Proper footwear is one of the most important factors that must be addressed for a Postural Restoration program to be effective. Many people are unable to maintain a neutral pelvic and thoracic position despite the fact they are following PRI posture guidelines and regularly performing PRI exercises prescribed by their PT. Often, shoes that do not provide adequate support are to blame. Many people have feet that are too flat (pronated), or overly arched (supinated). Either of these conditions can negatively affect the success of a PRI program.
One of the main goals of any PRI program is to recruit the left adductor. Patients with either the left or both sides of their pelvis tipped forward will have a weak, inhibited left adductor. At the same time the right adductor will be overactive. PRI exercises are inherently designed to recruit (turn on) the left adductor while at the same time inhibit (i.e. turn off) the right adductor. Many people will be able to recruit their left adductor, but continue to overuse their right adductor. This is often compensation from faulty foot mechanics and improper shoe ware. When the right arch does not have enough support, the body will compensate by turning on the right adductor. Shoes with adequate support will allow the right adductor to shut off and allow a PRI program to be progressed effectively. For some individuals, even more supportive foot ware is not enough to keep the right adductor inhibited. Those individuals often require custom PRI orthotics.
Many of the current trends in shoe ware can quickly destroy a good PRI program. Barefoot walking or walking with flip flops or other non-supportive sandals makes it a challenge for a PRI therapist to successfully progress their program. High heels are also very destructive to a PRI program, as they promote back extensors, and inhibit abdominals. Many of the new shoe styles such as the “Free” or “Barefoot” type shoes have minimal to no support which promote the above mentioned muscle imbalances.
The PRI recommended shoe list is reviewed and updated annually to provide choices of shoes that promote a neutral pelvis and ultimately a successful PRI program. When you shop for shoes, try to find something off this list. Not every shoe off this list will be good for everyone, but there are enough choices that anyone should be able to find a comfortable, supportive shoe. You will find this list posted on Specialized Physical Therapy's website.