Myokinematic Restoration

An Integrated Approach to the Treatment of Patterned Lumbo-Pelvic-Femoral Pathomechanics

Reserve your Myokinematic Restoration course today!

Morristown, NJ

"Myokinematic Restoration offers an incredibly detailed journey through the lower extremity with regards to position and gait, outlining the complex relationships between movement and position for optimal human performance and function."

See more testimonials below!

Course Information

We have taken video from the live 15-hour lecture and lab course including Power Point slides, demonstration, lab, and audience question and answer sessions. This home study course is available online/digital which allows for viewing in the comfort of your home or office. You will have 21 days to complete the home study from the time you receive online access.

This advanced lecture and lab course explores the biomechanics of contralateral and ipsilateral myokinematic lumbo-pelvic-femoral dysfunction. Treatment emphasizes the restoration of pelvic-femoral alignment and recruitment of specific rotational muscles to reduce synergistic predictable patterns of pathomechanic asymmetry. Emphasis will be placed on restoration, recruitment, and retraining activities using internal and external rotators of the femur, pelvis, and lower trunk. Guidance will be provided on how to inhibit overactive musculature. This will enable the course participant to restore normal resting muscle position. Participants will be able to immediately apply PRI clinical assessment and management skills when treating diagnoses such as piriformis syndrome, ilio-sacral joint dysfunction, and low back strain.

Education Level: Advanced

Price:

$475 (Online/Digital – you will have online access to all materials and will print your own manual)

* Home Study Advantage: $237.50 (If you have taken the live course in the past 12 months you are eligible for 50% off the regular price) Learn More

Outline biomechanical principles of lower half musculoskeletal dysfunction as they relate to rotational patterns of the femur, pelvis, and lumbar spine, as well as occupational influence.
Describe how musculoskeletal dysfunction relates to articular chain asymmetry and patterns of synergistic compensatory activity.
Recognize how to apply examination and assessment skills to neuromuscular dyssynchrony and postural asymmetries that affect stability and function of the lower half.
Identify how to restore synchronous activity across the lumbo-pelvic-femoral complex and improve neuromuscular motor control of the muscles that stabilize these joints.
Outline how to design an interventional plan that includes various activities of daily living positions to decrease asymmetrical musculoskeletal demands.

Videos 1-4

Left Anterior Interior Chain (AIC) Pattern and Pelvic Joint Dynamics
Lumbo-Pelvic-Femoral Capsuloligamentous Issues
Femoral Internal and External Rotators
Myokinematic Influences on the Pelvis and Femur
Examination Tests and Assessment
Examination and Assessment (Lab)
Repositioning Through Integrated Isolation Demonstration
Questions

Videos 5-10

Myokinematic Hierarchy
Left AIC Related Pathomechanics: “Piriformis Syndrome,” Right SI Joint Dysfunction or Low Back Strain
Left AIC Myokinematic Integration (Lab)
Designing Specific Sequenced Home Programs
Q and A Session
Bonus lab material
Skeleton Handout

Adductors

Arnold AS, Delp SL. Rotational moment arms of the medial hamstrings and adductors vary with femoral geometry and limb position: implications for the treatment of internally rotated gait. Journal of Biomechanics. (2001) 34:437-447.
Boyle, KL. Clinical application of the right sidelying respiratory left adductor pull back exercise. The International Journal of Sports Physical Therapy, 2013; 8(3): 349-358.
Broski SM, Murthy NS, et al. The adductor magnus “mini hamstring”: MRI appearance and potential pitfalls. Skeletal Radiol. 2016;45:213-219.
Ford KR, Myer GD, Hewett TE. Valgus knee motion during landing in high school female and male basketball players. Medicine & Science in Sports & Exercise. 35(10):1745-50, 2003 October.
Obey, MT, Broski SM, et al. Anatomy of the adductor magnus origin: Implications for proximal hamstring injuries. The Orthopaedic Journal of Sports Medicine. 2016;4(1). Accessed online January 2016 ahead of publishing.
Reimann R, Sodia F, Klug E. Die umstrittene Rotationswirkung ausgewahlter Muskeln im Huftgelenk. Ann Anat (1996) 178: 353-359.
Shori G, Joshi A. Effect of right sidelying respiratory left adductor pull back exercise in subjects with iliotibial band tightness. 2017, 25 (1), 13-16.
Warwick R, Williams P. Grays Anatomy 1973; (5)566.
Willett GM, Keim SA, et al. An anatomic investigation of the ober test. Am J Sports Med. Published online January 11, 2016.

Athletic Pubalgia/Osteitis Pubis

Dahan R. Rehabilitation of muscle-tendon injuries to the hip, pelvis, and groin areas. Sports Med Arthroscopy Rev. 1997; 3: 326-33.
Fricker PA. Osteitis pubis. Sports Med Arthoroscoy Rev. 1997; 5: 305-12.
Fricker PA, Taunton JE, Ammann W. Osteitis pubis in athletes: infection, inflammation or injury? Sports Medicine. 1991; 12(4): 266-279.

Hamstring Length & Flexibility

Bandy W, Irion J. The effect of time on static stretch on the flexibility of the hamstring muscles. Physical Therapy. Sept 1994; 74(9): 54-59.
Bandy W, Irion J. The effect of time on static stretch on the flexibility of the hamstring muscles. Physical Therapy. Sept 1994; 74(9): 54-59.
Bandy W, Irion J, Briggler M. The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Physical Therapy. Oct1997;77(10): 1091-1096.
Cameron D, Bohannon R. Relationship between active knee extension and active straight leg raise test measurements. JOSPT. May 1993;17(5): 257-260.
Clark S, Christiansen A, Hellman D, Hugunin JW, Hurst KM. Effects of ipsilateral anterior thigh soft tissue stretching on passive unilateral straight leg raise. JOSPT. 1999;29(1): 4-12.
Corbleet S, Woolsey N. Hamstring muscle length in school-aged children using the sit-and-reach test and the inclinometer measure of hip joint angle. Physical Therapy. Aug 1996;76(8): 850-855.
Gajdosik R. Hamstring stretching and posture. Physical Therapy. Apr 1997;77(4): 438-439.
Gajdosik R, Rieck M, Sullivan D, Wightman S. Comparison of four clinical tests for assessing hamstring muscle length. JOSPT. Nov 1993;18(5): 614-618.
Gajdosik, Lusin. Hamstring muscle tightness-reliability of an active knee extension test. Physical Therapy. July 1983;63(7): 1085-1088.
Garrett W, Safran M, Seaber A, Glisson R, Ribbeck B. Biomechanical comparison of stimulated & nonstimulated skeletal muscle pulled to failure. The Am Journal Of Sports Med. 1987;15(5): 448-454.
Li Y, McClure P, Pratt N. The effect of hamstring muscle stretching on standing posture and on lumbar and hip motions during forward bending. Physical Therapy. Aug1996;76(8): 836-845.
Moore M, Kukulka C. Depression of hoffmann reflexes following voluntary contraction and implications for proprioceptive neuromuscular facilitation therapy. Physical Therapy. Apr 1991;71 (4).
Moore, Hutton. Electromyographic investigation of muscle stretching techniques. Medicine and Science in Sports and Exercise. May 1980: 322.
Osternig L, Robertson R, Troxel R, Hansen P. Muscle activation during PNF stretching techniques. Am Journal Physical Med. 1987; 66(5): 298-307.
Valenza MC, et al. The immediate effects of doming of the diaphragm technique in subjects with short hamstring syndrome: a randomized controlled trial. Journal of Sport Rehabilitation. June 2015.
Wallin D, Bjorn E, Grahn R, Nordenborg T. Improvement of muscle flexibility a comparison between two techniques. Am Journal of Sports Med. 1985;13(4): 263-268.
Worrell T, Smith T, Winegardner J. Effect of hamstring stretching on hamstring muscle performance. JOSPT. Sept 1994;20(3): 154-159.

