Most of you who read my blog already know what it means when I say PRI. There is some misconception around the internet as to what PRI can do for you and where it fits into your treatment model as a strength coach, personal trainer, chiro, physical therapist, or whatever you do.
PRI comprises the bulk of my assessment and reassessment protocol for new clients. It is the base of my methodology. Eric does a great job of explaining the thought process in a way that is much more articulate than I could ever hope to convey.
The foreword below is Bill Hartman, and the information is courtesy of Eric Oetter, who writes from the perspective of physical therapy and strength & conditioning. The post speaks for itself and I share it here because the content needs to be disseminated to the masses. Pass it along.
BH: “This a post from our boy Eric Oetter. It’s probably the best written synopsis of therapeutic intervention with an understanding of the role that Postural Restoration Institute methodology and other tools play in the process. It needs to be passed around to everyone especially those responsible for educating the next generation of clinicians and practitioners. Please share.”
It’s becoming increasingly clear that the path to system variability and pain-free movement is gated by neuroception (i.e. limbic threat appraisal) and autonomic nervous system output. And its these two properties of the nervous system which govern the effects of the innumerable methodologies therapists use to expunge system rigidity.
Autonomous of discipline or method, clinicians intervene at the level of the receptor (rods, otoliths, mechanoreceptors, etc.), engendering unique signal transduction and transmission into a sea of equal status patterns which participate in collective summing within the brain.
We’d hope our therapeutic inputs contribute to a modification in the perceptive capabilities of the patient, though (as we all know) this is not always the case. Some inputs never reach the level of perception while others exceed the adaptive capacity of an already rigid system, perpetuating chronic limbic hijack and sympathetic dominance.
But a positive change in perception opens valuable cortical real estate for neuroplastic remapping via graded exposure, which is the substrate for system variability. This is really the goal of any physical therapy intervention.
So, how do we know we’re dealing with a rigid system in the first place? And furthermore, how can we evaluate the efficacy of our inputs with respect to restoring system variability?
Beyond many other “systems” I’ve experimented with, PRI seems to provide the most cogent answers to the above questions. And it’s the “umbrella” which explains, to me, why other methods work.
What PRI provides is a means to identify a predictable pattern of ANS-mediated anti-gravitational motor output for a collection of systems held in some degree of rigidity. The perspective they bestow is quite comprehensive; PRI is a unified system respective of ALL sensory inputs capable of influencing reticular output (mechanoreception, vision, audition, etc.).
But woven through its complexities, their simple orthopedic testing and treatment algorithms provide a reliable means to assess this aberrant output, as well as evaluate the systemic and perceptual perturbations that might follow any therapeutic intervention (PRI, Mulligan, Maitland, MDT, ART, etc).
Because interventions can be both synergistic or antagonistic to the pattern PRI presents, utilizing a withdrawal A-B-A study design during a treatment session (with the patient functioning as their own control) upholds an element of internal validity beyond what other systems might be able to provide. I’d argue this makes PRI a powerful adjunct to anything you’re already doing, as we scrounge for external validity in a increasingly heterogeneous population.
PRI treatment aims to recapture reciprocal and alternating movement in three planes across the three girdles of the body. And PRI is never about fixing posture – it’s about restoring system balance, variability, and adaptive potential.
I used to be a genius. I knew everything because I read T-Nation. That’s all it took; I didn’t need school. The ONLY reason I was in college was to get a degree. I already knew everything I needed to know, and anything else I could learn extracurricularly.
Then I grew up.
The invincible feeling that youth brings is nice at the time, but looking back it’s borderline embarrassing. Young kids are some of the worst humans to deal with. At least I can take solace in the fact that everyone’s been young before.
I always thought I was better than the rest. I’ve learned a lot since then, and ironically now see myself as much less intelligent. But I’ve learned that it is never a conversation of better – only different.
Some use their hours to learn therapy. Some learn how to train Olympic athletes. Some fine-tune their research skills. Some can recite whole movies word for word. Some are great at make people feel good just through conversation.
Some spend their time building a strong network.
Time offers experience, but everyone values different things. I like to study things, but if a client wants someone to pump in energy and motivation into their fitness lives, my experience means nothing to them. They won’t think I’m better than anyone because I don’t care about pumping in fake energy at all.
