Postural Restoration Using Breathing Augmentation

Patients will often tell me that the different kinds of treatments they do regularly (massage, acupuncture, adjustments, exercise) help temporarily but the pain they are having keeps coming back. The truth is, there is no one treatment that can fix everything for each person which is why there are so many different types of treatments out there. However, working on posture can, in time, help slow down and curtail the never-ending feeling of “the same old pain”. Postural exercises are not a quick fix, but if done properly can help stabilize the “good” muscle pattern that people experience right after exercise or massage, and slow down the return to the “bad” pattern.

There are many excellent postural techniques/methods (Tai Chi, Qi Gong, Rolfing, Alexander, Feldenkrais, Egoscue) that are available, and it can be hard to know where to start. Any one of the above mentioned ones are very acceptable, but I connected with a different one in 2018 from a physical therapist I know in Westbrook. Since then, I have been learning a method called “Postural Restoration,” that has been extremely helpful for me personally, and many of my patients with hip, low back and upper back pain.

A physical therapist in Lincoln, Nebraska, Ron Hruska MPA, PT, founded the Postural Restoration Institute (PRI) in 2011. He used his 35 years of clinical experience to develop a biomechanics based approach to better posture and overall body movement through a series of exercises that often have a breathing component.

The basic idea is that the liver is the heaviest organ we have and it happens to be on the right side of the body. This, unfortunately, pulls our center of gravity constantly to the right. In turn, this leads to rotation of the pelvis to the right and prolonged standing on the right leg. This right legged stance causes all kinds of unwanted changes throughout the muscles of the body, from right hip and low back pain all the way up to neck and jaw pain. Using breath work to open up the tighter right side of the rib cage is also a key component in this therapy. Ultimately, breathing with more efficiency and getting our pelvis and body weight more to the left side will get our whole body back to a more healthy neutral with less pain. Generally, these exercises are modified to the individual during treatment, and continued indefinitely because, unfortunately, we can’t escape gravity!

The three postural exercises I have on this site are directly from PRI techniques (or slightly altered) and are essentially effective starter exercises. To learn more, or to find a practitioner who is certified, you can visit the PRI website at:, or, I recommend Jeff Eckhouse, a fitness rehab specialist and owner of Back Cove Personal Fitness in Portland, or Greg Knapton, PT, and owner of Riverview Physical Therapy in Westbrook.