This is the main question I get when asked what my practice is based on or evolved around if you will. In north Texas, PRI is starting to become more familiar but never the less still a slow process. I personally believe the concepts are slow to grow due to the complexity of the science and difficulty it takes to truly understand PRI. I often encounter more seasoned therapists, who have been practicing longer, fearful of change and in the south one may say “if it ain’t broke, don’t fix it.” I practiced a little over 2 years before discovering PRI and I can 100% assure you PT schools should begin teaching PRI. No further statemends needed.
PRI, an acronym for Postural Restoration Institute, has been the sole driving factor in designing my own practice. The Institute is based out of Lincoln, Nebraska and was founded by Ron Hruska, PT. The webpage for the Postural Restoration Institute is www.posturalrestoration.com to learn more about the science and the constantly evolving Institute itself. The technical terms and more specific details will be found there but for the cliff notes version continue reading.
Postural Restoration to me isn’t just “physical therapy”, it encompasses numerous other practices in the healthcare industry. Interdisciplinary integration is a conference PRI puts on annually in Nebraska. I attended the seminar in April 2015. There was a psychiatrist, a dentist, a psychologist, a strength and conditioning specialist, an optometrist, a college basketball coach, and a physical therapist who presented information all related to the same topic in their specialties. The room had physical therapists, dentists, strength and conditioning coaches, athletic trainers, a Doctor of Osteopath, and chiropractors all present for the conference aside from the presenters. The reason I bring this up is that being trained by the principles of the Postural Restoration Institute means as a practitioner we are aware and understand that other systems outside of our scope may be a cause of pathology or dysfunction that our intervention alone won’t solve. We may have to refer to a dentist, an optometrist, or cast orthotics for the foot before a PRI program is successful. I recently took a course from hands down, one of the most brilliant men I’ve encountered by far in my professional career, Ron Hruska. He said, “I’m not an expert, nor should you all be. We get in trouble when we all claim to be experts.” That was a profound statement to me in that first off, how is he not an expert?? What?? People fly from around the country to see him?? But then I realized his point. There are evident consistent trends in the medical field continuously trying to put square pegs in round holes for various reasons but mainly because “I’m the expert, this is the only way to treat xyz, evidence and time say so.” My hidden message to the consumer is BE CAREFUL!
So why are you different than a “normal” PT is still the question on the table. The following is what I take into consideration the minute a patient walks into my clinic. PRI places a strong emphasis on breathing patterns and the diaphragm. Afterall, the average human breathes ~30,000 times a day. The other “obsession” is the asymmetries of the human body. Quick examples: a large liver on the right side (3-4lbs) vs a spleen on the left side (1lb); 3 lobes of lung on the right side vs 2 lobes on the left; a diaphragm that attaches lower on the lumbar spine on the right vs on the left. These inherent asymmetries cause patterns within all humans composed of chains of overactive muscles, underactive muscles, and disturbances in the Central Nervous System. These patterns all begin to form in utero with development; however, truly present once humans begin to walk. We do the best we can with what we’ve got but unfortunately many of us fail and end up requiring an intervention such as physical therapy, chiropractic care, surgery, or any other treatment designed to decrease pain and improve function.
Take home message: PRI has opened my eyes into not looking at my patients as bones and muscles, normal and abnormal, healthy and unhealthy, or good and bad. Instead, I want to know who you are as a person, how do you move and breathe in life, what is keeping you from achieving this or that, why are you not participating in life the way you want, and how well are you using your asymmetrical frame day in and day out? If you are further intrigued by PRI, I am open to all and any questions regarding PRI. I’m 5 years in and still intrigued daily!