Written by Kento Kamiyama PT, DPT
****NOTE*** – Please note this review is not comprehensive and notes some highlights from the course. For more information about the course please visit: http://www.posturalrestoration.com
2 weekends ago I took my 3rd primary PRI course Pelvis Restoration at Canton, CT taught by Lori Thomsen with my good friend and trainer Joe Gonzalez.
I’ve gone through Myokinematic Restoration and Postural Restoration earlier this year and I have to be honest, the more I reviewed these the more questions I had. However, many respectable clinicians and practitioners I know use this modality so I plan to stay with PRI for a little longer.
Then here came Lori Thomsen. She crushed it. She answered many of the doubts and questions I had about PRI. The great thing about Lori is she has also experienced years of struggles with the PRI concept. Thanks to her empathy, she thoroughly explains the why’s and how’s (don’t get me wrong all the other presenters were excellent as well). Pelvis Restoration helped bring all the information from myokinematic restoration and postural respiration together.
Postural restoration focused on the thorax, myokinematics on hip/SI and pelvis restoration highly focused on pelvis anatomy/biomechanics.
When it came to planes of motion each course had its characteristics:
Postural Restoration – Transverse Plane
Myokinematic Restoration – Sagittal Plane
Pelvis Restoration- Frontal Plane
Do note that each course works on all three planes but emphasizes or influences one of the planes more.
The first day dove heavily on pelvis biomechanics and anatomy along with assessment. If you want to learn about how the pelvis biomechanics has an affect on the pelvis inlet and outlet this IS the course to go. Lori emphasized that we all work on the pelvic floor since we do influence the pelvic outlet (pelvic floor) when we move the pelvis. For example, if you are anterior pelvic tilting, the ischial tuberosity gets closer to the coccyx thus shortening the posterior pelvic floor.
For visual learning, Zac Cupples has done a great video on this.
Anterior pelvic tilt lengthens and inhibits anterior pelvic floor but shortens and facilitates posterior pelvic floor whaaaaaaaat?
Hence, positioning will impact how those muscles will function and impact where respiration will flow.
Other tests were incorporated in this course that I have never used such as:
- Pelvis ascension drop test
- Standing Reach Test (similar to a toe touch)
- Passive Abduction Lift test
- Posterior Mediastinum Expansion test
Other tests from before were:
- Adduction Drop Test
- Hruska Adduction Lift Test
- Functional Squat Test
- Apical Expansion Test
These tests were fantastic since it helped me guide what treatment techniques will yield better results. I hate treating in the dark without knowing the why’s and these tests helped me guide where to go instead of just purely looking at extremity internal rotation/external rotation, etc.
If you have taken myokin or postural restoration, you have been exposed to the Left AIC/R BC pattern. Pelvis Restoration introduces you to the PEC pattern. These are individuals that have a strong extension pattern that may present with but not limited to L/S Lordosis, flatness of the thoracic spine, sacroiliac strain, spondylolithesis, and scoliosis. As noted with Zac Cupples video PECs tend to anterior pelvic tilt on both side and not just one side in a L AIC pattern. This pattern is quite common with active individuals and weight lifters. These individuals need a different treatment plan compared to L AIC where they need reciprocal patterning first before alternating. Get that Internal Obliques and Tranverse Abdominis firing well for these guys.
Lastly, the other tests also show you if you are a patho L AIC or patho PEC. This is when you are relying more on your passive structures (ligaments, bones, etc) since other muscles are not efficiently working. These individuals tend to take longer to get them to neutral as per Lori Thomsen.
Pelvis restoration was a great course that brought together a lot of information. One of my biggest takeaway was realizing how much of a high threshold strategy I myself was using with some of the PRI exercise which made it less effective. Some cueing and quotes that has helped me were:
- “Inhale gently in”
- “Exhale as much as you can while keeping a jelly belly” – This helps shut down the rectus abominis as a compensator
- “Just chill when you breathe” – Michael Mullin
- “Inhalation is inhibition, Exhalation is facilitation for the pelvic outlet”
- “Sometimes we should walk backwards instead of forward”
- “During stance, the pelvic diaphragm ascends to support the organs”
- “Cells could have memory of the pain for up to ~25 years”
- This is when Lori went into Pain Science research. Man, she killed it
- “PRI is NOT a cookbook”
- “You’re not short of breathe, you’re short of exhale”
Overall, my favorite course from PRI thus far. I will be taking cervical revolution in 2 weekends. Look forward to that review too 🙂