Postural Respiration

An Integrated Approach to the Treatment of Patterned Thoraco-Abdominal Pathomechanics

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Course Format

This advanced lecture and lab course is structured so that clinicians will gain an appreciation for the patterned respiration influences on: rib torsion, asymmetrical oblique strength, costal and crural function, habitual use of accessory respiratory musculature, and a positionally restricted diaphragm. The focus of this course will be to assess and restore polyarticular muscular chain function of both hemi-lateral thoraxes and their respective pleura. Treatment interventions including manual and non-manual techniques to restore reciprocal and alternating respiratory and rotational function of the thorax will be covered. Participants will be able to immediately apply PRI clinical assessment and intervention strategies when treating diagnoses that are related to undesirable airflow patterns, such as shortness of breath, thoracic outlet syndrome, and shoulder dysfunction.

Education Level: Advanced
Student Faculty Ratio 16:1

Instructional Methods: Lecture, demonstration & lab, clinical application, case studies, and Q&A

Live Stream courses will take place from 8am-5pm CT each day, and certificates of completion/CE credit will be awarded the following week after completion of the course evaluation survey and short post-test. For more information on whether your state/organization is approved for CE approval, please click on the “CE Approval” tab. Live Stream courses will be engaging, interactive and include demonstration of objective testing and/or non-manual techniques, in addition to course attendees being able to ask questions throughout the course. All that’s needed on your end is reliable internet access, a webcam, microphone and speaker (or a smart phone can be used if you do not have a computer or laptop with this capability) to utilize ZOOM for the live stream course. The ZOOM links for the live stream course will be included in the confirmation email. The course manual will be shipped directly to you 1-2 weeks before the course. *International registrants are discounted $30 since we do not ship manuals internationally, however you will be able to print the digital manual if you so choose. A digital version of the course manual will be added to your PRI account the week of the course. In addition, participants will receive access to the recording of the live stream course for 14 days to review the material, and re-watch any material that may have been missed due to connection issues. Those who attend in-person during a live streamed course will also receive access to the recording for 14 days. Extensions beyond this 14 day review are not available. ***Please note: In order to receive access to the recording for review, you must participate in person on the Live Stream course with your camera on for at least half of the course (7.5 hours). If you sign up for the course and do not participate in at least 7.5 hours of the live stream, you will not receive the recording and you will not be refunded. Also, once course manuals have been shipped (or the digital version has been added to your account), there will be no refunds for cancellations.***

Recognize relationships between static asymmetrical respiration, ideal physiologic respiration, and patterned respiration.
Identify how to restore restrictive polyarticular chains and torsional patterns of the trunk through specific manual and non-manual orientation of ventilatory muscle, and thoracic osseous structure.
Recognize how to maximize thoracic scapular force couples, rib alignment, and abdominal-diaphragm muscle integration for appropriate motor and sensory perceptual skill development of the upper extremities.
Outline how to design a postural isolation and inhibition program that promotes integration of appropriate hemi-thoracic airflow to reduce occupational, leisure, and sleep breathing dysfunction patterns.

Day One

7:30am – 8:00am	Registration and Light Breakfast
8:00am – 9:00am	Overview of Anterior Interior Chain (AIC), Brachial Chain (BC) and Zone of Apposition (ZOA) Relationships
9:00am – 10:00am	Static Structural Asymmetry and Dynamic Respiratory Influences on Hemi-Diaphragm and Hemi-Thorax Function
10:00am – 10:15am	Break
10:15am – 11:00am	Patterned Respiration and Associated Airflow
11:00am – 12:00pm	Anterior Interior Chain: Muscle and Structure
12:00pm – 1:00pm	Lunch (on your own)
1:00pm – 2:00pm	Left AIC Objective Testing (Demonstration)
2:00pm – 3:00pm	Left AIC Non-Manual and Manual Techniques (Demonstration)
3:00pm – 3:15pm	Break
3:15pm – 4:00pm	Left AIC Objective Testing & Manual Techniques (Lab)
4:00pm – 4:30pm	Brachial Chain: Muscle and Structure
4:30pm – 5:00pm	Overview of Thoracic Mediastinum Function

Day Two

7:45am – 8:00am	Sign-In and Light Breakfast
8:00am – 9:30am	Right BC Objective Testing (Demonstration and Lab)
9:30am – 10:00am	Postural Respiration Functional Relationships
10:00am – 10:15am	Break
10:15am – 11:00am	Right BC PRI Treatment Guidelines
11:00am – 11:30am	Superior T4 Airflow
11:30am – 12:00pm	Right Superior T4 and Right Subclavius Manual Techniques (Demonstration)
12:00pm – 1:00pm	Lunch (on your own)
1:00pm – 2:00pm	Right Superior T4 and Right Subclavius Manual Techniques (Lab)
2:00pm – 3:00pm	Left Low Trap/Left Serratus Anterior Non-Manual Techniques
3:00pm – 3:15pm	Break
3:15pm – 4:00pm	Right Low Trap/Right Tricep Non-Manual Techniques
4:00pm – 4:30pm	Posterior Exterior Chain and PEC Inhibition Techniques
4:30pm – 5:00pm	Case Studies