Hamstring Strains

Almekinders L, Gilbert J. Healing of experimental muscle strains and the effects of nonsteroidal anti-inflammatory medication. Am Journal of Sports Med. 1986;14(4): 303-308.
Best T, Garrett W. Hamstring strains – expediting return to play. The Physician and Sports Medicine. Aug 1996;24(8): 37-44.
Burkett L. Causative factors in hamstring strains. Medicine & Science in Sports. Spring 1970;2(1): 39-42.
Christensen C, Wiseman D. Strength; the common variable in hamstring strain. Athletic Training. 7(2): 36-40.
Garrett W, Califf J, Bassett F. Histochemical correlates of hamstring injuries. The Am. Journal of Sports Med. 1984;12(2): 98-103.
Garrett W, Rich R, Nikolaou P, Vogler J. Computed tomography of hamstring muscle strains. Med & Science in Sports & Exercise. 1989;21(5): 506-514.
Goom T, Malliaras P, et al. Proximal hamstring tendinopathy: Clinical aspects of assessment and management. JOSPT. 2016;46(6):483-493.
Hoskins W, Pollard H. The management of hamstring injury – part 1: Issues in diagnosis. Man Ther. 2005;10:96-107.
Hoskins W, Pollard H. The management of hamstring injury – part 2: Treatment. Man Ther. 2005;10:180-190.
Liemohn W. Factors related to hamstring strains. J. Sports Med. 1978;18: 71-76.
Mason DL, Dickens V, Vail A. Rehabilitation for hamstring injuries. Cochrane Database Syst Rev. 2007.
Nikolaou P, Macdonald B, Glisson R, Seaber A, Garrett W. Biomechanical & histological evaluation of muscle after controlled strain injury. Am Journal of Sports Med. 1987;15(1): 9-14.
Prentice W. Rehabilitation techniques in sports medicine, 2nd Ed. Nov 1993 Mosby-Year Book, Inc. 387-394.
Schuermans J, Danneels L, Van Tiggelen D,et al Proximal neuromuscular control protects against hamstring injuries in male soccer players AJSM 2017 Mar 1
Turl S, George K. Adverse neural tension; a factor in repetitive hamstring strain? JOSPT. Jan 1998;27(1): 16-21.

Obstetrics & Gynecology

Boyle K. Managing a female patient with left low back pain and sacroiliac joint pain with therapeutic exercise: a case report. Physiotherapy Canada, Volume 63, Number 2.
Hulme J. Roll for control, moving beyond kegels to treat incontinence. Physical Therapy Products. Sept 2002: 34-36.
Oleksy L, Mika A, et al. The influence of pelvis reposition exercises on pelvic floor muscles asymmetry. Medicine (2019);98:2.

Hamstring Strength

Kaminski, Wabbersen, Murphy. Concentric vs enhanced eccentric hamstring strength. Journal of Athletic Training. 1998;33(3): 216-221.
Molczyk et al. Reliability of testing the knee extensors and flexors in healthy adult women using a cybex II isokinetic dynamometer. JOSPT. July1991;14(1): 37-41.
Worrell, Perrin, Gansneder, Gieck. Comparison of isokinetic strength & flexibility measures between hamstrings injured & noninjured athletes. JOSPT. Mar 1991;13(3): 118-125.

Hamstrings & ACL

DeMont R, Lephart S. Repetition drives neuromuscular recovery after ACL Injury. Biomechanics. Apr 1998: 31-37.
Husted RS, Bencke J, et al. A comparison of hamstring muscle activity during different screening tests for non-cotact ACL injury. 2016, http://dx.doi.org/10.1016/j.knee.2016.02.004.
Maitland M, Ajemian S, Suter E. Quadriceps femoris and hamstring muscle function in a person with an unstable knee. Physical Therapy. Jan 1999;79(1): 66-75.
More R, Karras B, Neiman R, Fritschy D, Woo S, Daniel D. Hamstrings – an ACL protagonist. Am Journal of Sports Med. 1993; 21(2): 231-237.
Solomonow M, Baratta R, Zhou BH, Shoji H, Bose W, Beck C, D’Ambrosia R. The synergistic action of the ACL & thigh muscles in maintaining joint stability. Am Journal of Sports Med. 1987;15(3): 207-213.
Supplement to Biomechanics. Special report ACL injury. Jun 1998.

Hamstrings & Athletes

Canale S, Cantler E, Sisk D, Freeman B. A chronicle of injuries of an American inter-collegiate football team. Am Journal of Sports Med. 1981;9(6): 384-389.
Carvalho A, Brown S, et al. Evaluating injury risk in first and second league professional portuguese soccer: Muscular strength and asymmetry. Journal of Human Kinetics. June 2016;51:19-26.
Heiser T, Weber J, Sullivan G, Clare P, Jacobs R. Prophylaxis & management of hamstring muscle injuries in intercollegiate football players. Am Journal of Sports Med. 1984;12(5): 368-370.
Jonhagen S, Nemeth G, Eriksson E. Hamstring injuries in sprinters; the role of concentric & eccentric hamstring muscle strength & flexibility. The Am Journal of Sports Med. 1994;22(2): 262-266.
McMaster W, Walter M. Injuries in soccer. Am Journal of Sports Med. 1978;6(6): 354-357.
Ross M, Dahlke B. On the run: assessment of hamstring function following injury. Phys Ther Products. May/June 2000:13-16.

Hamstrings & SLR Testing

Bohannon. Cinematographic analysis of the passive straight-leg-raising test for hamstring muscle length. Physical Therapy. Sept 1982;62(9): 1269-1274.
Bohannon. Effect of repeated eight-minute muscle loading on the angle of straight -leg raising. Physical Therapy. Apr 1984;64(4): 491-497.
Bohannon R, Gajdosik R, Leveau. Contribution of pelvic and lower limb motion to increases in the angle of passive straight leg raising. Physical Therapy. Apr 1985;65(4): 474-476.
Hsieh, Walker, Gillis. Straight Leg-Raising Test. Physical Therapy. Sept 1983;63(9): 1429-1433.

