Possessing the ability to recover properly after heavy bouts of intense training, with respect to breathing patterns, posture and tone, has become a very hot topic worth discussing.
The Postural Restoration Institute (PRI) has been a hot topic in progressive sports performance circles for the last couple of years. If you aren’t familiar with PRI and the philosophy and methodology of their practitioners, here is a snippet from their official website:
“The human body is not symmetrical. The neurological, respiratory, circulatory, muscular and vision systems are not the same on the left side of the body as they are on the right, and vice versa. They have different responsibilities, function, position and demands on them. This system asymmetry is a good thing and an amazing design. The human body is balanced through the integration of system imbalances. The torso, for example, is balanced with a liver on the right and a heart on the left. Extremity dominance is balanced through reciprocal function; i.e. left arm moves with right leg and vice versa.
Postural Restoration Institute® (PRI) credentialed professionals recognize these imbalances and typical patterns associated with system disuse or weakness that develops because of dominant overuse. This dominant overuse of one side of the body can develop from other system unilateral overuse. For example, if the left smaller diaphragm is not held accountable for respiration as the right is, the body can become twisted. The right diaphragm is always in a better position for respiration, because of the liver’s structural support of the right larger diaphragm leaflet. Therefore, the left abdominals are always important to use during reciprocal function, such as walking, to keep the torso balanced.”
WHAT DOES THAT ALL MEAN?
Essentially, we are asymmetrical beings due to our internal organ architecture, and so by nature, we will develop and favor certain imbalances in posture and movement. Now, it is important to note that PRI is a Physical Therapy-based philosophy and methodology.
Though you can become a credentialed PRI professional without being a Physical Therapist, their systems have been primarily developed for the use of Physical Therapists for the treatment of postural and movement dysfunction. It is also important to note, as I write this article about how I use the concepts from PRI with my hockey team and how these concepts shape my thinking of training and human movement, that I am not a credentialed PRI practitioner.
That being said, I believe the principles, concepts, and methodologies of PRI have a profound impact on physical performance and injury reduction in a performance setting. I use PRI-based exercises on a daily basis with my NCAA Division I Ice Hockey team in several areas of our performance program.
In the following paragraphs I hope to illustrate how and why I use the PRI methodology with my athletes, and also describe what it is and what it is not.
QUICK BREAKDOWN OF PRI
The first thing to understand is that there is a lot of unique terminology in the PRI paradigm.
Things like AIC, PEC, and BC are all important acronyms. These phrases and names define specific dominant chains of muscles that all work together, which have tremendous influences on movement. If you decide to head down the PRI rabbit hole, it will be very important to become familiar with what these mean.
But, for the sake of this article, don’t worry too much about them. Recognize that they will ultimately be important, but don’t get lost in the fogginess of these unusual terms. What is most important to understand here is that each of these terms delineates different posturally dominant patterns and along with each, comes very predictable patterns of movement.
The two biggest postural compensations I will talk about are the LAIC and PEC.
These are the most common, in my experience, with the population of athletes that I see (ice hockey players). Left Anterior Interior Chain (LAIC) basically means that all human beings will tend to favor weight bearing on their right side, with an internally rotated right femur along with a posteriorly rotated right hemipelvis, an externally rotated left femur along with an anteriorly rotated left hemipelvis, and (among other things) a left rotated thorax (to compensate for the pelvis and femur not being orientated forward).
The Posterior Exterior Chain (PEC) is, for lack of a much more in-depth explanation, a bilateral anterior tilt due to excessive tone of the back extensor muscles.
COMMON QUALITIES SEEN IN HOCKEY PLAYERS
Now, if you’ve ever worked with ice hockey players, the idea that most of them will present with a pronounced anterior tilt is of no surprise.
Hockey players are known for their big back end, and it’s in part because of this postural compensation to their day-to-day training and sport-specific demands.
However, the LAIC that is present with just about everyone with a heart on the left, three lobes of lung on the right and a liver on the right supporting the more advantageously positioned right diaphragm (see here for the rare exception to this rule) adds a layer of complexity to the overall posture and its implications to training of the typical hockey player.
So, as my players walk in the door, I suspect that just about all of them will be in bilateral anterior tilt (resulting in extension/increased lumbar lordosis of the lumbar spine), and LAIC, causing them to “shift” into their right hip more than their left.
What are the implications of these postural compensations in training and competing as an ice hockey player? Also what can I, as a Performance Coach, do about it?
Glad you asked.
PRI APPLICATIONS IN PERFORMANCE TRAINING: PHASE 1
The first thing we want to think about is using specific exercises to get us more towards “neutral” before we start getting active.
What do I mean by “neutral”?
For the purposes of this discussion, I mean to get them somewhat out of anterior tilt, and somewhat medial to their right stance (i.e., shifting towards their left hip).
We do this by performing one of a number of PRI-influenced breathing exercises before we begin any part of our warm up. I should note here that “breathing” is a major part of the PRI methodology. This particular article isn’t the appropriate place to go in-depth with this, but please understand that breathing (optimal balanced breathing) is crucial, and is the glue that holds everything together for our bodies and in the PRI world.
Everything begins from the inside out, and your major respiratory muscles (diaphragm and pelvic floor) are as deep inside as it gets, anatomically of course. Again, as you learn more about the complexities of how these systems all work together, you will quickly have an idea of what I mean.