Dynamic Function/Posture

Boyle K, Olinick J, Lewis C. The Value of Blowing Up a Balloon. North American Journal of Sports Physical Therapy (NAJSPT). September 2010;5(3):179-188.
Buford J, Yoder S, Givens Heiss D, Chidley J. Actions of the scalene muscles for rotation of the cervical spine in macaque and human. JOSPT Oct 2002; 32(10): 488-496.
DiPanfilo R, Candelaria S, et al. Thoracic mobility and athletic performance. NSCA Coach. Aug 2019;6(2):36-42.
Flynn T. The thoracic spine and rib cage; musculoskeletal eval and treatment.1996. Butterworth-Heinemann, Newton.
Hodges PW. Is there a role for transverses abdominis in lumbo-pelvic stability? Manual Therapy. 1999;4(2): 74-86.
Hudson AL, Butler JE, et al. Role of the diaphragm in trunk rotation in humans. JN Physiol. Oct 2011;106(4):1622-28.
Kolar P, Sulc J, et al. Postural function of the diaphragm in persons with and without chronic low back pain. Journal of Orthopaedic and Sports Physical Therapy. Apr 2012;42(4):352-62.
Jackson LR, Purvis J, Brown T. The effects of postural and anatomical alignment on speed, power and athletic performance in male collegiate athletes: a randomized controlled trial. IJSPT. August 2019;14(4):623-636.
Karimi N, Fathizadeh M, et al. Efficacy of pelvic repositioning exercises on pain, hip and shoulder range of motion and disability of the patients with chronic non-specific low back pain: a single blinded randomized controlled trial. Journal of Rehabilitation Sciences and Research. 2021;8(3):106-114.
Kouwenhoven JW, Vincken KL, Bartels LW, Castelein RM. Analysis of preexistent vertebral rotation in the normal spine. Spine 2006;31:1467-1472.
Mezieres F. “Importance de la Statique Cervicale”, Cahiers de la Methode Naturelle, No. 51, 1972.
Mezieres F. “Le Reflexe Antalgique a Priori,” Cahiers de la Methode Naturelle, No. 44, 1970.
Mezieres F. “Les Pieds Plats,” Cahiers de la Methode Naturelle, No. 49, 1972.
Mezieres F. “Methodes Orthopediques” and “La Fonction du Sympathique,” Cahiers de la Methode Naturelle, Nos. 52-53, 1973.
Morais NV, Pascoal AG. Scapular positioning assessment: Is side-to-side comparison clinically acceptable? Manual Therapy. 2013;18:46-53.
Myers T. Anatomy trains; myofascial meridians for manual and movement therapists. 2002 Churchill Livingstone, Edinburgh.
Nourbakhsh MR, et al. The effects of pelvic alignment versus hip joint mobility on shoulder internal rotation deficit and torque production – A blinded randomized controlled study. Physical Therapy in Sport. 2018; 34:164-173.
O’Sullivan P, Beales D, Beetham J, Cripps J, Graf F, Lin I, Tucker B, Avery A. Altered motor control strategies in subjects with sacroiliac joint pain during the active straight leg raise test. Spine 2002; 27(1):E1-E8.
Oda I, Abumi K, Lu D, Shono Y, Kaneda K. Biomechanical role of the posterior elements, costovertebral joints, and rib cage in stability of the thoracic spine. Spine. 1996;21(12): 1423-1429.
Rothstein JM. Editor’s Note: What we don’t know can hurt us. Physical Therapy. Oct 2002;82(10).
Skaggs JR, et al. The effect of arm and body position on respiratory ventilation in high school athletes: a pilot study. International Journal of Athletic Training. 2016;21(1):30-34.
Szcygiel E, Weglarz K, et al. Biomechanical influences on head posture and the respiratory movements of the chest. Acta of Bioengineering and Biomechanics. 2015;17(2):143-148.
Waldron JL, McKenney MA, et al. The use of postural restoration for treatment of chronic rotator cuff pathology: a case report. Int J Sports Phys Ther. 2020 Oct;15(5):832-839.
Yeamattanaporn O, Mekhora K, Jalayondeja W, Wongsathikun J. Immediate effects of breathing re-education on respiratory function and range of motion in chronic neck pain. J Med Assoc Thai Vol 97 Suppl. 7 2014. S55-S59.

Neurology

Bagesteiro L and Sainburg R. Handedness: dominant arm advantages in control of limb dynamics. J Neurophysiol 88: 2408-2421, 2002.
Barnes M, Crutchfield C, Heriza C. The neurophysiological basis of patient treatment. Volume II, Reflexes in motor development. West Virginia, Stokesville Publishing Company, 1978.
Ben-Dov I, et al. Diaphragmatic paralysis: a clinical imitator of cardiorespiratory diseases. Israel Medical Association Journal. 2008; 10(8-9):579-583.
Bertherat T, Bernstein C. The body has its reasons; self-awareness through conscious movement. Healing Arts Press, 1989.

Bordoni B, Marelli F, et al. The five diaphragms in patients following cardiac surgery in sternotomy: An observational study. Int J Complement Alt Med. 2017; 7(6):00245.
Bordoni B, Simonelli M, Morabito B. The fascial breath. Cureus. 2019;11(7):e5208.
Bordoni B, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. Journal of Multidisciplinary HealthCare. 2013:6 281–291.
Bordoni B, Zanier E. The continuity of the body: Hypothesis of treatment of the five diaphragms. The Journal of Alternative and Complementary Medicine. 2015; 21(4):237-242.
Brunnstrom S. Movement therapy in hemiplegia. New York, Harper and Row Publishers, 1970.
Cherniack NS, et al. Responses of upper airway, intercostal and diaphragm muscle activity to stimulation of oesophageal afferents in dogs. The Journal of Physiology. 1984; 349(1):15-25.
Corda M, et al. Proprioceptive innervation of the diaphragm. The Journal of Physiology. 1965; 178(1):161-177.
Day LB, MacNeilage PF. Postural asymmetries and language lateralization in humans (Homo sapiens). J Comp Psychol. 1996 Mar;110(1):88-96.
Elliott S. The new science of breath, 2nd ed. Coherence Publishing. 2005.
Fiorentino MR. Normal and abnormal development. The influences of primitive reflexes on motor development. Springfield, Charles C Thomas, 1972.
Gabbard C, Hart S. Effects of standing and sitting on finger-tapping speed in healthy adults. JOSPT. Oct 2002; 32 (10): 525-529.
Henderson AT, et al. Effects of rib raising on the autonomic nervous system: a pilot study using noninvasive biomarkers. J AM Osteopath Assoc. 2010 Jun; 110(6):324-330.
Hjortskov N, et al. The effect of mental stress on heart rate variability and blood pressure during computer work. Eur J Appl Physiol. 2004 Jun; 92(1-2):84-89.
Hodges PW, Butler JE, McKenzie DK, Gandevia SC. Contraction of the human diaphragm during rapid postural adjustments. Journal of Physiology (1997), 505.2, pp.539-548.
Hodges PW, Heijnen I, Gandevia SC. Postural activity of the diaphragm is reduced in humans when respiratory demand increases. Journal of Physiology (2001), 537.3, pp. 998-1008.
Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. Physical Therapy. 1997; 77(2):132-144.
Hodges PW, Richardson CA. Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement. Exp Brain Res (1997) 114:362-370.
Kenyon CM, Cala SJ, Yan S, Aliverti A, Scano G, Duranti R, Pedotti A, Macklem PT. Rib cage mechanics during quiet breathing and exercise in humans. J Appl Physiol. 1997 Oct;83(4):1242-55.
Khedr EM, Trakhan MN. Localization of diaphragm motor cortical representation and determination of corticodiaphragmatic latencies by using magnetic stimulation in normal adult human subjects. Eur J Appl Physiol. 2001; 85:560-566.
Leonard C. The neuroscience of human movement. 1998. Mosby, St. Louis.
Malik M. Heart rate variability – standards of measurement, physiological interpretation and clinical use. Task Force – European Society of Cardiology and The North American Society of Pacing and Electrophysiology. Eur Heart J. 1996; 17:354-381.
Niedringhaus M, et al. Dorsal motor nucleus of the vagus: a site for evoking simultaneous changes in crural diaphragm activity, lower esophageal sphincter pressure, and fundus tone. AM J Physiol Regul Integr Comp Physiol. 2008 Jan; 294(1):R121-R131.

