Course Review: Pelvis Restoration Postural Restoration Institute Home Study | Modern Manual Therapy Blog

Course Review: Pelvis Restoration Postural Restoration Institute Home Study


It took me about 6 weeks or so, but I finally finished PRI's Pelvis Restoration Home Study course.


If you're interested, my reviews of PRI's other excellent home study's are here and here.

More abbreviations than you can shake a stick at

The focus of Pelvis Restoration is naturally more on the pelvis than MKR and Respiration courses. Each course has their natural overlap and its own set of movements for your pre-test and post-testing pleasure.

The first disc and portion of the course introduces you to the relevant pelvic pathoanatomy, which was the hardest for me. In getting used to repeated motions and SFMA type testing, you no longer think in terms of SI or IS, or even that they matter, but in this course they do. Honestly, it was this part of the course that took me weeks to get through, versus the tests and treatments portion I flew through. If you are into pathoanatomy and the minutiae of sacrum on pelvic, pelvic on sacrum, sacrum on femur, and femur on sacrum movements, this will be a great review for you. For me, it was mind boggling and frustrating. I never would have been able to do this in 2 days.

The PEC - Finally!

The goal I was after was learning how to evaluate and educate corrections for what PRI refers to as the PEC, or Posterior Exterior Chain of Muscles. This pattern is alluded to in both MKR and PR courses, but you are left with a big hole in your PRI bag of tricks without taking Pelvis Restoration.

The PEC consists of
  • Posterior Intercostals
  • Serratus Posterior
  • Latissimus Dorsi
  • Quadratus Lumborum
  • Iliocostalis Lumborum
Individuals exhibiting a PEC Pattern will be familiar to those who assess movement regularly. They are those who have difficulty squatting, bending forward, typically have high tone in the posterior trunk, have limited rib expansion, are unable to flex, have limited hip and shoulder mobility.

Algorithmic

The Pelvis Restoration course is more systematic and laid out algorithmically, possibly because it's a much newer course than the other home studies. You learn how to differentiate a left AIC patho or non-patho pattern vs a PEC or patho PEC Pattern based on a series of pre-test, post test movements. I found one of these tests, the Functional Squat test very useful for those with higher tone in the PEC Pattern.

As usual, the goal is to inhibit improperly facilitated muscles, and to facilitate improperly inhibited muscles. After running the patient through a series of passive, active, and functional tests exclusive to this course, you classify the patient as one of the 4 from the previous paragraph. The biggest difference for me compared to the older home studies was the layout of what to do next with a clearer emphasis on exercise progression/regression depending on how they test and re-test.

For example, again, with the PEC Pattern, starting with quadruped trunk flexion with breathing helps break the PEC tone, assisting with a functional squat test. This helped a centrally sensitized chronic pelvic pain patient I have been working with squat for the first time in years!

Pluses

  • organized and well laid out
  • follows the manual better than previous courses
  • much more clear on what to do with a patient's progression at each level of testing
  • allows you to treat pelvic pain patients without doing internal manual therapy
  • integrates very well with MKR and Postural Respiration Courses
  • emphasis on HEP for correction of predictable patterns of movement, tone, and inhibition
Minuses
  • again, almost too many exercise variations for a two day course
  • the reverse is not true for MKR and Postural Respiration integrating well with Pelvis Restoration (again they're older)
  • not intuitive for a non pathoanatomical based practitioner (MDT, SFMA, etc)
  • the exercises have too many steps for some patients
  • the tests are based on movements or positions that most likely have low reliability and validity most likely cannot be proven 

The Verdict

Would I recommend these series of courses to any movement based clinician? Absolutely! We do not learn enough about breathing, the pelvis (other than the ridiculous osteopathic stuff), inhibition, and test-retest models like PRI. Is it for new grads? Probably not as a first system. Even though PRI essentially has it's version of Rapid and Slow Responders, it is much more difficult to be proficient and get the results as a seasoned PRI practitioner or faculty member would get, when compared to something like MDT, which is very simple.

In the end, I am always looking for different ways to educate patients and empower them with self treatment. Treating pelvic pain or individuals which do not respond to my first and second tiers of education, treatments and HEP will definitely get screened using PRI. It's tertiary in my lineup because of my experience with it (low), and based on need. Most of my patients are rapid responders, not needing additional tools. However, this very nicely does fit in my bag of tricks and may be just the input a certain individual needs to reset their CNS to improve the output.

For more info, please read my man, Dr. Zac Cupples blog, I would never have considered these courses without his recommendations.

Keeping it Eclectic...

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