Another Course in the Books Back in November I had the pleasure of attending a new Baseball PRI affiliate course, taught by my homies Allen Gruver and James Anderson. I really enjoyed this course because it was such a high-level affiliate and great prep for my PRC. We went into great deal regarding position, throwing mechanics, and treatment. A…lot…of…stuff. One of the most amazing pieces of the course was Allen’s ability to breakdown complex baseball movements into their basic biomechanical bits, And from that point show what compensatory things could occur if limitations are present. His eye for these things is unreal. That piece of the course is a post or two on its own, so I won’t touch it here. In fact, I probably won’t touch it at all. Go to this great class and be wowed by Allen. You will be motivated to become a better clinician. I know I was. Here are some of the big takeaways. PRI 101 v 3.0 I’ve heard this overview three times this year now, and it is amazing that I still pick up things from it. James really outdid himself here. The big piece this time around was space. We want space maximized. In the vision course we discussed maximizing left peripheral visual space because the pattern reduces this quality. The pattern in general reduces our ability to move through triplanar space. There are a few other reasons that we would be unable to shift into our left side. Overactive muscles
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Course Notes: PRI Vision Integration for the Baseball Player
The first Section Where I Usually Say Something Like Whew or This Was the Best Course Ever! Phoenix has yet to disappoint on the CEU front, especially if the Dbacks are hosting. What a facility! After the baseball course that my homies Allen Gruver and James Anderson taught, Ron and Heidi put together a small vision course that one could apply on baseball athletes. Only it was so much more than advertised. Whether it was intended or not, the dynamic duo demonstrated just how extensive the PRI principles are, and spoke to many of the neuroscience foundations to which it was founded on. PRI Vision Integration for the Baseball Player was the Batman Begins of PRI. I am going to tell you right now, you must take this course yesterday. The foundational science alone is worth the price of admission, but adding in the visual training and corresponding life lessons, you get way beyond what you expect. Here were the major nuggets that I picked up. GGGGGG-rav…a…ty (Said as though 50 Cent read the title) Two major forces are acting upon a body at all times: gravity and ground. When one is able to manage and be aware of these forces, alternating and reciprocal triplanar activity can be realized. This reason is why PRI emphasizes finding the floor and feeling grounded so much. When these forces go unrecognized within a human system, extension is needed to maintain uprightedness. For example, do you ever notice that some individuals look at the
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Course Notes: PRI Impingement and Instability – Cantrell Edition
A Quick Trip Home I made my first trip back to my roots since moving out west to watch Mike Cantrell’s version of one of my favorite courses: Impingement and Instability. Yes, if you are wondering, my family does hate me for not being able to visit them. Mike absolutely killed all of the various topics we covered, and his ability to coach some of the advanced PRI activities is second to none. I had a blast learning from him. I won’t go over all the nitty gritty like I did here, but here were some of my favorite concepts that we covered. Learn on. The I&I Conundrum Impingement occurs due to the human system’s conflicting demands. We face a battle between instability and stability. Flexion allows for movement variability, which is desirable in the human system. Variable movement reduces threat perception. However, system flexion leads to increased instability and the risk of falling forward. To combat this risk, impingement may occur by compensatory extension. Extension begets joint and system stability, yet system variability is minimized. Increased stability is desirable when under threat, but not for long term. The “goal” then, would be to build control within flexed instability so the system can stay variable; to remain upright without extension. As Charlie Weingroff would say, we want “control within the presence of change.” That is alternating and reciprocal movement. That doesn’t mean you have to do silly little PRI exercises for the rest of your life. PRI activities are simply neuromuscular training
Read MoreCourse Notes: PRI Integration for Yoga
Portland is Cool The PRI road show continued on to Portland. This time I learned how PRI integrates with Yoga from the masters—Emily Soiney and James Anderson. Coming into the course I was incredibly biased against Yoga. I’m not a huge fan of crazy mobility expression, which in PRI-land could potentially lead to pathology. Moreover, the crowd that is typically attracted to yoga is of the more flexible variety. Bad news bears. That being said, Emily pleasantly surprised me. With the way Emily teaches Yoga, I see it more now as an expression of moving within your limits; not going beyond those limits like many poses attempt to do. Yoga can be done right, and when it is it’s fahkin’ haad! The goal for PRI-inspired Yoga is to keep the zone of apposition (ZOA) while expressing how far you can move. If you lose the ZOA, then movement integrity is diminished. Let’s find out how we can do that. Yoga Overview…Yogarview???? Whatever I came into this course knowing piddly diddly about yoga. Which being around several yoga practitioners was a big mistake. There was a lot of Yoga terminology and posing that was discussed nonchalantly, which more than a few times had me lost. I now know how those who are not familiar with PRI feel taking a course for the first time. I only blame myself though. Make sure you are prepped when you go and at least have basic familiarity with basic yoga poses, verbiage, and tenets. There is