Pickering M, Jones James FX. The diaphragm: two physiological muscles in one. J. Anat. 2002; 201: 305-312.
Porac C and Coren S. Lateral preferences and human behavior. Springer-Verlag New York, 1981.
Previc FH. A general theory concerning the prenatal origins of cerebral lateralization in humans. Psychol Rev. 1991 Jul;98(3):299-334. Review.
Redding G, Song K, et al. Lung function asymmetry in children with congenital and infantile scoliosis. The Spine Journal, 2008; 8(4):639-644.
Shumway-Cook A & Woollacott M. Motor control; theory and practical applications. 1995. Williams & Wilkins, Baltimore.
Terada M, Kosik KB, McCann RS, Gribble PA. Diaphragm Contractility in Individuals with Chronic Ankle Instability.
Tokizane T el al. Electromyographic studies on tonic neck, lumbar and labyrinthine reflexes in normal persons. Jpn J Physiol 2:130-145, 1951.
Volkmann J, Schnitzler A, Witte OW, Freund H. Handedness and asymmetry of hand representation in human motor cortex. J Neurophysiol. 1998 Apr;79(4):2149-54.
Vrijkotte TG, et al. Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability. Hypertension. 2000 Apr; 35(4):880-886.
Young RL, et al. Sensory and motor innervation of the crural diaphragm by the vagus nerves. Gastroenterology. 2010 March; 138(3):1091-1101.

Respiration

Barral JP. The thorax. 1991 Eastland Press, Seattle.
Basu S, Kakade PP, et al. Influence of abdominal and hamstring muscle activation exercises over iliotibial band stretching on a positive Ober’s test in subjects with low back pain. Global Journal for Research Analysis. May 2017; 6(5):704-705.
Beeckmans N, Vermeersch A, et al. The presence of respiratory disorders in individuals with low back pain: A systematic review. Manual Therapy. 2016;6:77-86.
Bertherat T & Bernstein C. The body has its reasons; self-awareness through conscious movement. 1989 Healing Arts Press, Rochester.
Bordoni B et al. The influence of breathing on the central nervous system. Cureus. 2018;10(6): e2724. DOI 10.7759/cureus.2724
Bordoni B, Morabito B. Symptomatology correlations between the diaphragm and irritable bowel syndrome. Cureus. 2018;10(7):e3036.
Boyle K, Olinick J, Lewis C. The value of blowing up a balloon. North American Journal of Sports Physical Therapy (NAJSPT). September 2010;5(3):179-188.
Bradley H, Esformes J. Breathing pattern disorders and functional movement. The International Journal of Sports Physical Therapy, Feb 2014, 28-38.
Buchholz I. Breathing, voice, and movement therapy: applications to breathing disorders. Biofeedback and Self Regulation.1994;19 (2): 141-153.
Calais-Germain B. Anatomy of breathing. Eastland Press, Inc. Seattle. 2006.
Carreiro JE. An osteopathic approach to children, 2^nd ed. Churchill Livingstone. 2009.
Chaitow L, Bradley D, Gilbert C. Multidisciplinary Approaches to Breathing Pattern Disorders. Churchill Livingstone. 2002.
Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine 2004; 7(1): 34-41.
Courtney R. The functions of breathing and its dysfunctions and their relationship to breathing therapy. International Journal of Osteopathic Medicine. Elsevier 12 (2009) 78-85.

Fried R. Breathe well, be well. John Wiley & Sons, Inc. 1999.
Gilbert C. Hyperventilation and the body. Journal of bodywork and movement therapies. July 1998.
Hellyer N, Andreas N, et al. Comparison of diaphragm thickness measurements among postures via ultrasound imaging. PMR. 2017;9:2-25.
Hodges PW, Gandevia SC. Changes is intra-abdominal pressure during postural and respiratory activation of the human diaphragm. J Appl Physiol. 2000:89:967-976.
Hodges PW, Kaigle Holm A, Holm S, et al. Intervertebral stiffness of the spine is increased by evoked contraction of transversus abdominis and the diaphragm: in vivo porcine studies. Spine. 2003:28:2594-2601.
Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine. 1996;21:2640-2650.
Hodges PW, Richardson, CA. Transversus abdominis and the superficial abdominal muscles are controlled independently in a postural task. Neurosci Lett. 1999;265:91-94.
Homma I, Hagbarth K. Thixotropy of the ribcage respiratory muscles in normal subjects. Journal of Applied Physiology 89:1753-1758, 2000.
Horris H, Anderson BE, et al. Clinical breathing mechanics differ based on test and position. Journal of Sport Rehabilitation. 2019;28:635-639.
Hruska RJ. Influences of dysfunctional respiratory mechanics on orofacial pain. Dental Clinics of North America. April 1997; 41(2): 211-227.
Izumizaki M, Shibata M, Homma I. Factors contributing to thixotropy of inspiratory muscles. Respiratory Physiology and Neurobiology 140:257-264, 2004.
Kiesel K, Rhodes T, et al. Development of a screening protocol to identify individuals with dysfunctional breathing. IJSPT. 2017 Oct;12(5):774-781.
Kocjan J, Adamek M, et al. Network of breathing. Multifunctional role of the diraphragm: a review. Advances in Respiratory Medicine. 2017;85(4):224-232.
Kolar P, et al. Analysis of diaphragm movement during tidal breathing and during its activation while breath holding using MRI synchronized with spirometry. Physiol. Res. 2009;58:383-392.
Layachi L, Georges M, et al. Diaphragm pacing failure secondary to deteriorated chest wall mechanics: When a good diaphragm does not suffice to take a good breath in. Respiratory Medicine Case Reports 15 2015:20-23.
Lomax M, McConnell A. Ispiratory muscle fatigue in swimmers after a single 200 m swim. Journal of Sports Sciences, 2003; 21:659-664.
Newton A. Breathing in the gravity field. Rolf Lines Fall 1997; 27-33. Available online.
Obayashi et al. Effects of respiratory-muscle exercise on spinal curvature. Journal of Sport Rehabilitation, 2012; 21:63-68.
Priyanka P Ostwal, Wani SK. Breathing patterns in patients with low back pain. Int J Physiother Res. 2014; 2(1):347-53.
Puliti B. Resistive Breathing Influence on Performance. Advance Aug 2007; 13-15.
Russell MEB, Scott AB, et al. Inclusion of a rest period in diaphragmatic breathing increases high frequency heart rate variability: Implications for behavioral therapy. Psychophysiology. 2017; 54:358-365.
Seo KC, Cho MS. The effects of a balloon-blowing exercise in a 90/90 bridge position using a ball on the pulmonary function of females in their twenties. J Phys Ther Sci, 2018;30:1267-1270.
Shimozawa Y, Kurihara T, et al. Point prevalence of the biomechanical dimension of dysfunctional breathing patterns among competitive athletes. J Strength Cond Res. 2022 May 24.
doi: 10.1519/JSC.0000000000004253.
Snosek M, Tubbs RS, et al. Sternalis muscle, what every anatomist and clinician should know. Clinical Anatomy. 2014;27:866-884.
Hirasawa T, Kuratani S. A new scenario of the evolutionary derivation of the mammalian diaphragm from shoulder muscles. J Anat. 2013 May;222(5):504-517.
Wallden M. The diaphragm – more than an inspired design. Journal of Bodywork and Movement Therapies. 2017 Apr; 21(2):342-349.
Wilson R, Legrand A, Gevenois PA, De Troyer A. Respiratory effects of the external and internal intercostal muscles in humans. Journal of Physiology. 530.2:319-330, 2001.

