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

I became interested in PRI after working at the University of Nebraska as an Intern-Assistant Football Strength Coach from 2002-2008.  We incorporated repositioning exercises into the lifting warm-up.  In 2011 I tore my right ACL and from other damage in my knee had an OATS procedure done on my lateral femoral condyle.  Toward the end of my rehab, I was still having difficulty during basic activities like going up and down stairs, stepping off a curb, getting in and out of my car, trying to jog was painful, just an overall feeling of something not being quite right with how my knee was functioning in general.  I made an appointment with the Hruska Clinic not really knowing what to expect, or how they could even help me.  Dave Drummer was my PT, and the inability for my body to perform certain tasks was a HUGE eye opener for me.  The difference I felt in my mechanics was immediately noticeable and was hooked.  I knew this was something I needed to learn for myself to incorporate with my background in strength and conditioning.  While I was a patient I started looking into the credentialing process of becoming a PRT.  I started by taking the Myokinematic Restoration home study, and then the Postural Respiration home study.  While I was going through that process I started personal training at Aspen Athletic Club, which now is Gold’s Gym here in Lincoln, Nebraska.  I had roughly 30-35 clients before I became a PRT, and now I range from 60 to 75 clients.  I have been applying PRI concepts into my exercises for three years now and I am becoming more integrative with every client.  I really cannot stress enough how big of a resource it is having the Postural Restoration Institute and the Hruska Clinic right down the street from the gym where I personal train.   

What is your typical client population and how are you incorporating Postural Restoration™ into your client’s programs?

My client population ranges from 12-88 years of age, with most of my clients ranging from 45-75 years of age.  I try to incorporate as many standing/upright activities as I can while establishing correct reference centers on EVERY exercise.  I do a lot of single arm and single leg alternation and reciprocal movement exercises. 

What is the response that you receive from your athletes and clients regarding your designation of PRT™ and incorporating PRI® principals into their work-outs?

When I first meet with a possible new client, normally they have an issue ranging from low back pain, knee pain, hip pain, shoulder pain, neck pain, plantar fasciitis, shin splints, patella tendonitis, IT band syndrome, hip flexor hyperactivity, shoulder impingement, or a hyperactive neck just to name a few.  I simply start by going through my algorithm of tests to show the person what limitation is causing the discomfort and then show them a repositioning exercise to improve, or limit the ROM I am looking for.  The response is tremendously great!  When you can take some ones pain away through a more functional way of moving, they are very appreciative! 

What would you say to others in your profession who are considering taking a PRI class or becoming Postural Restoration Trained™?

What are you waiting for!  If your passion is working with other people in improve their life style, then PRI is the foundation you MUST have!

Who have has been a mentor(s) on your PRI journey and how do you go about mentoring others in your profession?

I use Dave Drummer as key resource.  Any clinician at the Hruska Clinic is very helpful.  Ryan Hruska is a good friend of mine I use as a resource also.  Ron has been great!  He has taught most of the courses I have taken.  The Hruska Clinic does a great job of showing local personal trainer little tips on how to do certain exercises better.  I teach my fellow trainers at the gym and I know they learn a lot from me by watching the exercise I do and knowing the importance of why I do certain exercises the way I do. 

How has PRI been accepted within the company that you work for and what other advice would you give to fitness professionals that want to incorporate PRI into a chain fitness organization?

PRI has been greatly accepted!  You simply cannot deny the results!  And from a business stand point when you can show immediate results it’s always great for business!

In your profession what course has been the most influential in your development as a professional?

The Pelvis Restoration course really brought the Myokinematic Restoration and Postural Respiration courses together for me.  I use a lot of the Impingement & Instability course references quite a bit.  Since recently taking a Vision course with Ron and Heidi, I have learned to transition from finding and feeling a reference into functionally using that reference to guide and control the movement of the body forward. 

You recently returned from Great Britain consulting with professional golfers.  Tell us how this came about?
I was contacted by Kevin Duffy in the spring of this year.   Kevin is a golf fitness specialist in England who owns Duffy Golf Fitness and is integrating PRI with his professional golfers on the European Tour.  At that time he had a player who had won two tournaments in a row and he was strictly performing Postural Restoration exercises for his fitness program.  Kevin is pretty much self-taught in PRI through a combination of the home study courses and studying the manuals that he’s purchased. Through his own research, Kevin found out that I was heavily into the application of PRI and how it relates to golfers and we hit it off right away.  We began communicating through Skype on a regular basis and I would help him understand the when and why of how to progress his players programs with PRI.  About a month after we began communicating on Skype, he invited me to England to help him evaluate his players and design treatment programs based on their PRI assessment of feet, pelvis, brachium, neck, dental and vision.

Early mornings at the office in St. Andrews.

You went to a professional tournament immediately upon arriving, how was that?
My first assignment was to evaluate several of his players in St Andrews while they were there playing in the Alfred Dunhill Links Championship.  This is a pro-am tournament much like our AT&T in Pebble Beach so it had its own challenges.  First of all, the tournament is held at three different courses and the cut is made after three rounds.  Together we took a few players through an entire PRI evaluation including PRI orthotics and mapped out a plan on how to progress each one of them using strictly PRI repositioning, inhibition and strengthening techniques.  It was challenging to meet them during the pressures of a tournament but it was also great experience.  Talk about compliancy! Kevin had done a tremendous job getting the lads to appreciate left AFIR and insisting they feel a left glute med.  I had a tremendous amount of pride for PRI given that here was a very intelligent English trainer who completely understood the concepts of PRI and how to apply them and the players themselves were meticulous in performing the exercises.  Our typical days during the tournament were spent getting the players ready to play with some common stretches like left posterior outlet inhibition, right adductor inhibition and right apical expansion.  After their rounds they would return for a treatment session which consisted of manual work and corrective exercises based on how they presented that day.

Taking impressions for PRI orthotics in the parking lot at St. Andrews!

After the tournament was over, how did you spend the remainder of your trip in England?
We drove from St Andrews on Sunday, September 29^th to Manchester, England.  Manchester is where Kevin lives and will be opening his own office in the next couple of months.  The next few days were spent evaluating players for PRI orthotics and progressing their treatment programs.  We would either see the players at a golf course in Leigh, travel to their house or
work with them at Pete Cowen’s driving range in Rotherham.   This was considered an off week for the players so all of them were very relaxed and motivated to work on their individual PRI programs.  Most of the players that we worked with were under 30 years old and had already developed a significant amount of back pain as a result of playing golf in a patho-PEC pattern.  One of the players took 16 weeks off, worked with a Physiotherapist on traditional exercises only to return with the same amount of pain.  After working with Kevin for a short period of time he is now playing consecutive weeks, making cuts and feeling very little back discomfort.

Special thanks to Mike Walker who allowed me to observe him at Pete Cowen's driving range.

Was there any difference in working with the professional golfers in Europe vs those who you treat in America?

When you work with professional golfers, you have to be very sensitive to impress upon them that you are not going to affect their swing.  Most of them have swing coaches, putting coaches, sports psychologists, physiotherapists, trainers and wives or girlfriends.  All have a role and it is your job to get their bodies functioning in a way that will make their golf swing more efficient but most importantly keep them off the injured list.  PRI is the perfect complement to golf because most players and good coaches know golfers need a right glute max, left abdominals, left adductor, left glute med, serratus anterior and right upper trunk rotation.  I had some great dialog with Mike Walker who is a golf instructor at Pete Cowen’s range in Rotherham.  Mike and Pete both understand the concepts that we are applying with golfers but didn’t know that the challenges that right handed players face is that we all have an underlying pattern of asymmetry that makes some of their teaching very challenging.  For instance, Mike talked about the need for the upper arm (humerus) to be centered in the socket (glenoid) at the top of the backswing.  We know from a PRI perspective this is nearly impossible if you are in a right BC pattern, which most golfers are.  Kevin can make Mikes job as an instructor much easier if he can neutralize the players left AIC and right BC chains.  To my knowledge, these concepts are not taught in any other golf fitness or rehab program in the world.  It is refreshing to see that players in Europe are getting great results with PRI, but now it needs to become more main stream on the PGA and LPGA tours. 

Kevin Duffy and physiotherapist Martin Higgins at King Barns.

What does the future hold for your new venture in England?
The response from the players was such that they would like to see me come back periodically throughout the year.  Kevin and I are now planning perhaps five trips next year to follow up with the players that are currently in his system and help recruit new players into the pipeline.  Kevin is teaming up with Martin Higgins, a Physiotherapist who has also been studying PRI and they plan to open an office in Leigh, which I hope to consult on.  We are also working with the Postural Restoration Institute® to offer the first ever PRI course in England.  Sometime in July of next year around the British Open, my wife Jen and I hope to travel to England to offer Myokinematic Restoration and Pelvis Restoration courses.  Jen will teach and I will relax and play golf, just kidding.  The Open is at Royal Liverpool, not far from Manchester so this will allow us a chance to travel to Scotland to see our relatives and work with the players to help get them ready for The Open.   Stay tuned for those details. 

Can you share the names of the players who you worked with?
Out of respect for their privacy, I cannot give details of their conditions or patterns but I will share their names.  I would like to thank all of them for being very hospitable and for welcoming me into their lives for the week.  They are Matt Baldwin, Danny Willet, Tommy Fleetwood, Dave Horsey, Stephen Gallacher, Lee Slattery, Brett Rumford, Alejandro Canizares and Paul Waring.

St. Andrews, the birthplace of golf!

You moved this past year to Pinehurst, NC. Tell us a little bit about your new business, Sandhills Sports Performance?
This past year was a bit of a transition year for us. I have opened a new practice with a strong emphasis sports performance and rehabilitation. This practice allows me the opportunity to consult with a very diverse client base from retired golfers, Special Forces, high school athletes, professional baseball, physicians and middle age women looking to be in the best shape of their lives. I spend most of my days focusing on athletic rehabilitation in the form of helping golfers with bad backs. This usually involves looking at their swing on video and breaking down the biomechanics. I’ve also had success involving a K-vest system which quantifies the amount of movement that golfers have throughout the swing. There is a large military base in Fayetteville and many of the Special Forces and their families seek out postural restoration services both for performance and rehabilitation. Around here, Crossfit is popular and it’s typical that those participating in Crossfit are in a strong PEC pattern. It’s been fun integrating PRI into the programs of some of these athletes to allow them to continue to train the way they want but with respect for pelvic position, rib cage orientation, respiration and stance. The move to Pinehurst has allowed us to expose a new community to PRI, yet be accessible for consultation opportunities when they arise. 

