What is Postural Restoration and do I need it?

Dr. Holly Rigney, PT, DPT  December 15, 2017

Everyone is asymmetrical so what’s the big deal?

Are you…
Stronger on one side of your body than the other?
Suffering from neck, hip, or LBP?
Constantly injuring yourself on one side of your body repeatedly?
Experiencing frequent headaches or jaw pain?

Do you…
Notice that one shoulder is higher than the other?
Constantly cross one leg over the other?
Always sleep on the same side?
Spend a lot of time sitting?
Prefer to stand with your weight more on one leg?

While sometimes these asymmetries are normal, there are times they can lead to pain and injuries. These, and many other musculoskeletal issues, are common compensations that all physical therapists can identify. There are also many different options in how to address the pain and dysfunction in these areas. Common examples include strengthening, stretching, modalities, functional training, such as squatting, lifting, and modification to household activities. Educational components include positioning for daily activities, energy conservation, joint preservation, and more.

Part of my continuing education as a physical therapist has included additional training from the Postural Restoration Institute,™ who attempts to answer how these asymmetries affect us and can contribute to pain and other dysfunction. These treatments are based on anatomical studies that have found that the human body is naturally designed asymmetrically. There is an emphasis on identifying and treating patients based on these asymmetries. For example, we have a liver on one side and not on the other, a heart on one side and not on the other, and this asymmetry can affect the diaphragm, the major breathing muscle. Too often, we breathe inefficiently, and as the diaphragm begins to change orientation and shape, it becomes more of a postural muscle rather than a breathing muscle. Over time this can lead to pain in various parts of the body and can set you up for a more significant injury in the future.

As the diaphragm becomes inefficient the body compensates by instead using the neck muscles to help move air in and out of the chest wall to move our rib cage. This causes the muscles attached to the neck to work harder than they are supposed to causing pain and dysfunction here and in the surrounding joints. Due to a change in rib cage mobility, increased force is transmitted to our extremities, especially our shoulders and hips.

Not only can this cause pain local to the rib cage and spine but it can also affect our musculoskeletal system, causing decreased range of motion, decreased athletic performances, muscular imbalances, and pain. One example, is the way this asymmetry can affect the way we weight shift between the right and left lower extremities as we walk which can lead to diagnoses such as scoliosis, leg length discrepancy, joint pain in ankles, hips, and knees, and back pain, just to name a few.

Breathing is something so automatic and subconscious that it’s hard to believe it can have such a huge impact on our functioning. Consider how many times a day we breathe, along with the number of muscles that connect to our rib cage (neck muscles, low back muscles, abdominal muscles, and many others). To identify if some of these asymmetries may be contributing to your current symptoms or putting you at risk for future injuries, contact your physical therapist for an evaluation.

– Submitted by Dr. Holly Rigney PT, DPT.

About Dr. Holly Rigney PT, DPT
Holly is a native of Harrisonburg, VA in the Shenandoah Valley. She received her Bachelor’s degree in Health & Exercise Sciences from Bridgewater College and her Doctorate in Physical Therapy from Lynchburg College. She has a variety of experiences treating all patients from across the spectrum, including skilled nursing, outpatient, and home health sciences. Holly is trained in Fascial Manipulation, a manual technique which restores soft tissue mobility thus increasing joint range of motion and decreasing pain. She also enjoys utilizing Postural Restoration Therapy to restore optimal positioning of the patient. In her spare time, Holly enjoys spending time with her husband, Zane, and their dogs, Ruger, and Hoyt, as well as skiing, hiking, and biking.

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