Zone of Apposition

Bacci I, Richman M. Fibromyalgia: a new paradigm for its origins and treatment. ADVANCE for Physical Therapists and PT Assistants. Dec 3, 2001:31-32.
Bartels L. Rib cage influences on the volleyball players shoulder. Performance Volleyball Conditioning. 2007;13(7).
Boyle K, Olinick J, Lewis C. The Value of Blowing Up a Balloon. North American Journal of Sports Physical Therapy (NAJSPT). September 2010;5(3):179-188.
Boynton B, Barnas G, Dadmun J, Fredberg J: Mechanical coupling of the rib cage, abdomen, and diaphragm through their area of apposition. J Appl Physiol 70:3, 1991.
Buchholz I: Breathing, voice, and movement therapy, applications to breathing disorders. Biofeedback Self-Regul 19:2, 1994.
Cassart M, Pettiaux N, Gevenois PA, Paiva M, Estenne M. Effect of chronic hyperinflation on diaphragm length and surface area. Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):504-8.
Clanton TL, Diaz PT: Clinical assessment of the respiratory muscles. Phys Ther 75:11, 1995.
CliftonSmith T, Rowley J. Breathing pattern disorders and physiotherapy: inspiration for our profession. Physical Therapy Reviews. 2011;16(1):75-86.
De Troyer A, Wilson TA. Action of the diaphragm on the rib cage. Journal of Applied Physiology. 2016; 121(2):391-400.
De Troyer A, Estenne M: Functional anatomy of the respiratory muscles. Clin Chest Med 9:2, 1988.
Estenne M, Derom E, De Troyer A. Neck and abdominal muscle activity in patients with severe thoracic scoliosis. Am J Respir Crit Care Med. 1998 Aug;158(2):452-7.
Flynn T: The thoracic spine and rib cage. Musculoskeletal evaluation and treatment. Butterworth-Heinemann, Newton, MA. 1996.
Goldman M, Mead J: Mechanical interaction between the diaphragm and the rib cage. J Appl Physiol 35:2, 1973.
Hodges P, Gandevia S, Richardson C: Contractions of specific abdominal muscles in postural tasks are affected by respiratory maneuvers. J Appl Physiol 83:3, 1997.
Hruska RJ: Influences of dysfunctional respiratory mechanics on orofacial pain. Dent Clin North Am 41:2, 1997.
Hruska RJ: Management of pelvic-thoracic influences on temporomandibular dysfunction. Ortho Phys Ther Clin North Am 11:2, 2002.
Hutt D, Parisi R, Edelman N, Santiago T. Responses of diaphragm and external oblique muscles to flow-resistive loads during sleep. Am Rev Respir Dis. 1991;144(5): 1107-1111
Ishida H, Watanabe S. Changes in lateral abdominal muscles’ thickness immediately after the abdominal drawing-in maneuver and maximum expiration. Journal of Bodywork & Movment Therapies. 2013;17:254-258.
Kolar P, Neuwirth J, et al. Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment. J Appl Physiol. Oct 2010; 109(4):1064-71.
Koo P, Gartman EJ et al. Physiology in medicine: Physiological basis of diaphragmatic dysfunction with abdominal hernias-implications for therapy. J Appl Physiol, 2015. 118:142-147.
Lando Y, Boiselle PM, Shade D, Furukawa S, Kuzma AM, Travaline JM, Criner GJ. Effect of lung volume reduction surgery on diaphragm length in severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999 Mar;159(3):796-805.

Maskill D, Murphy K, Mier A, et al: Motor cortical representation of the diaphragm. J Phys Great Britian 443:119, 1991.
McKenzie DK, Gandevia SC, Gorman RB, Southon, FCG. Dynamic changes in the zone of apposition and diaphragm length during maximal respiratory efforts. Thorax. 1994;49: 634-638
Mead J: Functional significance of the area of apposition of diaphragm to rib cage. Am Rev Respir Dis 11:31, 1979.
Michaelson JV, et al. Effects of two different recovery postures durign high-intensity interval training. Translational Journal of the ACSM. Feb 2019;4(4):23-27.
Nason L, Walker C, et al. Imaging of the diaphragm: Anatomy and function. Radiographics. 2012;32:E51-70.
Petroll WM, Knight H, Rochester DF: Effect of lower rib cage expansion and diaphragm shortening on the zone of apposition. J Appl Physiol 68:2, 1990.
Reddy V, Sharma S, Cobanoglu A: What dictates the position of the diaphragm – the heart of the liver? J Thorac Cardiovasc Surg 108:4, 1994.
Reid WD, Dechman G: Considerations when testing and training the respiratory muscles. Phys Ther 75:11, 1995.
Valenza MC, et al. The immediate effects of doming of the diaphragm technique in subjects with short hamstring syndrome: a randomized controlled trial. Journal of Sport Rehabilitation. June 2015.
Vostatek P, Novak D, et al. Diaphragm postural function analysis using magnetic resonance imaging. PLOS ONE. 2013;8(3):e56724.
Vleeming A, Mooney V, Dorman T, Snijders C, Stoeckart R. Movement stability and low back pain. The essential role of the pelvis. Churchill Livingstone, 1997.
Walpin L. Sitting: there is more to it than meets the eye…or seat. Physical Therapy Products. Sept 1996: 64-67