Young Lance didn’t value school, but I had a drastic change in tone towards the end of my degree program. It’s silly really: how could I possibly know that chemistry is worthless… without knowing chemistry? These days it’s easier for me to just assume everything is important and learn it all.
Instead of waiting for an experience to be over, search to uncover its value.
Have you been there? Tell me about a time you’ve been short-sighted or a subject that you think everyone should learn about in the comments below!
ANOTHER UPDATE: Henrik Lundqvist did it too on stage receiving the Vezina trophy at the NHL Awards.
Simon Gagne carries the cup for the first time and almost eats it.
I don’t think I could have more respect for Dustin Brown. He is such a physical presence, but never seems to lose his cool. He opened the floodgates when he started scoring and his team followed suit. And he swears on live television. I wish he was a Red Wing.
If you don’t think hockey can be interesting, you didn’t watch this game.
How to be more like a Stanley Cup championship team’s captain
My personal developmental take-home points:
Don’t let minutia bother you. The end goal is the only thing that deserves your focus.
Leading by example is a very strong leadership trait.
Be prepared to divulge blood, sweat, and tears when everything is on the line.
When I see someone who looks strikingly similar to a toothpick, I feel bad for them. Sure, they’re missing out on all of the great things that can come from having a healthy, muscley body, such as not constantly feeling cold, being strong enough to move furniture, and increased frequency of sexual interactions (no guarantees on duration of said interactions, sadly). However, my real concern is the ignorance to all there is to be experienced in this hypertrophic journey.
The First Rule
Every person who can’t seem to put on weight has one thing in common: they’re not eating enough.
The n00bz make this rule especially important, so much so that I suggest it being the only dietary advice you suggest to them. Now, if we talk a little about the psychology of this suggestion, I would be a little more specific, showing examples to the person in question as to what exactly you mean.
I put on 5 pounds during a hockey season in high school by eating 6000 calories a day. How did I get that many calories? I had a gallon of milk every day. I always had double lunches when I was at school. I had 5 meals a day, and after at least 2 of these meals, I would feel like the food was at the edge of my esophagus, full to the brim.
Paint a picture. Engage their senses. Your advice will stick. They’ll picture you with your gallon of milk every time they sit down for a meal. They’ll put an extra scoop on their plate at dinner, and you know what else? They just might accomplish their goals.
Where is the Journey?
The journey comes from within. Aside from that being the most cliche thing I have ever said, there are tremendous benefits to be gained. Shoveling in perseverance, however trivial the task may be, can give this person heaping amounts of perspective. They can always think back to the time they were convinced they were never going to get any bigger. They thought, “I couldn’t have another bite,” but when they filled another plate, they dominated it like it was their job and overcame expectations.
Losing weight can give you a similar experience, albeit slightly different. I prefer gaining weight because it places more emphasis on putting in hard work (eating more) than developing the willpower to say no (eating less). Obviously, both have their benefits.
I mentioned the trivial nature of this whole topic. The rich kid can’t stuff his face more? Boo hoo, Africa is starving. There are many things far more important in the grand scheme of things than putting meat on some kid’s bones, but I take you back to the topic of gaining perspective.
Now that they have succeeded, this person knows what it means to work hard and how great it feels when all of that dedication pays off. What if they get the chance to go to Africa? They want to experience that success again. They help out, bring food, and feed the people there. How many lives have you indirectly impacted by teaching this person to put on weight?
It seems simple, but simple is most often the way to go.
Live, Learn, and Pay it Forward
We’re all in the business of education. Parents, coaches, mentors of all kinds. Nobody wants to leave the world before they’ve left their mark on it. Whenever you get the chance, try to teach something to someone. I don’t believe that there is a single feeling that I enjoy more than seeing something click in someone else’s mind.
Think about it: planting ideas of hard work in those around you will surely not go to waste.
Guys, I get the bravado. I understand where you’re coming from. “He’s a pretty little girl because he doesn’t break parallel when he squats, bro.”
I could go on and on about how there are millions of things more determinant of one’s character than how low he squats. For the love of all that you value, though, stop being so thick-skulled! He could shave the squats high because of a number of pain issues, structural limitations, or past experiences.
