This advanced lecture and lab course is designed to assist clinicians with those complex patients that are struggling to restore reciprocal function of the pelvis. The clinician will gain an appreciation for the influences of an asymmetrical pelvis and how this imbalance contributes to pelvis dysfunction. We will explore in detail the function of the pelvic inlet and outlet as it relates to anatomy, respiration, and asymmetry in a multiple polyarticular chain system. Participants will be able to restore pelvic and respiratory neutrality through a PRI treatment approach while keeping individual activities of daily living in mind.
Education Level: Advanced
Student Faculty Ratio 16:1
Instructional Methods: Lecture, demonstration & lab, clinical application, case studies, and Q&A
Live Stream courses will take place from 8am-5pm CT each day, and certificates of completion/CE credit will be awarded the following week after completion of the course evaluation survey and short post-test. For more information on whether your state/organization is approved for CE approval, please click on the “CE Approval” tab. Live Stream courses will be engaging, interactive and include demonstration of objective testing and/or non-manual techniques, in addition to course attendees being able to ask questions throughout the course. All that’s needed on your end is reliable internet access, a webcam, microphone and speaker (or a smart phone can be used if you do not have a computer or laptop with this capability) to utilize ZOOM for the live stream course. The ZOOM links for the live stream course will be included in the confirmation email. The course manual will be shipped directly to you 1-2 weeks before the course. *International registrants are discounted $30 since we do not ship manuals internationally, however you will be able to print the digital manual if you so choose. A digital version of the course manual will be added to your PRI account the week of the course. In addition, participants will receive access to the recording of the live stream course for 14 days to review the material, and re-watch any material that may have been missed due to connection issues. Those who attend in-person during a live streamed course will also receive access to the recording for 14 days. Extensions beyond this 14 day review are not available. ***Please note: In order to receive access to the recording for review, you must participate in person on the Live Stream course with your camera on for at least half of the course (7.5 hours). If you sign up for the course and do not participate in at least 7.5 hours of the live stream, you will not receive the recording and you will not be refunded. Also, once course manuals have been shipped (or the digital version has been added to your account), there will be no refunds for cancellations.***
Day One
7:30am – 8:00am | Registration and Light Breakfast |
8:00am – 8:30am | Introduction to Pelvis Neutrality |
8:30am – 10:00am | Left Anterior Interior Chain (AIC) Influence on the Pelvis |
10:00am – 10:15am | Break |
10:15am – 11:15pm | PEC Influence on the Pelvis |
11:15am-12:00pm | Pahologic PEC Influence on the Pelvis |
12:00pm – 1:00pm | Lunch (on your own) |
1:00pm – 3:00pm | Examination Tests and Assessment (Demonstration)
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3:00pm – 3:15pm | Break |
3:15pm – 4:45pm | Examination Tests and Assessment (Lab) |
4:45pm-5:00pm | Functional Relationships |
Day Two
7:45am – 8:00am | Sign-In and Light Breakfast |
8:00am – 9:30am | Respiratory Influences on the Pelvis |
9:30am – 10:00am | Respiratory Influences on the Pelvis (Lab) |
10:00am – 10:15am | Break |
10:15am – 12:00pm | Treatment of Pelvis Dysfunction as it Relates to the Left AIC Pattern |
12:00pm – 1:00pm | Lunch (on your own) |
1:00pm – 2:00pm | Treatment of Pelvis Dysfunction as it Relates to the Left AIC Pattern (Case Study) |
2:00pm-3:00pm | Treatment of Pelvis Dysfunction as it Relates to the PEC Pattern (Case Study) |
3:00pm – 3:15pm | Break |
3:15pm – 4:30pm | Treatment of Pelvis Dysfunction as it Relates to the Pathologic PEC Pattern |
4:30pm-5:00pm | Other Treatment Considerations |
Anatomy & Physiology
Respiration
Treatment Considerations & Interdisciplinary Integration
Muscular Skeletal Asymmetry and Influence on the Pelvic Floor
Muscular Influence on Pelvic Floor Function
