The PRI mission is to explore postural adaptations and asymmetries and their influence on the polyarticular chains of the body. Our mission is based on the development of an innovative treatment approach that explains the primary contributors of postural kinetic and kinematic movement dysfunction.
PRI concepts continue to grow. PRI now has 174 Postural Restoration Certified™ (PRC) therapists, 46 Postural Restoration Trained™ (PRT) professionals, and over 60 Postural Restoration Centers™. Over 90 courses are hosted each year in the United States and Internationally. This includes PRI's three primary courses, three secondary courses, the Annual Interdisciplinary Integration Symposium, as well as PRI Vision Courses and PRI Affiliate Courses. PRI has produced three editions of a CD comprised of Non-Manual Techniques and the first edition Manual Techniques DVD. Our website is the primary source for information regarding courses, location of nationwide PRI health professionals, educational materials, daily news, dialogue and references.
After 16 years of hospital and outpatient-based care, I knew I had reached a significant point in my career when a majority of my patients reached optimal functional outcomes through the incorporation of left acetabular femoral internal rotation, the isolated facilitation of left femoral adductors and left thoracic abductors, the establishment of a left zone of apposition, and the enhancement of right brachial expansion.
It was often difficult to convince physicians and physical therapists to reposition a pelvis and a femur before stretching out an iliotibial band or performing an iliotibial band release surgically. That’s why I established a private practice and the Postural Restoration Institute®. My clinical experiences, outcomes, and my former and present patients continue to guide PRI educational endeavors. The gratification on a patient’s face reinforces the development, formation and application of each PRI manual or non-manual technique.
Reading journal articles, books and research has increased my appetite for information on anatomical and physiologic imbalance. My mind is a reflection of my commitment to test knowledge through experience, persistence and willingness to learn from mistakes. The Anterior Interior Chain of our bodies is a reflection of reasoning, leading to a PRI experience. I will continue to connect links by continuing to commence with PRI experience in different areas like aquatics, ophthalmology or orthodontics.
As a former dental student who dropped out of the dental tract to pursue reasoning behind teeth being chewed up on one side, I’ve always had a mindset for non-linear linkage. As Leonardo da Vinci recognized and appreciated “interconnectedness of all things and phenomena,” so do I. Long before the Guide to American Physical Therapist Practice was written, I embraced ambiguity, paradox and uncertainty.
My clinical orientation and methodology of intervention has been, and will continue to be, guided by practical experience and an objective outcome approach rather than precepts or theory. We live in an evidence-based society that still believes the left appendages of our musculoskeletal system are in the same symmetrical position as the right. Research methodology, evaluation guidelines and treatment intervention do not include steps or measures that need to be taken into consideration because of our asymmetrical architecture, fluid-dynamics, gaseous diffusion and cerebral function.
Overuse of anti-gravitational muscle on one side leads to many different problems, but most importantly system hypertonicity.
PRI Neuromuscular Orthotic Principles
Reduces problems or improve other functions with other complimentary non-manual and manual PRI techniques.
Recognition of Altered Systemic Muscle
Neuro-mechanical issues can be initiated or compounded leading to altered force and timing of systemic muscle contraction. Visual and vestibular paradoxical function, tooth and mandibular functional limitations, respiratory patterns of dysfunction or pulmonary dysfunction, and improper foot proprioceptive feedback are integrated in the design of a treatment program that uses PRI algorithms.
Polyarticular Muscular Chains
Humans develop strong usage of their left Anterior Interior Chain (Left AIC), right Brachial Chain (Right BC), right Temporal Mandibular Cervical Chain (Right TMCC) and Posterior Exterior Chain (PEC) early. Consistent patterns of cervical torticollis, scoliosis, femoral-patellar compression and cranial-thoracic asymmetries are a few examples of early-adaptation to gravity and human asymmetry.
My first real orientation to hemispheric plasticity of the motor cortex occurred while working with patients who had cerebral vascular accidents. It was always more difficult to establish a center of gravity with the right lower extremity with a patient that lost the Broca and Wernicke area of the left hemisphere, than on a person with a right cerebral vascular accident. As I worked with non-cerebral vascular accident amputees in the same setting, I saw the same trend.
Regulatory Functional Lateralization
Functional lateralization, fundamental differences in the neural organization of cerebral hemispheres and cyto-architectural anatomic brain asymmetry was also recognized in the patients I worked with at a hospital outpatient-based physical therapy department. Patients with anterior knee pain who went through normal rehabilitation with little success had a reduction of pain with the establishment of left acetabular femoral and femoral acetabular internal rotation as they had on the contralateral side. I knew that the left pelvis and lower thorax was consistently forward, unstable, anteriorly rotated and more restrictive than the right.
Unilateral Compensatory Patterned Function
The unilateral orientation of organs and the vagal system, unilateral diaphragmatic function, unilateral neglect, unilateral lymphatic emptying and unilateral binocular dominance contribute to predictable, measurable and ineluctable patterns of vestibular-ocular, cranio-mandibular, cervical-thoracic, thoracic-lumbar, lumbo-pelvic, pelvic-femoral, femoral-tibial, tibial-calcaneal and rear foot-fore foot upright, synergistic, reflexive and non-reflexive compensatory function.
Multifaceted Approach of Non-Linear Treatment
To reduce the nature of unilateral influences on compensatory neuro-mechanics or the possible compensatory neuro-mechanical influences on our unilateralization; empirical experiences and a balanced, cross-linked mindset is needed. Prigogine, a Nobel Prize winning physicist, described organisms as “non-linear, complex, dynamic, self-regulating systems that are far from equilibrium.”
Imbalanced Inhibition vs. Balanced Strengthening
As a director of the physical and occupational therapy department, I had achieved the ability to reduce use of isokinetics for functional rehabilitation and increase the use of hamstring, gluteal, adductor, abdominal and hemi-diaphragm unilateral postural oriented programs. I developed a system that isolated left hamstring independent of speed, gravity or position to balance the pelvic femoral sagittal forces and pelvic biomechanical planes. Protonics® Neuromuscular Repositioning allowed me to finally maintain a neutral lumbo-pelvic position during low back or lower extremity retraining through hip flexor inhibition. The pinnacle of health is an active, on-going attempt to inhibit imbalanced force.
The Postural Restoration Institute (PRI) is built around 30 years of clinical practice associated with recurring successes of specific patient treatment programs. We established reproducible, outcome-based programs based on consistent evidence-based correlations, discovered with patient biomechanical, respiratory, and neurological functional patterns and limitations. My passion for the integrated systems of the body has resulted in an examination and intervention process of the asymmetrical human body called Postural Restoration.