Hamstrings Related to Back & Hip

Soumik Basu, Priti Pradip Kakade et al. Influence of abdominal and hamstring muscle activation exercises over iliotibial band stretching on a positive Ober's test in subjects with low back pain. Global Journal for Research Analysis. May 2017 Volume 6 Issue-5
Bohannon, Gajdosik, Leveau. Relationship of pelvic thigh motions during unilateral and bilateral hip flexion. Physical Therapy. Oct1985;65(10): 1501-1504.
Gajdosik R, Albert C, Mitman J. Influence of hamstring length on the standing position & flexion range of motion of the pelvic angle, lumbar angle, & thoracic angle. JOSPT. Oct 1994;20(4).
Gajdosik, Simpson, Smith, Dontigny. Pelvic tilt-intratester reliability of measuring the standing position and range of motion. Physical Therapy. Feb 1985;65(2): 169-174.
Gold K, Franklin C, North C, Keating C. Effects of hamstring – specific exercise in chronic low back pain patients. NE Spine Center, LLP, Omaha, NE.
Kage V, Naidu S. Effect of iliotibial band stretching versus hamstrings and abdominal muscle activation on a positive Ober's test in subjects with lumbopelvic pain: a randomized clinical trial. International Journal of Therapies and Rehabilitation Research. IJTRR 2015, 4: 4
Sihvonen T. Flexion relaxation of the hamstring muscles during lumbar pelvic rhythm. Arch Phys Med Rehab. May 1997;78.
Stokes I, Abery J. Influence of the hamstring muscles on lumbar spine curvature in sitting. Spine. Nov/Dec 1980;5(6): 525-528.
Tenney HR, Boyle KL, and DeBord A. Influence of hamstring and abdominal muscle activation on a positive ober's test in people with lumbopelvic pain. Physiotherapy Canada. 2013;65(1)4-11.
Youdas J, Garrett T, Harmsen S, Suman V, Carey J. Lumbar lordosis and pelvic inclination of asymptomatic adults. Physical Therapy. Oct 1996;76(10): 1066-1081.

Hip Impingement

Azevedo DC, Paiva EB, et al. Pelvic rotation in femoroacetabular impingement is decreased compared to other symptomatic hip conditions. JOSPT. November 2016;46(11):957-964.
Bagwell JJ, Fukuda TY, et al. Sagittal plane pelvis motion influences transverse plane motion of the femur: Kinematic coupling at the hip joint. Gait & Posture. 2016;43:120-124.
Cibulka M. Sacroiliac joint dysfunction as a reason for the development of acetabular retroversion: a new theory. Physiotherapy Theory and Practice. 2013; Early Online:1-5.
Dandachli W, Islam S et al. The influence of pelvic tilt on acetabular orientation and cover: a three-dimensional computerised tomography analysis. Hip Int. 2013;23(01):87-92.
Finnoff JT, Bond JR, et al. Variability of the ischiofemoral space relative to femur position: an ultrasound study. Physical Medicine and Rehabilition. 2015;7: 930-937.
Henebry A, Gaskill T. The effect of pelvic tilt on radiographic markers of acetabular coverage. AJSM Online PreView. August 27, 2103.
Lewis CL, Sahrmann SA. Acetabular labral tears. Phys Ther. 2006;86(1):110-121.
Lewis CL, Sahrmann SA. Acetabular labral tears. Phys Ther. 2006;86(1):110-121.
Martin RL, Enseki KR, Draovitch P, Trapuzzano T, Philippon M. Acetabular labral tears of the hip: examination and diagnostic challenges. J Orthop Sports Phys Ther. 2006:36(7):503-515.
Masek, J. Femoroacetabular impingement mechanisms, diagnosis, and treatment options using postural restoration®: part 1. Sportex. March 2015.
Masek, J. Femoroacetabular impingement mechanisms, diagnosis, and treatment options using postural restoration®: part 2. Sportex. Oct 2015.
Masek, J. Femoroacetabular impingement mechanisms, diagnosis, and treatment options using postural restoration®: part 3. Sportex. January 2016.
Narvani A, Tsiridis E, Tai C, Thomas P. Acetabular labrum and its tears. Review of Br J Sports Med 2003;37:207-211.
Nicholls R. Intra-articular disorders of the hip in athletes. Physical Therapy in Sport, 2004.
Ross JR, Nepple JJ, et al. Effect of changes in pelvic tilt on range of motion to impingement and radiographic parameters of acetabular morphologic characteristics. Am J Sports Med. 2014 Oct;42(10):2402-2409.
Simoneau G, Hoenig K, Lepley J, Papanek P. Influence of hip position and gender on active hip internal and external rotation. JOSPT 28 (3) Sept 1998.

