Monday, December 21, 2009

Postural Restoration: Physical Therapy that is Making Sense

I have been busy taking care of medical business the past couple of weeks. After cracking a rib last summer, I went to visit the doctor's office to get it checked out. I was reassigned a primary care doctor and told I needed to make an appointment since I had been avoiding doctors for too many years. So I had a checkup a couple months ago and the doctor got me signed up for all sorts of fun stuff. While getting me all these appointments I asked if I could see a physical therapist (about every five years I try to go in and see if there is someone that can help me out with my stride and mechanics). I haven't got much running in due to a minor surgery that left me with 2 inches of stitches on my hip and a week later the so very fun colonoscopy. I finally also got started with a physical therapist. I was hoping just to get a couple of questions answered on my ankle and hips and to see if a therapist could offer me some good information.

I ended up at Select Physical Therapy in Nashua. The therapist started looking at how my body worked and measured all sorts of angles and rotations. She spent some time looking at how my ankle did not work properly, but it was not the only thing she noticed. Hips, shoulders, back; there was something out of whack everywhere. She took lots of notes and I couldn't keep up, but it was nice I recognized every muscle, bone, and body part she mentioned. The hips were something she spent a lot of time on and I was hoping to get a diagnosis of what is wrong with my so I could get a better idea of what to do with the information in The Malalignment Syndrome book and DVDs I had studied last winter and spring. She noticed all sorts of weaknesses, tightness’s, and improper rotations, but the main thing is that my left hip is much higher than my right hip. This was a good confirmation if I got nothing else out of the visit.

Then she started teaching me some exercises. I received four that I practiced and then was sent home to do twice a day: before running and after. She said I could start up the therapy and that I could still run as part of the process! What I liked was that these exercises where not the standard exercises for hips or low back that I have been given by other therapists. These were targeted for my specific needs and problem areas. What I did on one side was completely different from what I did on the other. The exercises "made sense" to me too. My body could feel exactly what they were trying to do and if felt just right.

I was told that these exercises where "postural restoration" exercises and I recall bumping into this before on the internet. Of course, I went home to find out more about postural restoration and I think it is a perfect opportunity for me to have an expert work with me on trying to bring my body back into balance. I think that I lucked into the perfect physical therapy situation. So I am getting work on my feet, my adductors and abductors, my hips, and my thoracic spine and shoulders. I think it is the first time I have had someone work on all the misalignments in my body as well as seeing how my body works together as a unit. Most therapists just worked on my hips or my back and never the whole.

Here is a bit of information from the Postural Restoration website:

Basic Concepts of the Postural Restoration Institute™

The human body is not symmetrical. The neurological, respiratory, circulatory, muscular and vision systems are not the same on the left side of the body as they are on the right, and vice versa. They have different responsibilities, function, position and demands on them. This system asymmetry is a good thing and an amazing design. The human body is balanced through the integration of system imbalances. The torso, for example, is balanced with a liver on the right and a heart on the left. Extremity dominance is balanced through reciprocal function; i.e. left arm moves with right leg and vice versa.

Postural Restoration Institute™ (PRI) trained therapists recognize these imbalances and typical patterns associated with system disuse or weakness that develops because of dominant overuse. This dominant overuse of one side of the body can develop from other system unilateral overuse

Many therapies I have encountered treat the body as if it should work perfectly except for one little problem area. Then a stretch or a strength move is supposed to fix that problem leading to a successful resolution. It doesn't happen that way with me and this therapy looks at the body as asymmetrical when in dysfunction. It also has reasons for those dysfunctions. So let's see if I can be fixed or brought into a better functional ability.

Of the four stretches I was initially given, I could not get one to work. It was an obturator stretch (next to the piriformis) so we are dropping that one. Then I had a 90/90 hip shift (like this without the stool and balloon). The hip shift down on my left side is the real key. This strengthens the hamstring and the inside of the thigh, but the shift into the hip teaches me a new position and works one of my most chronically stiff muscles.

I have another exercise that also promotes the hip shift on the left hip and one that works the outside of the right hip. After one day of doing the exercises I had a much better than average 8 mile run on my treadmill. When I do the exercises before I run, I find that I get a better hip position where I actually use the left hip (the left usually does not do the work that the right does) and feel a better foot placement and movement over my knee.

Today I had my second appointment and we are continuing the exercises and adding some new moves. I found that one is their exercise of the week here. It is called the PRI Supine Weighted Punch with Right Apical Expansion and it I am doing it because the right side of my chest and ribs is very tight and rotated behind my fight side. It does not move forward as I run as it is stuck. This should help to strengthen and restore the movement as well as to help me with my breathing. The left side of my chest always seems rotated forward ahead of my right side, so it is nice to find an exercise that works on this problem area. It reminded me of the first move in a kettlebell turkish getup, so I can practice that part of a getup with more meaning. I also have a bridge type exercise and a clamshell type exercise to work on. As for now, I am going in twice a week and I am very positive that I will gain some new insight and direction for fixing my stride.

1 comment:

Exercise Physiologist Sydney said...

While this post is quite old I'm trying to find research from "3rd party" sources on whether PRI is worth it or not. Look's like I'm 100% right and will start looking into implementing it soon with my patients (I'm a exercise physiologist in Sydney