What was your first introduction to PRI?
I was introduced to PRI while receiving PT as a DPT student at the University of Minnesota. My PT had spent a clinical rotation at The Hruska Clinic and was able to correctly identify the imbalance in my thigh muscles as the source of my chronic knee pain. It was very validating to learn about my very inhibited hamstrings since I could never believe that my quads were weak (as my referring sports med doc had suggested) since I was bike commuting daily and had originally injured my knee from training for bike races years prior. In PT, I distinctly remember my body loving the 90-90 Hip Lift PRI technique, but experiencing pain with the traditional PT step-downs. With this small introduction to PRI, I was hooked. My body resonated with PRI and I paid attention to that. 

I took Myokinematic Restoration with Ron while still in grad school and it was love at first adduction drop! I was in awe of this rebelliously “zoomed-out” work and of its magnanimous and brilliant founder immediately. Since none of my clinical instructors had PRI training, it wasn’t until my job at Courage Center St. Croix in Stillwater, MN that I was able to use PRI with my adult outpatient clients. Referring physicians practically threw their patients with chronic pain into the warm-water pool there. These clients were eager to try anything that might help them and PRI fit the bill. The successes there spurred me to get out of the pool and pediatrics, and to move back home to Oregon to work at an outpatient orthopedic clinic. While there, I was able to study CranioSacral and visceral mobilization to augment what PRI could offer.

Tell us a little about your clinic, Shine Integrative Physical Therapy.  As a young clinician, why did you decide to open your own practice in Portland, OR, which also includes a Yoga studio?
Physical therapy clients need time to be thoroughly heard, assessed, and educated as well as be instructed to correctly perform therapeutic activities and receive manual therapies (especially CranioSacral). Physical therapists need adequate time to assess their clients and treatment outcomes, as well as communicate with other health care team members, produce accurate documentation, and more. I never felt I could do this under the appointment time and business constraints at the outpatient orthopedic clinic I was at.  So I left and opened Shine in June 2009. I chose the name Shine because of the optimism, joy, and empowerment the word embodies and because it hints at the spiritual aspect of true healing.

One of my main intentions in being on my own was to avoid the burn out I felt at the last clinic I was at. This meant prioritizing my overall health, creating sustainability, and maximizing my job satisfaction. One way this manifest was scheduling 1-hour appointments with a short break between each client. This is definitely against the typical “squeeze every billable unit out of the therapist’s schedule” business model but considering that I was doing everything in the business by myself and was learning everything as I went, it worked very well. The schedule is the same now as it was then and I don’t have any plans to change it. Clients deserve to be treated in a space that is vibrantly calm and filled with healthy, practitioners who are genuinely happy to be there. That is exactly what clients find at Shine.

After expanding and moving Shine twice in the first two years, I was blessed to receive a full build-out our current clinic and studio. Shine now employs two physical therapists, a clinic office manager, and a studio manager. Our independent contractors provide acupuncture, massage therapy, and Rolfing services. At least 30% of PT clients receive concurrent treatments of acupuncture, massage, or Rolfing. Many of our PT clients are referred to a yoga class during or after their rehab. With 22 classes per week at the studio, our practitioners can prescribe specific levels and types of therapeutic yoga classes for our clients to attend. Our entire team of practitioners and yoga instructors embrace PRI and this makes for very successful integration of services for Shine clientele. 

How has your clinic been able to succeed in the constraining healthcare environment?
It is easy to get discouraged with the multiple constraints and limited reimbursement in our current healthcare environment. Much of what keeps Shine afloat financially is the online service integration (scheduling, billing, documentation) that we have from AthenaHealth, a fantastic accountant, and optimal insurance contracts from the Northwest Rehab Associates (NWRA). I am lucky to know a world-class graphic designer who created an eye-catching logo and an effective brand identity for Shine.  This helps to make our marketing efforts more cost-effective, efficient, and enjoyable.

Obtaining consistent referrals from a broad and diverse network is a major reason we succeed. Many of our clients hear about us from their community yoga teacher, massage therapist, acupuncturist, or personal trainer.  As PRI-educated therapists, we refer out to like-minded professionals and find that the dentists, vision therapists, and other health care practitioners return the favor. Partnering with our in-house acupuncturist and massage therapist as well as the yoga community has allowed for a steady flow of clients in both directions.

Hands down, our biggest referral source is our clients word-of-mouth. We are very fortunate in that Portland is a tremendously health-conscious and active city.  Our clients want to be treated holistically and not as a body part so they are immediately resonate with our approach. A much higher percentage of our clients are self-referrals and end up telling their physician about us versus the other way around!

How did becoming a PRC therapist benefit you as a clinician and your practice? Any advice you would give to those who are considering the PRI credentialing program?
I would advise those considering the PRC to do more than just consider it. This process is so very challenging and rewarding that you can do nothing but improve by pursuing it. From the reviewer feedback on my application to the testing itself, I was validated and uplifted throughout. I observed my clinical reasoning skills congeal in a very efficient way. I especially enjoyed finding research articles that supported PRI, analyzing my case studies to see how I can improve as a clinician, and being with PRI staff and my fellow PRCs for a full week. The camaraderie was unimaginably strong and we all had so much fun, despite the stress that we put on ourselves. I felt as though was tapping in to this incredibly supportive community of very wise, caring, and passionate individuals. Even from my first class, but more now that I have earned the PRC, I sense this immense connection within the PRI family. This support lifts me up everyday and it seems to have magnetized a number of wonderful opportunities my way, including this interview, writing a chapter in Kyndy Boyle’s upcoming book, and hopefully the opportunity for teaching someday.

Another benefit of the PRC program is the sense that our clients are reassured by the clinic’s PRC status. It communicates that we are committed to this PRI work and –even if they don’t quite know what that means- it piques their interest. Another great benefit is access to all of the PRC updates and perks. I am always thrilled to see what PRC updates Jen has accumulated for us with her frequent emails and the PRC site. I use these resources extensively for patient handouts, presentations for referral sources, and research for staff in-services frequently.

Tell us a little about your Yoga background, and what you are currently doing with Yoga. How have you been able to integrate Postural Restoration® concepts into your Yoga classes?
I found yoga during my sophomore year at Oregon State University. There was a deep sense of imbalance from the compensation of running on a torn right meniscus for over one year pre-operatively and not receiving rehab post-operatively. So, I sought out a local studio and really liked how the practice provided a balance of fitness components including cardiovascular, strength, flexibility, and relaxation. Between learning all the new physical postures, I began to recognize and appreciate the more subtle aspects of the practice, too. Linking your breath to a particular pose to flow through the sun salutation and exploring the lower, middle, and upper sections of the lungs in 3-part breathing are two examples of ways I felt the spiritual practice embedded in each class. Yoga means union, and I experienced a felt-sense of this.

Unfortunately around that same time I found yoga, a well-meaning PT at a clinic I worked at as an aide told me that my knee pain was due to tight hip flexors. With that in mind, I allowed my yoga practice to become primarily focused on hip flexibility. Without a thorough assessment of what my true issues were, without a consistent teacher (poor college student), and with a competitive background to boot, I inadvertently created the dreaded pathomechanical PEC pattern in my body.

After earning my DPT, I took two 200-hour yoga teacher trainings and I taught to regular and specialized classes, including to kids with special needs and prenatal, as well as anatomy and therapeutic workshops. I integrated PRI concepts into my classes and eventually into teacher trainings I have been invited to present at. I studied yoga philosophy and resonated with the many rehabilitative concepts speaking from yoga’s ancient texts. Statements like “your connection to the Earth (asana) should be steady (sthira) and easeful/joyful (sukham)” sounded a lot like Ron encouraging us to get our clients neutral and stable so they could rest and feel better.

After the Pelvis Restoration course in March 2011, I put my yoga practice on hold to commit to resolving my patho PEC and bilateral BC patterns. Now I am back practicing in a more skillful way than just stretching out my hips! Last February, I began a Postural Restoration-Inspired Yoga class at Shine Yoga. This class is specifically sequenced in a way that optimizes Right AIC while inhibiting PEC, BC, and Right TMCC patterning. In each class, I integrate PRI tri-planar activities, emphasize zone of apposition, Left AF IR, and PRI reference centers. I emphasize some of the many yoga principles that complement PRI, such as: drishti (steady gaze), kumbhaka (pause after exhale), “back-body” (posterior mediastinum), mulabandha (optimal pelvic floor tone), alternate nostril breathing (to balance the left and right sides of the body), and relaxing visualizations to calm the CNS. The students are enjoying returning to postures that used to hurt them before finding PRI.

Unfortunately, despite significant overlap in the intentions and healing potential of PRI and yoga, many PRI clinicians and other healthcare practitioners only see the results of Western culture’s body-obsession that passes as yoga today. Namely, the physicality of yoga has been over-emphasized in the US. As I’ve briefly mentioned, there is so much more to yoga and regardless of the style of yoga one practices, the student will undoubtedly gain improved self-awareness. We know this can have multiple benefits, for rehab and for the preventative aspects of living including better stress management, improved mental and emotional wellness, and making healthy lifestyle choices. Once a yoga teacher told me that she doesn’t practice yoga for herself so much as for others. That ultimately she practices because she knows that yoga helps her be a better person and that is what she wants to bring to the world. There was no mention of obtaining longer hamstrings…

It has been an amazing journey and I’m thrilled to be able to integrate all the healing that I have received. It is an honor to be able to share PRI and yoga with so many. I look forward to continuing to cultivate more dialogue and provide integrative education in a way that is useful and accessible to PRI clinicians and yoga students alike. To that end, I am happy to be a resource for any PRI-related yoga questions you may have. You can email me at: emily@shinephysicaltherapy.com . Namaste’!

