In addition to examining the knee for joint or muscle injury, we are very interested in finding out why there are abnormal stresses causing pain at the knee, which may have led to injury. Abnormal stress is often the result of poor alignment of the knee joint bones and muscles, and of an inefficient, poorly balanced movement pattern. We assess the low back, the pelvis, hips and feet, for position and for appropriate muscle activity.

When the cause of pain is injury, inflammation, pain and weakness must be addressed and corrected. However, even in cases of injury, it is important to include correction of postural alignment in the treatment plan in order to minimize stress to the joint, to promote more rapid healing, and to ensure healthy movement patterns for the future.

Well, yes. But…  We intend to advance physical therapy. However, as in any practice the more you advance the more you see what still needs advancing. Even though our physical therapy is advanced, it is not finished,  it needs a lot more advancing. And that is what we intend to do:                              Advance Physical Therapy

Copyright 2010 © Postural Restoration Institute™
RUNNING SHOES
PRI Recommendations: (in alphabetical order)
1. ASICS 2150 (S-M)
2. ASICS Cumulus (S-M)
3. ASICS Evolution (S-M-L)
4. ASICS Foundation (M-L)
5. BROOKS Defyance (S-M)
6. BROOKS Dyad (M)
7. BROOKS Glycerine (S-M)
8. NEW BALANCE 850 (M-L)
9. SAUCONY Echelon (M-L)
10. SAUCONY Stabil (L)
Underline = neutral shoe considerations for orthotics
Italics = light lateral calcaneal give
Qualities of a good shoe:
1. Solid heel counter
2. Excellent calcaneal support (no lateral heel give)
3. Patient can feel arches of shoe
Sign of a good shoe:
PRI tests are negative (pick a few):
Adduction drop, SLR and HGIR (frontal, sagittal, &
transverse planes)

If you are a runner and have questions, ask Jean, one of our Physical Therapists who  is  trained in Postural Restoration.

Lori Thomsen, PT, PRC

Hruska Clinic – Restorative Physical Therapy Services

1. Keep your hamstrings strong, especially on the left. (4 & 5)

2. Avoid overstretching your hamstrings (90o straight leg raise at the hip with the

knee straight). Have the ability to stand and bend over and slightly touch toes

(palms to the floor is too much).

3. Occasionally walk slowly up the stairs backwards to keep your glutes

symmetrical. (1 & 4)

4. Properly stretch your Achilles tendon, your toes, and your low back.

a. Heel to floor in the squat position (8)

b. Ankle stretch with shoes on and knees bent (7)

c. Pull great toe up

5. Concentrate on striding out with your right leg and left arm when running. (6)

6. Try to find and feel your right arch when running to assist with shifting to the

left. (4)

7. Perform Standing Resisted Wall Reach to stretch your back, latissimus, and

pectoral musculature. (3 &

8. Stand and shift your body weight over your left leg regularly, keeping weight

shifted through you heel. (4)

9. Keep your left lower abdominals “alive” by performing sidelying activity. (2)

10. Wear correct footwear. Wear shoes that support your heels and that have good

arch supports. Avoid wearing flip flops, sandals and wearing shoes that are

untied during the running season.

Copyright © 2007 Postural Restoration Institute™

I only know of two approaches that try to get to the causes of scoliosis, the Schroth Method and Postural Restoration. All other attempts deal  with the symptoms of scoliosis and they don’t need a thorough understanding of it.

Katharina Schroth suffered from scoliosis herself and she developed an exercise program based on her intuitive understanding of what helped. The Schroth Clinic in Germany, since the middle of the last century, has been very successful, even with older people with significant curves.

Postural Restoration provides a bio-mechanical understanding of the causes of scoliosis and the very precise exercises  are based on that understanding. The exercises help diminish the curvature, particularly among young adults or teenagers. The main difficulty is to get teenagers to do these exercises religiously on a daily basis.

The younger the people and the less pronounced the curve, the easier it is to re-balance the body and get rid of the curve. However, young teenagers are the hardest to motivate.

One of  our therapists, Susan Henning, is hoping for or dreaming of a regular screening  at schools for scoliosis, because the imbalances and the suffering that follows for a whole lifetime, could be avoided.

The fluid that causes the swelling of lymphedema is protein-rich and this makes the tissues easily susceptible to infections. Each infection damages lymphatic structures and places the area more at risk for developing lymphedema. Once the lymphatic systems malfunctions or lymphatic structures are damaged and lymphedema has developed it can be treated but not cured. Early treatments can usually effectively control the swelling. Without treatment, the lymphedema symptoms become progressively more serious. Left untreated, lymphedema is much more serious than the inconvenience of a swollen limb. It is a progressive condition in which frequent infections cause serious pain and may require hospitalization. Skin changes, like benign papillomas may develop. Eventually, lymphedema can lead to the loss of mobility and total disability. In rare occasions malignant skin cancer develops, like lymph-angiosarcoma (Stewart-Treves-Syndrome.)

Alma Vinjé-Harrewijn PT CLT-LANA

I can say this easily because I am not a physical therapist and certainly not a Postural Restorationist. I don’t know all the details of Postural Restoration. However, it is clear that Postural Restoration provides us with a paradigm shift in the short history of Physical Therapy. It is not just another technique that will be added to the many other techniques. Postural Restoration is a revolution.

The basic insight is as simple as Newton’s apple falling from a tree: We are asymmetrical beings by nature and it is good that we are asymmetrical because we probably could not move well at all if we were symmetric. We are reaching out with the right arm or  leg because it is easier and more powerful. We are made that way.

We see the application of it for instance in sports. To give one example: In all track and field activities we always run around the field in the same direction, opposite clockwise. There is no culture and no individual that prefers to run the opposite way. It is because we are faster this way. The reason is our basic asymmetry.

There are many other examples. The point, however, is that based on the insight into our fundamental asymmetry and on a sound understanding of bio-mechanics, the founder, Ron Hruska, developed what we call now Postural Restoration, a growing canon of hundreds of exercises.

The exercises can be used to either enhance performance in movement or sports, to avoid injuries or to correct painful imbalances like back pain, neck pain, hip pain, knee pain and so on. A couple of sport teams have been using the exercises successfully, as do a couple of physical therapists.

Unfortunately, there are limitations. The exercises are so precise and difficult that they are not easy to learn. It is an effort.For physical therapists also, Postural Restoration is not easy to learn and challenging intellectually. To slap on a hot-pack and use the ultrasound machine is a lot easier for both the therapist and the patient. Much easier also to do the same exercises first twice to the left, then twice to the right as it is done almost everywhere, ignoring our basic asymmetry. It is easier, but it does not always help.

Once the exercises are understood, which may take a couple of sessions, progress should be immediate.