Read MoreA Fly on the Wall of the Hruska Clinic
The Saga Continues This post is way overdue, but a lot has been going on in life. I have just moved to Arizona to start anew, and the change is bittersweet. The Midwest is all that I have known for the past 27 years. I’m leaving a lot of loved ones behind that I will miss dearly. However, getting out of the Midwest to a warmer place has always been a dream for me, and I finally got that opportunity. I also get to work at an awesome clinic alongside like-minded clinicians. One of my good friends will even be there. Plus, summer forevaaaaaaaaaaaahhhhh!!!!!! So with this transition in my life marks a good time to reflect on one of my many experiences at the Hruska Clinic. This time, I will show you how the clinic itself operates. And their operation is a beautiful thing. The General Feel You walk in the door and can immediately shift into your left hip. That’s what this place is like upon entering. With various shades of purple and tan, you just feel at ease being there. It screams parasympathetic. This build was no accident of course. Purple is a calming color, giving those at the clinic a huge home-field advantage. I bet there is also a reason why you walk left to check-in at the front desk. The clinic is an interdisciplinary dream. The staff includes 5 physical therapists, an optometrist, a dentist, and a podiatrist. This setup allows for great communication among
Read MoreTreatment at the Hruska Clinic: The Finishing Touches
For part 1, click here. For part 2, click here. A Low Key Day 3 Day three consisted mostly of putting the finishing touches on my quest toward neutrality. The morning began by tweaking my gelb splint so I was getting even contact on both sides. This way I would be ensured to not have an asymmetrical bite. I put a pair of trial lenses that fit my PRI prescription, and grinding commenced. We finished with this: Once the splint was done, I had a final meeting with Ron to go over my exercise program. I was placed into phase one visual training with two pairs of glasses. My training glasses were to be used when I lift weights, perform my exercises, walk around, etc. I could wear these for up to 30 minutes at a time; making sure I maximize my visual awareness of the environment. While I was wearing these glasses, I was to be keen on finding and feeling my heels; especially when I turn my head. The glasses would help me find the floor, as well as help my eyes work together and independently from my neck. My second pair of glasses was to be used while performing any activities within arms reach. This pair helps my eyes converge better and promote less eye fatigue. Ron gave me several phase I vision activities as well as a few others. His main objectives were to get my eyes to move independent of my neck. We also
Read MoreTreatment at the Hruska Clinic: PRI Dentistry and Vision
For part 1, click here For part 3, click here Jaws will Drop I’m in the dentist chair, The room slowly get darker and darker. I feel my mouth open, and I wasn’t sure what would happen next. Then Dr. Schnell places the necessary goup in my mouth to get an impression for my splint. I bite, and out comes the finish product. Before the impression was taken, Ron came in and explained what he was hoping to accomplish. He wanted to fit me for a gelb splint to give my tongue some space to move in my crowded mouth. This splint would also help bring my mandible forward. Dr. Schnell: “Is he neutral right now?” Ron: [throws a towel over my eyes and sets my neck in a lordosis] “Now he is.” And with that, the above sequence occurred and I was ready for vision. I couldn’t leave the room without that overarching reminder Ron gave me: Ron: “Margo, if this was your son, what would you do with those wisdom teeth?” Dr. Schnell: “I’d have them pulled.” Yikes! An Eye Opening Experience It was so much fun watching Ron and Heidi teach together, that I could only imagine what it was like seeing them treat. They did not disappoint. My session was getting videotaped for their marketing department, so I again told them my story. It ought to end up on the Internet sometime, so stay tuned for that! They began the session by showing some of my
Read MoreTreatment at the Hruska Clinic – Initial Evaluation
