By Matt Stensrud, PT, Clinic Director
Midwest Orthopaedics Physical Therapy
I have trained extensively over the last 8 years through the Postural Restoration Institute® (PRI) and wanted to pass along the basic concepts of PRI to educate my patients on how they will be treated. The focus with this approach is on how we assess for imbalances and retrain the body to be more efficient in a holistic manner. Please follow this link to see a description of the PRI basic concepts:
https://www.posturalrestoration.com/the-science/basic-concepts-of-the-postural-restoration-institute
How do we assess for these imbalances? Ex: how does this affect my knee that is wearing out? We utilize tests that are similar to checking tires on your car (2 arms, 2 legs, and the neck for the human body). When your car is not balanced you may have uneven wear and tear on the tires. It is not the tire’s fault, but the imbalanced use of the car is leading to the wear and tear. With the PRI approach we are attempting to get you balanced at the center of the body, the pelvis and thorax, so that there is not uneven wear on the extremities.
A great orthopaedic example would be uneven wear at the knee joint. Many individuals tend to have more wear (osteoarthrosis) on either the medial or lateral side of the joints. Why does this occur? The knee joint is not designed to move significantly from side to side, but the hip and pelvis have this ability. We will often look at balancing out the hip and pelvis to assist with balancing out the forces at the knee joint. For example, if your knee is wearing out more medially (inside ½ of the joint) the knee will tend to bow outward due to the bony changes. We focus on utilizing the inner thigh to re-position the pelvis and hip to assist with stabilizing the knee in the direction that offloads the medial compartment (more biased to the outside part of the knee). This can help preserve your “tire” for more miles just by balancing out the forces above the knee. For the lateral (outside) joint wear, the knee will tend to bow inward and we would be looking at a glute program to minimize this inward movement that is causing more force on the lateral joint. Most individuals with knee arthrosis/arthritis do not think of the hip and pelvis and are often told that not a lot can be done to slow the process. Patients that see our Physical Therapy staff are often surprised at how much better their knee can feel with emphasis on specific muscle control designed to reduce stresses on the compartment of the knee that is worn down.
With my treatment philosophy and understanding of the anatomy and biomechanics through my extensive PRI training, we at MWO Physical Therapy are able to successfully design exercise programs to balance out your joints that are wearing out through integrated activities that can help you preserve the integrity of your “tires”. We have a great surgeon team that is available to step in if you need a “new tire on the car”, but our goal in PT is to help you get more miles out of your body doing the things you enjoy!