The Restriction of the Vertical Shin
Squatting with a vertical shin is quite common. For example, if you don’t have adequate ankle mobility, you have to keep your shin vertical or you get a valgus collapse up the entire leg.
A valgus collapse
How about when someone has had a history of knee trouble? What if she’s 65 years old and has a reconstructed ACL? Squatting with a vertical shin will decrease the shear stresses on her knee, and shear stresses are the ones we as trainers are the most worried about.
The problem is, how deep can you squat with a vertical shin?
Try it out, I dare you. You need FREAKY levers (or powerlifting gear) to accomplish such a task.
So is our old lady with a bum knee going to be squatting below parallel? No.
Problems at the Hip
The multitude of problems that can happen at the hip is remarkable.
Torn labrum? The extra movement of the femoral head may be eliciting pain.
Unstable pelvis? The hip flexor muscles are getting overworked to try to get you SOME stability. Then they start screaming in pain because you’re working them like a slave driver.
Glutes don’t turn on? If your glutes aren’t turning on and your knees aren’t getting out, you can run out of room for hip flexion before you even get to parallel.
Bony impingement? Femoroacetabular impingement (FAI) is when there’s abnormally shaped bone in the hip joint. Forcing range of motion to “get deep” causes back pain and hip labrum tears.
Bony block due to poor positioning? This ties in with a number of previous examples, but what if the pelvis is oriented in such a way that the correct motion cannot be obtained? Maybe you can’t sit in to your left hip, so you shift your weight to the right and overload that knee.
Is This Really Necessary?
Do they even need to be squatting that deep? Aside from the potential aforementioned ramifications, maybe the reward just isn’t enticing enough.
Take a basketball player. Does he really NEED to get deep? Every time there is a reverse of the direction of motion, there is an isometric phase. This is the hole of a squat. Isometric training develops strength within 15 degrees of the joint angle trained. How many athletes can you think of whom need to develop extreme hip and knee extension power from such a great angle of motion?
I hear a lot of people tell others to check their ego before they start doing their half squats with insane amounts of weight. You are blaming this man for doing something that makes him happy. Leave it alone and stop dragging people into the sulking oblivion in which you live.
What if he struggles with depression and bending his knees with a ton of weight on his back makes him happy? Do your Supermanly deep squats on your own and maybe he’ll ask for your advice. If he doesn’t ask, he probably wouldn’t listen to your unsolicited advice anyways.
Maybe he’s very introverted. He doesn’t like to bother other people. Asking for a spot is the most embarrassing thing he could possibly do in the gym, so he squats high, where he’s confident he’ll be able to manage the weight.
Maybe he has been stapled to the floor before by a weight, which he blamed on going too deep, and he simply never recovered from this traumatic experience. The bar crushed him and he doesn’t want that to happen again because it hurts, physically and mentally. Some people are just more resilient than others.
Support Over Judgement
So what if the guy squats a little higher than you do?
First off, I’d like to make the point that he’s squatting. Not many people do any lower body training at all, so there’s something to be said about that.
If he’s talking down to you, he is not worth your time and needs to read this article. You cannot make snap judgements about people. I would have thought Dr. King’s words would have reached everyone by now, a half century later.
Maybe he’s trying to get a training effect despite the crap joints his genetics and past training experiences brought him.
There is someone, somewhere out there who is stronger than you. Get used to it and be the best you can be.
Squatting heavy weights makes you feel better than squatting light weights, right? He’s doing it because it feels good. Can you hate him for that?
There are PLENTY of other things worth worrying about over someone else’s squat technique, like your income, loved ones, equality, world hunger, world illiteracy, rampant diseases, and our government’s view of food.
If you’re going to make assumptions, why not assume that he has a good reason for doing half squats instead of assuming he’s simply dumber and weaker than your alpha male persona.
The broscience has to stop. If the words “Go deep or go home!” are on your door, realize going deep is a choice, not a necessity. Stop pressuring people into changing the way they do things and you will gain the respect of many. Training full range of motion is an excellent philosophy, but “full range of motion” and “to parallel” are not interchangeable.
This isn’t meant to be an instructive post. I could talk for hours about POSSIBLE limitations. Rather, I want you to walk away with perspective. Quit looking at things through your own small filter and open up your eyes.
Most importantly, offer up support, not judgement. It will take you MUCH further.