, work, and learning so much more fun and enjoyable!

Don’t get caught up in drama, egos, and negativity – certain people will always have an opinion about PRI because they’re paradigms don’t allow them to see the value in it.  If you see the value in it, my recommendation is not to associate with them or waste too much energy down this road. The fact is the Institute will continue to keep growing and the truth will come out in the end. There is too much integrity within this system and it is deeply rooted in principles and natural laws. It will preserve through judgement and each year we continue to watch PRI grow.

Periodically evaluate your effectiveness as a therapist, trainer, and leader. Are your patients and clients getting the results that they came to you for? Are you getting these results efficiently and repeatedly? Seek out honest feedback about your current practices– when patients or clients are not responding to your programs – are you looking at what you may be missing or are you blaming them? If people disappear off your schedule or stop showing up do you seek out feedback to understand why?

I believe it’s more effective to learn one system at a time than trying to learn several systems at once. There was a point where I was trying to do too much and trying to mix PRI with my own beliefs or other systems that didn’t share similar values. All this did was complicate compensations, muddle the pattern, and camouflage the key objective measures that were telling me the direction I needed to go. I’ve seen this same struggle in people I’ve mentored.

Get effective at applying the basic principles. When things get confusing, go back to applying and perfecting the basics. Oftentimes cleaning up the basics is all the client’s needs, but it’s easy to travel down the “up and coming” road and to not be patient and consistent enough with applying the basics. Perfect your application of the basics principles.

Being an effective professional means knowing your own blind spots. You need to know yourself, to grow yourself. Knowing yourself doesn’t mean trying to fix your weaknesses as much as it means knowing your strengths, when to capitalize them, and when to silence them. All strengths can be a weakness when pushed out of balance or when being used at an inappropriate time.

Knowing yourself and your strengths makes you a better team player to synergize and produce results larger than you can do alone. Building your team doesn’t mean pairing up with people that think exactly like you. The best synergy and teamwork comes when you bring different specialties together who respect and value each other’s differences. Learning how to work with other professions is crucial for long term success.

You are currently working to develop an affiliate course with James Anderson titled PRI Integration for Fitness and Movement. How has your background helped you in the development of this course?

Without a doubt I can say the variability in my career has helped me take a well-rounded approach with developing this course. I have been dedicated to understanding the various paradigms that people view fitness, performance, movement, and PRI. James and I have consulted with many people across the country. I think I’ve become a better listener through this whole process – well I at least tried! I tried to listen and understand the language and trends amongst these professionals and piece together ideas and viewpoints while looking for opportunities to help people piece together PRI, apply it more ethically in their setting, and identify the underlying themes seen in the industry.

I also highly respect the differences associated with different professions and also have a strong passion for making interdisciplinary care and a team approach work. I believe trainers, coaches, therapists, dentists, and doctors can and should creatively collaborate and synergize expertise to work together to improve the health of our communities and each individual we serve. With this passion, I’ve witnessed and experienced the struggle with communication and associated contention due to too many professionals being used to working in silos. When I say communication, it’s not only communicating about PRI, but also being able to communicate in one universal language that can be understood amongst various professions. I hope my passion for interdisciplinary care and my ability to explain complex concepts in a common language will help others communicate better. I am passionate about teaching and talking in a language novice and experienced PRI professionals can relate to and respect.

What have you learned during the process of developing this new course that you would like others to know?

That there are a lot of “right ways” out there to do things. I’ve learned that a lot of people have strong opinions and that our industry is and will remain quite versatile. There are many different paradigms which “experts” look at movement and view fitness. We can all learn from each other. I don’t think any one method or any one person has all the right answers. One ironic thing I realized is many disagreeing people are saying the same thing and just using different words to describe the same basic principles and similar concepts.

Also you can overdue everything. Every theory or method can be taken to an extreme and be made out to be something it’s not, including PRI. Oftentimes we don’t need to go down these extreme paths, but instead we need to get better, more consistent, and more patient with applying the basics.  I hope this course will help more people understand the value in staying rooted in foundational basics of PRI, elaborate on our understanding of those basic principles, and influence health in our communities in a positive way. 

What do you feel course attendees will benefit from the most after attending this new affiliate course? (Some teasers for the course here J)

I know that this course will help attendees piece together PRI and help them apply it in a more systematic way to the everyday movements which are taught more mainstream. Attendees will be presented a framework to look at and understand trunk stabilization and “the core” at a whole new level. This course will also help attendees look at gait and various planes of three dimensional movements. We will break down flexion and rotation in a whole new light learning the value of keeping the core dynamic through a PRI lens. I think the concepts taught in this course will also improve the language that is associated with PRI and will help people discuss principles of PRI more universally and comprehensively. Lastly, we are going to discuss the differences between fitness and performance especially how performance enhancement is specific and multifaceted. I hope that the course attendees will learn how to sneak PRI application in more often in their programming and into their conversations with colleagues that don’t know anything about PRI.

Who have been some of your mentors in your career? How have these mentors helped you become the clinician you are today?

Many various people have influenced my career at various stages. Early in my career the Director of Sports Medicine at my college, Saint Francis University, believed in me and encouraged me to sit for the BOC ATC exam. This had opened up many doors of opportunity and gave me great experience working the athletes and developing a love for sports medicine at an early age. My first Physical Therapy job was also a great experience. I had a great first boss and the owners of that private practice taught me a lot.  They molded my work ethic, allowed me to go to a ton of continuing education courses, and helped be develop efficient manual and sports medicine skills.  This experience shaped a lot of my core business beliefs I have today. Another good friend of mine was a business owner who also believed in me and encouraged me to do things differently. She mentored me and helped support me through the challenges of moving for my husband’s career and encouraged me to open up my own business. In the PRI community, Mike Cantrell and James Anderson have been my biggest mentors. They’ve answered so many of my random questions and I can’t thank them enough. I wouldn’t be where I am today with PRI without their mentorship. Lastly, I would have to say another mentor would be my most recent boss and the visionary leadership of the healthcare organization I’ve worked for over the past 18 months. They taught me the value of making sure you have systems and processes in place to drive long lasting results in your business and influenced my beliefs on how to grow and mentor employees and how to run efficient sustainable operations.