Here is my not so long awaited review of PRI's Postural Respiration Course Review!
Here is my first post on Myokinematic Restoration Home Study from PRI. And onto the review!
An assistant faculty member contacted me after my first review stating that he believes most PRI newbs should start off with Postural Respiration versus Myokinematic Restoration. After finishing two of the three available home studies in a short period of time, I cannot attest to this but will come back to it as I delve more into the approach.
The tests instructed in the course, much like Myokin seem to predict patterns of asymmetry and thus lead you to treatments like breathing correction via manual methods and exercise based, plus more explanation on the diaphragm and how use decreases upper quarter tone. Since this was only glazed over or mentioned in Myokin, I really wanted a better explanation to provide my patients as to why it worked so well.
The more common patterns of limitation you are supposed to see are
- right shoulder IR more limited than left
- left shoulder flexion more limited than right (had these reveresed earlier, sorry!) - Thanks Zac Cupples!
- cervical axial rotation more limited to the left than right
- apical expansion (anterior ribs) more limited with passive anterior left compression during inhale than right
The above build upon the tests from Myokinematic Restoration that also have predictable patterns of right versus left asymmetry that rapidly changes with the correct exercise or manual techniques. They definitely acknowledge that these can happen bilaterally, but not normally opposite due to the nature of the natural asymmetry occuring in the body that when gone wrong with predictable patterns of tone and inhibition, cause the above asymmetries.
I have been looking for the above listed patterns in cervical, shoulder, and HA patients and more often than not, regardless of where they have complaints, there are at least 2-3 of the asymmetrical movement patterns. They often rapidly change with some breathing instruction or a simple manual technique.
As I mentioned on Friday's post, I am excited at the prospects of using a balloon to assist with diaphragm cuing as it makes rapid changes in patients who are not responding to my traditional MDT + OMPT treatments. In fact, it is even easier to combine this with some manual breathing corrections and definitely less threatening than coming at someone with your hands or a tool on their neck when they have what feels like a 10/10 migraine HA. I see this as possibly my go to test-Tx-retest approach when someone comes in flared up for upper quarter, especially for cervical pain and HA.
In short, if you want a better background on why focusing on breathing may help cervical, thoracic, shoulder movements/pain and more, this is a great place to start.
- inexpensive for a 2 days of course material
- acknowledgement that the changes are autonomic and tone changes, and less focused on bony repositioning than Myokin (but still a large part of the course)
- easy to use test/retest that seem to have predictable positive and negative based on natural patterns of asymmetry (although you are definitely biased as to what they should be after hearing it for hours)
- easy manual correctives and exercises to instruct patients on to keep the rapid changes
- the manual techniques are not only shot on the course, but also reviewed again after the live shot in a closed, professionally shot environment
- No clear progression on when to move on to a certain exercise/technique
- The speaker, Ron Hruska, founder of the institute glosses over the manual in many parts, making it very difficult to follow (now I know how my course participants feel like when they complain about me not following my slides)
- it is easy to forget what participants do not know when you have it all in your head
- too many options for treatment and corrective exercises based upon review of 4-5 techniques with no easy indication of when you should choose supine versus sidelying, versus standing or sitting correctives
- not sure how I feel about sticking my hand down a girl's bra whether or not I gave informed consent and not touching their areola for a sternal manual technique, it's all well and good until you get the one wrong patient
- if you do this regularly, comment below or email me, curious as to live patients who are not put on the spot in a course take this!
Do not let the fact that I have as many negatives as positives be your take away for this course. As I mentioned in my Myokin review, and like many OMPT based courses, there is not a clear system of progression due to the sheer number of options. However, many of the experiences PRI practitioners I have been contacting seem to focus on a core number of techniques/exercises much like traditional manual therapists do. I am going to take a month to integrate this before ordering Pelvic Restoration, but I feel my hard earned dollars were well spent because traditional programs that I have studied do not integrate the importance of breathing and it's rapid effects on symptoms, function, and ROM.