Orthopedic

Adler KL, Cook PC, et al. Current concepts in hip preservation surgery: Part 1. Sports Health. Nov-Dec 2015;7(6): 518-526.
Arendt E. Management of patellofemoral disorders. Orthopedic special edition. 2001:7(2).
Bedi A, Warren RF, et al. Restriction in hip internal rotation is associated with an increased risk of ACL injury. Knee Surg Sports Traumatol Arthrosc. Published online September 2014.
Bohannon R, Gajdosik R, & LeVeau B. Relationship of pelvic and thigh motions during unilateral and bilateral hip flexion. Physical Therapy. 1985;65(10): 1501-1504.
Cummings G, Scholz P, Barnes K. The effect of imposed leg length difference on pelvic bone symmetry. Spine.1993;18(3): 368-373.
Dananberg H. Subtle changes in walking posture may be the root of many painful conditions. Advance for Directors in Rehab. March 2002:47-51.
Defazio G, et al. Primary cervical dystonia and scoliosis; a multicenter case-control study. Neurology 2003;60: 1012-1015.
DeRosa C, Porterfield J. Weightbearing. Biomechanics, December 2000:14-30.
Dowling R, Hruska R. Hamstring injuries require triplanar assessment. Biomechanics, Feb 2003.
Dunn J, Graham S. Treating dancers. Advance for Physical Therapists and PT Assistants. Feb 4, 2002:37-40.
Eckhoff D, Brown A, Kilcoyne R, & Stamm E. Knee version associated with anterior knee pain. Clin Orthop. 1997 Jun;(339): 152-5.
Eckhoff DG, Montgomery WK, Kilcyne RF, Stamm ER. Femoral morphometry and anterior knee pain. Clin Orthop. 1994 May; (302): 64-8.
Fowler C. Muscle energy techniques for pelvic dysfunction. In: Grieve GP, ed. Modern manual therapy of the vertebral column. Edinburgh, Churchill Livingstone;1986: 805-814.
Frey L, Haftel H. Shoulder, knee, and hip pain as initial symptoms of juvenile ankylosing spondylitis: a case report. JOSPT. Feb 1998; 27 (2):167-172.
Friberg O. Clinical symptoms and biomechanics of lumber spine and hip joint in leg length inequality. Spine. 1983;8(6): 643-650.
Gray G, Dowling R, Gambetta V. Back out again? Training and Conditioning. Dec 2000:15-21
Han H, Kubo A, et al. Hip rotation range of motion in sitting and prone positions in healthy Japanese adults. J Phys Ther Sci. 2015; 27:441-445.
Henebry LT and Gaskill T. The effect of pelvic tilt on radiographic markers of acetabular coverage. AJSM. Preview, published online August 27, 2013.
Hesch J. Letter to the editor. Sacroiliac joint. The Journal of Manual & Manipulative Therapy. 2000;8(1): 29-31.
Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for the first-episode low back pain. Spine, Vol 26(11). June 1, 2001.e243-248.
Hodges PW. Is there a role for transverses abdominis in lumbo-pelvic stability? Manual Therapy. 1999;4(2): 74-86.
Hodges PW, Richardson CA. Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. J Spinal Disord. 1998;11:46-56.
Hruska RJ. Management of pelvic-thoracic influences on temporomandibular dysfunction. Orthopedic Physical Therapy Clinics of North America. June 2002; 11 (2): 263-284.
Hruska RJ. Pelvic stability influences lower extremity kinematics. Biomechanics. 5(6): 23-29.
Innes K. The pronated foot and the lumbo-pelvic area. CD Scarborough, Ontario Canada.
Jansa S. Femoralpatellar dysfunction. Advance for Physical Therapists and PT Assistants. Feb 1, 1999.
Kim W, Shin D. Correlations between hip extension range of motion, hip extension asymmetry, and compensatory lumbar movement in patients with nonspecific chronic low back pain. Medical Science Monitor. 2020; 26:e925080.
Klein KK. Progression of pelvic tilt in adolescent boys from elementary through high school. Arch Phys Med Rehabil. 1973; 54: 57-59.
Krengel W & King H. Scoliosis: diagnostic basics and therapeutic choices. Journal of Musculoskeletal Medicine. 1995;12(9): 54-69.
Lee D. The pelvic girdle (2nd Ed.) – An approach to the examination and treatment of the lumbo-pelvic-hip region. Edinburgh, London, New York, Philadelphia, Sydney, Toronto: Churchill Livingstone, 1999.
Manoli A, Graham B. Cavus foot diagnosis determines treatment. Biomechanics. Jan 2001:55-69
Marshall C, Knutzen K. Female knee reclaims strength after ACL injury. Biomechanics. Jan 2001: 43-52
Matava M, Hollman J, Deusinger R. Knee kinematics underscore gender differences. Biomechanics. Feb 2002:77-85.
Maxwell GM and McCrackin H.J. Geometrical constraints on the rotational function of the femoral adductors in man. J Biomed, Eng. Jul 1983;5: 253-256.
Meknas K, Christensen A, Johansen O. The internal obturator muscle may cause sciatic pain. Pain. 2003 Jul;104(1-2):375-80.
Moore K, Dalley A. Clinical oriented anatomy, 4th Edition. Lippincott Williams and Wilkins, 1999.
Noonan KJ, Weinstein SL, Jacobson WC, et al, Univ of Iowa Hospitals and Clinics. Use of the Milwaukee brace for progressive idiopathic scoliosis. J Bone Joint Surg. Apr 1996;78-A: 557-567.
Norkin C, Lebangie P. Joint structure and function: a comprehensive analysis, 2nd Edition. FA Davis, Philadelphia.
Oliver, GD. Powering the windmill: Lower body mechanics of softball pitching. Lower Extremity Review (online edition). June 2011.
Pearson WM. A progressive structural study of school children. J Am Osteopath Assoc 1951;51: 155-167.
Pearson WM. Early and high incidence of mechanical faults. J Osteopath 1954; 61:18-23.
Retchford TH, et al. Can local muscles augment stability in the hip? A narrative literature review. J Musculoskelet Neuronal Interact. 2013; 13(1):1-12.
Roach SM, San Juan JG, et al. Passive hip range of motion is reduced in active subjects with chronic low back pain compared to controls. IJSPT. Feb 2015;10(1):13-30.
Roos H. Hip pain in sport. Sports Med and Arthroscopy Review. 1997; 5:292-300.
Rothstein JM. Editor’s Note: What we don’t know can hurt us. Physical Therapy. Oct 2002;82(10).
Schamberger, W. The malalignment syndrome, implications for medicine and sport. Churchill Livingstone 2002.
Sikorski JM, Peters IW. The importance of femoral rotation in chondromalacia patellae as shown by serial radiography. Journal of Bone and Joint Surgery. Nov 1979;61-8( 4).
Smith JA, Popovich JR, Kulig K. The influence of hip strength on lower-limb, pelvis, and trunk kinematics and coordination patterns during walking and hopping in healthy women. JOSPT. July 2014; 44(7):525-531.
Song K, MD & Herring J, MD. Early recognition and assessment of idiopathic scoliosis. J Musculoskel Med. 1993;10(4): 63-76.
Swedan N. Women’s sports medicine and rehabilitation. 2001. Aspen Publishers, Inc.
Timm KE. Randomized controlled trial of Protonics on patellar pain, position and function. Med Sci Sports Exerc. May 1998;30(5): 665-70.
Valmassy R. Clinical biomechanics of the lower extremities, 1st Ed. Mosby, 1996.
Van Dillen L, Bloom N, Gombatto S, Susco T. Hip rotation range of motion in people with and without low back pain who participate in rotation related sports. Physical Therapy in Sport. May 2008;9(2):72-81.
Vleeming A, Mooney V, Dorman T, Snijders C, Stoeckart R. Movement stability & low back pain. The essential role of the pelvis. Churchill Livingstone, 1997.

Neurology

Chong D. Stop pushing. Advance Dec 2006;32-34.
Cowan S, Bennell K, Hodges P, Crossley K, McConnell J. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Arch Phys Med Rehabil. Feb 2001; 82.
Grabiner MD, Koh TJ, Draganich LF. Neuromechanics of the patellofemoral joint. Medicine and Science in Sports and Exercise, August 1993
Hebert LJ, Gravel D, Arsenault AB, Tremblay G. Patellofemoral pain syndrome; the possible role of an inadequate neuromuscular mechanism. Clinical Biomechanics 9(2): 93-97.
Reisman D, Scholz JP. Aspects of joint coordination are preserved during pointing in persons with post-stroke hemiparesis. Brain 2003;(126):2510-2527.
Travell and Simons. Myofascial pain and dysfunction, the trigger point manual, the lower extremities. 1992. Williams and Wilkins Volume 2, page 259.
Voight ML, Wieder DL. Comparative reflex response times of vastus medialis obliquus and vastus lateralis in normal subjects and subjects with extensor mechanism dysfunction; an electromyographic study. The American Journal of Sports Medicine. 1991; 19(2).
Witvrouw E, Sneyers C, Lysens R, Victor J, Bellemans J. Reflex response times of vastus medialis oblique and vastus lateralis in normal subjects and in subjects with patellofemoral pain syndrome. JOSPT. Sept 1996; 24(3): 160-165.

Patellar Tracking/Knee Impairments

Biomechanics. By the numbers: patellofemoral pain. Biomechanics, July 2005.
Boling MC, Padua DA et al. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the joint undertaking to monitor and prevent ACL injury (JUMP-ACL) cohort. Am J Sports Med. 2009;37:2108-2116.
Denton J, Willson J, Ballantyne B, Davis I. The addition of the protonics brace system to a rehabilitation protocol to address patellofemoral joint syndrome. J Orthop Sports Phys Ther. April 2005;35(4):210-219.
Dolak K et al. Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial. Journal of Orthopaedic and Sports Physical Therapy. August 2011; Vol 41(8):560-700.
Grelsamer R. The argument for in vitro testing of the patella. Biomechanics. Mar 1997: 29-33.
Jette DU, Jette AM. Physical therapy and health outcomes in patients with knee impairments. Physical Therapy. Nov 1996;76(11): 1178-1187.
Lee TQ, Morris G, Csintalan RP. The influence of tibial and femoral rotation on patellofemoral contact area and pressure. J Orthop Sports Phys Ther. 2003;33:686-693.
Mangine R, Bilbo J, Mangine M. Knee rehabilitation – examining external supports for patella pathology. Biomechanics/Phys Ther. May 1997: 7-9.
Meira, E and Brumitt J. Influence of hip on patients with patellofemoral pain syndrome: a systematic review. Sports Health Vol 3(5):455-465.
Metgud S, Chougule A, Heggannavar A. Effects of hemibridge with ball and balloon exercise as an adjunct to conventional therapy in knee osteoarthritis patients: a randomized control trial. Asian J Med Health Res. 2017;2(6)
Piva S, Goodnite E, and Childs J. Strength around the hip and flexibility of soft tissues in individuals with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2005;35(12):793-801.
Powers C. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010;40:42-51.
Powers C. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003;33:639-646.
Powers C, Landel R, Perry J. Timing and intensity of vastus muscle activity during functional activities in subjects with and without patellofemoral pain. Physical Therapy. Sept 1996;76(9): 946-955.
Powers C, Perry J, Hsu A, Hislop H. Are patellofemoral pain and quadriceps femoris muscle torque associated with locomotor function? Physical Therapy. Oct 1997;77(10): 1063-1075.
Prins MR, van der Wurff P. Females with patellofemoral pain syndrome have weak hip muscles: a systematic review. Aust J Physiother. 2009;55:9-15.
Rathleff MS, Rathleff CR et al. Is hip strength a risk factor for patellofemoral pain? A systematic review and meta-analysis. Br J Sports Med. 2014;48:1088.
Salsich GB, Perman WH. Paterllofemoral joint contact area is influence by tibiofemoral rotation alignment in individuals who have patellofemoral pain. J Orthop Sports Phys Ther. 2007;37:521-528.
Tiberio D. Kinetic chain. Biomechanics/Phys Ther. May 1997: 15-16.
Van Can J, Pineux C et al. Hip muscle strength and endurance in females with patellofemoral pain: a systematic review with meta-analysis. Int J Sports Phys Ther. 2014;9:564-582.

