Shawn, Thanks for the comment. The fact that you need elevation under your heels to squat tells us that you are in a pattern with too much overall extension tone or tension. You certainly could squat this way but you rare just continuing to reinforce the same pattern of excessive back tension. As Lori said there could be many reasons why that is the case for you. But without knowing more, I'd encourage you to get into that full squat that Lori demonstrated by holing onto something with your hands like a bench or weight stack. Hold it and breathe 4-5 good breaths letting your heel-cords, quads, and back stretch. Repeat several times and see if it gets easier fro you to get into that full squat without load. This is a good pre- and post- squat activity. Obviously don't squat this way with load.

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Great question and as you so keenly are aware there are many factors both physically and neurologically beyond what s going on at the pelvis and low back that can influence why you could or maybe couldn't squat. Finding a practitioner that thinks this way (PRI practitioners usually do) and having them look at your whole system is the best way to get a good answer. Otherwise we're really just guessing....

Thanks for the question. We will often see a hyperkyphotic thoracic spine as a *compensation* to the hyper lordotic or extended posture. In either case if the thoracic spine is flat with anterior rib flares or kyphotic to try and achieve "false" expansion for respiration the need is catamount for those patients is to achieve a proper pelvis (and therefore pelvic floor position) and respiratory diaphragm position to allow normal respiratory mechanics to occur. These issues are discussed in depth at the Postural Respiration course put on by the Postural Restoration Institute (www.posturalrestoration.com) if you want more information. Thanks for the comment!

Hello my name is Andres Soto, I am a practitioner of physical therapy in Costa Rica. I am very interested in the PRI method, and the PRI squat technique. I have watched several presentations on youtube, and I am trying to grasp some of the concepts, maybe you can help me out a bit. I have to agree 100% with the importance of breathing, Stuart McGill calls that type of breathing Okinawa strengh, because it is a very ancient concept in Martial Arts. It is very interesting how you incorporate it in the squat technique. Also, the concept of moving the knees forward makes a lot of sense to me because you are encouraging ankle mobility (dorsiflexion) which is so important in so many movements. Also, it makes a lot of sense to me to mantain a neutral spine, and avoid extension, i agree 100% that this spares the back joints so much and allows for a better movement. Where I am getting confused, is that it seems to me the PRI squat allows for a lot of lumbar flexion, and posterior pelvic tilt ( I have even seen Ron mention that there is no such thing as a flex lumbar spine!). Maybe you can help me out with this concept, Dr Stuat Mcgill has proven in his Laboratory that there is such a thing as lumbar flexion ( he can view it in fluroscopy) and that it is a mechanism for disc herniation and discogenic pain. He has proven that the lumbar spine is much more able to handle heavy load with a natural lumbar lordosis. I am very open minded but it seems to me that the concept of repetitive lumbar flexion and posterior disk herniation has been proven in very formal scientific studies. I do believe that the concepts in PRI squat will help someone that is extension intolerant and someone who tends to hiperextend in the lumbar thoracic juncture. But don't you think the PRI squat might be risky in someone with discogenic pain ? (which i think tends to be very common since the general population tends to sit for prolonged periods of time). Please help me out here, I want to help my patients and sometimes it's difficult to see experts in the field with such different points of view.@@HruskaClinic

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Your back may feel tense and tight as you are working to inhibit those muscles. It should get better however. Since these positions are meant to inhibit rather than "stretch" muscles also make sure you aren't going after these positions too aggressively with these exercises. You don't need to feel a stretch for them to be effective.

@@HruskaClinic Thank you. My practitioner indicated that I was doing the exercise incorrectly and recruiting my back muscles to rise from the squat. I'm going to correct my technique and get back to it.

I3arty, Great (common) question. If you are unable to achieve a full "PRI Squat" in our minds it tells us you have a difficult time getting your pelvis and therefor lower spine in an optimal (neutral) state when not loading your spine. The addition of load in this state increases (in our opinion) the need to excessive back muscles, compensation and extension tone which puts you at a bigger risk for injury/reinjury. Hopefully this was reinforced that when you lift heavy you should not do a "PRI squat" with load. There are many reasons you may not be able to get your pelvis in a proper position to perform a PRI squat. Could be anything from your feet to your visual system. But when those things are addressed properly your squatting will be significantly more efficient with less risk of injury. Hope that helps some!

@@HruskaClinic So this PRI type of squat should never be used when squatting heavy weights?

@@TyEichele Correct, This squat technique is more of a rehabilitation tool or way to inhibit overactive back extensors. If you cannot perform this squat we feel your pelvis, and therefore lower lumbar spine, are improperly positioned and doing "traditional" workouts (including squats) may demand movement patterns or muscle activation patterns that are not ideal.

Thank you for that clarification!

Our PT Jason did a series of articles that were published on hip impingement a few years ago, this video discusses those articles. But a great idea for something that may be a good video for us to get out there for you guys. I'll pass it on! kzfaq.info/get/bejne/md1_iJZ9t7GnhI0.html

@@HruskaClinic thank you!

I just discovered this yesterday ( I mean PRI videos ) and it means postural restoration institute