Tell us a little about your background and how you first got interested in the physical therapy profession. What was your first exposure to Postural Restoration®?

That’s a good question, with kind of an involved answer because Physical Therapy is actually a second career for me.  I became interested when I was about 16 years old.  I was playing a game of backyard football and crunched something in my knee.  I went to an orthopod but nothing significant was found so I was sent to PT for a few weeks.  My therapist was fresh out of school, very attractive and I had a total crush.  This was a case where quad sets and hamstring curls got the job done, but that experience turned me on to PT.  I mean, how cool would it be to work with athletes and return them to activity?  I went to college with every intention of becoming a Physical Therapist.  The problem was that I was a 17-year old kid, at a party school, with no idea yet how my brain learns or how to properly apply myself.  As a result, I bombed my first semester freshman year.  I think I had a 2.1 GPA.  When I went to see my advisor (he was just a general class advisor in a huge university), his “advice” was that I’d never get into PT school and that I should consider a different path.  I was an impressionable kid and I took his advice.  To this day, the anger I have as a result of that conversation still drives me to prove that guy more and more wrong. 

I fell into Economics.  It came very easily for me.  I didn’t have to study much and I seemed to excel on the tests.  After finishing my Bachelors, I was recruited to go through the graduate program, which was only 15 months longer so I did.  Because of that, I was able to land a job in the School of Public Health at the University of North Carolina working as a research assistant.  Actually, my title was “Applications Analyst”, which is a fancy name for data programmer.  This was a great place to be because I was working closely with very critical and analytical thinkers on new and original research topics.  The environment was a great learning opportunity because the nature of the work was to break down complex problems into smaller components, fix, understand or alter those components, and then put them back together so that the complex problem became solvable.  Not too different from an integrated Postural Restoration® program.

It was a great learning experience, but something was still calling me toward PT.  I began taking an anatomy course through the University for fun.  About mid-way through the semester I realized my grade average was over 100.  When I finished the semester with a 106 average I started thinking, why not try to finish up my PT school pre-reqs and take a chance?
Elon, as a PT program, had three attributes that drew me towards it.  First, it was one of three schools in North Carolina that was offering the DPT degree when I began looking.  Second, they had a modular setup rather than a semester set up.  They could spend variable amounts of time on each topic with longer timeframes for highly important subjects like anatomy, and shorter timeframes for things like modalities.  But the biggest appeal was that they were accepting students with varying backgrounds, not just the standard 2 chem classes, 2 bio classes, 2 physics classes.  I fit in very well with their program. 

I met Dr. Boyle (Kyndy) in my first month there.  I had her for a 4-week class on “Intro to Mechanics” or something like that.  We got along very well and I can remember some things she taught that are PRI concepts, but they were presented more along the lines of looking at general asymmetry, which I had an interest in.  I say that because at the time I was working out a lot and I noticed little things like: no matter how many extra repetitions I did with my left, my right arm could always curl more weight for more reps.  The same was true for my left arm with triceps extensions.  At any rate, Kyndy went on sabbatical to finish her dissertation for her PhD after that module and I didn’t really cross paths with her again formally as a teacher until my third year.

You began taking PRI courses as a student. What was your reaction to being exposed to Postural Restoration® while still a student? What advice would you give to others who have or are interested in taking PRI courses as a student?

Thanks to Kyndy Boyle and Sangini Rane (my first clinical instructor), I was exposed to PRI ideology at an early stage.  I mentioned before that I met Kyndy in my first month of PT school, but that PRI was not taught per se.  We read articles that are current PRI reference articles.  We talked about PNF concepts, and a little known muscle called the triangularis sterni.  She came into our anatomy lab to point out some eccentricities with the diaphragm, but it wasn’t until I met Sangini that I was challenged with a (now seemingly simple) concept of a ZOA, or lumbo-pelvic asymmetry, or officially introduced to Postural Restoration®.  Three weeks after starting my “clinical” with Sangini I was sitting in a Postural Respiration course that Ron was teaching.  Timing was perfect because I had just finished my anatomy and orthopedics courses.  The information was still very fresh, but to me, nothing I heard was surprising (but I can’t say that I fully understood it all).  I soaked up as much as I could at the time.

The challenge I ran into was getting back to campus after our clinical affiliations.  My friends and I would spend time in the skills labs “showing off” what we’d learned.  I wasn’t able to defend or explain what I had learned at the time, but I did learn just how much I didn’t understand.  I was able to continue progressing through the PRI theory and concepts while in school through courses and individual study, but I wasn’t really able to clinically apply concepts for rehabilitation. 

I don’t know that I really had to worry much about “putting PRI aside” to prepare for boards.  I think the test is designed to make sure aspiring clinicians know how to not hurt someone, or if a patient is appropriate for PT or requires outside referral.  I would suggest that students who have been exposed to PRI understand that each and every thing they are taught in school is a progression and could be beneficial to their patients on some level.  It is worth learning and it may help them immensely someday. 

The other thing to keep in mind is that for every test and every technique, there is a time and place.  Keeping an analytical head is continually necessary.  What I mean by that is that you wouldn’t perform a Lachman’s test on someone with shoulder complaints.  That is not what the test was designed for, and it is not what it is validated for.  As a therapist, there are times when I may not want treat a patient, for instance in the case of an undiagnosed ACL tear that is confirmed by a compendium of tests learned in school. 

You are one of a handful of therapists to complete the Postural Restoration Certification (PRC) program within a few years of graduating. How has this decision and process helped you as you reflect on your short career at this point?

To be honest, I think becoming so involved with PRI so early has pigeon holed me as a Physical Therapist.  I can’t work with “an ankle problem” any more.  I can’t work with “shoulder pain”.  The science of Postural Restoration® has afforded me the knowledge and insight to realize that, and the PRC process reinforced it.  Some folks come in with certain expectations.  They want a neck massage, or ultrasound and I can’t do that for them.  I believe that those methods do not empower a patient.  The patient does not have to take ownership of their situation.  I have had many patients over my very short career whose issue is something very different than what they believe it is.  Working with the patient so that they can understand their own body is one of the biggest challenges (and biggest rewards) that I have.

As a clinical thinker, the PRC process was validating.  I think one of the biggest things I learned is confidence.  That, there really isn’t a wrong answer clinically if you can logically justify your reasoning.  This is a concept that has been huge for me in developing as a clinician, especially with the types of patients I get to work with these days.

You recently opened your own private practice with your wife in Cary, NC. Tell us a little about that adventure and your practice, STEPS for Recovery. How has this decision set the path for your future?

STEPS for Recovery opened its doors in 2012, but the practice has been in the planning and development stages since 2008.  When I first graduated from PT school, I worked in an Inpatient Rehabilitation facility (with my now wife), mostly with patients who’d had a stroke.  Our treatment approach worked to facilitate and restore normal motion.  The idea is that normal motion cannot be restored if only compensations are taught (i.e. using the unaffected leg to lift the affected onto a bed).  One of the things we noticed early on is that we’d do what we could while the patients were in Rehab, but once they were discharged our methods were lost at follow up.  Our idea was to open an outpatient neuro PT clinic specializing in rehabilitation for patients with stroke and brain injury outside of a hospital system.  I don’t want to discount hospital systems, but as a private clinic we would not have the same rules and constraints to follow.  If we wanted to see patients for hour (or longer) individual sessions, we could and that was a big desire. 

In 2008, a few wrenches got thrown in the gears of that plan.  One of those was running into James Anderson for a Myokinematic Restoration course.  The only Myokinematic Restoration course I had taken up to that point was given the year before, but was truncated to one day due to air travel issues.  So when it was being taught locally in ’08, I wanted to take it again to get the full course.  When I was there, I really felt at home.  Not to sound more weird than normal, but it was pretty much an instant thing – “this is where I am supposed to be”.  So, the clinic was put on hold while I pursued that feeling for the next few years.

Shortly after returning from Vermont, where I was working with Jen & Chris Poulin, an opportunity arose for us to revisit the idea of STEPS for Recovery.  As it turned out, this was a bit of a now or never endeavor.  A very well respected mobility DME vendor had some space next door for sale.  We jumped on it for the potential collaboration and proximity.

In its current form, STEPS for Recovery’s caseload is mostly traditionally neurologically involved patients.  We see patients affected by stroke/brain injury, and we’ve started a SCI program and a wheelchair seating clinic.  I consult with some of those patients, and I have a small caseload of more traditional PRI-type patients.  The variety in this patient population is unbelievably complex.  It isn’t realistic to expect that someone with ataxia, hemiparesis or paraplegia can do a 90-90 Hemibridge, or a Knee Toward Knee PRI Non-Manual Technique.  For that matter, I can’t expect PRI tests to be valid due to altered tone and spasticity (I see that all the time with HGIR and Should Horizontal Abduction testing). 

Patterned asymmetry still exists however, but this population also has less predictable forced compensatory movement.  So I get a lot of practice taking PRI concepts and improvising.  I continually ask myself, “if the patient can’t use their left side at all what do I do?  If I take the arms and legs off, what does this patient need, and how can we help them get it?” Of course, just because we are able to make a change in one position (supine, for instance), it doesn’t mean that the patient will be able to generalize that motor skill to another position or situation, so there is a lot of refining that goes on for one muscle activation pattern.  It is really challenging and also pretty exciting because we are seeing patients make changes.  That being said, it is also nice to get a grand slam (one or two visits and you’re done) knee pain patient every once in a while. 

The verdict is still out as to whether STEPS was a good idea or not.  We’ve only been open for a year, which means the work-day usually starts between 7-8a, and lasts till 9:30 or 10p (weekends are fair game too).  As an owner and manager it can be really difficult to get much done during the day so there is always some sort of “homework”.  Plus, being a new clinic, the caseload is still somewhat volatile.  It’s like planting a garden, a lot of hard work and not much return in the beginning.  But I believe the freedoms that private practice has allowed are well worth it. 

As a Postural Restoration Certified (PRC) therapist, what types of patients continue to challenge you the most? What advice would you give to other therapists (who may be newer to PRI) who are struggling with some challenging cases?

