Postural Restoration

[Bas Asselbergs]

Sorry - no. All I thought when I read the name "Postural Restoration" was: to what?

[Barrett Dorko]

I asked for confirmation that someone had recieved my message and just got this:

Barrett-
Your message has been received. Janie, director of Postural Restoration Institute, is out of the office until Monday June 5th. She will be able to respond once she returns.
Thank You-
Bobbie

Perhaps others here can ask a couple of questions before then.

[Barrett Dorko]

Today this arrived:

Dear Barrett-

Thank you for your recent email bringing our attention to PRI discussion. While Ron Hruska is currently out of the country, he will be returning soon. I have also forwarded this thread to PRI Certified therapists and faculty.

Sincerely,
Janie Ebmeier, PTA
Education Coordinator, Director of Certification
Postural Restoration Institute
5241 R Street
Lincoln, NE 68504
Phone (402)467.4111; Fax (402)467.4580

Sounds like we're getting closer to the therapists actually following the theory proposed on the site.

[Jason Silvernail]

I wonder what sort of outcomes they are reporting? I also wonder if they are engaged in any type of research? Even a case study?

All this money and "certification" - for what? They don't appear to be engaged in efforts to advance the treatment of the conditions they purport to treat through the research process.

I wonder where all the money goes. Oh, yeah.

J

[Barrett Dorko]

I would like everyone to please note that Jason said this and I didn't. No telling what I might be thinking though.

I'm willing to be patient waiting for a reply here and feel that the end of this week should be sufficient for at least one of the "certified therapists and faculty" to come up with something. I feel that the questions Jason has asked and those previously listed in the thread should be enough to get us started.

It's unfortunate that my student in Minneapolis has chosen not to participate. She was adamant in class that this work was well-referenced, logical and effective. She wanted details regarding the work Luke Rickards is doing in Australia and wrote down his name.

It sure didn't seem that she was done objecting to my lecture. Where is she?

[Barrett Dorko]

Here's the reply received today.

Dear Barrett-

This morning I was able to share with Ron Hruska the recent postings/discussion about Postural Restoration from Soma Simple. We strongly encourage those with an interest in the science to consider attending one of the four courses offered by our Institute (Myokinematic Restoration and Postural Respiration are both appropriate for introduction of the science). Each course is two days in length and corresponds with a very detailed course manual of nearly 200 pages. Since there is a great deal of material covered in each course it is best to discuss questions following at least one course attendance. I am also happy to answer questions that can be sent directed to this email address. We very much appreciate your invitation and hope that you will consider learning more through our educational courses.

Sincerely,
Janie Ebmeier, PTA
Education Coordinator
Postural Restoration Institute
5241 R Street
Lincoln, NE 68504
Phone (402)467.4111; Fax (402)467.4580




So,it appears that information from PRI comes at a price.

[Diane]

And if you pay good money for something called "science", then it must be worth every penny, right?

[emad]

Please ;Could i comment

I like to reserve a place

Emad

[Jason Silvernail]

Ooh, "Myokinematic Restoration" - it sure sounds like science!
:sad:

J

[nari]

Another case of 'this is my science', perhaps.

There seems to be an epidemic of PTs, DCs, et al, all claiming to have discovered their special way of beating round the bush - at a price, of course.

I think they will run out of neologisms soon...there is a limit on how many ways one can mangle the word -myo-.......

Nari

[Bas Asselbergs]

"myoathrokinematic re-educational patterning"
"myologic de-pathologisation"
"myofibric reorganisational therapy"
"my god it's a plane"
"myographic restructuring"
"myotonic balancing"
"myomy - it's hot"
"myofascial cosmetic postural correction" (grab the hair at the top and pull hard....)

you're right nari...I'm running out. Should I do a copyright on these?

[Jon Newman]

It's like a sandwich, a little myo makes things better.

Perhaps a better closing for their letter would have been this

[Jon Newman]

I am also happy to answer questions that can be sent directed to this email address.

Barrett,

Is it possible to post or to send me the above referenced email address? I think I can come up with some reasonable questions to ask and perhaps I can post the answers here.

Thanks.

[Barrett Dorko]

Jon,

It's janie@posturalrestoration.com

This afternoon I got an email from Raulan Young, an associate faculty member of PRI. He detailed things such as the "polyarticular chains and zone of apposition" that Mr. Hruska speaks of. I suggested he post what he said here. If he doesn't it won't be because he doesn't know how.