Anterior Interior Chain (AIC)
Muscles: Diaphragm, Psoas, Iliacus, TFL, Vastus Lateralis, Biceps Femoris
Opposition Muscles: Hamstrings, Gluteals, Internal Obliques
There are two anterior interior polyarticular muscular chains in the body that have a significant influence on respiration, rotation of the trunk, ribcage, spine and lower extremities. They are composed of muscles that attach to the costal cartilage and bone of rib seven through twelve to the lateral patella, head of the fibula and lateral condyle of the tibia. These two tracts of muscles, one on the left side of the interior thoraco-abdominal-pelvic cavity and one on the right, are composed of the diaphragm and the psoas muscle. With the iliacus, tensor fasciae latae, biceps femoris and vastus lateralis muscles this chain provides the support and anchor for abdominal counter force, trunk rotation and flexion movement.

Brachial Chain (BC)
Muscles: Anterior-Lateral Intercostals, Deltoid-Pectoral, Sibson’s Fascia, Triangularis Sterni, Sternocleidomastoid, Scaleni, Diaphragm
Opposition Muscles: Triceps, Lower Trapezius, Abdominal Obliques
There are two brachial polyarticular muscular chains lying over the anterior pleural and cervical area. These chains influence cervical rotation, shoulder dynamics and apical inspirational expansion. They are composed of muscle that attaches to the costal cartilages and bone of ribs four through seven and xiphoid to the posterior, inferior occipital bone, anterior, inferior mandible and coracoid process of scapula. These two tracks of muscles, one on the left side of the sternum and one on the right, are anterior to the medial and upper mediastinum and upper thoracic cavity and are composed of the triangular sterni, sternocleidomastoid, scalene, pectoralis minor, intercostals and muscles of the pharynx and anterior neck. They provide the support and anchor for cervical-cranial orientation and rotation and rib position. The right brachial chain muscle is opposed by the right posterior back muscles (PEC), lower trap, serratus anterior, and external rib rotators, in addition to the left internal abdominal obliques. The brachial chain muscle on the left is opposed by the left posterior back muscles (PEC), lower trap, serratus anterior, external rib rotators, and right internal abdominal obliques.

Posterior Exterior Chain (PEC)
Muscles: Latissimus Dorsum, Quadratus Lumborum, Posterior Intercostals, Serratus Posterior, Iliocostalis Lumborum
Opposition Muscles: Abdominal Obliques

Licensed Physical Therapists and PT Assistants

Licensed Occupational Therapists and OT Assistants (Classification Codes)

Licensed Chiropractors

Certified Athletic Trainers

Certified Strength & Conditioning Coaches

Certified Personal Trainers

Licensed Massage Therapists

Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited university are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.

Accessible Learning Environments
All participants in Postural Restoration Institute™ (PRI) continuing education courses are entitled to an accessible, accommodating, and supportive teaching and learning environment. Participants have the right to request accommodations and the responsibility to provide disability documentation that supports those requests. PRI has the right to establish eligibility guidelines in accordance with both law and policy regarding disability and provide those accommodations that appropriately provide equal access to the programs and activities it sponsors.

A Certificate of Completion for 15 contact hours is awarded to attendees upon the successful completion of this course. Before attending a course, please verify CEU acceptance with your profession’s regulating body.

Physical Therapists and PT Assistants

In the states where PRI is sponsoring courses and where approval through state American Physical Therapy Association (APTA) or licensing agencies is required, PRI will apply for approval for CEUs for Physical Therapists and Physical Therapist Assistants.

The following states accept other state approval and thus would honor this course as an approved course:
Alabama, Arizona, Colorado, Connecticut, Washington DC, Delaware, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, Wyoming.
Approved by the Arkansas State Board of Physical Therapy for 15 hours. Date of Approval 6/21/18. Approval does not expire, provided the course does not change.
Approved by the Maryland Board of Physical Therapy Examiners for 1.5 CEU’s. Approval valid January 12, 2022 – January 12, 2026.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 – February 17, 2025.
Approved by the Texas Board of Physical Therapy Examiners as meeting continuing education requirements for PTs and PTAs. Approval has been granted for 15 continuing competency units (CCUs). Approved October 25, 2024-October 25, 2026. Approval #79116TX.
Approved by the California Physical Therapy Association for 1.5 CEUs. CPTA#24-310 Approval valid October 25, 2024 – October 25, 2025. *Approval valid only for courses offered in the state of California & Live Streams. If you attend this course outside the state of California, you will need to submit an individual CEU approval application with the CPTA.
Approved by the Illinois Physical Therapy Association for 15 CE Hours. Course Approval #205-9090. Approval valid January 1, 2024 – January 1, 2025.

Chiropractors

In the states where PRI is sponsoring courses and where approval through state licensing agencies is required, PRI will look into applying for CEUs for Chiropractors (upon request). Requests must be made at least 90 days prior to the course date.

Approved by the Minnesota Board of Chiropractic Examiners for 15 regular units of instruction for 2024 course dates.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 – February 17, 2025.
Approved by the Maryland State Board of Chiropractic Examiners for 15 CEU credits. Approval valid January 11, 2024 – January 11, 2029.

Occupational Therapists and OT Assistants

PRI is no longer recognized as an Approved Provider through the American Occupational Therapy Association (AOTA). Many states do not require any sort of pre-approval process. And of the ones that do, most state licensure boards allow self-submission of CE programs. Please check with your state licensure board to determine if you will be able to submit PRI courses for CE hours.

Athletic Trainers

Postural Restoration Institute (BOC AP# P2376) is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. This program is eligible for a maximum of 15 Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.

Strength and Conditioning Coaches

This course is approved by the Collegiate Strength & Conditioning Coaches Association (CSCCa) for 7.5 CEU’s.

Since continuing education courses are not required to have pre-approval through the National Strength and Conditioning Association (NSCA), this course is not currently approved through the NSCA. NSCA certificants interested in completing this course may contact the NSCA to inquire about CEU eligibility.

Massage Therapists

PRI is approved by the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) as a continuing education Approved Provider. Provider number 451877-12. *Approval applies to select live courses only. This live course is approved. **Approval not valid for New York licensed massage therapists.

Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited universtity are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.

PRI reserves the right to cancel and refund a course attendee’s registration if any concerns arise regarding the course attendee’s qualifications as a healthcare or fitness professional, copyright infringement, or any other illegal activity involving PRI copyrighted materials. International attendees may be required to review and sign a Copyright and Intellectual Property Recognition and Disclosure Contract prior to receiving access to course materials.