For part 2, click here. For part 3, click here. “Do you produce enough saliva?” That was the first interview question Ron Hruska asked me; something I will never forget. I went to Lincoln, NE for almost a week to take a course, get treated, and observe PRI in it’s purest form. I wanted to see Ron out of curiosity and because I cannot achieve neutrality on my own. I have done most every exercise that could be thought of and been “worked on” by my fellow comrades and a couple PRI instructors in courses; nothing could budge. I knew I needed some type of orthotic to get somewhere; the question was which one? Subjective Complaints I do not have any pain really. My only complaints are a tight neck and I can’t seem to deadlift without feeling most of the effort in my back. I don’t see this deadlifting problem as a form issue necessarily. Interning with Bill Hartman at IFAST cleaned that up, and for a long time I could feel glutes and hamstrings all day when I deadlift. But not now. Other “issues” I have Left TMJ clicks; nonpainful. Clench jaw at night. Eye strain after reading on a computer too long (duh). By PRI standards, I am a classic PEC. I have no pathology anywhere, but I am limited in almost every motion. I knew this and so did Ron. Objective Exam First Ron had me walk and was pointing out some things to my student-to-be Trevor,
Read MoreCourse Notes: PRI Vision Postural Visual Integration
Explosive I am still picking up the white matter that exploded all over the pavement as I left the PRI Vision course that was hosted in Grayslake, IL. It was an excellent experience interacting with Ron and Heidi, and believe it or not they are familiar with my blog…and the corresponding pictures. Therefore I was the butt of many jokes this past weekend, which definitely made me feel at home with the PRI family that I have so grown fond of. There is a reason it has taken me so long to put this work up. These notes have been the most challenging I have written yet, as the material was way out of what I have normally been studying. It is this class however, that solidifies PRI methodology as grounded in neurology. It was two days of brain, autonomics, vision, and optometry. I will do my best to show you what I learned in a semi-understandable manner. Seeing Visions Definition – “The deriving of meaning and the directing of action as a product of the processing of information triggered by a selected band of radiant energy.” – Robert Kraskin Vision is not just what we see, it is what drives us to make decisions. It is a skill that we develop as we age. It is the dominant sense in the brain, as 70% of the brains connections are related to vision. Vision can and does become lateralized. Sight is the clarity of our visual field, which is slightly
Read MorePRI 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
Read MoreCourse Notes: PRI Craniocervical Mandibular Restoration
“The Head and Neck Runs The Show.” ~Ron Hruska Hello, my name is Zac Cupples, and I have an addiction. I am addicted to attaining CEUs. But not just any CEUs, I want me some of that purple haze from the Postural Restoration Institute. I got my fix and then some. This past weekend I was at Endeavor Sports Performance in Pitman, NJ. I got to spend time learning about the neck and the cranium from none other then PRI founder, Ron Hruska. From the get-go, Ron was adamant in saying that this class was his baby. That this information is what started it all. And what I learned did not disappoint. When I took Advanced Integration this past winter, I understood that we were affecting a system, but it didn’t really settle in with me until now. What we are predominately using to affect the nervous system is not specific muscles, but namely triplanar muscle families. I am not trying to turn on the hamstrings, but I am trying remap the brain’s sagittal plane. I am not trying to turn on the IC adductor, but remapping frontal plane adduction to send me into left stance. Similarly, we can affect these movement planes with cervicocranial mandibular muscles. It is just another location in the system to which sensory input is applied. Though seeing what outputs resulted will leave you just as surprised as your patients and cleints. Watching Ron affect a person’s mobility throughout the entire body by manipulating a
Read MoreCourse Notes: PRI Pelvis Restoration
Just recently attended another excellent PRI course taught by Lori Thomsen and new instructor Jesse Ham called Pelvis Restoration. The weekend was filled with great discussion about inlets, outlets, shoes, and many other pearls that helped solidify my PRI understanding. So without further ado, let’s summarize. If this is your first reading on a PRI course, it may be beneficial to review my post on Myokinematic Restoration. PRI 101 Jesse started off the class discussing some PRI basic philosophical tenets. In PRI, we talk a great deal about position, which will be defined as a stance or posture at one point in time. Or as Jesse defined it, a position one can maintain for an extended period of time without pain. With this operational definition, our goal as a PRI clinician or trainer is to organize activities in the following order: Reposition – inhibit muscle chains. Retrain – Facilitate muscle chains Restore – Create reciprocal alternating activity (using all muscle chains when it is desired). Reciprocal activity is defined as going from one end-range to another (extension to flexion) and alternating activity is switching from one side of the body to another (right to left stance). When we alternate, the joint on one side of the body ought to do the exact opposite at the other side. With the above treatment hierarchy, we are working on allowing positional freedom within the person being treated. We call this movement in multiple planes. Now the Pelvis This part is where things can
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