Pelvic Floor Mid Zone
Muscular Structures of the Pelvic Floor
Pelvic Inlet: diaphragm, rectus femoris, sartorius, internal obliques, transverse abdominis, iliacus
Pelvic Outlet: hamstrings, IC adductor magus, gluteus maximus, piriformis, coccygeus, pubococcygeus, obturator, iliococcygeus, puborectalis, urogenital diaphragm
Anterior Interior Chain (AIC)
Muscles: Diaphragm, Psoas, Iliacus, TFL, Vastus Lateralis, Biceps Femoris
Opposition Muscles: Hamstrings, Gluteals, Internal Obliques
There are two anterior interior polyarticular muscular chains in the body that have a significant influence on respiration, rotation of the trunk, ribcage, spine and lower extremities. They are composed of muscles that attach to the costal cartilage and bone of rib 7 through twelve to the lateral patella, head of the fibula and lateral condyle of the tibia. These two tracts of muscles, one on the left side of the interior thoraco-abdominal-pelvic cavity and one on the right, are composed of the diaphragm and the psoas muscle. With the iliacus, tensor fasciae latae, biceps femoris and vastus lateralis muscles this chain provides the support and anchor for abdominal counter force, trunk rotation and flexion movement.
Posterior Exterior Chain (PEC)
Muscles: Latissimus Dorsum, Quadratus Lumborum, Posterior Intercostals, Serratus Posterior, Iliocostalis Lumborum
Opposition Muscles: Abdominal Obliques
Position
Mechanics Without Hip Shift
Mechanics With Hip Shift
Left AIC: Inability reflects:Lack of right anterior left posterior inlet, lack of left anterior and right posterior outlet, hyperactivity of left anterior and right posterior inlet, or hyperactivity of right anterior and left posterior outlet
PEC: Inability reflects: Lack of bilateral posterior inlet and bilateral anterior outlet, or hyperactivity of bilateral anterior inlet and bilateral posterior outlet.
*ability to touch toes with + Adduction Drop Test & + PADT = Pathological PEC
The patient lies on their side with the top and lower hips and knees flexed to 90 degrees.
The patient is then instructed to actively bring the top leg back to neutral while maintaining 90 degrees of knee flexion, and to touch their knee to the mat. This represents a negative test.
A positive test is indicated by the inability of the active leg’s pelvic floor to ascend secondary to the left outlet’s inability to abduct.
The patient lies on his or her side with their bottom knee and hip flexed at 70-90°. Their top knee and hip will remain straight (0-degrees). Passively stabilize the patient’s innominate with one hand as the other hand passively moves their leg into abduction. Standing behind the patient usually provides more examiner biomechanical comfort in lifting the leg. Patients with tight right intercostal walls and short and strong right adductors will demonstrate limited passive abduction when compared to the other side. Usually the examiner will feel lateral buttressing of the femoral head on the lateral superior acetabulum as the femur is abducted. When right thoracic abduction or sidebending occurs, discontinue the test.
A positive test is indicated by a restriction on one or both sides that does not allow sufficient abduction secondary to lack of outlet adduction. Usually seen on the right side especially if Left Adduction Drop Test is positive in a Left AIC oriented patient or a patient has a right Hruska Adduction Lift Test of less than a 3.
LEVEL 1: Ability to initiate a squat by slightly bending knees while trunk remains in flexion. Inability reflects lack of posterior pelvic rotation and hyperactive back extensors.
LEVEL 2: Ability to begin squatting, moving bottom back and knees forward while trunk remains in flexion. Inability reflects lack of femoral adduction, hyperactive hip flexors, and overactive FA ER’s.
LEVEL 3: Ability to squat bringing bottom below knee level while keeping heels down and trunk flexed. Inability reflects tight intercostals and hyperactive anterior / posterior tibialis.
LEVEL 4: Ability to squat keeping heels down, trunk flexed and bottom to heels. Inability reflects hyperactive quads and gastroc-soleus.
LEVEL 5: Ability to maximally squat keeping heels down and trunk flexed while keeping center of gravity through heels. Inability reflects lack of maximal AF IR and synchronized mechanics of diaphragm and pelvic floor respiration.
