PRI is an approach to rehabilitative exercise that accounts for normal human asymmetry. By recognizing that the two sides of the body are not symmetrical and testing for the degree of asymmetries present in an individual – chronic drivers of muscle imbalances and movement dysfunctions can be treated at the most fundamental level.
PRI is especially valuable for runners due to its unique emphasis on the evaluation of running mechanics. Most runners have a more difficult time loading their left leg and pushing off of their right leg – this is due to normal human asymmetry that supports right side dominance.
There are a number of assessment methods that evaluate basic movement patterns, fitness related attributes, and sport specific qualities. These three domains can be viewed as categories of proficiency in life (movement competency), fitness (capacity), and sports (specific skills).
The biological domain is often overlooked by fitness training programs and during training of sports related skills. The degree that someone is competent in the seven basic movement patterns (movement variability) is directly related to the likelihood of a future injury.
Maintaining movement variability should be the first priority before trying to improve fitness (capacity) or sports specific skills.
While asymmetries may arise due to imbalanced training and the inherent stressors found in sports (competitive running) – everyone to some degree has normal human asymmetries that should be accounted for.
PRI is a method of restoring movement variability at a biological level. The ability of the thorax to properly synchronize its movement with the pelvis is dependent on good breathing patterns. This co-activation of the pelvic and thoracic diaphragms enables good movement variability and supports the body’s ability to return to a neutral position during transitional phases of movement and at rest.
However, due to normal human asymmetry – the right diaphragm functions very differently than the left diaphragm which has profound implications for understanding errors in running form.
Anatomy of the Right Diaphragm
- Larger diameter
- Thicker central tendon
- Larger central tendon
- Higher central dome
- Better able to maintain its domed shape
- More crura fibers and fascia
- Has crura that attach lower on the lumbar spine
- Better abdominal eccentric opposition
- Concentrically effective for respiration
The diaphragm on the right side of the ribcage is supported by the liver and is typically in a better domed position. The left side of the thorax tends to be hyper inflated which manifests as visible rib flare on the left side. This pattern creates a need for better exhalation on the left side of the ribcage and a training emphasis on using the left abdominals to help support the left diaphragm.
The anatomical asymmetrical design of the right diaphragm would not present a problem for a person that regularly engages in a variety of movement patterns and that avoids prolonged sitting and work on a computer or iPhone.
This however, is often not the case – due to the sedentary nature of our culture and the imbalanced nature of fitness training programs that heavily rely on symmetrical bilateral movements (squat, deadlift, bench-press, pushups, pullups) – all performed with two arms and legs).
Our inherent asymmetrical design, in this context – begins to exert an influence on our axial skeleton. The right diaphragm tends to orient the pelvis and lumbar spine to the right leading to sub clinical patterns of scoliosis and specifically an inability to shift into the left hip.
“This right dominant pattern exists underneath all other patterns that develop in our lives and needs to be understood to fully appreciate the underlying mechanics of human movement dysfunction.” – Postural Restoration Institute
Left Hip Shift Mobility
Most athletic movements require a weight transfer from the right to the left in order for loading to occur on that left leg. Throwing, kicking, punching, running – all of which require ground up support through the left leg for good trunk rotation and arm swing to occur.
This is important to note because most people have a hard time shifting into their left hip. This perpetuates muscle imbalances in running form especially in regard to loading the left leg and pushing off of the right leg.
A right oriented pelvis (middle) will make it hard to shift into the left hip without compensation. The pitcher above (left) is having trouble transferring the weight of his upper body over the left leg. Notice the rigidity in his left leg and the torsion in his lower leg which is trying to compensate for the lack of internal rotation of his upper leg (femur).
The baseball pitcher pictured to the right is unable to internally rotate his left leg during weight transfer resulting in an externally rotated left femur and externally rotated lower leg (see foot turned out to the right). This is a different type of compensation where the upper and lower leg both are turned out. Both pitchers are experiencing different faulty mechanics due to the same problem – one that many runners also regularly experience.
Chronic conditions like SI joint pain, plantar fasciitis, low back pain, and shin splints are all commonly related to this inability to transfer weight effectively between sides.
Determining your ability to shift into your left hip is a key part of the evaluation process and a quick and effective intervention for running imbalances.
Restoring Movement Variability
When we lose variability in our movement we then tend to default to compensatory stabilizing strategies one of which is a right dominant pattern. Performing corrective exercises “equally” on both sides is a flawed strategy despite its good intention. Recognizing the different requirements that the left and right sides of the body present allows for a more comprehensive treatment strategy.
The is especially important in regard to integrating asymmetrical breathing positions and engaging muscles that restore the neutrality of the pelvis and ribcage.
Restoring movement variability will allow you to achieve competency in all of the fundamental movement patterns. PRI provides a method of understanding of how and why a runner’s form is compromised and allows for an intervention to change running mechanics BEFORE running specific drills are even considered. This will then allow your training to build strength and endurance (capacity) upon this competency of movement.
Interdisciplinary Integration
The Postural Restoration Institute is unique in its approach to treating musculoskeletal disorders in its emphasis on factoring in often overlooked drivers of dysfunction. Cranial-mandibular torsion patterns, hearing and visual dysfunctions, and even occlusal (dental) influences on alignment are all considered.
PRI is also unique in its ability to test the effect a given shoe has on the nervous system. Instead of simply relying on video playback of running form that ‘looks good’ – PRI testing provides instant feedback of how a given stimulus (such as a shoe) affects range of motion and the ability of the nervous system to alternate between fight or fight (sympathetic) and rest and digest (parasympathetic) states.
Postural Restoration Benefits
- Recognizes normal human asymmetries
- Identifies pathological stabilizing strategies
- Tests for ligament laxity and hypermobility
- Restores movement variability
- Incorporates restorative breathing exercises
- Focused on patient self – empowerment
- Includes unique neurological testing
- Framework for understanding running mechanics