Posture

Bagwell J, et al. Sagittal plane pelvis motion influences transverse plane motion of the femur: Kinematic coupling at the hip joint. Gait & Posture, 2016;43:120-124.
Boyle K, Demske J. Management of a female with chronic sciatica and low back pain: A Case Report. Physiotherapy Theory and Practice, 25(1):44-54,2009.
Chaudhari A, McKenzie C, et al. Lumbopelvic control and days missed because of injury in professional baseball pitchers. Am J Sports Med. Published online August 26, 2014.
Hodges PW, Cresswell AG, Daggfeldt K, Thorstensson A. Three dimensional preparatory trunk motion precedes asymmetrical upper limb movement. Gait Posture. 2000;11:92-101.
Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine. 1996;21:2640-2650.
Hodges PW, Richardson, CA. Transversus abdominis and the superficial abdominal muscles are controlled independently in a postural task. Neurosci Lett. 1999;265:91-94.
Inglis JT, Horak FB, Shupert CL, Jones-Rycewicz C. The importance of somatosensory information in triggering and scaling automatic postural responses in humans. Exp Brain Res 1994;(101):159-164.
Jackson LR, Purvis J, Brown T. The effects of postural and anatomical alignment on speed, power and athletic performance in male collegiate athletes: a randomized controlled trial. IJSPT. August 2019;14(4):623-636.
Karimi N, Fathizadeh M, et al. Efficacy of pelvic repositioning exercises on pain, hip and shoulder range of motion and disability of the patients with chronic non-specific low back pain: a single blinded randomized controlled trial. Journal of Rehabilitation Sciences and Research. 2021;8(3):106-114.
Spence H. Case study report: postural restoration: an effective physical therapy approach to patient treatment. Techniques in Regional Anesthesia and Pain Management, 2008; 12: 102-104.
Tenney HR, Boyle KL, and DeBord A. Influence of hamstring and abdominal muscle activation on a positive ober's test in people with lumbopelvic pain. Physiotherapy Canada. 2013;65(1)4-11.
Zink JG and Lawson, WB. An osteopathic structural examination and functional interpretation of the soma. Osteopathic Annals, 1979; 7(12): 433-440.

Anatomy

Terms

Lower Half Exam Tests

Adduction Drop Test

The patient lies on his or her side with the lower leg and hip flexed (90 degrees). Stand behind the patient and passively flex, abduct and extend the hip to neutral while maintaining 90 degrees of knee flexion. Passively stabilize the pelvis from falling backward and allowing femoral internal rotation to occur. Make sure the top innominate is positioned directly over the bottom innominate so the frontal plane starting position does not give any false positives (top innominate too cephaled) or false negatives (top innominate too caudal).

A positive test is indicated by a restriction from the anterior-inferior acetabular labral rim, transverse ligament, and piriformis muscle or impact of the posterior inferior femoral neck on posterior inferior rim of acetabulum that does not allow the femur to adduct; possibly secondary to an anteriorly rotated, forward hemipelvis. Usually seen on the left especially if left Extension Drop Test is positive in a Left AIC oriented patient.

Adduction Drop Test

Extension Drop Test

The patient is positioned in supine with both thighs on the table. Both hips and knees are flexed to the chest. Passively lower one leg over the edge of the table while helping the patient hold the untested knee close enough to the chest to maintain the low back against the table. Do not allow hip abduction to occur past zero degrees on the tested extremity while passively dropping the FA joint into extension.

A positive test is indicated when the tested lower extremity (usually the left) is restricted in hip extension because of the forward orientation of the tested side compared to the other. If both femurs do not approach the edge of the mat or table the patient is tested on, the innominates are rotated forward bilaterally and the psoas muscles are on slack. Placing the femur in “neutral” is actually placing the patient’s femur in external rotation. This tightens the TFL and VL and restricts hip extension.

There is also a rotary component to this issue, especially seen with limitation in hip extension on one side. Since the forward, anteriorly rotated pelvis accompanies sacral rotation to the contralateral side (right rotation on a right oblique axis or left rotation on a left oblique axis) the iliofemoral ligament will also limit extension when the femur is externally rotated by the therapist, through testing with the femur in a “neutral” position.

The femur in this case will not approach the patient support surface without femoral internal rotation and or through luxation (i.e., “click”) of anterior superior femoral head moving forward under the superior anterior condyloid labral rim of acetabulum.

Extension Drop Test

Lower Trunk Rotation Test

The patient is positioned supine with knees maximally flexed and together, and feet flat on the table. Passively rotate the legs to the trunk’s resting state with one hand, while stabilizing the trunk with the other hand (placing it on the anterior lower ribs and sternum). A yardstick may be used to measure the distance from the mat to the upper-most point of the superior knee, while maintaining the opposite posterior thorax contact with the mat. Repeat the test in the other direction.

A positive test is indicated when the legs do not rotate in one direction as compared to the other. For example, the legs are restricted in rotation to the left (i.e., the legs do not rotate to the left as they do to the right as measured through the use of an upright ruler). This means that trunk rotation is limited more to the right secondary to probable left hip anterior rotation and sacral-lumbar orientation of the spine to the right. Therefore, postural restoration should be initiated at the left lower extremity to address left mechanical instability and maintain proper restored pelvi-femoral neuromechanics.

Lower Trunk Rotation Test

Hruska Adduction Lift Test

This test is used as a Myokinematic measurement with each grade reflecting muscle position, strength, and neuromuscular ability. The test is named for the leg, which is placed on the examiner’s shoulder. (Patient is lying on their right side with left ankle placed on examiner’s shoulder – “Left” Hruska Adduction Lift Test.)

Position
Patient sidelying – back rounded
Uppermost lower extremity resting on therapists shoulder (neutral hip, extended knee)
Lower leg in flexed position
Maintain pelvis in a neutral position (do not allow upper pelvis to rotate forward or backward)

Mechanics
Step 1: ask patient to raise ankle of flexed lower leg to upper knee
Step 2: have patient raise flexed lower knee while keeping ankle to the knee
Step 3: patient will then raise lower hip while maintaining the above positions
Discontinue test at the step patient is unable to perform

Grading Criteria

LEVEL 0
Inability to raise lower ankle off mat or table.
Obturator weakness of flexed extremity.

