Pictured left to right, with , Lisa Mangino, PT, DPT, PCS, C/NDT, PRC is Postural Restoration faculty Mike Cantrell, MPT, PRC, Ron Hruska, MPA, PT, founder of Postural Restoration Institute, and James Anderson, MPT, PRC.
In December 2014, our pediatric physical therapist, Lisa Mangino, completed the requirements for obtaining the designation of Postural Restoration Institute™ Certified (PRC). This was the culmination of roughly 5 years of independent study and application of intensive techniques to a patient caseload. Here is an example of how she is using these powerful techniques with children:
Through my work with children with joint and muscle pain, I often got frustrated with not being able to change the cause of the patient’s pain. They could get relief from the pain, but sometimes this relief was only temporary. The theories and concepts of Postural Restoration Institute™ (PRI) are different than traditional physical therapy exercises as they focus on unique body positioning and asymmetric activation of specific muscles, while focusing on breathing. From a PRI perspective, the attention to breathing is too important to overlook. The way you use your muscles changes depending on the position of the powerful respiratory muscle, called your respiratory diaphragm. The diaphragm is a mushroom-shaped muscle that lives in the middle of your body. It attaches to the front your lower spine, and inner surface of your lower rib cage. It is below your lungs and domes up over your liver and other digestive organs. Its primary role should be to help you breathe efficiently. If it is the wrong position (i.e. not domed) your brain recruits it for postural demands, which is when things start change with your posture and biomechanical pain patterns begin. Examples of pain caused by a faulty diaphragm position include: back pain, shoulder pain, hip pain, knee pain, and foot pain, including plantar fasciitis.
My colleagues at Advance Physical Therapy apply this technique to adults with great results. Being a pediatric physical therapist for 15 years, my new certification enhances my ability to use these effective techniques with children. This is a technique very few pediatric physical therapists are using across the country.
A parent of an 11 year-old patient I treated recently wrote a great testimonial about his son’s plantar fasciitis. With attention to the boy’s breathing pattern, repositioning of his diaphragm, and activation of muscles that were being underused, his posture changed from leaning forward with most of his weight centered over his toes, ball of his foot and arch, to being better aligned over his midfoot, heels and ankles. This change in alignment and muscle use patterns relieved his foot pain. We used Kinesiotape to relieve his acute pain so he could participate in Tae Kwon Do while his system was changing with the powerful PRI exercises. After 10 visits, and participation in a home PRI exercise program, he was pain free without a need for Kinesiotape.
The full testimonial follows:
Our son had been having foot pain for over a year (coinciding with a major growth spurt), especially after running or walking. It was interfering with gym class, tae kwon do, vacations, and other family activities. Seeing a podiatrist/orthopedist, he had multiple diagnoses and multiple rounds of physical therapy over the course of a year, but the pain was not resolved. We even bought multiple special sneakers, inserts, and even custom orthotics. Another podiatrist told us to give it 6 months and then consider surgery – cutting up bones, etc. if the pain did not clear. Yikes! Instead, we went to Advance Physical Therapy. (We had delayed going to APT earlier because they were not in our insurance network.) Lisa was wonderful in her bedside manner, friendliness, and her patience in explaining everything to us and to Andy. Whereas he had tired of the PT from the other therapists that did not work, Lisa earned his trust so that he was willing to do new exercises without too much complaining.
Lisa, the awesome physical therapist, figured out that our son’s foot pain was related to his posture and gave him various rounds of unique physical therapy exercises to do. Since this took time to work, she also showed how us how to apply Kinesio tape to his feet and calf to mitigate or eliminate pain associated with his physical activities. The tape was an inconvenience for a month or two but we were glad to have him back to participating in tae kwon do and gym class. The PT exercises were very strange and seemed very unrelated to his feet, and some even to his posture, but IT WORKED. It all worked! Our son can now do his tae kwon do AND run a mile on pavement with no pain.
If your child is reporting foot, back or joint pain, it may be the result of the position of his or her respiratory diaphragm, muscle use patterns, and overall posture. I’d be happy to talk with you about your concerns and about your child’s reports of pain. The highly effective Postural Restoration Institute™ exercises offer a solution to change the source of the painful posture and movement patterns. These concepts can be used for pain relief for a lifetime!
Lisa Mangino, PT, DPT, PCS, C/NDT, PRC is a pediatric physical therapist with 15 years of experience in hospital, outpatient, and home health settings. She has a clinical Doctorate of Physical Therapy (DPT), is a Pediatric Certified Specialist (PCS), is Certified in Neuro-dvelopmental Treatment (C/NDT), and is Postural Restoration Certified (PRC).
She can be reached at Advance Physical Therapy at (919) 932-7266.