What do you notice in the above picture? At first glance it just looks like three boys hanging out during a soccer game. They're all wearing different clothes and are different heights. Two of the boys are leaning on one another while the third stands independently. Despite their differences, they are all standing with the same postural pattern.
Take a look at them, no matter how they are leaning, they are all standing on their right legs, crunching or shortening the right sides of their trunks, and lowering their right shoulders. Doesn't this seem weird considering two of the boys are leaning in opposite directions so they can lean on one another? How does that happen?
This common pattern is due to our naturally-occurring anatomical asymmetry. It begins with the asymmetrical attachment of our diaphragm. This primary muscle of respiration attaches to the back part of our lower ribcage and onto the front of our lower (lumbar) spines. The attachment sites are bigger and more robust on the right side. As this side has more attachments, it is "stronger" and tends to pull our lower spines into right rotation. Eventually this will pull our pelvis into right rotation as well. When our pelvis' and lower spines are oriented toward the right, our right hip joint is in a better, more functional position to weight bear. Therefore, we all tend to put more weight on our right leg than our left.
Additionally, this muscle is asymmetrically domed. Because of our heart, the left side of our diaphragm tends to flatten which flares our ribcage and weakens our abdominals on that side. The liver, on the right side, helps to preserve the muscle's domed shape here. This makes the right side of our abdominals stronger than the left. Due to this and the flared ribs on our left side, our trunks tend to lean to the right. This gives us the classic lowered right shoulder. Complicating matters, when our trunks lean slightly toward the right, more weight is displaced onto the right leg. This further ingrains our postural asymmetry.
In PRI language, this is called a Left AIC (anterior interior chain) position and it is the most common postural pattern. As our bodies spend more time in this position and our compensatory strategies we use due to this pattern break down, we tend to go further into compensatory patterns and this Left AIC pattern can degrade into others. To read more about this, check out our blog post What's Your Postural Pattern. This poor postural pattern, and therefore problematic loading on our muscles and joints, can lead to pain and dysfunction. A PRI trained therapist evaluates the entire body and it's systems to look for musculoskeletal position and function. We can then intervene on not only the area of pain, but also all of the surrounding areas that are feeding into the problem. Because of this more holistic approach, we are able to bring relief to many patients that have "failed" with physical therapy before, no matter where the site of pain is.
Next time you're at the mall, restaurant, or airport, watch people as they stand. Typically, no matter where they are looking, what direction they're learning toward, or what side they may be holding a heavy bag or purse, they'll likely be standing on their right leg with their right shoulder low.