Level 0

LEVEL 1
Ability to raise lower ankle to upper knee.
Inability reflects either weakness of FA external rotators or AF stability of active extremity.

Level 1

LEVEL 2
Ability to raise lower knee and ankle.
Inability reflects instability of AF and weakness of adductor magnus and obturators or an anterior tilted and forwardly rotated pelvis with accompanying FA IR weakness secondary to long position of ischiochondylar adductor and short position of gluteus minimus, medius and TFL.

Level 3

LEVEL 3
Ability to maintain above position while lifting lower hip off table slightly.
Inability reflects weakness of FA stabilizers on extended extremity including the short head of the biceps femoris and adductor magnus and possibly bilateral AF stabilizers including muscles of the pelvic diaphragm and lower gluteus maximus.

Level 3

LEVEL 4
Ability to raise hip completely off mat or table to level of patients shoulder and examiner’s shoulder.
Inability reflects lack of core lumbopelvic femoral strength and more than likely the internal obliques on side of extended leg and external obliques on side of flexed leg.

Level 4

LEVEL 5
Ability to raise hip above level of the patients shoulder and equal to examiners shoulder.
Inability reflects patient’s strength and neuromotor proprioceptive skills to shift hips.

Level 5

Hruska Abduction Lift Test

This test is used as a Myokinematic measurement with each grade reflecting muscle position, strength, kinesthetic awareness, and neuromuscular ability. The test is named for the leg, which is placed on the wall (Patient is lying on their left side with right foot placed on the wall – “Right” Hruska Abduction Lift Test).

Position
Patient sidelying with upper leg extended and aligned with hip and shoulder.
Adjust position of knees to wall, so that top knee is above the level of the ipsilateral shoulder.
Lower leg is flexed with lower toes positioned on the wall directly under the top foot and placed on 4 to 6” bolster.
Top palm should be placed flat on surface in front of chest and upper hand under head.

Mechanics (Discontinue test at the step the patient is unable to perform)
Step 1: ask patient to press bottom toes into wall to stabilize pelvis
Step 2: instruct patient to press bottom hip into the surface to engage lower abs and lower adductors
Step 3: ask patient to turn and raise bottom knee up or inwardly using lower ischiocondylar adductor and anterior gluteus medius, without moving top hip backwards.
Step 4: turn top heel up or top toes down without lowering bottom knee or moving top hip forward.
Step 5: attempt to raise top leg off wall while trunk and hips are stabilized in previous positions.

Grading Criteria:

LEVEL 0
Inability to position top leg in alignment with top shoulder and hip and with top knee above top shoulder without experiencing top hip impingement, sacral iliac pain or low back pain.
Malaligned pelvis and poor integration of adductors, abductors and FA rotators in frontal plane.

Level 0

LEVEL 1
Ability to push bottom hip into surface.
Inability reflects weakness in bottom internal oblique and transverse abdominis or bottom quadratus lumborum or top external obliques.

Level 1

LEVEL 2
Ability to raise or turn “in” bottom knee without moving top pelvis backwards.
Inability reflects poor strength or kinesthetic awareness of ischiocondylar adductor or anterior gluteus medius; or lax iliofemoral – pubofemoral ligament.

Level 2

LEVEL 3
Ability to rotate top extremity inward (FA IR) without moving top pelvis forward.
Inability reflects poor strength or kinesthetic awareness of ipsilateral gluteus minimus and anterior gluteus medius, or impingement of medial femoral head on anterior medial cotyloid labral rim secondary to forward, anteriorly rotated contralateral pelvis.

Level 3

LEVEL 4
Ability to raise top leg completely off the wall and hold without using lateral trunk muscle.
Inability reflects poor integration between contralateral hip adductors, and ipsilateral hip abductor (gluteus medius).

Level 4

LEVEL 5
Ability to move correctly abducted top lower extremity into extension without extending low back or flexing knee or rotating leg externally (FA ER).
Inability reflects inability to extend leg with gluteus maximus during concomitant abduction and FA stabilization provided by adductors (IR’s) and anterior gluteus medius and TFL.

Level 5

Recommended Reading

Licensed Physical Therapists and PT Assistants

Licensed Occupational Therapists and OT Assistants (Classification Codes)

Certified Athletic Trainers

Certified Strength & Conditioning Coaches

Certified Personal Trainers

Licensed Massage Therapists

Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited universtity are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.

Accessible Learning Environments
All participants in Postural Restoration Institute™ (PRI) continuing education courses are entitled to an accessible, accommodating, and supportive teaching and learning environment. Participants have the right to request accommodations and the responsibility to provide disability documentation that supports those requests. PRI has the right to establish eligibility guidelines in accordance with both law and policy regarding disability and provide those accommodations that appropriately provide equal access to the programs and activities it sponsors.

A Certificate of Completion is awarded to attendees upon the successful completion of this course. Before attending a course, please verify CEU acceptance with your profession’s regulating body.

Physical Therapists and PT Assistants

In the states where PRI is sponsoring courses and where approval through state American Physical Therapy Association (APTA) or licensing agencies is required, PRI will apply for approval for CEUs for Physical Therapists and Physical Therapist Assistants.

The following states accept other state approval and thus would honor this course as an approved course:
Alabama, Arizona, Colorado, Connecticut, Washington DC, Delaware, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, Wyoming.
Approved by the Arkansas State Board of Physical Therapy for 15 hours.
Approved by the North Carolina Board of Physical Therapy Examiners via approval by other states.
Approved by the Texas Board of Physical Therapy Examiners for 15.5 CCUs. Approved August 10, 2023 – August 10, 2024. #77601TX.
Approved by the Louisiana Physical Therapy Board for 15.5 clinical hours. Approved for the 2023 calendar year.
Approved by the Louisiana Physical Therapy Board for 15.5 clinical hours. Approved for the 2024 calendar year.
Approved by the Maryland State Board of Physical Therapy Examiners for 1.5 CEU's. Approval valid June 14, 2021 - June 14, 2025.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 - February 17, 2025.
Approved by the Illinois Physical Therapy Association for 15 CE Hours. Approval #205-8775. Approval valid January 1, 2023 - January 1, 2024.
Approved by the Illinois Physical Therapy Association for 15.5 CE Hours. Approval #205-9086. Approval valid January 1, 2024 - January 1, 2025.
Approved by the Minnesota Board of Physical Therapy for Category 1 continuing education credit for 15.5 hours. Approved #7520. Approval valid January 1, 2023 - December 31, 2023.
Approved by the Wisconsin Physical Therapy Association for 15.5 contact hours. Approval valid January 1, 2023 - January 1, 2024. CEUL108245. Approval #10926.
Approved by the Wisconsin Physical Therapy Association for 15.5 contact hours. Approval valid January 1, 2024 - January 1, 2025. CEUL128361. Approval #19443.
Approved by the Ohio Physical Therapy Association for 15.5 contact hours. Approval valid September 13, 2023 - September 13, 2024. Approval #23S2668.

Chiropractors

In the states where PRI is sponsoring courses and where approval through state licensing agencies is required, PRI will look into applying for CEUs for Chiropractors (upon request). Requests must be made at least 90 days prior to the course date.

