Postural Restoration Exercises

“The Postural Restoration Institute mission is to explore and correct postural adaptations and asymmetries that influence the human body, and how they factor into movement dysfunction and pain”.

Everything in Postural Restoration starts at the left side of the pelvis, or left hemi-pelvis. Due to the asymmetrical way that human body is organized, most people will have a left side of the pelvis that rotates forward compared to the right side. This starts a potential chain of events that can lead to postural distortions and movement compensations that can work their way up through the torso and into the neck and head.

What does this look like? Visually, you may not notice anything. But strip away your skin and muscles and this is what you will actually look like. The picture below is of a full body scan of someone who came to see me recently. Her doctor told her there was something really wrong with her pelvis and lower spine. As you can see, they are not positioned symmetrically. The left side is rotated forward and flared out, which is why you can see more of the inner surface. The right side is rotated slightly back and turning in, which is why you see less inner surface but more of the front edge of the bone.

LeftAICWhile this asymmetrical pelvis position is completely normal, when the asymmetry gets too great, when it exceeds our natural ability to compensate, our body stops moving and breathing as it should.

The testing that I show below predicts perfectly what you see in the picture above.

(picture 1) a right leg that can move down to the bench (adduction). This indicates a right hemi- pelvis that is not rotated forward. It’s actually rotated slightly back.

right leg adduction drop test

(picture 2) a left leg that can not move down to the bench. The reason it can’t go down is because her left pelvis is forward and blocking the path of the left leg.

Leg that won't adduct

Leg that won’t adduct. I’m pushing down on her leg. It isn’t moving.


(Picture 3) a left leg that can now move down to the bench after pelvic repositioning.

Negative PRI adduction drop test

Leg that will now adduct after pelvic repositioning.

When a left pelvis is rotated forward the body can’t use its left leg as nature intended. It now must use compensation strategies to create the same movement. The compensation strategies involve recruiting different muscles to accomplish the task that the adductor can no longer do. This results in overworked, tight, stressed out muscles and various issues such as hip, knee, ankle, and back pain

The person in the picture was feeling intense bouts of back pain for years. Her back pain disappeared after repositioning her pelvis, essentially getting her pelvis out of the way, so that the leg could then adduct. Repositioning the pelvis enabled her left leg to regain true movement in all three planes of motion.

The Pelvis is the True Core

Your pelvis is the true core of your body. It connects everything. Your legs attach to the pelvis to form the hip joints, and your spine attaches to the pelvis and forms the SI joints.

Suffice to say, where your pelvis goes, your legs and spine will follow!

If this “pelvis forward on the left” pattern gets too strong, you lose the ability to move as you should.

You lose strength, flexibility, stability and balance.

You lose power.

You lose the ability to breathe normally.

Your brain will create compensation patterns for your body to achieve what it needs to do, but you will experience dysfunction in the process. And your body can only compensate for so long before it starts to break down.

Postural Restoration pelvis repositioning

Repositioning Annie’s pelvis

“I didn’t know anything about pelvic repositioning at all but I totally knew about the sharp pain in my right knee and how it would make a cracking or popping noise every time I had to squat or kneel down. I wasn’t totally sold on what repositioning my pelvis would do because no one knows about it, but I tried it and my pain went away.

Then I stopped doing the exercise for a while and after a few months the pain returned. So I came back to training and Neal had me do the breathing and repositioning exercise again, and the pain disappeared again. Now I was sold. I haven’t had knee pain again”.

– Annie E.

Getting Stuck

The body often gets “stuck” in one position, such as the aforementioned forwardly rotated left pelvis.

But your upper body can get stuck, too.

The set of pictures below show a very typical way the upper body gets “stuck” in a position. This position often accompanies a forwardly rotated left pelvis: left ribs that are higher and more prominent than the right, and a left shoulder that is higher than the right.

Left ribs that are higher and more prominent than the right.

this picture is of elevated left ribs

elevated left shoulder due to left aic right bc pattern

Elevated left shoulder.


“After the birth of my daughter, I developed horrible pain in my right shoulder. I felt numbness, tingling, and pain. Sometimes it would wake me up at night because it hurt so badly.

I didn’t start working out with Neal because of my shoulder pain, I started working out because I needed to get into better shape. However, Neal asked me about any pain or injuries I had, and I told him about my shoulder.

He did a couple tests and checked my shoulder range of motion. After the first training session with some strange exercises, I felt better. During the next couple weeks I continued with the exercises at home and once a week with him. The pain got less and less until I was finally able to train without any pain”.

– Esther S.

Enter Postural Restoration

I use techniques learned from PRI with many clients, and many of them experience the same thing that I did, breathing and pelvic re-positioning techniques can often lead to lower back or joint pain going away.gabe

And a fascinating point is that no amount of stretching, massage, therapy, or strength training would have fixed these issues. As Ron Hruska, the founder of Postural Restoration repeatedly emphasizes, this training is “neuro”.

It’s all about the brain.

PRI techniques teach your brain to break out of the old “stuck” pattern and into a new one. They teach you to move like humans are supposed to move: in three planes of motion with both the left and right side of your body.

It is often so effective that people are in disbelief that their countless trips to chiropractors and physical therapists did nothing to help, yet these techniques did.

Postural Restoration Institute is changing the way that physical therapists, athletic trainers, and strength and conditioning coaches view and train the human body.

Here are some examples of PRI inspired adjustments to traditional exercises.

Bulgarian Split Squats with PRI adjustments

The “Ribs Down” Push-up

A Safer Way to do Chin-ups

And here is an example of a PRI pelvic repositioning exercise as I would coach it in real life. Remember, this is just an example of one exercise. Without testing, it’s impossible to know if this is the one I’d use with you.

Learn About PRI

Want to know more? Check out these articles about PRI.

Men’s Health: The Benefits of Diaphragmatic Breathing

The USA Today: Bronson Arroyo of the Arizona Diamondbacks blows up balloons to stay healthy

The Norfolk Daily News

The Washington Post: A NBA player and his right hip injury

CNN: Train to Breathe Like A Pro Athlete

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