Aside from some of what I described above, I think some of the more challenging patients are those who “know about their bodies.”  These are the folks who “do yoga”, or take Pilates, or have seen 10 other professionals and have been told different things, or heaven forbid, someone who has medical training.  These patients “know what is wrong” with them when they walk in the door, and it takes a lot of energy, politics and patience to invite them to think a little differently.  It is a continual struggle to educate patients and oftentimes I feel like I go overboard in that sense.  But I feel like my job is an educator.  Folks that are looking for a manual therapist to push them around aren’t going to get that from me.  I’m not good at it.  I find knowledge to be more empowering and I think it develops a greater level of trust with the patient.

Probably the thing I find most helpful in working with the chronic and complicated patients is simplicity.  Keeping things basic.  What I see is that most patients will find a way to compensate with a lot of the PRI activities.  I think that is because body awareness is a developed trait and the average Joe hasn’t developed that trait.  Sometimes, I’ll spend half an hour teaching someone how to perform a 90-90 Hip Lift, and it might take another 10 minutes to get a balloon in the mix.  But usually when I put that kind of effort in, my patients benefit better than if I fly through four or five activities and send them on their way.

Another thing I try to do when struggling with difficult cases is to take a step back and ask, “Why am I recommending this activity?  Why is this person unable to maintain neutral?  What are they doing through their day that is pulling them away from a good position?”  I’m not a “pull an exercise out of the book” type of clinician.  Every activity I give has a reason and I really try to understand the tri-planar components involved before handing it over.  That’s because (for example) some activities may have a sagittal inhibition component, but a larger frontal plane facilitation component.  If I am working with a strongly extended patient, they may not be able to handle the frontal component without also losing the sagittal component, and thus they may not be able to use that activity to inhibit their Left AIC pattern.  Understanding that from a “why” perspective allows me to hone in on more appropriate activities.

Who have been your mentors over the years (PRI and non-PRI related)?

I’m interpreting your meaning of “mentor” as people who have helped me get to today, not necessarily people who have stood at the front of a class room.

• My parents always allowed a long leash, which gave me plenty of room to find my way.  It took me a long time to “find my stride” in life.  They never judged or pushed me towards something they wanted for me.  They did have high expectations and instilled a strong work ethic.  That inspired a lot of creativity and adaptability in how I work cognitively.
• My Aunt has been a driving force in many aspects of my life.  She is such a free spirit that it is hard not to want to be more like her.  She spent most of her 20s living on a beach.  Somewhere along the way she wanted to get into “our” field, but her college degree was a little dated by then and PT schools turned her away.  So she went to Chiropractic school, became an ART (Active Release Techniques) instructor, and became the most referred to clinician (for sport injuries) in the San Francisco Bay area for a time.  And when it was time for all of that to be over, she sold that business and moved on.  Even knowing what I know about PRI, there is not a clinician I trust more on this earth. 
• Slash – This one might be reaching for it and I am not endorsing the early “rock & roll lifestyle” days.  But there is a certain element of “going with your gut” that we as clinicians must entertain.  I’ve always been a fan of the guitarist, but from a career perspective, I think there is a lot to learn from that renegade spirit.  When something feels right and you know it, then work for it tirelessly, follow that gut feeling, do things your way and make it happen.
• Ron – I’m pretty sure everyone who has done one of these has named Ron, James, Mike, Lori, or Jen.  I think they are all fantastic teachers and the Institute is changing rehabilitation in this country.  But aside from all of that, I really get a lot out of spending time (outside of a course) with Ron.  I just get tickled by the things he notices and finds interesting.  The first time he visited STEPS for Recovery, he literally spent half an hour looking our portable mirror.  He was mesmerized by the slight variability in the glass, which causes a slight stretch of the reflected image.  I think the Buddhist concept of the infant mind applies ~ observe things as if it is the first time you see them.  As a fairly creative person, it is good to be reminded by seeing that implemented.
• Kyndy – my first exposure to PRI, without realizing.  As a third year student, I had a 5 week selectives class that Kyndy instructed.  This is where our balloon article (The Value of Blowing Up a Balloon) was born.  I believe it was roughly 3 years after that class when we finally got around to sending that in for publication.
• Sangini – my first clinical instructor.  I think I was her second student and we met at a time when she was pretty new to PRI.  I think we both got a lot out of those early discussions.  Sangini has a commitment to her patients that I have not seen anywhere else. 
• When we met, Katie (my wife) was an instructor for the Neuro-IFRAH organization.  This is a treatment approach developed for the management of patients with lesions at the level of the brainstem or above.  I think what I want to say here is that working with Katie and learning about this approach taught me to look at how movement occurs “normally” (asymmetry aside), the variability in what is “normal”, and how things change with neurologic insult.  This lesson still drives me, I find myself watching people walk on a brick sidewalk (different than in a lab), or how people get out of cars (it’s a sit – stand transfer, but entirely different than one that might be documented by a therapist).  The list literally could go on for days. 
• Jen & Chris Poulin & Josh Wellenstein – I spent about 13 months at Poulin Performance in Vermont, which was an unbelievable experience.  This was when Jen was preparing to become a faculty member for the Institute.  Jen and Chris are both really passionate about PRI and helping others to learn and understand these concepts.  We’d have weekly clinical development meetings to discuss concepts, cases, or techniques.  And Josh is a fantastic clinician with loads of outpatient orthopedic experience and was a great resource.  In fact, I still call on him when I run into difficult situations with patients.

What types of activities and hobbies do you like to do outside of work?

Since opening STEPS for Recovery there really hasn’t been much of an “outside of work”.  But I am lucky because a lot of my hobbies coincide with work.  I’m a pretty introverted guy.  Working as a PT where I have to interact with a lot of people can drain me.  Most of my hobbies are things that I can do by myself.  There are three that immediately come to mind. 

I’ve been into running since high school.  That happened by accident really.  I was always a “jumper”.  One day in gym class we were playing basketball.  I had an opportunity for a dunk so I took it.  I broke the rim (which surprised me more than anyone else).  The track coach was in the gym at the time.  Instead of being in trouble or having to pay for it with cash, I had to pay for it by joining the track team.  I don’t know that I have ever really stopped running since then.  But being out gives me ample opportunity to observe other people’s form and mechanics.  More recently, I’ve started competing in bike racing too.  I suppose these things help me to set goals now, which keeps me moving forward.

I got my first guitar when I was 9-years old.  I took lessons for about a month.  The teacher I had was teaching me bluegrass and gospel type tunes.  I wasn’t at all into that so I quit for a few years.  When I was 12 or 13, I pulled it back out of the closet and taught myself from listening to the radio.  I still play pretty often.  I’d say I’m pretty bad.  But sometimes turning the volume up to eleven helps even out the day.

Wood-working is the same type of vibe – high volume with a myopic cognitive focus to task.  My first project was one that my uncle and I threw together.  I had gotten a chunk of birds eye maple and wanted to make a head board for my bed.  My uncle realized that I didn’t have enough wood to make it happen, so he donated a piece of Hawiian Koa and we made a coffee table.  My first individual projects were making cutting boards using salvage wood that I’d get out of a flooring company’s dumpster.  One day I thought, “why not try to do a PRI logo (the polyarticular chain)?”.  The first time I tried, I made three at once.  I wasn’t sure how badly I’d mess up so I wanted some insurance.  The first one (which now resides at the Institute) turned out the best of all of them.  It’s made from Peruvian walnut with a curly maple inlay.  It may be my favorite one to date.  Since then, I’ve made about 8 for different clinics around the country.  I’m hoping to continue doing so.  Each new one that I make is more unique and interesting.

You and Karen Jiran were both members of the very first Postural Restoration Certification (PRC) Class in 2004. Tell us about how you and Karen first got to know each other, and the journey you took together in studying Postural Restoration and also opening a business, Kinetic Physical Therapy Institute together.

My journey into PRI started about 13 years ago while Karen and I worked for the same physical therapy company.  We initially worked at different locations within the company and thankfully fate would have us working together after we were both transferred to the same clinic.  Karen had started her PRI journey taking her first course months before me.  My introduction into PRI came learning from Ron Hruska at the course called “An Integrated Approach to Treatment of Upper Half Musculoskeletal Dysfunction”, better known today as Postural Respiration.  This was a game changer for me and opened up a whole new world involving the thorax and the diaphragm.  Soon after, I experienced a course given in coordination with Inverse Technology called “The Influence of the Pelvic-Femoral Complex on Anterior Knee Pain”.  I believe it was the suave James who taught this class and introduced Karen and I to the Protonics System.  And then it was on to Chicago to learn about Myokinematic Restoration from Ron. Within that first year of hearing the terms “zone of apposition” and “Left AFIR”, I had taken 3 courses.  At this point I was caught hook, line and sinker.  Karen and I started teaming up with discussions, practicing every exercise we could on ourselves and amazed by the results we saw with our patients.  Physicians started to see the positive changes and successes we were having with our patients. Our schedules began to fill up with referrals by name from around the area. As word spread our patient base began to change from simple cases to the more problematic and challenging.  With this challenge came the need for more time to spend with these patients as we were working in a 30 minute per patient environment.  The next hurdle was trying to negotiate with our employers about changing our schedules to accommodate the type of patients and referrals we were getting.  This was difficult for both sides as a large system needs to keep the money flowing and what Karen and I were doing was not understood.  The terms “VooDoo” were heard periodically throughout the offices.  Karen and I continued to fight for our belief in what we were doing and shared our knowledge by trying to teach others within the company.  Eventually, we were at an impasse: conform or move out on our own.  We decided there was no going back and took the leap of faith.  We had tremendous support from physicians and our families which made this move that much easier.  I can happily say, there is not a day that goes by in which we regret our decision. 

How have you (and Karen) built a practice with PRI? Have there been any struggles that you have encountered and what advice would you give, as a mentor to other therapists who are interested in operating their clinic utilizing PRI as a benchmark?

