Postural Restoration

Postural Restoration Treatment

Postural Restoration is a treatment approach used at Austin Physical Therapy. It is an approach based largely on the work of Ron Hruska, founder of the Postural Restoration Institute™ in Lincoln, Nebraska. We have seen first hand the effect this type of treatment brings about in our patients, and have adopted its concepts as an integral and essential part of the rehabilitation process.

Postural Restoration is based on the concept of eliminating unwanted muscle tension as it develops in the body. This muscle tension may be a result of many things, including but not limited to:

  • trauma
  • habitual movement patterns
  • respiratory patterns
  • right or left handed patterns
  • as a response to pain
  • and as a result of stress

When excessive muscle tension is present, there is a contraction or shortening of the muscle. This places abnormal forces on the joints and the soft tissue that supports them (muscle, tendon, cartilage, ligaments, etc). This is observed during a physical therapy examination as a reduction in flexibility, ROM, strength, and poor posture. The result is pain that may develop at the site of the muscle tension or at some distant location as the body compensates.

Relaxation of the muscle tension is necessary to achieve neutral posture, full ROM, strength, and flexibility, and ultimately to reduce the abnormal forces in the area of pain, so that tissue healing and subsequent pain reduction can occur. There are a number of ways that this can be achieved. Treatment of the muscle tension requires an approach that activates the muscles in the body that opposes the muscles that are contracting unnecessarily. Activating the antagonistic muscle will shut down the unwanted muscle contraction through reciprocal inhibition. For example, if the quadriceps are over contracting, the hamstrings can be used to help them relax because they work in opposition.

Home Exercise Program

There are two main categories of treatment that are generally used to achieve Postural Restoration. The first intervention, and the most important for success, is the home exercise program. Many of these exercises are done on the floor with your feet on the wall in what is termed the 90/90 position because both the hips and knees are at a right angles. Then functional and integrative exercises are progressed to sitting and standing as a neutral posture is achieved and maintained. There are also exercises that will achieve neutral posture in the frontal and transverse planes. These exercises MUST be done frequently in the beginning (2-4 times per day) as it is necessary for motor re-education to take place. As the pattern of muscle tension is eliminated, the frequency of exercise can diminish.

Manual Therapy

The second treatment approach that is commonly used in Postural Restoration is manual therapy. This approach requires the therapist to guide the body into the new positions as you engage the muscles to hold those positions. Most of these techniques work the ribcage/torso to help with realignment. The muscles that are often found to be in a state of tension are accessory muscles of inhalation (breathing in), and the diaphragm. Most of the home exercises and manual therapy techniques incorporate breathing, and specifically exhalation (breathing out) because they work in opposition.

For more information, contact our physical therapists at Huntsville & Brownsboro, AL centers.