In part I, we covered the The Selective Functional Movement Assessment (SFMA). Here, we’ll discuss the Postural Restoration Institute® (PRI). PRI is composed of multiple courses but for the sake of this discussion. I’ll focus on Myokinematic Restoration, Postural Respiration, and Impingement and Instability. Collectively, these three courses cover the biomechanics of the thorax, pelvis, and extremities in tremendous depth. Posture has become a dirty word in rehabilitation lately because static posture has not been demonstrated to correlate much with pain. Operationally defining “posture” is an article in itself but suffice to say, PRI does not advocate having people stand still while a clinician measures deviations from a plum line. PRI defines posture as a behavioral manifestation of the neuromuscular system. In this sense, posture is a dynamic behavioral output that is reflective of any sensory input that can influence movement. As movement professionals, our job is to change motor behavior to decrease pain and elicit physiological adaptations that increase resiliency. A better word for posture as elucidated by PRI is position. Position is fluid. While posture as traditionally defined may not matter much, position always matters. Position is the foundation of sport and the currency of movement.
One of the most divisive things in the physical preparation and rehabilitation community is the emotional attachment people develop to specific continuing education courses. The courses that deal with movement analysis tend to be some of the most polarizing despite the fact that they all attempt to answer the same question. Since there are scores of movement “systems” (the definition of system is a blog post in itself), I will only opine on the ones I’ve experienced firsthand, those from the Postural Restoration Institute®, The Selective Functional Movement Assessment, and Functional Range Conditioning. I did not review my notes from these courses in preparation for this post because I want to focus on the things that continue to resonate with me years later. Consequently, my current interpretation of the material might differ from each model’s official stance. I will review each system in the order that I think makes the most sense.
Last week, Usain Bolt withdrew from the Jamaican National Track and Field Championships with a grade 1 hamstring strain, a mild but extremely untimely injury with the Olympics approaching. The reaction from some factions in the physical preparation and sports rehabilitation community has been disappointing and speaks to a larger issue in these fields- the propensity to criticize other practitioners without proper context. Many Internet commentators suggested that if Bolt had practiced what they preach he would not have sustained an injury. Hamstring injuries in sprinting are like shoulder injuries in pitchers. They are completely unavoidable at the highest level of sport. Repeatedly running or throwing as fast as humanly possible is not conducive to longevity or health. Elite sport requires one to subject the body to stresses that elicit adaptations at physiological extremes. The relationship between elite performance and health is a tight rope that medicine will never definitively navigate regardless of technological advances, improved surgical procedures, and the emergence of commercial systems of movement analysis. Considering all that Bolt has accomplished in his career, his injury history is actually quite unremarkable.