Adduction Drop Test
See Myokinematic Restoration Review Guide
Hruska Adduction Lift Test
See Myokinematic Restoration Review Guide
Hruska Abduction Lift Test
See Myokinematic Restoration Review Guide
These references are attached below as PDF files. After clicking on them, you may have to “Allow Add On” if it pops up an error message at the top of the internet browser. You also may need to download a free version of PDF software, allowing you to view the articles below. Please contact us if you continue to have difficulty accessing the articles below.
Sahinkanat T, Arıkan DC, et al. Effects of lumbar lordosis and pelvic inlet orientation on the outcome of the transobturator tape sling operation in women. Arch Gynecol Obstet. 2011.
Licensed Physical Therapists and PT Assistants
Licensed Occupational Therapists and OT Assistants (Classification Codes)
Licensed Chiropractors
Certified Athletic Trainers
Certified Strength & Conditioning Coaches
Certified Personal Trainers
Licensed Massage Therapists
Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited university are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.
Accessible Learning Environments
All participants in Postural Restoration Institute™ (PRI) continuing education courses are entitled to an accessible, accommodating, and supportive teaching and learning environment. Participants have the right to request accommodations and the responsibility to provide disability documentation that supports those requests. PRI has the right to establish eligibility guidelines in accordance with both law and policy regarding disability and provide those accommodations that appropriately provide equal access to the programs and activities it sponsors.
A Certificate of Completion for 15 contact hours is awarded to attendees upon the successful completion of this course. Before attending a course, please verify CEU acceptance with your profession’s regulating body.
Physical Therapists and PT Assistants
In the states where PRI is sponsoring courses and where approval through state American Physical Therapy Association (APTA) or licensing agencies is required, PRI will apply for approval for CEUs for Physical Therapists and Physical Therapist Assistants.
Occupational Therapists and OT Assistants
PRI is no longer recognized as an Approved Provider through the American Occupational Therapy Association (AOTA). Many states do not require any sort of pre-approval process. And of the ones that do, most state licensure boards allow self-submission of CE programs. Please check with your state licensure board to determine if you will be able to submit PRI courses for CE hours.
Chiropractors
In the states where PRI is sponsoring courses and where approval through state licensing agencies is required, PRI will look into applying for CEUs for Chiropractors (upon request). Requests must be made at least 90 days prior to the course date.
Athletic Trainers
Postural Restoration Institute (BOC AP# P2376) is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. This program is eligible for a maximum of 15 Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.
Strength and Conditioning Coaches
This course is approved by the Collegiate Strength and Conditioning Coaches Association (CSCCa) for 7.5 CEU’s.
Since continuing education courses are not required to have pre-approval through the National Strength and Conditioning Association (NSCA), this course is not currently approved through the NSCA. NSCA certificants interested in completing this course may contact the NSCA to inquire about CEU eligibility.
Massage Therapists
PRI is approved by the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) as a continuing education Approved Provider. Provider number 451877-12. *Approval applies to select live courses only. This live course is approved. **Approval not valid for New York licensed massage therapists.
Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited universtity are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.
PRI reserves the right to cancel and refund a course attendee’s registration if any concerns arise regarding the course attendee’s qualifications as a healthcare or fitness professional, copyright infringement, or any other illegal activity involving PRI copyrighted materials. International attendees may be required to review and sign a Copyright and Intellectual Property Recognition and Disclosure Contract prior to receiving access to course materials.
A Certificate of Completion for 15 contact hours is awarded to attendees upon the successful completion of this course. Before attending a course, please verify CEU acceptance with your profession’s regulating body.
Physical Therapists and PT Assistants
In the states where PRI is sponsoring courses and where approval through state American Physical Therapy Association (APTA) or licensing agencies is required, PRI will apply for approval for CEUs for Physical Therapists and Physical Therapist Assistants.