Approved by the Minnesota Board of Chiropractic Examiners for 15 regular units of instruction for 2023.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 - February 17, 2025.
Approved by the California Board of Chiropractic Examiners for 15.5 Hours of Category B - Physiotherapy, CA-A-23-01-12300. Approval valid January 1, 2023 - December 31, 2023.

Occupational Therapists and OT Assistants

The American Occupational Therapy Association (AOTA) recognizes PRI as an Approved Provider of continuing education. AOTA Provider #6596. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA or indicate AOTA approval of a certification or other professional recognition. This course awards 1.5 AOTA CEUs/15 Contact Hours.

Athletic Trainers & Athletic Therapists

Postural Restoration Institute (BOC AP# P2376) is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. This program is eligible for a maximum of 15 Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.

Approved by the Canadian Athletic Therapists Association (CATA) for 6 CEU's. Approval valid January 1, 2023 - December 31, 2023.

Strength and Conditioning Coaches

This course is approved by the Collegiate Strength and Conditioning Coaches Association (CSCCa) for 7.5 CEU's.

Other Healthcare and Fitness Professionals

PRI Welcomes any interested healthcare or fitness professional to attend our courses. Attendees are responsible for following their state statues regulating their professional practice as they integrate interdisciplinary PRI concepts.

PRI reserves the right to cancel and refund a course attendee’s registration if any concerns arise regarding the course attendee’s qualifications as a healthcare or fitness professional, copyright infringement, or any other illegal activity involving PRI copyrighted materials. International attendees may be required to review and sign a Copyright and Intellectual Property Recognition and Disclosure Contract prior to receiving access to course materials.

Learned a ton and started to apply it right away! | October 2022
The course was everything that I expected it to be, and gave me a greater appreciation for human movement | July 2022
Better than anything I've learned in 20+ years! | May 2022
Absolutely amazing content! | April 2022
Phenomenal. Craving the next class already. | February 2022
Fantastic, Inspirational, Enjoyable. Thank you so much as always!!! | December 2021
A great course that exceeded my expectations. | December 2021
Absolutely incredible. | September 2021
UNREAL. Thank you! | July 2021
Fundamentally a gamechanger in our healthcare system. Buy a ticket today - it's a heck of a ride!!! | July 2021\
Thank you for creating such a thorough course manual. I appreciate being able to use the exercises and pictures for patients. |September 2020
As a home study person, the lab videos demonstrating the tests were excellent. Made me feel that I was actually thre in person and involved in the assessments. | August 2020
Very well organized. Will use this as a reference for the rest of my career. | May 2020
Absolutley enjoyed the content and the recorded sessions. I will surely be taking more courses in the future! | April 2020
Blown away by the theories! | March 2020
I enjoyed it very much and benefited from the home course approach. I had plenty of time to review, take breaks when my head said stop and had much more time to digest the material than folks at the 2 day course. | March 2020
One of the best courses ever. Lots of things to learn. A bit complicated on the beginning, but after re-watching 2 times : awesome! | February 2020
I feel very happy that you give this possibility to learn for people who live far away from USA. That's why I wanted to say thank you for home study possibility. I want to write too that this course seems for me very well prepared and very well explained. Till now I have had an experience that many times there are technics where they tell you that you have to do something because it's working, but without any explanation. This course is different, all seems to make sense. | February 2020
The course has a lot of new knowledge, quite different from any previous courses (school or continuing ed) I have previously experienced. It will take some time and review for some of the concepts to sink in, but with practice and repetition, I think this will be a great skillset to incorporate in my practice. | February 2020
I enjoyed taking this course as a home study so that I could re-watch sections that were new concepts to me. I felt like I was able to take more out of the course and make it applicable to my practice. | January 2020
A lot of good information. I feel like it's going to be very valuable and beneficial for me. I feel a little overwhelmed, and I usually don't, so I hope I can pull everything together this week in the clinic. I'm sure I will, and am looking forward to taking the other courses. Thanks. | January 2020
I feel that I can now give patients tools to use even after discharge to maintain neutrality for longevity and to address the cause of their pain, not just manage symptoms. | January 2020
I believe this course will be greatly beneficial to my practice. I treat a range of youth to professional athletes and this information can be used in both populations. | December 2019
We see a lot of patients with knee and low back pain. With the information presented in this course, it perfectly describes how the orientation and compensations influence patient's symptoms and how to address them. | December 2019
Thank you for broadening my perspective on the human body! | September 2019
This course is an absolute game changer for strength and conditioning coaches. | September 2019
What a treat to hear this course from Ron Hruska, his passion for the material is very apparent and made the course very engaging. | August 2019
Excellent. This course really helped tie the other two courses together. This was my favorite course yet and I feel like I have a better understanding of PRI now. | August 2019
Great information. I look forward to taking the Postural Respiration course. | August 2019
Overall, I was very impressed with this course. It took my base knowledge and skill set and greatly expanded them. I believe the thoroughness and evidence based approach are what separates this course from others of the same category. The manual is put together very well and will allow for easy integration into my practice. | July 2019
Fantastic course, got everything I was looking for and more. | July 2019
Did an excellent job in the home video switching between the view of the speaker and the PowerPoint - made it very easy to follow along in the manual at home. | June 2019
A great foundation course for any medical provider to dig deeper into lumbo-pelvic anatomy and function. Highly recommend. | May 2019
I think any level of student, practitioner, or enthusiast is capable of absorbing this material. Ron does a fantastic job of ensuring the audience understands both the bigger picture and details. It's a great introductory course allowing one to challenge their understanding of human movement. | April 2019
I have always looked for better ways to help my clients overcome injury and pain. This course has definitely increased my knowledge ten-fold! | March 2019
I really appreciate the material, the availability of the material (online) and the cost. I'll definitely be taking more PRI courses! | March 2019
The most inspirational course that I've ever had. PRI formulates all the muscle roles around the pelvis and solves the problems of asymmetry. | March 2019
Excellent course and speaker, really loved the myokinematics and felt that it was more valuable than many of the musculoskeletal courses in my DPT program. | March 2019
I think any level of student, practitioner, or enthusiast is capable of absorbing this material. Ron does a fantastic job of ensuring the audience understand both the bigger picture and details. It's a great introductory course allowing one to challenge their understanding of human movement. | March 2019
Ron is brilliant, and I loved every minute of this course. | March 2019
I really appreciate the material, the availability of the material (online) and the cost. I'll definitely be taking more PRI courses! | February 2019
The most inspirational course that I've ever had. PRI formulates all the muscle roles around the pelvis and solve the problems of asymmetry. | February 2019
This course has given me a new perspective to view patients through and I feel my assessment process will be far more advanced going forward. I will be better equipped to find the root cause of many pain syndromes or dysfunction, therefore treatment can be more focused and effective. | December 2018
I thought that this course contained great information to assist with intervention selection in various patient presentations and different pain patterns. The discussion on R vs. L piriformis syndromes was very helpful. I also learned more about how to help cue patients during exercises to help them better find and feel desired muscle groups. | December 2018
This is critical information for a PT to have in order to treat not just the symptoms of dysfunction, but the source of the dysfunction as well. | June 2018
My practice of over 20 years is based of MFR, and i have found these PRI courses extremely complementary to the population of patients I see daily. | January 2018
This course is worth MORE than the money, easily gets 5 stars and this type of raw dedication to discovery, compassion and ingenuity will change the face of therapeutic medicine. | January 2018
This was an outstanding course from presentation, speaker to content. I am looking forward to the other courses offered. THANK YOU! | October 2017
I thought the content exceeded the price by bounds… Again, just thrilled that cost was not so prohibitive as to preclude my attendance. I loved the walk-thru's and the additional 'lab' footage which was a nice touch. | September 2017
Myokinematic Restoration offers an incredibly detailed journey through the lower extremity with regards to position and gait, outlining the complex relationships between movement and position for optimal human performance and function. | June 2017
Excellent! I am recommending this to my colleagues. Definitely rehab from a different and "missing link" perspective. | Lafayette, IN October 2015
Best course ever. Hats off to Ron, James and the rest of the PRI group. Thank you very much for improving physiotherapy. | Hatchet Lake, Novia Scotia, Canada April 2015
Very in depth and educational, exactly what I was looking for when I decided to be a PT | Boston, MA March 2015
I have gotten better results in the last few days using PRI Concepts than I have gotten in the last 3 years as a PT! | Littleton, CO, March 2015
Best course for me to date can't wait to take the next couple before I come see you all in Nebraska for my PRT certification in a year or two! | Monrovia, MD, December 2014
Mind blowing! | Highland Park, IL, March 2014
Very well done DVD’s - probably the best home study course I’ve taken to date. | El Dorado, Kansas, July 2013
Loved it, has changed the way I practice. | Fort Jennings, Ohio, February 2013
This information is incredibly exciting – if it holds up in the clinic, I would characterize the use of this approach as a revolutionary positive paradigm shift in PT. Ron Hruska must be very astute to have put these ideas together, designing ways to assess and treat with this method. It is difficult to express how superb James Anderson is as a teacher. He has clearly through through their concepts in excruciating detail and so has been very effective at developing teaching tools and techniques that enable the learner to grasp the material and put it to use immediately! Great course!

