Corrective Case Study: Correcting Left Unilateral Extension


There was some recent discussion regarding the application of the Postural Restoration Institute model of treatment on Facebook recently, so I thought I’d put this up to show how quickly changes can be made in alignment and, in this case, symptoms. (for anyone concerned, I did get permission from the patient to use his photos)

The patient’s symptoms were of lower back pain and left posterior leg pain.

Significant initial findings:

Painful limited toe touch
Left hip IR 20, ER 60
Right hip IR 40, ER 30
Positive Ober left
Negative Thomas test left
limited SLR left
Weak right hip ER
Weak left hip adduction

Here’s the initial photo:









Testing indicates that the patient is in a left extension pattern (AKA Left AIC in PRI terms)

90/90 hip lift w/right arm reach and balloon
Left hip respiratory adductor pullback
Right glute max

Immediately after exercises (total treatment time ~10 minutes):

Full pain-free toe touch
Normal Ober test
Normal left hip IR
Normal SLR

Here’e what he looked like after:









If there is an example of a classic unilateral extension pattern, this was it. Are there other approaches that could achieve the same result? Absolutely. This is merely an example of applying the PRI model. This patient still has some work to do, but this was an excellent start.


Please note: I reserve the right to delete comments that are offensive or off-topic.

  • Great article Bill. As an personal trainer and osteopathic student in Sweden, this is extremely interesting for me because no one really seem to work with it, and therefore it’s difficult to learn these skills. Can you provide links or name on resources where I could learn/read more on this?


  • Andy

    Hey Leon,

    Here is the link for the Postural Rehabilitation Institute, not sure if they do oversee’s events, as they do not come to Canada that Im aware if of. Although they do have a home study option for a couple of their courses.


  • Hi Andy,

    Thanks for the link. Hopefully the home study option can give me the tools to get started.


    • The two foundational courses will allow you to help a lot of people.

  • Thanks!