[ollyhall]

Postural Restoration

Hi Barrett,

I have gotten a kick out of reading your Postural Restoration thread and peoples assumptions of what it is. I always appreciate hearing the views of other open minded therapists. I am a Postural Restoration Certified therapist and I’ll try to answer the questions you have asked.

You mention that asymmetry is the “norm not the problem”. I believe this statement is a reflection of therapist’s frustration of not knowing how to treat the problem. How can asymmetry not be a problem when it puts uneven loads on joint surfaces and muscles are forced to work asymmetrically and inefficiently? Postural restoration does not just say that you are asymmetrical, but that you will be asymmetrical in very specific patterns (ie a common compensatory pattern – read the common compensatory pattern which is cited on the PRI website in the Educational Resources section under References. This is by the way a very good reference list that will give you articles that support the approach and are the evidence that the approach is based on).

If you can accept the existence of a common compensatory pattern, then it makes sense that any isolated segmental deviation from this pattern will necessitate excessive lengthening of soft tissue. One example of this is that the common compensatory pattern will limit adduction, IR and extension of the L hip. If a person tries to compensate for these limitations during gait the L iliofemoral ligament will become lax. Have you ever had patients whose hips click when performing a Thomas test. Pay close attention and you will find that the vast majority of clicks occur on the L side.

Why don’t we all hurt? Well, in many ways I think most people do hurt to a certain degree. A common compensatory pattern will change length tension relationships of muscles throughout our bodies and because of this certain muscles will become overworked and trigger points will develop – as an example how many people have trigger points on their vastus lateralis or in the sub-occipital area – this is a form of increased tension that may not initially register as pain, but as physical demands increase these can very easily become tender and bothersome, maybe not at that specific location, but the increased tension in these muscles will necessitate altered function elsewhere in the body. Back muscles are also likely to become tight and painful, as we are in a twisted state that puts the L hemidiaphragm in a poor position to work. In this position our spine is twisted, putting strain on facets, ligaments and disks and our back muscles work to lift our anterior ribs in an effort to compensate for the inefficient use of our diaphragm. Looking for evidence of a poorly positioned L hemidiaphragm? Check how many of your patients have a rib flare on the L vs the R.

How do we treat posture? Well there’s a lot more to it than telling patients to stand up straight. We treat the polyarticular muscle chain imbalances that pull us into a twisted common compensatory pattern. Because the pattern is asymmetrical so are our treatment interventions. We will work on L hamstrings to inhibit an active L hip flexor, we’ll work a L abdominal oblique to oppose the poorly positioned L diaphragm, we’ll work a L adductor, R glut etc, etc etc. Our manual techniques are also asymmetrical and are typically applied to the thorax which expands asymmetrically (read the articles on the reference list that talk about Thixotrophy). We work on equalizing expansion so that we can breathe in a relaxed state and rest.

Ron Hruska is a very charismatic man and a great teacher, but if he could not show instant changes in patient ROM and strength (improved length tension relationship) people would not be buying into his approach so wholeheartedly. I would be interested in any other approach that could with one exercise (not even using manual techniques for simple patients) could correct a L Thomas test, L ober’s test, equalize trunk rotation, allow full R shoulder internal rotation, full L shoulder flexion, full L horizontal abduction, full cervical rotation L as well as more. In all of these examples I mean creating complete equality not just minor changes in the direction of equality.

Postural restoration is an approach for therapists who understand that the body needs to be treated as an interconnected and interdependent being not on a joint by joint basis. The therapists who take postural restoration classes will typically make postural restoration the basis of all of their treatments rather than mixing and matching techniques from different approaches to make a treatment. This is somewhat unique that one philosophy/technique will dominate your entire practice. A dissertation is currently being written on this phenomenon, which I believe will be published within the next year. If you look at the reference list on the postural restoration website, I think you will find it is one of the most evidence based practices anywhere. Ron has devoted his career to developing the approach and it’s clinical application as well as teaching others. It is up to others to participate in research to validate what is very obvious empirically. Discussions into formal research have been started and hopefully research will start soon.

I can’t recommend Postural restoration classes highly enough. If you can take a course with an open mind and if you have a thorough understanding of anatomy and biomechanics, I am very confident it will alter the way you practice in future.

Many thanks for the questions and interest in PRI

Oliver Hall, PT,PRC