The 90-90 with hip shift is one of the Postural Restoration Institute’s basic techniques used to reposition a forwardly rotated left hemi-pelvis. It is one of five repositioning techniques included in the Myokinematic Restoration manual. This technique is best used for classic Left AIC patterned people because it is designed to reposition the left hemi-pelvis only. This is not something you’d generally use with PEC people, who have both sides of their pelvis rotated forward.

The goal of this exercise is to reposition the pelvis of a Left AIC patterned individual. This means that we will pull the left hemi-pelvis backwards (posteriorly) out of its anteriorly rotated position and into a more neutral resting position.

The Supine 90/90 with hip shift will facilitate:

1. Left Hamstring
2. Left Internal Obliques and Rectus Abdominus

And inhibit:

1. Left psoas
2. Lower back muscles

Keep in mind, you may actually accomplish a lot more than what I just listed with this technique. It is possible to not only turn off the Left AIC pattern, but also to inhibit the Right BC pattern and the neck pattern as well. I would say this is not the norm, however. It depends on the individual that you are working with.

All PRI exercises are designed to both activate certain muscles and inhibit others. The inhibition aspect is generally thought of as the more important of the two, the reason being that it is overactive chains of muscles that are holding us in certain positions.

When doing PRI, keep this in mind: activation is easier than inhibition. Inhibiting an over-active muscle chain is harder than facilitating an under-active muscle chain.

So when a technique doesn’t work, it’s usually an issue of unsuccessful inhibition rather than unsuccessful activation. This requires a paradigm shift for most trainers. As trainers, we are in the mindset of muscle activation. But PRI is heavily about turning “off” muscles, otherwise the exercises won’t succeed.

Whenever a technique doesn’t work, my mind immediately thinks “what muscle won’t turn off” rather than “what muscle won’t turn on”.

Also, as the exercises get more challenging, the individual will likely fall back on old inefficient movement patterns to accomplish the exercise. This is undesirable since in the process they will be activating the muscle chains we are trying to shut off.

In the case of a Left AIC patterned individual (the majority of people), it is overactive hip flexors, primarily the left psoas, that is holding the left hemi-pelvis forward. Thus, the left psoas must be inhibited, and the best position to do this is in the supine 90/90 position. This explains why repositioning techniques are generally done in supine on the floor.

Some important points about this exercise:

When lifting your hip up off the ground, it is important to not lift so high that your lower back loses contact with the surface.

Keep the lower back in contact with the ground while you inhale and exhale. This is hugely important. In fact, you can reposition a pelvis without even putting the feet up on the wall if you can get the individual to go through the breathing process without losing contact with the ground. Many people will try to arch their lower back as they inhale due to their dysfunctional breathing patterns. Arching a lower back during inhalation is “extension”. This extension will not enable a hip flexor to shut off. You can activate a left hamstring all day long, but the left pelvis won’t budge if you can’t shut off the hip flexor.

Don’t push into the wall with the left foot. Pushing into the wall will turn on hip flexors. Instead, you want to pull down through your heel (without letting the heel move). You are essentially performing an isometric left hamstring curl.

Inhale gently through your nose, exhale more forcefully through your mouth, and make the exhalation twice as long as your inhalation. But don’t blow your air out by turning on your neck muscles. Neck muscles should stay relaxed. You can think along the lines of “sighing” all your air out. Some people keep their lips too closed to get effective exhalation, others open their whole mouth and you see their cheeks flutter. You’ll see a lot of odd breathing styles. The goal is to get the air “out”.

When this technique doesn’t work on someone, it’s usually a breathing issue. They are either arching their back, and thus keeping the hip flexors turned on, or not exhaling fully. Usually it’s both.