Physical Therapists and PT Assistants

The following states accept other state approval and thus would honor this course as an approved course:
Alabama, Arizona, Colorado, Connecticut, Washington DC, Delaware, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, Wyoming.
Approved by the Arkansas State Board of Physical Therapy for 15 hours. Date of Approval 6/21/18. Approval does not expire, provided the course does not change.
Approved by the Maryland Board of Physical Therapy Examiners for 1.5 CEU’s. Approval valid January 12, 2022 – January 12, 2026.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 – February 17, 2025.
Approved by the Texas Board of Physical Therapy Examiners as meeting continuing education requirements for PTs and PTAs. Approval has been granted for 15 continuing competency units (CCUs). Approved October 25, 2024-October 25, 2026. Approval #79116TX.
Approved by the California Physical Therapy Association for 1.5 CEUs. CPTA#24-310 Approval valid October 25, 2024 – October 25, 2025. *Approval valid only for courses offered in the state of California & Live Streams. If you attend this course outside the state of California, you will need to submit an individual CEU approval application with the CPTA.
Approved by the Illinois Physical Therapy Association for 15 CE Hours. Course Approval #205-9090. Approval valid January 1, 2024 – January 1, 2025.
Approved by the Minnesota Board of Physical Therapy for 15 hours. Course Approval #9647. Approval valid January 1, 2024 – December 31, 2024. *Approved for live stream courses only. If you are planning to attend an in-person course, please reach out before the course so we can look into getting approval.*

Chiropractors

Approved by the Minnesota Board of Chiropractic Examiners for 15 regular units of instruction for 2024 course dates.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 – February 17, 2025.
Approved by the Maryland State Board of Chiropractic Examiners for 15 CEU credits. Approval valid January 11, 2024 – January 11, 2029.

Occupational Therapists and OT Assistants

Athletic Trainers

Strength and Conditioning Coaches

This course is approved by the Collegiate Strength & Conditioning Coaches Association (CSCCa) for 7.5 CEU’s.

Massage Therapists

Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited universtity are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.

