PRI Postural Restoration — Briefing & Action Plan

• Breath pattern: Upper chest + clavicle elevation + lower rib flare on inhale → pure accessory-muscle inhalation, complete loss of Zone of Apposition
• Asymmetry: None — symmetric bilateral pattern. Rules out Left AIC overlay. Bilateral resistance training has suppressed natural lateralisation.
• Lower Crossed confirmed: Tight hip flexors, low back stiffness after sitting, restricted hip extension
• Upper Crossed confirmed: Forward head, winged scapula, rhomboid strain, limited shoulder flexion / overhead reach (added 28 May — significant downstream progression of PEC into scapulohumeral mechanics)
• Sleep-disordered breathing flag: Snoring on supine sleep — positional OSA risk to evaluate
• Absent symptoms (also diagnostic): No tension headaches / TMJ / jaw clenching → cervico-mandibular system contained. No air hunger / sighing → sympathetic arousal not extreme. No knee / foot / arch issues → distal kinetic chain still compensating; you have a finite window before downstream cascade.
• Posture load: Sit-stand desk, mixed. Moderate hip-flexor exposure.
• Primary perpetuator: Heavy bilateral resistance training (valsalva bracing, OHP arch, scapular retraction patterns) entrenches PEC over years.

The single highest-leverage intervention for your entire pattern. Your six symptoms have one mechanical root: failed diaphragm descent and loss of Zone of Apposition. Restoring ZOA collapses the downstream cascade automatically. Aggressive daily protocol below is calibrated for fastest possible correction given heavy resistance-training context.

Compliance > Complexity. 5 simple exercises done 3× daily for 21 days beat 15 exercises done once a week. Build the daily habit first; refine technique with Tim.

• Vertical push (handstand / pseudo-planche push-up): Drop entirely until shoulder mobility restores. Sub: ring rows + push-up plus (focus on scapular protraction at top, no rib flare).
• Vertical pull (assisted one-arm chin): Keep but add scapular pull-ups (hanging shrug-down) as warmup. Don't shrug into the top.
• Horizontal push (pseudo-planche push-up): Keep, but film from the side. Stop the set the moment you see rib flare or lumbar arch.
• Horizontal pull (rows, tuck lever): Keep as-is. This is anti-PEC work — serratus + lower trap.
• Legs push (pistol / one-leg squat): Pre-load 2 sets of clamshells + glute bridges before pistols. Cue: drive heel down, hip back into space.
• Legs pull (Nordic curl): Keep but cue: pelvis tucked under, glutes squeezed, ribs over pelvis throughout. If you can't hold that, regress to good-mornings or hip thrusts until pelvis-neutral is reliable.

✓ Best for you: Left side-lying with pillow between knees

Reduces airway collapse (no snoring), supports cardiac/lymphatic drainage, doesn't disrupt sleep. Pillow between knees keeps hips/pelvis stacked and prevents the top leg from twisting your lumbar. This is your primary recommendation. Optional: hug a body pillow against your chest to keep top arm supported and prevent unconscious rolling to prone.

📷 See clear position diagrams: Sleep Foundation — Best position for lower back pain · Mayo Clinic — Sleeping positions that reduce back pain

⚠ Supine with pillow under knees — optimal for lumbar, NOT recommended for you

Knee pillow tilts pelvis posteriorly and reduces lumbar lordosis. However: your snoring on back indicates this position causes airway collapse. Only return to supine after a sleep study clears positional OSA risk (or after positional therapy with a vibrating wedge/Night Shift device). For now: skip supine entirely.

✗ Avoid — Prone (stomach)

Locks lumbar into hyperextension for 7+ hours and forces head rotation (cervical strain). Worst position for your pattern. If you wake up in this position, train yourself out of it: hug a body pillow against your chest (prevents rolling), use a sleep tracker with positional alarm (Somnox, Apple Watch sleep settings, or a tennis ball sewn into pyjama back as the old-school trick).

Conor Harris explains this better than any text can. Watch the video below — it shows exactly what rib flare looks like and how to fix it. Two minutes:

▶ Conor Harris — How To Fix Rib Flare With This 1 Powerful Exercise

📖 Deep-dive reading from Conor Harris: The Best Posture-Fixing Guide On The Internet · The Massively Underrated Role Of Breathing In Posture · The No B.S. Guide To Anterior Pelvic Tilt

1. "Can you assess my current ZOA position with a Hruska Adduction Lift Test (or your preferred test) and tell me where I sit on the spectrum?" — establishes baseline.
2. "Which 3–5 home exercises will give me the highest yield in the first 14 days?" — calibrates the daily protocol.
3. "What exhalation pattern do you want me to lock in — 4-2-8, 4-1-8, or something else?" — gets his preferred breath cadence.
4. "What cues do you want me to use when bracing under load on squat, deadlift, bench — so I'm not reinforcing PEC every training session?" — most important question. The training is the perpetuator.
5. "Can you assess my scapulohumeral rhythm and tell me what's driving the limited overhead reach — pec minor, lats, T-spine, or all three? And how do I structure shoulder mobility work alongside the ZOA protocol?" — addresses the shoulder limitation specifically. Get a wall-test baseline measurement.
6. "How do I actually find 'ribs stacked over pelvis' in real time? Can you give me a tactile cue — hand placements, mirror check, or specific feel — so I can self-correct throughout the day without overthinking?" — addresses the recalibration problem. The concept is alien; needs a kinesthetic anchor, not just a mental cue.
7. "My deep core feels disconnected — rounded belly, can't reliably 'switch on' TVA and internal obliques. How do you teach the right baseline tone (not full valsalva), and what's the test that tells me I've got it?" — addresses the bracing confusion. Ask him to demonstrate the cough-test or his preferred wake-up cue.
8. "My glutes are underdeveloped despite regular glute bridges + calisthenics work. Is it the chronic anterior tilt inhibiting them, my recruitment pattern, or volume? What activation drills do you want me running before pistols and deadlifts?" — addresses the glute amnesia. Confirms whether to pulse vs sustain glute tension, plus glute-med-specific drills.
9. "Sitting and standing — where should the weight sit on the sit bones, how active should my posterior pelvic tilt be, and how do I know I'm not over-cueing?" — the daily-life calibration question. Get the 70/30 rule confirmed or refined.
10. "Realistic timeline — when should I expect visible rib-flare reduction, hip-flexor release, and the rounded belly to recede?" — anchors expectations. Note the belly shape question specifically — TVA tone + ZOA + pelvic neutral should resolve it without abdominal training.
11. "Should I pair you (PRT/movement) with Dr. Courtney Sullivan, PT for the insurance-billable clinical side? Or do you recommend a different PT?" — splits movement vs PT efficiently.
12. "What am I doing in my current training (both barbell and Jack Woods calisthenics) that's making this worse?" — gets the specific Stop-Doing list across both training modalities.
13. "What's the maintenance protocol once we hit baseline ZOA — and how do I prevent regression?" — long-term plan.