Karen and I were very fortunate in starting our clinic.  When we set out our main goal was to be able to offer our patients the individual time and care they deserved and of course – to treat the way we wanted to treat.  We had many physicians, peers and family that supported our decision and helped make it possible.  There are many challenges in starting a clinic, including staffing, budgeting, building referrals, marketing decisions, EMR software, etc.  Finding hard working and “PRI type thinkers” for staff can be difficult, but I feel we have been very fortunate in this area. Building referrals comes with time and I feel the best marketing is word of mouth.  If your patients believe you care and you impact their life the news will carry to their family, friends, physicians, etc.  In my opinion, the biggest challenge in our start up and even now is the insurance and reimbursement arena.  Every year, sometimes every month, it is a game of what do we have to do this time to get paid less than before.  As our current healthcare environment is in flux and the days of easy re-imbursement are well over, changes in how we practice need to occur.  Karen and I decided at the start that we would keep our clinic as slim and trim as possible.  Every staff member we have has been instrumental in this, including our ever important front desk personnel.  As a clinic we have unified as a team to give each patient a quality and purposeful visit from beginning to end.  My biggest recommendation for those PRI folks interested in starting up their own clinic is to stick to what you are good at, show people you care, and have a good support/business structure around you.

How has PRI and being a PRC therapist helped you overcome past professional challenges and propelled you to where you are today?

I believe PRI has opened many doors for me professionally.  Not only has it allowed Karen and I to open a clinic and find our nitch, but it has challenged me to constantly learn from my peers and patients on a daily basis.  As a Postural Restoration Certified (PRC) therapist I am pushed to work with some of the most challenging of patients.  Even though this can be overwhelming at times it is what makes every week feel like I have accomplished that much more.  It has also introduced me to many other health care providers such as dentists, podiatrists and recently, optometrists.  Dr. Michael Hoefs, an orthonagthic dentist; Dr. Paul Coffin, podiatrist; Dr. Jessica Schara, optometrist; and others have all become invaluable and instrumental in helping our patients receive the complete care they need.  I continue to hope this level of treatment coordination and sharing of knowledge will grow and become common practice throughout our health care system. 

In addition to your role as a physical therapist, you also have a background in Athletic Training. Are you currently working (or consulting) with any athletic teams? If so, how does Postural Restoration® play a role when you are working with these athletes?

I have worked with different athletic teams over the years.  These opportunities have involved group consulting and screening and also following a team throughout a season. These teams have ranged from high school to the professional level with the most recent being the Minnesota professional lacrosse team a few years ago.  I have used PRI concepts in all of these endeavors.  The biggest challenge was trying to educate and change old myths about muscle balance, stretching and off the field/court training.  There continues to be such a high level of overtraining in the current sports world which is starting at a younger and younger age all the time.  Working with the athletes themselves can be easier to convince them of PRI concepts as they can feel the changes to their body.  The biggest challenge can be coordinating with other members of the team such as the coaching staff, training staff and parents.  I am thankful for my experience in PRI as I feel it has given me something special to offer to this particular group. 

Within the past year, you have hired Brent Albrecht, who was a member of the first Postural Restoration Trained (PRT) class in 2012. Having Brent on staff, how has this changed your practice? How long have you known Brent? What process or processes did you use to recognize the value of having Brent, who has worked in the sports performance and fitness fields on your staff?

Brent has become a valuable asset to what we can offer our patients.  There are many patients we see in clinic that have very little muscle development or have the desire to do more than exercise at home and want to be pushed harder to meet their goals.  Karen and I have often thought this was a missing link that needed to be addressed with many of our patients.  Some need it because they want it and some need it because they don’t have enough structural strength to handle daily gravity or maximize ground reaction forces during daily activities.  I feel it is a disservice to my patients to ignore their gym programs and other methods of exercise they do, as well as not recommend them when they obviously need to develop muscle.  As we all know, these activities can make or break long term success of the patient. Prior to Brent, I would take time outside my hours to go to my patient’s gym and help them with setting up a PRI based program to build upon what we had worked on in the clinic. I have referred various patients ranging from a high school Jujitsu athlete to 60 year old patients wanting to get more out of their community center membership or cross country ski season.  Brent’s knowledge is invaluable and I encourage many of my patients to take the next step with him.

You were a member of the very first Postural Restoration Certification (PRC) Class in 2004. Tell us about how you first got interested in Postural Restoration and the journey that you have taken since attending your first Postural Restoration course.

I initially became intrigued by Postural Restoration over 17-plus years ago when I was a student athletic trainer at the University of Nebraska-Lincoln.  During that time, Ron Hruska had been asked to consult with various athletes regarding their chronic natured injuries, with athletic pubalgia and osteitis pubis being the most prevalent.  I had the opportunity to observe these consultations in which he had placed these athletes in the most awkward positions and had these athletes blowing up balloons.  At the time I had no idea what he was trying to accomplish and I thought this was the most bizarre thing I had ever seen!  Shortly thereafter the medical staff started to utilize the Protonics Neuromuscular System for athletes suffering from chronic knee pain.  The science behind this system really intrigued me in that activating a hamstring changed the position of the pelvis and in turn influenced the mechanical demands placed on the knee.  So I really knew at that point there was more to rehabilitation than just looking at the joint and/or extremity involved and I was always asking myself “WHY?” or “WHAT IF?” questions as it related to more traditional orthopedic injuries. 

After my undergraduate schooling I attended the University of Minnesota and was a graduate assistant athletic trainer, with my primary responsibility being football.  During my time there I was responsible for the rehab of various injuries and I had taken some of my knowledge from UNL and utilized the Protonics Neuromuscular System with various athletes.  After graduating with a Masters in Kinesiology, I pursued my physical therapy degree at Des Moines University-Osteopathic Medical Center.  It was there that I started to appreciate the answers to the “WHY” and “WHAT IF” questions.  I was grateful to have the opportunity to be trained in an osteopathic mindset.  This education was invaluable to my current career as a Postural Restoration therapist in that I had been instructed in a very strong curriculum that discussed biomechanics, pathomechanics and the various relationships that a joint, structure or system may have on another.  During my last year of physical therapy school I had the opportunity to have a clinical affiliation at the Hruska Clinic.  It was during this time that I appreaciated all that I learned from PT school and put the pieces of the puzzle together.

Following graduation from PT school, I was hired as a full-time physical therapist at the Hruska Clinic.  I am truly blessed to be a part of this organization.  We have one of the best staffs that anyone could be a part of and having the opportunity to work along Ron Hruska is invaluable.  I don’t think I have ever met an individual who is more passionate than Ron.  He is and will always be one of my strongest mentors.  On a personal level, I consider him a close friend and a father figure in many regards. We have both gone through a lot of ups and downs over the last 12 years not only from a professional standpoint but also on a personal level.  Through my tenure here I always remind Ron, the staff and myself that “there is only one Hruska Clinic”.  It is here at the Hruska Clinic where the origin and clinical advancements of Postural Restoration occur.  It is hard to believe that after this year there will be over 100 individuals credentialed in PRI.  This says a lot for these individuals to have the faith, passion and expertise in Postural Restoration.  There is not a week that goes by that I have not been able to learn something new as it relates to PRI.  I am thankful for being able to work with a staff who all has a common belief, that being PRI.  I am thankful for all the patients I have been able to meet and treat from across the United States, Nebraska, and Lincoln.  There is truly no place like the Hruska Clinic!

As a Physical Therapist at the Hruska Clinic and a member of the Associate Faculty for the Postural Restoration Institute, you have had the opportunity to in-service many physicians, dentists, athletic trainers, etc. locally and also around the county.  What advice would you give to those who are interested in educating other healthcare professionals about PRI in their communities? What in-services have you had the opportunity to do this year and do you have any arranged for 2013?

I have had the opportunity to do many in-services and presentations during my career. My first recommendation would be to try to make the presentation as simplistic as possible.  Postural Restoration concepts/philosophies can be overwhelming for the beginning learner.  I try to take these concepts/philosophies and use analogies and/or bring these concepts into practical/realistic manner.  I always try to remember back when I took my first course and experienced frustrations of the “Whys” and “Hows”.  To this day there are many concepts that can be learned or taught in a different manner.  How one individual interprets information may be different from another’s interpretation.  I am constantly learning from my colleagues at the Hruska Clinic in how they explain information to their patients.  Furthermore, talking with physical therapists across the nation whether it is at a PRI course or through email also helps one get a better understanding of how individuals interpret PRI concepts.

I most recently had the opportunity to speak with a group of Athletic Trainers and Physical Therapists at South Dakota State University and am excited to be presenting at the National Athletic Trainers Association (NATA) convention in Las Vegas, NV in June 2013. 

You also hold the credentials of Athletic Trainer Certified and Certified Strength and Conditioning Coach. Tell us about your background in these fields and how you feel Postural Restoration applies to these two professions. What advice can you share with other ATC’s and strength coaches from around the country who are interested in successfully integrating Postural Restoration?

I have had the opportunity to work in the Athletic Training arena at two major university settings.  My primary sport responsibilities were football and other Olympic sports including Track and Field and Baseball.  Having worked in this setting sometimes the saying “easier said than done” applies.  For those of you that have worked or are currently working in such a setting you can appreciate how Postural Restoration concepts apply to many of the athlete’s conditions.  In the athletic setting you see a vast array of injuries whether they are acute or chronic in nature, yet often times the manner in which they are treated can often provide different results.  I have found Postural Restoration to be very effective in the treatment of chronic conditions in this setting.  Sometimes you need to “clean the slate” and start from scratch and think “outside the box”.  Many times the traditional way of thinking will take you a long ways however when you see recurrent episodes of the same injury and no resolution it often asks you the questions “why” and “how”.  Due to the time constraints and the volume of athletes seen in this setting it is often difficult to implement PRI from a purist perspective.  The simpler you can make it the better.  My experience is that many of these athletes are PEC’s and are constantly exposed to extension positions whether it is on the playing field or in the weight room.  I feel that the PRT credential has and will continue to address the many obstructions that occur in the athletic setting.  By understanding position, patterns, and postures and implementing PRI concepts to include tri-planar activity (more specifically the frontal plane) will assist in the prevention and management of athletic injuries.  I have had the opportunity to implement various screenings for various sports and have realized that some sports have more extensive movement patterns than others and that you have to individualize your treatment plan based on the demands of the sport which sometimes does not always follow PRI concepts/philosophies.  For example, it would be impractical to tell a gymnast or a diver not to extend their back or tell a football player never to perform squats.  It is the nature in which they are performing the activity that matters.  We as PRI professionals have a strong bias against extension, yet extension is just one part of a fundamental movement within the sagittal plane.  Extension is acceptable, however it is when these individuals become extension dominant and cannot appreciate the flexion component within the sagittal plane that it becomes a problem.