Dan does such a good job presenting the info. Such valuable info on the rib cage and breathing mechanics, which are widely undervalued in con-ed courses I’ve taken before. | Live Stream, October 2024
Dan was great and really exemplified his experience in the field with some excellent examples of his work and his experience applying PRI concepts in his work and in his career overall. | Live Stream, October 2024
Louise and Craig were my favorite instructors so far! | Cary, NC, October 2024
I thought Louise and Craig were exceptional instructors. I loved how they would “zoom out” and show us how pressure and airflow are affecting movement up and down the chain. | Cary, NC, October 2024
Skip was an excellent and knowledgeable presenter and I would be delighted to take future courses with him. |Missoula, MT, October 2024
Louise was great!! She “translated” the compacted PRI language and made the presentation easy to follow. | West Boylston, MA, September 2024
Louise was awesome. Best PRI speaker so far. She taught the PRI in a language that made sense. She was very good about answering all questions as well. | West Boylston, MA, September 2024
Dan did a fantastic job of showing the nuance of certain exercises and techniques that he has found to be useful in his career. He was able to explain why these techniques were performed a specific way and was able to teach us how to get clients to perform them correctly.| Warner Robins, GA, September 2024
The speaker did a great job answering very complex questions from the audience. She kept it interesting the whole time with her examples and demonstrations. Speaking ability and interaction with the audience were excellent, and technical contents were explained very clearly. | Munich, Germany, June 2024
Louise is an absolute fantastic teacher!!!! She is amazing and the way she explains the concepts of PRI are amazing. I thank her for staring my journey of PRI! | Munich, Germany, June 2024
Amazing! I will never practice the same way again. | Munich, Germany, June 2024
Thank you for the clinical pearls. | Abilene, TX, May 2024
Skip’s ability to spell out the connections between the intricate PRI patterns was top notch. | Sacramento, CA, April 2024
I thoroughly enjoyed this course. In 25+ years of con-ed, this course has helped me the most with my personal health challenges. I’m looking forward to the next two courses. | Annapolis, MD, March 2024
Love the courses and the information. Inspired to really start to further my use and knowledge going forward. | Decorah, IA, March 2024
Louise was excellent! She was approachable and easy to learn from. | Stillwater, MN, November 2023
Louise was an excellent Teacher!! My favorite so far. | Stillwater, MN, November 2023
Louise was wonderful, I think she might have been one of the best instructors I have ever had for a continuing Ed course. I’ll definitely take another course with her! | Fort Collins, CO, September 2023
I thought Louise was an excellent presenter and appreciated her energy, knowledge, and time. Thank you! | Fort Collins, CO, September 2023
Skip has a lot of practical experience, and a gentle, inclusive quality that makes for a great learning environment. | Valencia, CA, September 2023
Wonderful course! Enjoyed learning it! Excited to put it into practice. | Live Stream, April 2023
Excellent course, excellent use of time and money. Great way to start to put the missing pieces together with patients. Would highly recommend. Basic concepts are the building blocks for further PRI study. Well done. | Live Stream, April 2023
Skip did well not only answering questions directly but adding some more depth to the answers so people asking got more of an understanding. | Chandler, AZ, April 2023
This course was amazing! I finally understand why so many of my patients hurt. I now, not only do I have the ability to educate them on what is going on with their body, but treat them with specific exercises to correct postural changes. These exercises give my patients the power to control their pain. | Chandler, AZ, April 2023
Learned a lot, really enjoyed the content and felt Louise led great conversation/discussion throughout the weekend. | Jupiter, FL, November 2022
Dan is a phenomenal presenter and while I love the information in this course, he really made it continually enjoyable and relatable. Especially when the information gets difficult to put together.| Live Stream, October 2022
After the weekend I feel even more reverence for the human body and commitment to my own repositioning, re-patterning and retraining through the non manual techniques. Dr Kelley’s good humor even her trustworthy encouraging, engaged and expectant affect helped me trust my own ZOA and stay engaged! | Baltimore, MD, September 2022
I think Louise did a fantastic job of bringing the material to life. | Live Stream, August 2022
I am so glad I did this course! I really enjoyed the information that was shared and I think it was presented in an extremely organized, professional and practical way. I can see the value of doing this course in person, but also really appreciate being able to participate in the livestream. Traveling for the course would not have been financially feasible for me at this time, and the livestream allows me to start learning and putting the knowledge into practice in my training business. Thank you! | Live Stream, August 2022
Skip did an amazing job, including the whole group, and always emphasizing the scientific information and not to just “believe him”. | Munich, Germany, July 2022
The course information refreshed, expanded & enhanced my knowledge about the PRI’s approach regarding human body. This will allow me to treat/coach & support my clients in a more efficient and better way. | Munich, Germany, July 2022
Skip was awesome, made the course fun, and helped breakdown all the questions and exercises to understand much better. | Munich, Germany, July 2022
Skip knows how to translate it to the participants and bring it together in a way they can apply the next day. | Davis, CA, June 2022
I appreciated the professionalism, the depth of knowledge, humility and calm manner of the presenters. I also got a lot of value out of observing the students troubleshoot their way through the labs and hearing the feedback from Louise about how she makes adjustments based on what she is observing. Top notch course and top notch presentation and manual. | Live Stream, May 2022
Louise was outstanding. One of the best presenters I have ever been to. | Lancaster, PA, April 2022
Louise is and excellent speaker and teacher. Did a great job with explanations of difficult concepts that made it possible to understand and carry out the techniques. Thank you! | Lancaster, PA, April 2022
Dan was fantastic. He is a gifted educator. | Live Stream, May 2021
Louise was great! Very easy to follow with wonderful explanation & demonstration. I felt more confident walking away from this course and less confused than my 1st one. Thank you! Great content. | Minot, ND, March 2020
Skip did a great job of keeping it simple and reinforcing the primary concepts of the course. Great for beginners and gave more experienced (attendees) time to integrate. | Warner Robins, GA, August 2019
Great! Best course I have been to, ever! | Fort Collins, CO, February 2019
Learned more than ever in a Con-Ed course. | Providence, RI, August 2018
I was able to blow up a balloon for the very first time in my life at 32 years old!! | Providence, RI, August 2018
The course was excellent. The Abundance of materials to read independent beyond the course is appreciated. | New York, NY, August 2018
Overall great course and great learning experience to supplement my experience in PT school. | Philadelphia, PA, April 2018
Posture and breathing have always been important. This gives me a new, better conceptual framework that addresses asymmetry. | Atlanta, GA, February 2018
Wonderful content, excellent speaker, very helpful and educational. | Seattle, WA, October 2017
Louise was the best instructor I have had out of the 3 courses I have taken. Great listener, observer, great review throughout, calm, very hands on, professional. Thank you! | Seattle, WA, October 2017
Mind-blowing. New respect for ribs and the diaphragm. | Albuquerque, NM, September 2017
Some of the most intriguing material I’ve ever had in my educational process. | Kearney, NE, June 2017
Great course! I now understand the importance of breathing with both hemispheres of the diaphragm and how to assess and achieve this. | Minneapolis, MN, May 2017
Jesse, you’re a great person and a great instructor. Thanks for working to become a high level teacher. This course has the best inhibition section and great clarification on inferior R glute max stretch. | San Francisco, CA, February 2017
This course definitely changes the way I think now. I can think outside the box now, and I feel like I have a good understanding of respiration and how it’s the foundation of treatment. | Philadelphia, PA, November 2016
Great, ahead of a lot of thinking out there. | Minneapolis, MN, April 2016
Best CEU course I’ve taken in my 6 years of being a PT. | San Diego, CA, February 2015
This has been the best course I have ever attended! Excellent content and game changing material. | Boston, MA, June 2014
Great course! Each course builds on one another to develop a complete picture of how the asymmetrical human body works. | Stanford, CA, June 2014
I was highly skeptical of PRI before the course. With several videos and seminars under my belt. I was highly engaged in this course. Now, on to the challenge of implementing it… before my next course! | Indianapolis, IN, March 2014
I loved it. I love everything about PRI and what it stands for. Thank you, thank you, thank you! | Indianapolis, IN, March 2014
Thank you! These classes have completely changed how I approach and treat patients with pelvic dysfunction. I has completely filled the hole that I had in my practice – which was the neuromuscular piece!! Much thanks! | St. Louis, Missouri, January 2013
Taking it for a second time was very enjoyable. I could really listen and take it all in! | St. Louis, Missouri, January 2013
Thanks – I will use this tomorrow in the clinic. I want to learn more!! | Sioux Falls, South Dakota, January 2013
I took this course 3 years ago – and it is so much better now. Same theory, but much easier to follow and integrate immediately into practice! Thank you | Phoenix, Arizona, May 2012
BEST speaker of any of the 100 different courses I have been to over 20+ years. | Phoenix, Arizona, May 2012
Very good. Ron always does a great job. I learn new idea every time I take a course, no matter how many times I have taken it. | Lincoln, Nebraska, June 2012
I appreciate thoroughly explaining the important topics more than once to be sure we understood before moving on! | Lincoln, Nebraska, June 2012
It was great! Thanks so much I’m excited to review and incorporate. | Lincoln, Nebraska, June 2012
Thanks for making the “older” PTs feel welcome. I haven’t always felt that way in other courses. This was an eye and mind opening experience to look at anatomy, physiology/neuro from a different, flip side of the coin way. Thank you. | Lincoln, Nebraska, June 2012
I really want to thank you for your expertise, knowledge and relief that you provided for me. I know you have heard this many times but I feel so blessed that you have changed my life. I have for the past year changed my practice techniques and achieved more success. I will be in contact. Thank you. | Missoula, Montana, March 2012
Thanks for your teaching energy/changing how I think has made a huge difference in my PT world | Missoula, Montana, March 2012
This was my first ever CEU course and it was great choice. I hope to make it to others to make more connections. | Missoula, Montana, March 2012
Overall, course was very good. Integrated the AIC material from prior course – I understand the whole body pattern much better. | Missoula, Montana, March 2012
Was very informative and an awesome (and legitimate) new way to see/think about neck/shoulder/back pathology. | Missoula, Montana, March 2012
Very informative, really enjoyed the speaker’s enthusiasm and helpfulness. | Urbana, Maryland, February 2012
Great learning experience! | Urbana, Maryland, February 2012
Very informative, enlightening, helpful and beneficial to further and help my career as a trainer. | Urbana, Maryland, February 2012
What I learned what that I need to learn more | Clearwater, Florida, January 2012
Very happy with the speaker! As a PTA, I was able to understand. | Lincoln, Nebraska, October 2011
Great speaker, very fun and made it very interesting! Thanks! | Lincoln, Nebraska, October 2011
This course has changed the way I look at everything! This could be the beginning of a whole new career in physical therapy! | Hayden, Idaho, May 2009
Instructor was fabulous and wonderful at explaining and applying the material! | Rockville, Maryland, February 2009
This course filled in many “blanks” about the myokin course. We will be much better prepared to eval, treat and educate our patients. Thank You! | St. Louis, Missouri, September 2008
Ron’s compassion for the subject matter is unmistakable. This course does a great job of filling in the upper quarter puzzle and emphasizing the importance of respiration- thank you! | Lincoln, Nebraska, January 2008
Best series of courses I’ve ever taken, including Upledger and Myofascial Release courses. The most comprehensive approach I’ve found. | Portland, Oregon, July 2007
Just wanted to share a success story with you after the course this last weekend in Lincoln. I have a patient who is s/p mva some 6 weeks ago, severe pain cervical/thoracic/and lumbar; very guarded and flexed posture. We had seen her maybe 6 times prior to the course last weekend, and hadn’t made any progress. She was very guarded and we could not release any tension with massage, modalities, and ROM. I performed the manual AIC technique taught in class, restored her ZOA and got the rib cage to move, and the results were amazing. The patient was so excited her burning pain in her mid-back was gone, she broke down in tears. And my 2 PTA’s started to cry with her as they had seen how much pain she was in, and now was feeling relief. Just wanted to relay that story and to say thanks. Your class was amazing. And after 2 days in the clinic, I’ve already seen amazing results. I want to encourage you to keep on empowering therapists as you have me. Thanks again. | Lincoln, Nebraska, October 2006
Thanks for “re-booting” me, giving me belief back in my profession, and hope for relieving my pain. You just changed my life and the lives of my patients. | Crookston, Minnesota, March 2006
Ron has revolutionized the way I treat my athletes. He is the most passionate speaker I have ever had the privilege of hearing. | Omaha, Nebraska, August 2005
I doubt I will attend any other continuing education course besides PRI or something related to. | Omaha, Nebraska, August 2005
Ron was very dynamic in introducing this concept and treatment techniques. This method of PT really makes sense. Finally an approach that ties it all together and help for those people who haven’t been able to be helped yet! | Sioux Falls, South Dakota, May 2005
This material is based on a paradigm that includes the whole body and its interconnections unlike anything else in our training. | Sioux Falls, South Dakota, May 2005
This is my 5th PRI class. As always, they are life changing as my understanding deepens. I am grateful for this approach! It is evidence based, makes sense, can be validated by objective tests and readily applied in the clinic. It has changed the way I practice and made my career more satisfying. | Bloomington, Minnesota, October 2004
I want to thank you for another great class. The responses we get from patients is probably the most rewarding I felt in the 30 some years I have been practicing, and I thought we were doing a good job then… | Bloomington, Minnesota, October 2004
Absolutely outstanding! Excellent course and instructor. He had complete command of the material. A master expert clinician. Thank you for putting the human body back together again and integrating all systems of the body. | Elon, North Carolina, May 2004
You are an innovative thinker, thanks for opening my mind, broadening my horizons and enabling me to better treat my patients. | Elon, North Carolina, April 2004
Awesome course and information. Will incorporate this info in our practice. The lab was great and very beneficial in actually seeing it put into action. | Sioux City, Iowa, December 2003
Thanks for a fresh, common sense approach to biomechanics of the body. Thanks for affirming that there is a lot more to physical therapy than stretching and strengthening. | Sioux City, Iowa, December 2003

