PRI and Pain Science: Yes You Can Do It

Questions You may have noticed that my blogging frequency has been a little slower than the usual, and I would like to apologize for that. I am in the midst of creating my first course that I am presenting to my coworkers. It has been a very exciting yet time-consuming process. It makes me excited and more motivated to someday start teaching more on the reg. Ever since I started blogging people started asking me questions. These range from many topics regarding physical therapy, career advice, and the like. Some of the more frequent ones include: What courses should I look at? Any advice for a new grad? Seriously, Bane. What’s the deal? But the one I get asked more often then not is as follows: “Zac, how do you integrate PRI into a pain science model?” A great question indeed, especially to those who are relatively unfamiliar with PRI. With all the HG, GH, AF, FA, and FU’s, it’s easy to get lost in the anatomical explanations. Hell, the company even has the word (gasp) “posture” in the title. Surely they cannot think that posture and pain are correlated. I think there is a lot of misinformation regarding PRI’s methodology and framework. What needs to be understood is that PRI is a systematic, biopsychosocial approach that predominately (though not exclusively) deals with the autonomic nervous system. The ANS is very much linked into pain states, though not a causative factor. But of course, that may not be enough. Perhaps

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Course Notes: Advanced Integration Day 4 – Curvature of the Spine

Today we get wild and crazy and talk about scoliosis and the like; the last day of AI. For day 1, click here For day 2, click here For day 3, click here Scoliosis Variations The entire day focused predominately on treating scoliosis, which oftentimes amounts to exaggerations of the common patterns PRI discusses. Because scoliosis is an exaggerated PRI pattern, one must beget the question if the pattern or scoliosis came first? This question obviously cannot be answered, but for our intents and purposes we ought to assume pattern precedes curve. That way we may be able to alter the impairment. The scoliosis we can alter is often functional aka rotational. These types are ones that everyone has; the question is to what degree. Nonpathological Curve The nonpatho curve is an exaggerated version of the LAIC/RBC pattern, oftentimes with superior T4 syndrome involved. In this pattern the left ribs are externally rotated and right internally rotated. This reason is why 98% of scoliosis has right sided rib humps. A rib hump is akin to excessive rib internal rotation.  In this case, the spine looks like so… Here we can see how the spine excessively right orients up to T8-T9, then rotates left superior to that. These patients will present with typical Left AIC and Right BC test results along with typical right lateralization. One difference may be the right shoulder is not as low as typical with most patterned individuals. This change is due to compensating for the excessive curve. When

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Advanced Integration Day 3: Thoracic-Scapula Integration

Day 3 was all thorax and scapula. Here we go! For day 1, click here For day 2, click here A Philosophical Ron Intro Since the day began talking thoracic-scapula, Ron started us off by showing all the T-S connections in the body. Temporal——-sphenoid Thoracic———sternum Thoracic———scapula Tri-os coxae—-Sacrum You will notice that the thorax is very connected to many of these areas. Therefore,  it is very important to control this area early on; especially if one’s problem is in the cervical spine. The “pattern” dictates the thorax governing the cervical spine because the neck follows suit with the rotated left thoracic spine. Thus, if we restore position to the thorax, oftentimes neck position will clear up. From here, my man James Anderson was introduced, and we started off the discussion with a bang. Brain, Brain, and a Little More Brain The first hour was spent talking about a subject much needing discussion: PRI’s cortical foundation. James really hammered the fact that our brains are what drive us to the right. None of the previous mentioned material matters. Zones don’t matter, left AFIR, right shoulder internal rotation, nothing, if you can’t get the brain to change out of a left hemispheric dominance. How do we do this? Per James, let’s get a zone of apposition (ZOA) in a right lateralized pattern.   Say what? All the talk you have been hearing involves getting out of this right-sided dominance. But think of PRI activity in this fashion. We are most comfortable with performing right-sided activities. So why not use graded exposure to slowly

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Course Notes: PRI Myokinematic Restoration

What a Class Wow. That’s all that really needs to be said.  I have had a great deal of exposure to PRI in the past, but I have only had one formal class under my belt. Needless to say, I was looking forward to learning more. James Anderson and the PRI folks did not disappoint. Myokinematic Restoration was easily the best class I have taken all year. It also helped having another like-minded group attending. You learn so much more when you are surrounded by friends. Here is the course low-down. Disclaimer for the Uninitiated I know there are a lot of misconceptions about PRI on the interwebz. Even though posture is in the name, PRI has little to do with posture in the traditional sense. We know posture does not cause pain, and PRI agrees with this notion. But it’s not like they can change the name of the organization now. What? Do you think Ron Hruska is Diddy or something? After discussions with James and his mentioning this aloud in class, the target of PRI is the autonomic nervous system. Not posture, not pain, not pathoanatomy, but the brain. Essentially, they have figured out a window into the autonomic nervous system via peripheral assessment. Moreover, PRI is not in the pain business, though many think this is the case. Hell, even in the home studies they mention pain quite a bit. But realize those were done in 2005. Would you like me to hold you to things you have

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