You've done it. You've started a rehabilitation program utilizing Postural Restoration Institute's (PRI) concepts and tools and you're ready to get back to your gym routine. How can you best incorporate the strategies you've learned in PT into your work out? Follow these tips and you'll be on your way.
1) Don't forget your core- Remember that without proper diaphragmatic position/activation coupled with a neutral lumbar spine (low back), the abdominals are in an elongated and weakened position and cannot work to their fullest potential. Before performing ANY activity, perform a deep exhale and depress or "pull down" your ribcage. At the same time, perform a posterior pelvic tilt by pulling your belt buckle up toward your nose. You should then feel your abdominals engage. Be sure to maintain this position throughout whatever exercise you're performing. This is particularly important when using free weights or pulleys as you don't have any machinery around to help you keep you in good position.
2) Reach! - In order to maintain proper core engagement as well as fully strengthen your back or chest, your ribcage must be in the proper position on which your shoulder blades can sit and go through their full range of motion. For any activity in which you are pressing away from you - push ups, incline press, planks, etc., start with a full exhale and perform your posterior pelvic tilt and ribcage depress. Be sure to keep this posture throughout the entirety of the exercise. Now, when you are pressing the heavy object away from you, or pushing yourself away from a stable object (like the floor in a push up), think about reaching with your arms as your elbows become fully extended. This allows the upper back to round, allowing for full contact of the curved scapula on the rounded ribcage. This allows for full periscapular stabilization, particularly of the serratus anterior and lower trap. Once your shoulder blades are properly stabilized, whatever muscle you are trying to strengthen around that area can now be fully, and properly strengthened.
3) Don't arch your back - Extending or arching your back turns off your abdominals and gluts and activates your lower back. This will cause pain or tightness in your back, poor exercise performance, and minimal results. Again, before performing any activity breathe out fully, depress your ribcage, and perform a posterior pelvic tilt. Think of rounding your lower back into the floor, workout bench, back support, etc. As you are performing your activity, keep your pelvic tilt and be sure your lower back stays against the support. Once your lower back begins to pull away, you're no longer utilizing those abs or glut. Your hip flexors and lower back extensors are now taking over. Ouch!
4) Squat correctly - It's a common misconception that a squat must be performed with an arched lower back and your knees behind your toes or you'll hurt yourself. In order to do this, you must lose your posterior pelvic tilt, extend your back, and lift your chest. This will cause your lower back extensors to control all of the weight you are squatting with. Your abs and gluts are in an elongated position and cannot work appropriately. Start by performing your pelvic tilt and depressing your ribcage with a full exhale. Then, try squatting straight down allowing your weight to settle in your heels. On your way back up, you'll be able to drive with your hips as you engage your gluts.
watch this video for poor/typical squatting technique
watch this video for correct squatting technique
5) Hinge correctly - Utilize the same mechanics as described for the squat. This video does a great job demonstrating proper form.
Always remember to speak to your therapist with specific concerns or questions about your routine. Not only can we give you additional information, we can watch you do the activity in question to be sure you're using the best form possible.
Feel like you need help bridging the gap between PT and hitting the gym? Integrate 360's therapists have developed relationships with personal athletic trainers in the area and can refer you to someone who is familiar with PRI as well as the type of training you're interested in. They can help you transition back to the gym or your sport while feeling confident that you're performing activities that will help keep you healthy for life!
For you trainers, this article was inspired from this one from dsstrength.com . He does an amazing job of explaining how to utilize PRI principles with your clients and has some great videos to share.