What?
A sidelying PRI non-manual technique used to integrate right adduction and active abduction, with right abduction muscle in a lengthened state and during ongoing left adduction to promote left AF IR in the frontal plane with appropriate ankle, thoracic, and cervical position. This technique is designed to decrease right adduction demands at mid-stance and increase lateral abduction stabilization without engaging into extreme right AF IR or right thoracic abduction.
Why?
This technique is designed for individuals who have difficulty with abduction of the right lower extremity without engaging right low back, right quadratus lumborum and right hip flexors and who need concomitant facilitation from left adductors in a shortened position and right abductors in a lengthened position; after they have achieved right abduction with left adductors in a short position and right abductors in shortened position. The gluteus medius, minimus and gluteus maximus need to work in a feed forward fashion during mid stance on the right in a neutral position, i.e. the femur is not too adducted to abducted. Previous PRI techniques in this position focus on developing abduction of right lower extremity in an abducted, shortened state or raised position. This technique requires lifting from and lowering to a “lowered” state to mimic gait dynamics at mid stance, without over-stabilization offered by the right abductor because of poor reciprocal left AF IR capability.
When?
This is a good technique to use for individuals whom have difficulty with: 1) abducting right leg (grade 2 or less with right abduction lift test) or with limited passive abduction of the right leg compared to the left with toweling placed under contralateral abdominal region; 2) actively abducting without lateral superior femoral acetabular impingement; 3) seated femoral acetabular external rotation immediately after repositioning of pelvis with left adductor, left hamstring or right gluteus maximus; 4) ambulating without increased right thoracic abduction, decreased right arm swing or increased right lower extremity external rotation with or without appropriate footwear and PRI oriented orthotics; 5) and achieving a grade 4 or better with Right Adduction Lift Test because of overactive right lateral supra-iliac activity.
Where?
Follows Left Sidelying Left Flexed Adduction with Concomitant Right Extended Abduction and precedes Left Sidelying (left extended adduction) Right Lowered Extended Abduction with Left Abdominal Co-Activation in the integration, left adduction and right abduction PRI programs of the 2nd Edition CD. This technique should be considered only after the individual can abduct right lower extremity with leg and right ankle above level of right hip and with concomitant left leg flexed adduction and left thoracic abduction. Control of the pelvis in this left sidelying, frontal plane position during abduction with a short length of abduction muscle is recommended before advancing some type of activity with abducting muscle in a longer length. Individuals who can’t keep right leg adductors and right thoracic abductors inhibited during left sidelying, right extended leg abduction should not advance to this more highly integrative technique.
Who?
Recommended for individuals who: 1) cant find or feel their left abdominals without side bending to the left versus abducting at the left thoracic wall; 2) experience right lower lateral anterior thoracic quadrant ‘restriction’, ‘tightness’, or ‘pulling’ during running or upright dynamic function; 3) clinically are challenged with right squat/stance activities when asked not to lower their right upper quadrant or shoulder; 4) experience right peroneal tightness, overuse or fatigue; 5) continue to externally rotate lower extremity with right hip flexors after they are placed in appropriate footwear or orthotics; 6) and individuals who have subsiding right sciatic symptoms and no right sacral iliac strain.