Core Integration Utilizing PRI and DNS Approaches: Practical Applications
Part 1 of this series discussed the theoretical constructs of positional influence on muscle performance, the role the diaphragm plays in spinal stability, and how respiration affects pH, the muscular function, and recovery. If you missed it, you can check it out here: Core Integration Utilizing PRI and DNS Approaches: Theoretical Constructs
Practical Applications
While the discussion up to this point has been largely theoretical, hopefully it has served to illustrate the importance of these concepts and the impact they have on performance and recovery. While diving into the corrective strategies associated with common postural asymmetries is beyond the scope of this article, three primary and inter-related applications of these concepts involve:
- Controlling extension
- Restoring pelvic floor and diaphragm alignment
- Train proper diaphragmatic breathing with an emphasis on posterior expansion
Because these concepts are also so interdependent, I won't address them independently, but will present strategies to address this pattern as a whole.
Strategy 1: Exhale First
One of the most simplistic ways to shift an individual toward a more optimal spinal alignment and restore proper positioning of the rib cage is to cue “exhale and feel your ribs come down.” Sometimes athletes will need a visual, but the idea is that they exhale completely so their ribs shift downward before they set their core for various lower load exercises (e.g. ½ kneeling belly press, glute bridge, scap wall slide, slideboard hamstring curl, etc.), or before they inhale and then set their core to maximize intra-abdominal pressure for higher load exercises (e.g. back or front squat, deadlift, bench press, etc.). In this latter scenario, the goal is to inhale from an exhalation position, not allowing the thoraco-lumbar junction to extend excessively upon inhalation, which would drive further extension upon loading.
Strategy 2: Posteriorly Tilting the Pelvis
The first strategy is effective in restoring positioning of the rib cage and diaphragm, or the top half of the scissors. This strategy aims to pull the pelvis back to position the pelvic floor back beneath the diaphragm and rib cage. The goal here isn't to put the pelvis in a position of posterior tilt, it's to posteriorly tilt the pelvis back to a more neutral alignment. Many athletes will have a difficult time internalizing this motion. In these cases, I'll have the athlete put their hands on top of their pelvis and tell them to tip their hips forward to maximize the arch in their lower back, as I demonstrate this motion for them. I'll then tell them to do the exact opposite motion and roll their hips back. This typically does the trick.
Strategy 3: Drive Hands Against Wall
Many athletes struggle with lying/supine exercises that require “anti-extension” core control. In addition to exhaling first, another effective strategy to help facilitate intra-abdominal pressure and the core is to press their hands against the wall. We've used this a lot for exercises like glute bridges (and their single-leg variations), slideboard hamstring curls, supine single-leg lowers, and supine single-leg hip extensions (e.g. a lower body only “dead bug” movement”) and have found that it both helps improve the athlete's ability to maintain the desired alignment AND their awareness of when they start to lose it.
Strategy 4: Balloon, Prayer Position, or Quadruped Breathing
Simply, these exercises all provide an environment for the athlete to practice breathing. The balloon serves both as resistance to exhalation (to facilitate the desired muscular involvement) and as a source of proprioceptive feedback. They also give the coach an indication of how much air the individual is holding and therefore the degree of hyperinflation, as dictated by the degree of balloon filling on the first exhale, and of the individual's ability to fill up a balloon in general (you'll be surprised by how many people have such a weak expiratory pattern that they can't overcome the initial resistance of the balloon). Both the prayer and quadruped positions are effective in facilitating a posterior expansion upon inhalation, which is typically limited with an over-extended posture. Because athletes, understandably so, may be hesitant to just lay down and breathe as part of their training program, these exercises can be pitched as a means of facilitating recovery immediately following a workout. Because the correct execution of these exercises also stimulates a parasympathetic shift, they can also be used at night to help calm the athlete's mind and body to allow him or her to fall asleep faster.
While there are still some folks that argue against the need for postural correction, the bottom line is that it's impossible for muscles to function properly if they're not positioned properly. Because common postural malalignments heavily influence the position and function of the diaphragm, restoring proper spinal and pelvic alignment is the most appropriate starting place. The corrective strategies above are far from an exhaustive list, but provide a few basic starting places that can be easily integrated into your current program.