Course

Schedule

Date	Location	Faculty	Register
Feb 7-8, 2025 (Fri-Sat)	Postural Restoration Institute Lincoln, NE	Louise Kelley	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 550.00 20 available Quantity Quantity: 0 Total: $ 0.00
Mar 1-2, 2025 (Sat-Sun)	Spooner Uptown Chandler Chandler, AZ	Robert "Skip" George	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 550.00 55 available Quantity Quantity: 0 Total: $ 0.00
Mar 8-9, 2025 (Sat-Sun)	Finish Line Physical Therapy New York, NY	Louise Kelley	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 550.00 37 available Quantity Quantity: 0 Total: $ 0.00
May 17-18, 2025 (Sat-Sun)	University of the Incarnate Word San Antonio, TX	Craig Depperschmidt	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 550.00 40 available Quantity Quantity: 0 Total: $ 0.00
Aug 9-10, 2025 (Sat-Sun)	G2 Sports and Physical Therapy Sammamish, WA	Robert "Skip" George	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 550.00 21 available Quantity Quantity: 0 Total: $ 0.00
Sep 20-21, 2025 (Sat-Sun)	Henry Mayo Fitness & Health Center Valencia, CA	Dan Houglum	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 550.00 33 available Quantity Quantity: 0 Total: $ 0.00
Sep 27-28, 2025 (Sat-Sun)	Mercy Edmond, OK	Louise Kelley	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 550.00 29 available Quantity Quantity: 0 Total: $ 0.00
Oct 24-25, 2025 (Fri-Sat)	Postural Restoration Institute Lincoln, NE	Craig Depperschmidt	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 550.00 20 available Quantity Quantity: 0 Total: $ 0.00
Nov 8-9, 2025 (Sat-Sun)	Active Edge Physical Therapy Tualatin, OR	Robert "Skip" George	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 550.00 22 available Quantity Quantity: 0 Total: $ 0.00

Course Registration

Registration is limited to ensure a low faculty to student ratio. Please register early. Courses will be canceled or rescheduled if fewer than 15 participants have registered by the early registration deadline of four weeks prior to the scheduled course date.

Special Needs Requests

If you have a disability and require accommodation in order to fully participate in this course, please contact us at least two weeks prior to the course date or prior to purchasing any online home study course so that arrangements can be made.

Course Completion

The course must be attended in full, and an online course evaluation summary and short post-test (with a passing score of 70% or higher) must be completed in order to receive a certificate of completion. Certificates of completion will be emailed after the online course evaluation summary and post-test have been completed If you arrive late, or leave early, your certificate of completion will be adjusted for the number of CE hours you were in attendance. *For live stream courses, if you have your camera turned off (or you are not visible on camera) at any time for greater than 15 minutes, this time will be deducted from your total hours on your certificate of completion.

Cancellation and Refund Policy

Tuition is refundable less $50 if cancelled 14 days before the course date. Tuition is not refundable for registrations or cancellations within 14 days of the course. However, you may have someone attend in your place or attend on another date. If you choose to attend on another date, a $50 fee applies to transfer your registration. If you are a no show and we have no communication with you before the course you will forfeit your course tuition. PRI reserves the right to cancel a course and will refund the tuition fee only. *Please note: For Live Stream Courses, once course manuals have been shipped (or emailed to international attendees), there will be no refunds for cancellations.