My experience within the weight room is limited.  However, throughout my career I have had the opportunity to consult with many strength coaches, athletic trainers and personal trainers across the country from the high school to the professional setting.  Most of these individuals have had that “A Ha” moment through the implementation of PRI.  It is in my professional opinion that technology has sometimes hindered the thought process of treatment.  The latest innovative modality and/or piece of weight room equipment are not always the answer.  There is an extensive amount of money spent within these settings for their own intent and purposes, most often recruiting.  I feel that often times these individuals get “caught up in the moment” from such technological advances and tend to forget about the basics to include anatomy and biomechanics.  It is when you get exposed to PRI that you have that “A Ha” moment and appreciate the “Why’s” and “How’s”.

You have served on the PRC Application Review Committee, and played a large role in helping establish the Postural Restoration Trained (PRT) credentialing process, which included 5 members of the first class in January 2012. What advice would you give to those who are considering the PRT credentialing process?

My advice to any individual that is considering applying for the PRT process is to attend the 4 required PRI courses (Myokinematic Restoration, Postural Respiration, Pelvis Restoration, Impingement and Instability).  For most individuals they have obtained the basic knowledge of PRI concepts through the didactic coursework.  It is within the clinical setting in which these individuals have the upper advantage because they often see it right before their eyes and can make the appropriate adjustments to correct/treat a specific movement pattern, posture, or injury.  I encourage all individuals working within this arena to continue to expand PRI concepts/philosophies within their respective fields whether it is in the weight room or athletic training room.  Postural Restoration therapists around the country are looking for individuals such as these to “bridge the gap” from a progressing an individual from a rehabilitative perspective to functional performance perspective.

When not seeing patients, I can usually find you researching articles on the computer. What topics specifically interest you and how do you use the research that you find?

I enjoy reading any research that relates to PRI.  Specific topics that interest me are the diaphragm, cranial torsions, dental integration, and osteopathic literature.  Often times PRI is criticized that it is not evidence based.  It is through my experience that it is by fact that a lot of the information out there has been researched but no one has put all the pieces of the puzzle together.  I get more out of a 1950-60’s osteopathic article than I do a 2012 research article on ACL rehabilitation.  It is the vintage articles that provide me with a lot of insight in that they stick to the fundamental basics: anatomy, physiology, and biomechanics.  Any article that differentiates the left and right sides of the body and accepts that the human body in asymmetrical is a great find!  Furthermore any article that provides a biomechanical explanation of “how” or “why” something occurs is also a treasure.  I am extremely biased towards osteopathic literature in the sense that these articles can relate to structure and function.  Most of the articles that I find are not researched within the USA, but rather come from Brazil, Australia, New Zealand, United Kingdom, Belgium and Sweden. 

You have also done a lot of writing over the years. This includes the Cough-Variant Asthma: Responsive to Integrative Management and Postural Restoration case report which was published in EXPLORE journal, and many series articles for the Performance Conditioning newsletter. Are you currently working on any projects?  What advice would you give to others who would like to get involved in submitting articles or case studies for publication?

I enjoy writing but often cannot find the time to write.  I am currently working on an article regarding the proper mechanics and position of an Olympic squat and PRI implications.  I also have other topics with other authors across the country including scoliosis, ribcage position and the throwing shoulder, and PRI in the athletic setting.  The biggest piece of advice I would provide to any individual wanting to submit an article is to choose only one or two PRI concepts within your article.  There is a vast amount of information to be covered with one or two concepts and often time I find myself going on tangents and bringing in other valid relationships rather that sticking to the task at hand.

How were you first introduced to PRI and when did you attend your first course?

I first met Ron in the spring of 1998 in Lincoln at St. Elizabeth’s.  I was doing my first orthopedic rotation in PT school, and it happened to be at St. E’s.  My CI was not Ron, but because I went to the osteopathic school in Des Moines and he knew my instructor, he was kind enough to show me some things.  He would pull me into a room and I would watch him work his magic.  He did a good job of not overwhelming me, but he showed me that what I was learning in school was just the tip of the iceberg.  It did get my mind working in that as much as we got osteopathically, there obviously was more to it. 

I started to work in Illinois in 1999, and Ron called me and said he was going to be in Chicago for a Saturday course and it was $100 and he would really like for me to attend.  I had just moved and started this new job, and I literally had $17 to my name.  I really wanted to go, but I couldn’t swing it because of the timing.  I got busy with life and kind of put PRI on the back burner.

One of my classmates from PT school who had worked for Ron for about a year called me in February 2003.  He said Ron was coming back to Chicago to do the a Myokinematic Restoration course, and was wondering if I could attend.  This time it worked out great, and that was the first course I took.  There were only about 8 of us in that class, but I was hooked.  I had a better grasp of what I was seeing and doing compared to 1998 and could apply the information.  I took the Postural Respiration that October, and then got lost.  I didn’t take another course for over 2 years because I wanted to make sure I had the first two courses down well enough before I started to invest more time and money in future courses.  At that time, my clinic was slow enough that I could take the time to methodically go through the manuals and invest the time to apply the concepts to patients.  Those 2+ years were vital for me to be able to comprehend and apply the concepts.  I started to re-take the courses and every time I took the courses, I got more out of it because of the two years I had to take to digest the information.

We know that you have been very successful implementing Postural Restoration into your practice setting without owning your own practice. How did you go about gaining the support from your administration and fellow colleagues at your employer?

When I started taking the courses, no one knew what I was doing.  My boss still doesn’t know what I do.  But I was fortunate to be working for a PT who owned the company that didn’t care what I did, as long as patients and doctors were happy.  In the nearly 10 years since I have made the clinical change to doing only PRI, none of my superiors have ever questioned it.  After I felt that I was well versed enough and had enough experience to begin explaining it to others, I began hosting courses.  Once again, my boss gave me the latitude to do whatever I wanted to do.  I was the director of continuing education for our company (Sports Physical Therapy at that time), so that helped as well.  The results spoke for themselves.  The therapists I worked with could see I was getting results they could not and were not getting, so that helped sell PRI as well.  I now have 4 other PT’s doing PRI quite a bit, and I am trying to get another to take her first class.  Now that we have merged with Accelerated Rehab, I have been with the company long enough and have a strong enough following that I can do whatever I need to do.  I was very fortunate that my boss is a PT and he has never made any comments or judgments as to how to treat as long as the results were there.  When I was taking my time those 2 years and the clinic was slow, I was fortunate that there was no outside pressure from him to change what I was doing, and it has paid off.  I think the big thing was that my boss is not a micro-manager and gave us the freedom to grow as clinicians. 

Your facility has now hosted a couple PRI courses, how has this experience been for you and your co-workers?

Hosting has been a bigger learning experience for me than I had anticipated.  Originally, I just wanted to make it easier for my co-workers to take the courses.  But having to field questions from the other PT’s taking the course was a bigger learning experience than I had expected.  And it provided my co-workers the opportunity to take the class and see what I am doing and see where I am getting the information from.

What areas of clinical practice are you most passionate about?

My interests in PRI have evolved over the years.  Originally, I really liked working with athletes because it was fun and they responded so quickly. But then it evolved into taking PRI to other, less obvious diagnoses like plantar fasciitis, bunions, and biceps tendonitis.  Now my interests are more in the integrative aspect of treating patients. I guess my treatment approach has evolved to be more integrative, which is the expectation.  I enjoy working with the patho (L) AIC patients, superior 4 patients, and the more chronic patients who have had pain for a long time.  Those used to scare me as a younger therapist, but now they are not nearly as daunting.  My next challenge is to find a dentist I can work with, because that is a piece I am missing.  I know I need to take some patients out of their bite, but I have not been able to do that marketing piece yet.

As you pursue becoming a Postural Restoration Certified (PRC) therapist this year, who have been your mentors?

I guess my mentor in PRI has been Ron.  He’s the first, and really only one, I have looked to for guidance.  I was fortunate to know Ron before the Postural Restoration Institute existed and see his challenges doing PRI while working in a hospital based outpatient setting.  That is where I am now, so I can appreciate the similarities.  Ron has been very kind to me, and I greatly appreciate that.

Ron likes to know everyone’s story.  What has been your story in your career? Is there any advice you would give to PT’s out there reading this interview?

My story with PRI started with Ron in 1998, and even as a student, I could tell this was different and the results were amazing.  As a student, it was like magic.  So I went back to school following my first clinical rotation in Lincoln realizing that in order to be the kind of therapist I wanted to be, I had to take the information I was getting in school and follow PRI down the rabbit hole.  So in school, I had this idea in the back of my mind that there was more, but I had to learn the basic stuff first.  I had to take other continuing education courses to help build a baseline skill level in order to appreciate and apply PRI.  But the big thing for me was taking the time and, through trial and error, applying the Myokinematic Restoration and Postural Respiration courses to patients. I was very lucky to be in a very slow clinic that afforded me the luxury to do that.  I was at a slight disadvantage that I had no one in my region that I could bounce ideas off of, so that is why it took me so long to digest the information, but it was well worth it.

My advice to people starting out in PRI is to be patient.  The other piece of advice I would offer to new grads is to practice for a few years first and take other continuing education courses to see what is out there and to find out what you don’t know.  You need to struggle and realize that there is something missing in all the other treatment approaches.  It does take time to apply the concepts and shift your mind set to a different approach of seeing the body and how it works.  The biggest challenge I had was I had to stop treating the diagnosis and treat the person.  A plantar fasciitis patient is not a plantar fasciitis patient; they are a (L) AIC, R BC, and can’t breathe with their diaphragm or locate a ZOA with a road map.  I needed to get out of my box mentality and stop putting patients into boxes.  The other thing I did is make the conscious decision was to apply PRI to everyone I could regardless of protocol, diagnosis, and not even tell the doctor I was doing it.  The doctors care about patient satisfaction and improvement.  With PRI, I was able to get both, so the MD’s and the patients never questioned it.  But you have to commit to it.  The more you do it, the better you get, the better the results are, the easier it is to not get questioned about what you are doing.  By the same token, I was not violating MD protocols or doing things that was against MD orders.  In order to build a practice, I needed to observe the MD orders.  But in that framework, I also was able to apply PRI a lot and get the desired results. 