We start our training, or pre-practice routine, with a breathing “reset” to get everyone into better alignment. The reason we do this is so that once we get up on our feet and start sprinting, squatting or skating, we are in a better “neutral” position to move around and through, thus allowing more efficient movement and less wear and tear. Our body is more “posturally aligned and positioned” before we start doing what we need to start doing.
Another reason we start all of our training this way is to influence the parasympathetic nervous system. The parasympathetic system is the “rest and digest” part of the Autonomic Nervous System (ANS). It is what helps you calm down and relax. We want to start our training day this way for a number of reasons, but one of the main ones is so that we begin our soft tissue quality and mobility/flexibility work from a position of relaxation.
This doesn’t mean we want everyone to fall asleep and be completely “parasympathetic” before we train or compete. However, shifting the ANS towards a more relaxed state can help improve some of the first things we will work on in any given training session, such as: tissue quality, flexibility, and mobility. Breathing (whether it be PRI-influenced or not) is a big contributor to the relative state of your ANS.
Don’t believe me? Here’s proof:
Put your hands behind your head, arch your back, and hyperventilate for 30 seconds.
How do you feel? A little wired? A little stressed? A little crazy?
That’s all good and well if you’re in the 3rd round of a prize fight, but not so great if you need to improve the length and quality of your muscle tissue.
Now, put your tongue on the roof of your mouth. Let yourself “slouch” down and forward just a little bit. Breathe slowly into your nose, filling your belly, and exhale very slowly, letting yourself flex into a little bit more of a rounded posture.
How do you feel now? A little more relaxed? A bit calmer? Maybe even a little more at peace?
You just influenced your Autonomic Nervous System (ANS). Congratulations!
PRI APPLICATIONS IN PERFORMANCE TRAINING: PHASE 2
The second way we use PRI-influenced exercises is within our training session. We will perform tri-sets (a circuit of 3 exercises) or quad-sets (a circuit of 4 exercises) our training blocks with a postural reset exercise. For lack of a more nuanced way to explain it, many of our “performance exercises” necessitate some degree of extension.
For example: a 350-pound Rear Foot Elevated Split Squat (RFESS) or a 500-pound Barbell Rack Pull requires relative extension, and a sympathetic blast from the ANS. Basically, you better get jacked up for that lift. Crank up the ACDC!
However, we want to be able to move out of extension when we don’t need it. In the same way that we want to be able to be sympathetically dominant (fight-or-flight) when we lock into that big rack pull, we also want to be able to turn it down some and shift a little more into parasympathetic dominance when we are recovering between sets (or recovering between shifts on the bench during a game).
With this in mind, we will often include a breathing exercise during the active rest between sets of our major exercises. The goal is to help put us in posterior tilt along with allowing us to better shift onto the left side, and a little more off of our naturally dominant right side.
PRI APPLICATIONS IN PERFORMANCE TRAINING: PHASE 3
The third way we utilize the PRI methodology is through cueing many of our standard exercises, in order to promote a more neutral posture. The biggest coaching cue I use is “ribs down”.
This cue gets our athletes to move into a degree of relative thoracic flexion, engaging the abdominal musculature, taking them out of spinal extension, and allowing proper coupling of the diaphragm and pelvic floor.
For instance, during an exercise such as the Half-Kneeling Chop, I will cue the athletes to keep their ribs down instead of allowing lumbar extension. This creates all kinds of good things: a ribcage that allows proper scapular congruency and movement, an “internal core” that is properly functioning to support and stabilize the spine, and pelvic and thoracic positions that allow proper breathing patterns, overall improving aerobic capacity and function.
PRI APPLICATIONS IN PERFORMANCE TRAINING: PHASE 4
The fourth way we incorporate exercises and concepts from PRI is to engage in breathing and postural work post-training or post-practice/competition.
We do this with a couple of goals in mind. First, we want to get the body back into relative alignment after strenuous movement that very likely has “nudged” us back into our compensated patterns.
YOU try to pick up 500 pounds or get run over by a 200-pound animal at 25 mph and not be out of whack!
After we train or skate, part of our larger “recovery and regeneration” program includes some basic PRI-influenced breathing and postural exercises to get us back to neutral before we call it a day.
Of course, there is an ANS component to this, as I want our athletes to leave the facility in a “down regulated” state, able to go about their day without feeling wired and tense, or in a “fight-or-flight” state when they shouldn’t be. This recovery component of how we use the PRI philosophy is crucial in our hockey performance program, as the ultimate goal is to win the two games we have on the weekend. More importantly, the more recovered we are when we get to Friday night, the better chance we have to put more pucks in the net.
All in all, the Postural Restoration Institute (PRI), it’s philosophy, methodology, and general point of view regarding human function and movement have been very influential in my perspective and in my training program. Our goals are always to reduce the incidence of injury, and then to improve performance, in that order.
PRI has given me a lens and a strategy to influence both of these outcomes. I am by no means an expert when it comes to the utilization or even the nuanced understanding of PRI, but the more I learn the more I buy in. The Postural Restoration Institute, its certified practitioners, and its overall philosophy on human posture and function will continue to be a major source of influence in how I look at and train my ice hockey players at UMass Lowell.
ABOUT THE AUTHOR
Devan McConnell is the Head of Hockey Performance at UMass Lowell. He is involved and responsible for all aspects of performance and physical development of the UMass Lowell River Hawks NCAA DI Ice Hockey Team. In addition, he is an Adjunct Professor in the Department of Physical Therapy at UMass Lowell, as well as a partner in HockeyStrengthandConditioning.com. Devan can be reached by email at DMcConnell29@gmail.com.
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