I can’t tell you how excited I am by the work that you’ve done (are doing), bringing together concepts and techniques from various disciplines, and building a unique and incredibly insightful approach to physical therapy examination, evaluation and treatment. I realize that your work (as all of our work) is built on the shoulders of others, and I am not prone to hyperbole, nor have I ever had a hero; still, I am awed by the genius of your constructions. I am reeling a bit from all of the information I have received in taking 3 of PRIs courses in the last month, but everything I have learned has resonated strongly. There are many patients who I haven’t been able to help, many more who I could never to to 100%, and I’ve always been very away that I was missing something. Though I have treated very few patients with the PRI approach thus far, I am convinced that this is the missing link.

I am a bit of a continuing ed junkie, have taken many hundreds of hours of courses (most of them excellent) and am in the process of completing my DPT degree, but I have never encountered coursework that was this inspiring. It seems that you are grossly under-appreciated in the physical therapy world and I just want to thank you for all you have done and all you continue to do. | St. Louis, Missouri, February 2013

Love that PRI can not only improve pain function but can have additional niche of performance enhancement. | Orange City, Iowa, January 2013
You guys do excellent work this is the best course I’ve taken. It’s not just surgical protocols and research; it’s directly observable information that is hugely important in PT. Thank you for your efforts. | Lincoln, Nebraska, January 2013
WONDERFUL!! Inspiring, thought-provoking, challenging to my traditional education and practice patterns which is fantastic as it pushes me to evolve as a practitioner. Thank you!! | Lincoln, Nebraska, November 2012
The home study course was extremely convenient and allowed me to review key points at my own pace. | Bonita Springs, Florida, October 2012
Fantastic course. | Somerton Park, Australia, Alabama, September 2012
Great course! It has already proved to be extremely beneficial in treating a variety of patients. | Carlsbad, California, August 2012
New perspectives, amazing course. I can’t wait to continue with progression and possibly PRC. | Watertown, Massachusetts, July 2012
Excellent! Helped to pull many pieces together for me. | Wrentham, Massachusetts, May 2012
Loved this. I was nervous about having insufficient background knowledge, but James explained things so well and thoroughly. Loved all the different considerations taken into account. | Loveland, Colorado, December 2011
It was a great course. It is a completely different way of thinking which is a lot to digest. | Essex Junction, Vermont, November 2011
I was surprised at how well put together this home study course was. I hadn’t taken one before but I learned a lot even though I didn’t have a chance to be in a lab setting which would have been even more beneficial for me. | Chesapeake, Virginia, October 2011
I wanted to send a thank you note to you and everyone on your staff for their help during the summer. I especially wanted to let you know that Bobbie and Janie have done a wonderful job in coordinating these courses, as well as answer any and all questions in a quick and timely manner. I recently finished the course material for the Home Study Postural Respiration course, and completed the Home Study Myokinematic Restoration course earlier this summer. The home study format was perfect with my schedule this past summer. I have thoroughly enjoyed taking both of these courses, as well as look towards completing future courses through the Postural Restoration Institute. I will continue to review my notes and start to integrate the material into my daily treatments and rehabs here at the University of Miami. Please let me know if there is anything I can do for you all in the future. | Miami, Florida, July 2011
I plan to use the course information to treat the ‘source’ of symptoms vs. just symptoms to improve results/longevity of results. Great course on integration of biomechanical, neuromuscular, and orthopedic concepts! I am excited to take the Postural Respiration course! | Salem, Oregon, February 2011
This proved to be a wonderful way to learn material that is initially difficult to conceptualize, especially when it requires a different thought process than is employed in traditional PT practice. | Fayetteville, New York, July 2010
Loved this course along with the whole concept of PRI! I have used manual techniques often (from the Postural Respiration course) and the tip of the ice berg is non-manual techniques taught in this course. I’ve had amazing results even in the short time I have been practicing these techniques. | Louisville, Mississippi, February 2010
Great stuff! I wish this was taught in PT school. Missing piece of the puzzle!! | Kalida, Ohio, January 2010

Course Registration

Register online or by phone
Format: Online/Digital
You will receive an email within 24 hours after purchasing the home study with instructions to login and begin your home study online. (*Please note that you must order before 3pm CST on Friday to receive your online access information before the weekend. If you order the home study after 3pm on Friday, you will receive your online access information on Monday). You will receive all materials online including the videos and course manual (which you will be able to download and print). You will also complete the post-test and course evaluation form online. You will need high speed internet in order to watch the videos (the videos are NOT downloadable). Once you have been emailed your online access information, you will have 21 days to complete the course online before your access to the course materials will expire.
You will receive a Certificate of Completion by email if post-examination test is passed (miss 8 or fewer) and course evaluation summary is completed.

Course Materials

Online/Digital Format – Each registrant will receive online access to the approximately 15 hours of course video content, as well as access to download and print the entire course manual (printing the manual is recommended). The post-test and course evaluation form will also be completed online. You will have 21 days to complete the course material, before your online access expires.

Special Needs Requests

If you have a disability and require accommodation in order to fully participate in this course, please contact us at least two weeks prior to the course date or prior to purchasing any online home study course so that arrangements can be made.

Cancellation and Refund Policy

To cancel your registration, please call as soon as possible for a full refund. Cancellations and refunds will not be accepted once the course registrant has set up their online username/password.

Course Tuition

Online Home Study $475

*50% off if you qualify for the Home Study Advantage

Discounts

Those who have earned the designation of Postural Restoration Certified (PRC) or Postural Restoration Trained (PRT) are eligible for a 50% discount. Students are eligible for a 25% discount.

*Discounts exclude Interdisciplinary Integration Symposium, PRI Vision Courses, and PRI Affiliate Courses.

Supportive Products

(This is not the homestudy)

Myokinematic Restoration