PRI has radically changed my treatment approach!  Meeting Ron in 1998 has changed my career path and made me a better therapist.  If you are able to commit to practicing PRI and take the time to learn, it will revolutionize your practice.  But it is not a quick change.  It does take time and it is a learning process, but it is beyond worth it.  PRI is a different way of looking at how the body functions, but it works.  If you are able to accept the notion that everything you have learned up to the point of your first PRI class is high school level education in that it is mostly correct, but not nearly the full picture, and accept that, by comparison, PRI is graduate level education, you will have a greater level of success.  PRI is taking your knowledge, expanding on it, and applying it in a more functional manner that it appears to be dramatically different, but it really isn’t.

We are excited to have you as a member of the first Postural Restoration Trained™ (PRT) class this year! How did you become interested in PRI® and when did you attend your first course?

I first was introduced to PRI through reading about Protonics and then as a patient. In 2005 I sought a therapist that was knowledgeable in PRI. This led me to Mike Dixey, a Physical Therapist at Ortho Rehab Specialist in Eden Prairie, Minnesota. My “Ah Ha” moment and my first meeting with Mike Dixey are one in the same. As I went through the assessment and his explanation of what the tests showed and how my position and pattern were affecting my function it JUST CLICKED! The powerful results and outcomes I had from working with Mike and PRI turned me into the biggest PRI advocate. I started referring anyone and everyone to him for PT. He was open to let me shadow their appointments, ask questions and guide me to education recourses to learn more about PRI. Since then, I have devoted all of my studies to understanding the science and application of PRI. I was able to attend Myokinematic Restoration as my first PRI course in October 2010.  If I could have attended earlier, I would of in a second! 

What is your typical client population and how are you incorporating Postural Restoration™ into your client’s programs?

I have been a Strength Coach and Personal Trainer for 15 years. At this point in my career, the clients I work with range from the 8 year old to the 93 year old and everything in-between.   

I primarily work at Lifetime Fitness in St. Louis Park, Minnesota. A majority of my clients are in a one on one or small groups setting. At Lifetime Fitness, I use the PRI assessment process with all of my clients. This guides me in the development of their PRI techniques and fitness programs. Most clients are dealing with little issues such as intermittent back pain, knee tweaks, tight shoulders ect… but don’t seek Physical Therapy for it. They just live with it. Using the PRI assessment process I am able to develop the PRI and fitness programs needed to address the problems and keep the issues from becoming more problematic down the road. I also work with other trainers helping them to design their programs to better meet the needs and abilities of their clients based off of my PRI assessment of them. 

I also work at Kinetic Physical Therapy in conjunction with the whole staff. It has been an amazing experience to work with and learn from each of the therapists at Kinetic. The patients are referred to me to help them make the transition back into an active lifestyle or redesign their current fitness programs. The programs that I design support what they have been doing in their therapy and teach them how to avoid many of the pitfalls you can run into in the exercise world. We are also in the early stages of starting a sports performance program that is based in the principles of PRI. The vision of this program will blend the science of PRI with a sports performance program to increase performance, decrease the potential for injury and develop a healthy balanced lifestyle.

When evaluating or analyzing your clients, what PRI® tests or objective measures do you look for?

Most clients I meet with are Left AIC patterned individuals with PEC tendencies, PECs or Patho-PECs. A very high amount of PEC pattern however (Minnesota is the land of 10,000 lakes and 2 million+ PECs). In the initial intake appointment, each client is put through a full PRI assessment, much like they would go through with a PRC therapist. This allows me to discuss what is going on in there body and show how this may be affecting them currently or could affect them in the future. I use the information from the assessment to start them on a PRI technique program to address the findings in the assessment and lay the proper foundation for training. 

Most personal training clients I meet with on a weekly or biweekly basis. Before each session I perform a quick check that consists of but not limited to, the ability to adduct their hip passively and actively, horizontal arm abduction, the Hruska Adduction Lift Test and with most people the Functional Squat Test. Each program is individual in design to the goal of the client. There are underlying rules that guide the design of the program.  A couple of those rules include, educating the client on proper positioning when performing exercises (avoid over-extension, correct head placement, breathing pattern), teach reference centers to be aware of while performing the exercise (left ischial seat, right arch, left abs). Achieving a solid 3 on the Hruska Adduction Lift Test determines when a person is ready to progress to increased activity, whether it’s in their strength, speed, agility and conditioning programs. 

The general layout of a clients program involves a PRI technique program specific to their needs, followed by the main part of the program with exercises that are tweaked with PRI principles and geared towards the clients’ goals. The work-out session will end with a PRI exercise, again geared to the clients needs. So a person who is a PEC or has PEC tendencies will finish with a PRI technique that incorporates flexion, abs and breathing.

As a strength and conditioning specialist, you are very familiar with the Olympic style lifts. With your interest in Postural Restoration™ and after going through the PRT™ process, how do you have your clients/athletes modify these lifts?

How I have approached the use of Olympic style lifts has changed due to the influence of PRI. A majority of my athletes that I work with are middle school to high school age.  To qualify an athlete ready to move into Olympic lifts they must be a solid 3 to 4 on the Hruska Adduction Lift Test and Functional Squat Test score of a 4. I use a “ying and yang” approach when it comes to Olympic lifts in the program. After performing the Olympic lift(s) in the program, there is a flexion based exercise to follow. That could be a Resisted Wall Reach, Door Squat or IO/TA Squat. Due to the Olympic style lifts being primarily sagittal plane, they play only a part in the development of the athlete. To help develop the explosive power needed by an athlete, I integrate multi-dimensional exercises involving medicine balls, ropes, Viprs (looks like a log made of rubber with handles), boxing and plyometric style exercises. All of these tools allow multi-directional/dimensional tri-planar work and in some cases reciprocal movement.

The young athletes I work with are still taught traditional exercises (pressing, rows, ect…). I do this because likely someday down the road, they will be asked to perform them in a gym class setting, with friends or even in a strength program at school. I want them to learn how to execute those exercises with proper form and position and not how some coach did it when he/she was in sports or how a big brother does it at school, or what they have see in a magazine or on TV. 

What is the response that you receive from your athletes and clients regarding your designation of PRT™ and incorporating PRI® principals into their work-outs?

All of my clients and athletes have been very supportive and positive throughout the process of obtaining the designation of PRT. Most of my clients have been with me for many years and have seen and experienced how PRI has influenced the focus and direction of their fitness goals. Educating the client through the PRI assessment process, demonstrating what they can and can’t do and explaining why in simple relatable terms gets the seed planted. During the exercise session the clients will ask questions such as “why they are doing things only one direction?” or “why are we doing this exercise like this and I see everyone else doing it like that?”  Keeping the explanations simple, and as the client experiences the change in how their body feels and functions, they really begin to understand what their training program is trying to accomplish.

Not all clients are ready for the full PRI infusion into their training programs. With these clients it is a slower process of giving them the exercises they need and tweaking the exercises they think they need, until you have time to educate them. If you go “all in” with the PRI style training to soon you may loose them because they are looking for a certain thing that they have seen on TV or in other fitness centers. So if you can bring them along slowly, seeing their PRI assessments change and the positive improvement in the function and feeling of the body, will in turn bring them around the PRI side of things.

What would you say to others in your profession who are considering taking a PRI class or becoming Postural Restoration Trained™?

Start slow, you will have many questions because the material will make you view the body and how it moves different then you have ever thought. I never considered or thought of how the position of the ribs and their movement could affect the function or performance of my athletes and clients. It can be a lot to wrap your head around in the beginning, but as you go through the courses, study the material and gain experience with PRI, each step along the way will bring increased clarity, understanding and confidence. 

The best place to start in conjunction with the courses is as a patient. Everyone I know in the fitness industry has an issue (or 10 issues).  Seek out a PRC therapist and go through the therapy as a client. Experience how your body will change and develop a working relationship with that therapist or clinic. Start slow, don’t try and take the courses as quickly as possible. Take a course, digest and learn the material.  Find a mentor or mentors in the PRI world to help guide you on your journey. 

The study, application and infusion of PRI into performance and fitness training have become my passion. I have seen and experienced the powerful positive affects PRI can have on myself and my athletes and clients. I will soon begin a blog addressing the incorporation of PRI in performance and fitness training. Look for more information to come!

You are currently practicing as a physical therapist at the Hruska Clinic in Lincoln, NE. Tell us what led you to a career in physical therapy and ultimately to your first position at the Hruska Clinic?

I was very involved in athletics growing up, and during high school realized that I had the most talent in golf, so I focused all my attention on my golf game. My senior year of high school I suffered an injury which led me to multiple doctors, physical therapists, Mayo Clinic, and then finally the Hruska Clinic as a patient. Long story short, through this self-experience, I realized that I wanted to become a physical therapist. Playing nearly every sport growing up, I knew that I wanted to work with athletes and still be around sports, so I decided on a major in athletic training. I graduated from Nebraska Wesleyan University in 2006, and became certified as an athletic trainer that summer. While attending physical therapy school at Rockhurst University my first semester, I was approached about becoming a graduate assistant athletic trainer for their athletic teams. This was a tremendous experience, and if I did it over again, I would do the same thing! Being a former patient at the Hruska Clinic, I knew that the Postural Restoration approach was “different” than what I was learning, and I inquired about completing a clinical rotation for my final semester of physical therapy school. I feel so fortunate to have had this opportunity, and then receiving a job offer at the Hruska Clinic following graduation in 2009 was a dream come true.

In addition to seeing patients, you have been involved with our Institute by way of clinical development and support. How has your background prepared you for this role and why do you think this role has suited you so well?