Occupational Therapists and OT Assistants
PRI is no longer recognized as an Approved Provider through the American Occupational Therapy Association (AOTA). Many states do not require any sort of pre-approval process. And of the ones that do, most state licensure boards allow self-submission of CE programs. Please check with your state licensure board to determine if you will be able to submit PRI courses for CE hours.
Chiropractors
In the states where PRI is sponsoring courses and where approval through state licensing agencies is required, PRI will look into applying for CEUs for Chiropractors (upon request). Requests must be made at least 90 days prior to the course date.
Athletic Trainers
Postural Restoration Institute (BOC AP# P2376) is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. This program is eligible for a maximum of 15 Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.
Strength and Conditioning Coaches
This course is approved by the Collegiate Strength and Conditioning Coaches Association (CSCCa) for 7.5 CEU’s.
Since continuing education courses are not required to have pre-approval through the National Strength and Conditioning Association (NSCA), this course is not currently approved through the NSCA. NSCA certificants interested in completing this course may contact the NSCA to inquire about CEU eligibility.
Massage Therapists
PRI is approved by the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) as a continuing education Approved Provider. Provider number 451877-12. *Approval applies to select live courses only. This live course is approved. **Approval not valid for New York licensed massage therapists.
Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited university are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.
PRI reserves the right to cancel and refund a course attendee’s registration if any concerns arise regarding the course attendee’s qualifications as a healthcare or fitness professional, copyright infringement, or any other illegal activity involving PRI copyrighted materials. International attendees may be required to review and sign a Copyright and Intellectual Property Recognition and Disclosure Contract prior to receiving access to course materials.
Course
Date | Location | Faculty | Register |
---|---|---|---|
Feb 1-2, 2025
(Sat-Sun) | Henry Mayo Fitness & Health Center Valencia, CA | Jennifer Poulin | |
Feb 22-23, 2025
(Sat-Sun) | One on One Physical Therapy Atlanta, GA | Lori Thomsen | |
Apr 11-12, 2025
(Fri-Sat) | Postural Restoration Institute Lincoln, NE | Lori Thomsen | |
Aug 2-3, 2025
(Sat-Sun) | UNC Orthopedics at Goldsboro Goldsboro, NC | Jennifer Poulin | |
Sep 6-7, 2025
(Sat-Sun) | Finish Line Physical Therapy New York, NY | Jennifer Poulin | |
Sep 27-28, 2025
(Sat-Sun) | Central Mass Physical Therapy and Wellness West Boylston, MA | Lori Thomsen | |
Oct 18-19, 2025
(Sat-Sun) | Presbyterian Healthplex Albuquerque, NM | Jason Miller | |
Nov 14-15, 2025
(Fri-Sat) | Postural Restoration Institute Lincoln, NE | Jennifer Poulin |
Registration is limited to ensure a low faculty to student ratio. Please register early. Courses will be canceled or rescheduled if fewer than 15 participants have registered by the early registration deadline of four weeks prior to the scheduled course date.
Special Needs Requests
If you have a disability and require accommodation in order to fully participate in this course, please contact us at least two weeks prior to the course date or prior to purchasing any online home study course so that arrangements can be made.
Course Completion
The course must be attended in full, and an online course evaluation summary and short post-test (with a passing score of 70% or higher) must be completed in order to receive a certificate of completion. Certificates of completion will be emailed after the online course evaluation summary and post-test have been completed If you arrive late, or leave early, your certificate of completion will be adjusted for the number of CE hours you were in attendance. *For live stream courses, if you have your camera turned off (or you are not visible on camera) at any time for greater than 15 minutes, this time will be deducted from your total hours on your certificate of completion.
Cancellation and Refund Policy
Tuition is refundable less $50 if cancelled 14 days before the course date. Tuition is not refundable for registrations or cancellations within 14 days of the course. However, you may have someone attend in your place or attend on another date. If you choose to attend on another date, a $50 fee applies to transfer your registration. If you are a no show and we have no communication with you before the course you will forfeit your course tuition. PRI reserves the right to cancel a course and will refund the tuition fee only. *Please note: For Live Stream Courses, once course manuals have been shipped (or emailed to international attendees), there will be no refunds for cancellations.
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