I have a fairly good excuse for not posting in a while- our beautiful, healthy daughter Lulu was born last month and, well, I’ve been a little busy in my free time.

I wanted this post to be about Postural Restoration (PRI), what it is and what it means in my practice.  Talk about physical therapy can frankly be a little dry, so I wanted to make sure when I blogged about PRI I could put an interesting spin on explaining it.  It came to me after I sent the email below to a patient recently.

I’ve seen this patient a handful of times over the past several months.  She had some siginficant back pain that was limiting all aspects of her life.  The really interesting thing was her history and how it played into her problem.

The science behind PRI is based on the body’s aymmetrical anatomical and physiological patterns and how one deals with them.  We as humans have anatomical differences in our bodies on one side compared to the other and we are either going to compensate and accomodate well for them or we are going to compensate poorly and ultimately develop problems.  PRI utilizes a system of evaluating the postural and biomechanical patterns that we develop based on these asymmetries.

My patient had some very obvious asymmetrical issues, from how her spine, hips, and shoulders were positioned to how her face, jaw, and teeth looked.  She had some fairly significant issues with her jaw that she had been working on with a dentist and other therapists for many years.  She was “obsessed with her asymmetries” (her words).  Results from therapy had been nominal at best and we believed that her current problems were a direct result of these persistent issues.

The program I’ve put her on together with consistent use and reworking of her oral appliance (a night splint) have helped a lot.  She’s doing much better and she’s basically back to living her life the way she was before the back pain.

I sent her this email the other day and I wanted to share it because it sums up nicely what a lot of my patients are going through.  I had to write this email to her because I’ve woken up a few times since Lulu was born with some familiar postural problems, torqued and twisted.  I’ve realized that I hold and feed Lulu predominantly on one side and the asymmetrical muscle tone I’ve created has really played a number on me.

Ok, I have an advantage since I can recognize it quickly and know what I need to do to change the habitual postures, but it’s frustrating (and painful) nonetheless.  My patients, however, need a lot of education and, most importantly, an understanding that to change these postures and ways of moving it takes some time. And when you’ve got obvious cranial (dental and vision) issues then it may take a lot longer for your body to change.

Here’s what I shared with her:

“I woke up this morning and thought of you.  Holding and feeding the baby has occasionally gotten the best of me and on a couple of occasions I’ve woken up torqued and unable to make tooth contact on the left.  This morning is one of those times. Of course there’s some head and jaw pain, as well as back pain.  Nothing I’m unfamiliar with but frustrating nonetheless.  I see where the jaw thing can drive the most sane individual crazy (not that I’m the most sane person…).

I wanted to write because, for lack of a better way of stating it, I’m proud of you for sticking with the program. Nothing you’ve gone through emotionally is out of the ordinary.  It’s a long and difficult road to go down.  But you have to be commended on sticking with it, following all of my crazy advice to a tee, and doing your homework.  I know that you’ve basically known all of this all along- that you needed to be doing this.  You have good body awareness and that has paid off in the end.

So, I just wanted to say thank you for hanging in there and to encourage you to keep sticking with the process.  It really is a process.”