I have really enjoyed the opportunity to be involved with the Postural Restoration Institute over the past year, providing clinical support to healthcare professionals around the country (and world). Having had 9 weeks of clinical internship with Lori Thomsen at the Hruska Clinic while in PT school was so helpful. I cannot even tell you how much I learned during that short time! It was then that I not only knew that I wanted to practice Postural Restoration, but that I wanted to become certified and help spread this approach to others. I went through Postural Restoration Certification in December 2011, and it was a wonderful learning experience as well. I know there are so many individuals who are on their way to becoming PRC and PRT, and I not only want to help them achieve this, but also help grow the Institute for years to come. As I have told others, providing support to healthcare professionals in PRI is “clinical care”, except you are assisting the clinician so that they can in turn assist their patients. I feel honored to be in the situation to spread the knowledge of PRI with others, so that they can help all of their patients and clients!

You and I will be working closely together as we plan for the future of PRI. Both Bobbie and I will be spending more time at home with our young and growing families. This would a great time to let everyone know about the transitions coming up and your new role with PRI.

In the next couple months, I will be transitioning into a full-time position at the Postural Restoration Institute. I am very excited about this opportunity and change in my career! During the transition, I will continue to see patients 1-2 days/week at the Hruska Clinic. Although it wasn’t an easy decision to decrease my time in patient care, I knew it was an opportunity that I couldn’t pass up. Last year, I had the opportunity to fill in part-time at the Postural Restoration Institute while Bobbie was home on maternity leave, and during those couple months I was able to see what really goes on in PRI. There is a lot of “behind the scenes” work, and also a lot of clinical stimulation. By this I mean that I continued to be “challenged” clinically on a daily basis by peers with their clinical questions relating to the courses they have taken, as well as Ron Hruska and the rest of our faculty when preparing course materials. It was for this reason, that I feel the decision to move from patient care to the Postural Restoration Institute is a perfect fit for me!  I loved hearing about how people “found” PRI, their first course attended, their trials and tribulations, as well as a lot of interest being shared in becoming recognized as a Postural Restoration Certified or Postural Restoration Trained professional. All of this excites me, as I see the Institute growing every single day!

Tell us about any projects you are currently working on or goals you have for the coming months.

The biggest project that I am currently working on are the new Non-Manual Techniques CD’s. We hope to have these three CD’s completed in the next couple months, and appreciate everyone’s patience as we continue to work on them. I think people will be excited with the finished product! In addition, I will be meeting with Janie a lot over the next few months on establishing the course schedule for 2013. I am looking forward to assisting those interested in going through the PRC and PRT application process in the coming months!

Congratulations on your recently earned designation of PRT! Can you give us a brief history of your background and how you became interested in your profession and also PRI?

I am the Director of Athletic Training Services at Appalachian State University in Boone, NC. All through high school I really enjoyed sports and had an interest in medicine. My guidance counselor combined my interest in both sports and medicine and directed me into the profession of athletic training.

While working at Hampton University I was struggling with right sacro-iliac joint dysfunction.  Things would get so bad I would not be able to function. One of my assistant athletic trainers would perform muscle energy to get me back into position. However, this would only hold for about ten minutes. The strength and conditioning coach said let me take a look at you and see if I could help. In need of relief I agreed to do whatever he said. After performing the PRI exercises he prescribed I would remain asymptomatic for an entire day. At this point I became intrigued and very inquisitive. After he explained the PRI concept to me I said that makes so much sense I want to know more. I took my first course in 2005 and have been using PRI ever since.

What ultimately made you decide that this designation was of value for you?

As an athletic trainer and a certified strength coach the qualifications mean that you have met set certain criteria to be recognized as a professional in that field. The PRT designation allows me to be recognized as a well trained and qualified professional in Postural Restoration. I also believe that the designation gives more support to PRI when I do presentations and publications and I can say that there is a credentialing process for PRI and I am one of those knowledgeable professionals.

What advice would you have for someone else considering the PRT process?

I would tell everyone to make sure that they take the courses a few times and really get to know the information. Make sure that you spend plenty of time preparing, have a good understanding of what is going on, and study. I really learned a great deal preparing for PRT. I believe the process of getting ready for the PRT credentialing process is as educational as taking the courses.

How do you effectively utilize the Postural Restoration course material in your daily practice? What challenges do you face and how have you overcome them?

I use PRI with every patient I see. I rarely, if ever, do traditional treatment. PRI actually makes sense and the results that I get are phenomenal. The biggest challenge that I encounter is that the majority of athletes are strongly chained PECs. They do not respond as well as traditional patients or non-athletic PECs. To overcome these challenges I do a couple of things.  1.) I will step back and take a look at the given pattern and figure out the best way to break it. I will experiment with different exercises to see what works.  2.) If I am not able to work through something I usually contact another therapist for other opinions. I have found that Raulan Young and Mike Cantrell are very helpful.

Do you have any projects or plans for 2012?

Yes. I am currently working on my PhD in Athletic Training and I have different projects that I have to do. This semester I have to write a case report and submit for publication. I am going to write about a collegiate baseball player that I successfully treated his bilateral SI joint dysfunction with prism glasses. I am also working on a research project where I am going to compare the 90/90 Hip Lift with Right Arm Reach with Balloon to the sleeper stretch. I created a baseball thrower’s prevention and treatment program that is getting a lot of attention due to its success. I may look at getting that published.

I plan on attending the Pelvis Restoration and a PRI Vision course. I also plan to mentor those who express an interest in PRI.

Tell us about your journey with PRI that began back in 2001 at your first course. How did you become interested in Postural Restoration?

Shortly after I graduated from college I was introduced to PRI concepts at a Protonics course offered by EMPI.  However, it wasn’t until I attended a Myokinematic Restoration course that was taught by Ron that I really began to understand PRI.  The concepts were difficult to grasp, but I began using them as I treated.  My early success, particularly with chronic patients, convinced me that there was something profound to the science and I eagerly began taking more and more courses.

You’ve attended multiple courses over the years, taught and mentored other clinicians as an Associate Speaker for PRI, and served on our PRC Application Review Committee. What advice can you share with our readers for successfully integrating PRI into your practice?

First of all, PRI takes significant practice to perfect.  When you first take the course, and see PRI demonstrated, it is very exciting.  However, it is amazing the number of ways that patients will compensate effectively defeating PRI techniques.  It takes time to learn how to spot patients compensation techniques and learn to guide patients to facilitate the correct muscles and inhibit the compensating patterns.  Understand that each patient will have the potential to teach you as much as any PRI Course you may attend.  Second, you must understand PRI is not a cookbook treatment plan.  It is important to understand the basis of every test so that you may interpret the findings . The tests are the tools that guide you in your treatment progression.

You have been a private practice owner for a number of years.  Do you have any advice for therapists considering private practice?

Yes, go someplace else (lol – just kidding)!  The primary reason my business partner Carrie Langer and I decided to go into private practice was that it gave us the opportunity to treat patients as we thought they should be treated.  Unfortunately, most PT clinics we are familiar with treat 1 patient every half hour.  It is extraordinarily difficult to properly treat patients using PRI techniques in that amount of time.  Because of the hour visits we do make the same profits of a traditional PT practice.  To compensate for this, you will need to keep your overhead low.  One of the best methods we have for this is instituting EMR Software immediately after opening our clinic.  It was a significant initial expense, but has paid for itself many times over in the years since and by doing it immediately; we did not have the huge costs that would have been associated with conversion later on.

You were a member of the very first class to earn the designation of Postural Restoration Certified in 2004 (along with James Anderson, Raulan Young, Jason Masek and Carrie Langer). What made you decide to go through the Postural Restoration Certification process?

I had the luxury of working with Carrie Langer who was just as passionate as I was about the science of PRI.  Once we began to understand PRI concepts, we fed off each other’s success and enthusiasm.  Once certification was an option, wild horses couldn’t have prevented us from getting certified.  As all who have chosen the path of certification will tell you, it was the most rewarding and educational experience one can go through.

Has becoming certified presented any new opportunities you feel you wouldn’t have had otherwise?

Absolutely!  First and foremost, I wouldn’t have the love for what I do without PRI.  Second, I wouldn’t have had the opportunity to lecture and have the exposure to other medical professionals without PRI.  And third, I probably would not have gone into private practice without PRI.

You have in-serviced physicians, dentists, optometrists, trainers, etc, around your area.  Has this helped opened doors for your own practice?

Our initial in-service sessions did open some doors, but more importantly they introduced us to other medical professionals who were willing to learn PRI concepts.  Educating these professionals on an ongoing basis gives us a common understanding of PRI science so that we can work together for the best treatment of our patients.  It is the success with our shared patients that creates real opportunities for both us and our medical partners. 

What PRI non-manual techniques do you find yourself using most often?

Being in the upper Midwest we tend to see a lot of patients that are stuck in the posterior extension chain (PEC) pattern.  Therefore I tend to focus on activities that increase flexion of the spine using the abdominals, most importantly the IO/ TA.  For example: Standing Supported IO/TA with Chair or Short Seated Wall Reach with Balloon.

Out of all of the courses PRI offers, do you have a favorite?  If yes, why?

I enjoy all of the course work, but have found the Pelvic Restoration course has advanced my practice further in the last year.  I am grateful for the time that both Lori and Heather have put into the course as it has expanded my understanding of how the pelvic floor diaphragm works with the abdominal wall and respiratory diaphragm to stabilize “the core”.  I was excited to see the course has a new name which better reflects the nature of the course.  That it is not just a woman’s health course, but is applicable to all PRI practitioners.  I encourage all those who have not attended the course to look into attending in the future.

If you were to attend a non-PRI continuing education course, what would it be?

I have discussed this with other PRC therapist and I believe this is one of the most difficult challenges: to find courses that encourages growth and integrates will with PRI concepts.  I look to more neurological based course work than orthopedic.  However since PRI science is expanding, the new course work looking towards vision and auditory components will keep us busy for the foreseeable future.

Do you have any projects or plans for 2012?

I continue to search for other professionals to further expand our patient’s treatment options.  We also hope to grow our staff with PRI trained therapists.  I look forward to continuing my role as adjunct facility to help spread the adoption of PRI science.