Quick(ish) Explanation of the Postural Restoration Concepts Used at BTF

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I have been trying to write this article for a few years now. The idea is to make the postural restoration concepts we use at Back to Function (BTF) easy to understand for our current and potential future clients. The trick is, postural restoration, as defined by the Postural Restoration Institute®, is complex! I have taken over a dozen courses over the last decade, and I am still learning and adding to my bag of tricks when it comes to postural restoration. Hopefully this will serve as a basis for your understanding of postural restoration that we use at BTF.

Asymmetry of the Human Body

The human body is not symmetrical. When we look in a full length mirror, many expect to see perfect symmetry from the left to the right side of the body. Yet, the different systems of the body are not the same on the left as they are on the right side. The human body is balanced through an integration of system imbalances. An example of this integration of system imbalance is the torso that is balanced by the liver on the right and the heart on the left. The Postural Restoration Institute® does an excellent job of defining the complex nature of the asymmetry of the human body.

Postural Restoration Institute®

The Postural Restoration Institute® (PRI), based in Lincoln, Nebraska, was established in 2000 to explore and explain the science of postural adaptations, asymmetrical patterns and the influence of polyarticular chains of muscles. PRI’s mission is based on the development of an innovative treatment that addresses the primary contributions of postural kinematic movement dysfunction. The Institute offers over a dozen courses that lead to a professional credentialing opportunity for healthcare providers called Postural Restoration Certified (PRC).

Postural Restoration Institute® (PRI) credentialed professionals recognize these imbalances and typical patterns associated with system weakness that develops because of dominant overuse. An example is the liver’s structural support allows the right diaphragm to be in a more suitable position for respiration while the left diaphragm is typically smaller and weaker and therefore can allow the body to become twisted at the thorax. Another example is standing more on the right leg to offset the weight of the left upper torso that contains the heart. This propensity for right-legged standing causes the left pelvis to move forward and the shoulder girdle on the right to move downwards.

What is Posture?

The BTF postural exam is more than seeing how the bones and joints of the body compare to an expected standard of good alignment. The PRI exam takes into account how the size, shape, position and pressure of the pelvic, abdominal, thoracic and cranial cavities are affecting overall body position and function. These cavities work together to coordinate 3-dimensional core movement of the body and influence the position and function of the jaw and extremities via their connection to one another via the function of the spine. Therefore, the concept of posture is not simply a choice you make to position yourself a certain way, but rather the overall position you are in because of the combined influences of all of your body systems.

When these normal imbalances are not regulated by alternating and reciprocal function during walking and breathing, a strong pattern emerges creating structural weakness, instability and even musculoskeletal pain syndromes. The asymmetrical design of the human systems can limit the movement of our functional patterns into the left hemisphere. This tendency to be limited with our body patterns to the left and excessively to the right is called right lateralization.

I use the analogy of a car’s alignment being off and the car’s steering is pulling to the right. In this car analogy, driving far and/or fast can present a real problem with this right-oriented alignment, as the car will constantly veer off to the right side, wearing the tires asymmetrically and presenting a danger to the driver of driving off the right side of the road! Of course the solution is to have a mechanic fix the car’s alignment issue.

PRI has narrowed it down to 3 major reasons for right lateralization in the body.

3 Reasons for Right Lateralization in the Body
  1. Unbalanced pattern of airflow across the thoracic cavity that exists because of our asymmetrical design of the respiratory system/diaphragm (I have already discussed this earlier)
  2. Overactive internal muscle chain on the left side of the body (Left Anterior Interior Chain) – this chain of muscles pushes the pelvis to the right and limits our ability to move back towards the left
  3. Nervous system adapts to the right lateralization of the body and accommodates to the overuse of this right lateralized position sense – this can create a complex issue where the body loses the ability to properly sense movement to the left

PRI is an approach that works from inside-out to minimize the negative influence of asymmetrical airflow, muscle activity and nervous system awareness. The body works in 3-dimensional functional patterns and needs to fully alternate from one side of the body to the other in order to achieve optimal and balanced movement. PRI credentialed professionals recognize the common patterns of human posture and gait and balance these patterns through specific repositioning strategies. For more information on these strategies, please see the article, Do You Feel Crooked When You Look in the Mirror?

If you need help from a Postural Restoration Institute® (PRI) credentialed professional, please contact us at Back to Function. One of our highly skilled doctors can guide you safely and effectively on the road to feel, recover and perform better. BTF also has one of the only Reformer Pilates instructors that is trained in PRI. Please call 310-534-1900 or email info@backtofunction.com to schedule your assessment today!


What is Posture? James Anderson, MPT, PRC

PRI Integration for Pilates course manual. Postural Restoration Institute.


Do You Feel Crooked When You Look in the Mirror? backtofunction.com

Dr. Chad Moreau
About Dr. Chad Moreau

Dr. Chad Moreau is the President of Back to Function, a sports chiropractic office dedicated to providing elite quality care for athletes and athletic-minded clients. He is Certified in Postural Restoration by the Postural Restoration Institute. His positions include: Chiropractic Consultant for the University of Southern California Athletics (2020-2022) & Team chiropractor for the Los Angeles Kings (NHL) from 2012-2020, Los Angeles Dodgers 2017-2019 and the Los Angeles Lakers 2020. He can be contacted at drchad@backtofunction.com.