Waldron Jacob L, McKenney Michael A, Samuel Michelle N, Girouard Tedd J, Turner Catherine L, Radzak Kara N
University of Nevada, Las Vegas, Department of Kinesiology and Nutrition Sciences, Las Vegas, NV, USA.
Northeastern University, Sports Performance, Boston, MA, USA.
Int J Sports Phys Ther. 2020 Oct;15(5):832-839. doi: 10.26603/ijspt20200832.
Postural Restoration Institute® (PRI) theories and rehabilitation techniques focus on restoring balance to anatomical systems. Common postural asymmetries can present in athletes as dysfunctions and limitations. The purpose of this case report was to examine the use of PRI exercises and theories to address pelvic alignment, along with core stabilization, during treatment of shoulder dysfunction in a collegiate volleyball player.
A 22-year-old female volleyball athlete reported unresolved right rotator cuff tendinopathy. She presented with bilateral rib cage flare, anterior pelvic tilt, and bilateral ROM differences in hip and shoulder internal and external rotation. PRI® special test findings included a positive left and right Adduction Drop Test (ADT), positive left Extension Drop, and Hruska Adduction Lift test (left=2, right=3) indicating posterior exterior chain (PEC) pattern of dysfunction. The traditional shoulder rehabilitation program from the previous season was eliminated and a PRI based intervention was performed. Intervention exercises included the 90/90 dead bug diaphragmatic breathing, 90/90 hamstring hip lift, and right sidelying respiratory left adductor pull back. Exercises were performed as three sets of ten diaphragmatic breathing repetitions, a minimum of three times weekly prior to activity.
Likert scale ratings of pain decreased from a six pre-intervention to two. The left hip gained 10° of internal rotation and the right hip gained 14° of external rotation. Right shoulder internal rotation increased 15°. Hruska Adduction Lift improved to a four bilaterally (right by day 24, and left by day 31). Left extension drop test was negative following day 17.
PRI® exercises focusing on core and pelvic stability translated to improved hip and shoulder ROM, and decreased shoulder pain associated with rotator cuff tendinopathy. By treating pelvic alignment with the PRI® exercises, the ROM imbalance and pain at the shoulder joint were addressed.
Incorporating PRI exercises and theories into the rehabilitation program of a volleyball player was useful in addressing underlying imbalances throughout the kinetic chain.
3b.
姿势恢复研究所（PRI）的理论和康复技术专注于恢复解剖系统的平衡。常见的姿势不对称在运动员中可能表现为功能障碍和限制。本病例报告的目的是研究在一名大学排球运动员肩部功能障碍的治疗过程中，如何运用PRI练习和理论来解决骨盆排列问题以及核心稳定问题。
一名22岁的女性排球运动员报告右肩旋转袖肌腱病未愈。她表现出双侧胸廓扩张、骨盆前倾，以及髋部和肩部内旋和外旋的双侧活动度差异。PRI特殊测试结果包括左右内收下降试验（ADT）阳性、左侧伸展下降试验阳性，以及赫鲁斯卡内收提升试验（左侧=2，右侧=3），表明存在后外侧链（PEC）功能障碍模式。取消了上一赛季的传统肩部康复计划，并实施了基于PRI的干预措施。干预练习包括90/90仰卧腿部提升膈肌呼吸、90/90腘绳肌髋部提升，以及右侧卧位呼吸左侧内收肌后拉。练习以三组，每组十次膈肌呼吸重复进行，并在活动前每周至少进行三次。
疼痛的李克特量表评分从干预前的6分降至2分。左髋内旋增加了10°，右髋外旋增加了14°。右肩内旋增加了15°。赫鲁斯卡内收提升试验双侧均改善至4分（右侧在第24天，左侧在第31天）。第17天后左侧伸展下降试验为阴性。
专注于核心和骨盆稳定的PRI练习转化为髋部和肩部活动度的改善，以及与旋转袖肌腱病相关的肩部疼痛减轻。通过PRI练习治疗骨盆排列，解决了肩关节的活动度不平衡和疼痛问题。
将PRI练习和理论纳入排球运动员的康复计划，有助于解决整个动力链潜在的不平衡问题。
3b。
