Treatment 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 wanted to create thoracic rotation on my rock-solid hip alternating capacity.

Here was my list:

The first activity helped with differentiating eye and neck movements.

The next activity was more alternating reaching in left stance; key is to keep eyes on left arm.

This beast below used a mirror to help me visualize doing the exact opposite pattern that I was trying to create; more visual tricks.

This next exercise utilized viewing the environment while using my alternating skillz

And here we have another very good alternating thoracic activity.

The Neutral Lifestyle

 I’ve had my splint for a month, reading glasses for 3 weeks, and consistently using the training glasses for 2 weeks now.

In just that short amount of time I’ve noticed quite a few changes. Granted, there could be many influences as to why these things have occurred, but I’ve tried to minimize as few variables as possible.


This area is where I’ve noticed the most changes. My recent program block for the past couple months or so has been very aerobic based. I lift weight 3 times per week at mostly tempo style. The other 2-3 days I train consists of one day playing basketball for cardiac output and either high intensity continuous training on my bike and/or tempo intervals with a jump rope or sled.

Before glasses (BG), I was measuring my heart rate variability (HRV) and resting heart rate (RHR). These numbers have not budged much with the month or two that I have been training like this. But after glasses (AG), I have noticed general trends of my HRV being higher and my RHR lower.

The HRV changes are what impressed me the most, as I have had many more outside stressors occurring in this time period. So despite being in a higher stress environment, my HRV climbs.

In the weight room itself, the load I have been lifting has generally tanked. I have lost strength in many of the lifts that I was doing, yet I’m actually feeling more work occurring in the areas that ought to be working. My neck and back seem to be kicking in much less. This was a pleasant surprise. I also seem to get less tired during the aerobic stuff I have been doing. Again, these changes could be due to time, but most of these reports have not changed in the few months that my aerobic training has occured.

The craziest change yet? Without performing any true “jump training,” I was able to easily grab the rim on a 10-foot basketball hoop for the first time since high school.

I can also now perform a full deep squat unsupported, which is something I have been practicing since January. I was unable to do this until the second week AG.

Regular Life Stuff

 Many more changes have occurred to me with just regular life stuff. I generally feel much more rested after sleeping, even if I get less hours than I am normally accustomed to. I also don’t seem to get as many afternoon lulls as I used to.

Reading. Oh My lanta. What a huge difference. I am retaining quite a bit more of what I read, and find that I do not get eye fatigue. Like, at all. Even if I am on the computer for a very long time.

Neck tension has been variable. I notice quite a bit less when I am reading, but I still tend to feel it if I am away from my orthotics, driving, or extremely stressed. The frequency this tension is present is quite a bit less.

I do still get some jaw clicking with opening, but the gelb splint seems to decrease this frequency quite a bit.

Overall, I generally just feel good.

Why Neutral

 I have had a lot of people ask me why I went through this process, especially if I do not have pain. Curiosity and need for completion drove me there, but I left with so much more than I thought I would ever get.

The nervous system craves three things: movement, space, and bloodflow. As a PEC with limited mobility in every plane, my system was not getting space. Less space increases stress to my nervous system, which may or may not have led to many possible outputs.

Pain is only one of many outputs that a system under threat could produce. Perhaps an output could be hypertension, dizziness, fatigue, heartburn, decreased attention, inability to learn, constipation, anxiety, depression, etc.

Maybe even a decreased vertical jump could be an output in response to system threat.

Likely anything that has a large contributing factor from our normal stress response could be affected favorably by decreasing system load through achieving neutrality.

It is here that I feel PRI is leagues beyond any other treatment methodology, and could potentially have impacts beyond pain; something many conventional PT methods may not always address. It is not because these methods are bad or do not work, but it is because they are only addressing a few pieces of the human system.

PRI is the only framework I have seen that addresses and explains most completely how the human being functions under threat.

Does that mean PRI is going to cure everyone’s problems? Probably not. Some conditions could be too far gone, some may have causes/effects beyond our normal stress response.

You cannot know if something will be helped or harmed by PRI until you take the autonomic nervous system out of the equation. And that is how I believe PRI works.



  1. Zac, I just read this series in one sitting and, like everything else of yours that I’ve read, enjoyed it tremendously. You’ve given me plenty to ponder and have made me want to make my own visit to the Hruska Clinic. (I don’t know how much money I’d pay in order to retain more information from what I read, but I expect it’d be a lot.)

    Also, my favorite part might be the line “He then checked my hip abduction, which was a solid 30 degrees bilaterally. The next test followed in a logical progression…He gloved up and checked my bite.”


  2. Zac, thanks for what you do on this blog. We definitely enjoy it and appreciate the real insight you provide from both a patient and a therapist perspective. I am personally so excited for the changes you are describing…..glad the near pair lived up to their marquee billing!