Is “Corrective” Exercise Necessary?

Is “Corrective Exercise” necessary?

By Matt Pack

CorrectiveArticlePicA simple, not easy program design strategy to help your clients move, feel and look better while at the same time alleviating pain and preventing injury.

I will argue that a balanced strength-training program mixed with soft tissue mobilization and a consistent individualized stretching/mobility program is all the correctives that you may need.

“If you’re not assessing, you’re just guessing.”

From the moment our clients walk in the door my staff and I are watching body language, gait, and a host of other things happening in the pre-hab and active warm up portions of our training sessions.

The session begins and we’re back at it. Assessing, coaching and cueing everyone, “chest up, knees out, double chin” etc…

I know I’m going against the grain here but I’m convinced that when someone has an injury or pain they don’t always need an individualized corrective exercise program or Physical Therapy session

When in doubt refer out…

Training around pain NOT injury is part of the job and I’m convinced with the system I’ll show you below you can not only effectively prevent injury but also rid yourself or clients of common aches and pains.

Who’s your “Tribe”?

I’m often asked whom we serve and treat and how we assess them.

In our case the majority of our clientele would be “general population” business owners and professionals between the ages of 35-60 yrs. old looking to lose body-fat and feel better.

They are like most of the population spending a large majority of their day in the seated position.

They drive to work seated.

They work at their desk seated.

They workout seated and then they repeat it all over again the next day.

This very common scenario will eventually take its toll on your health and body showing up in low back, hips, shoulder, neck, or knee pain or some with a combo of it all.

This clientele without fail will usually be “stuck in flexion” but not always and showing:

Tight pecs
Tight neck flexors (SCM and Scalene’s)
Tight Lats
Tight Hip Flexors
Tight rectus abdominals

Weak Serratus Anterior
Weak upper back
Weak lower traps
Weak low back
Weak Glutes
Weak hamstrings
Weak lower abdominals

They also but not always lack:

Ankle mobility
Hip mobility
Thoracic spine rotation
Thoracic spine ext.

The goal in designing this persons program would be to “open” up the anterior portion of the body and “wake up” and strengthen the posterior aspect of the body. It’s easier said than done but ultimately we want to do the opposite of what they show up with and not reinforce the dysfunction that they may already have.

Programming is a science no doubt but not rocket science and once you understand the human body, “assess” 10312enough moving people and know your population and niche it’s more common sense than anything else.

First things first…

I believe that all good coaches should be asking themselves questions like who, what and how.

Who’s my client?

What do they want?

And…

How can I get them there the fastest safest way possible while helping them move and feel better?

Who do you train? Do you really know the clientele that you are serving, who your niche actually is?

If not, there is a good chance you may not be helping them as much as you could. In order to truly help someone you should know everything about them. You should be an absolute expert in that particular population.

Is it a particular sport?

Bodybuilding?
Geriatric?
Woman?

What is this population’s ultimate goal?

Increased speed?
Increased muscle mass?
Improve bone density?
Lose body-fat?

How do they spend their day?

Are they seated?
Standing?
Desk ergonomics?
Night shift?

What are the common stress demands that they encounter?

Work stress, home stress?

Are they married?

Do they have children?

What are their eating and sleep habits and common choices and mistakes made?

Health history, medications?

What motivates this person?

To effectively communicate, engage and positively effect, you must know your clientele’s goal, lifestyle and personalities like the back of your hand.

Now for the fun part…

The Program Design

After answering some of these questions and knowing this person you can then begin choosing movement patterns from the following categories:

Upper Push-
Bi-Lateral vert/horizontal- Shoulder press/Push-up
Uni-Lateral Vert/horizontal- Single arm shoulder press/Single arm cable press

Upper Pull-

Bi-lateral vert/horizontal- Pull up or chin up/barbell bent over row
Uni-lateral vert/horizontal- Single arm”W” Cable Pulldown/Single are Db row

Lower body-

Squat and hinge-
Bi-lateral hip/quad dominant- Trap bar deadlift/Barbell Back Squat
Uni-lateral hip/quad dominant-One leg RDL/Step-up

There are literally hundreds of exercises you could plug in this formula above. You are truly only limited by your imagination.

Want to take it even further?

Rotational pattern’s– Presses, Pulls, Wood chops, Grappler, Med Ball
Crawl pattern’s– Contra-lateral, mult-directional, prone, supine, bear, crab etc…
MUT (movement under tension) – Loaded carries and walks (kb’s, sandbags, partner)
Core and “anti” core patterns– ab wheel roll outs, Paloff presses, Club Bell anti-flexion, anti-extension
Conditioning- sprint/hill work, battlerope, med ball slams, versa-climber, air-dyne etc…
Correctives– Blackburn mob’s, shin-box, halo’s, prone cobra, crab reach, scorpion reach’s etc…

Misc…

Tumbling– rolling patterns
Animal Flow– Traveling forms, flow patterns and sequences
Gymnastics– ring work and body-weight ie. Levers, planches, cart wheels, parralettes
Hand balancing– wall and free standing

A “traditional” strength program-

Pre-hab

SMR– Foam roll
SCAM (Stretch hip flexors, Core Four Matrix, “activate” Glutes and Mobilize Hips
Stick work
Active warm-up

A1 Trap bar deadlift– Hip dominant leg
A2 Flat bench Db – bi lateral horiz. Push
A3 DB renegade row- uni-lateral horizontal pull
B1 Bulgarian Split Squat– uni-lateral quad dominant leg
B2 Kb Push Press– bi-lateral vertical push
C1 Jungle Gym Skull Crusher– single joint isolation with abdominal component
C2 Jungle Gym Scarecrow– bi-lateral pull/lower trap work

An Un-conventional Training Program
Restoration/Conditioning session using a similar formula

Pre-hab

8 movements, 45s ON, 15s OFF 2min break and 4 rounds.

Rotational Lunge– transverse plane, uni-lateral, hip Dom w/mobility,
Loaded Front Step– Prone closed chain uni-lateral w/ thoracic ext and hip ext
Alt Tripod– supine close chain, uni-lateral w/hip ext (Glute activation), shoulder stability and thoracic rotation
Alt side kick through– prone, closed chain, uni-lateral w/ core stability, anterior sling activation and conditioning
Bicycles-supine, core stability
DB Halo– core stability, shoulder mobility
Static Beast- prone, closed chain, shoulder stability, core stability
Blackburn Mob– posterior chain activation w/ scapular mobility and humeral internal rotation

As you can see each one of these movements has a particular purpose for a desired outcome that tackled strength endurance, stability, mobility, dynamic flexibility or conditioning.

There should always be a rhyme and a reason for every movement chosen.

You can also see that this isn’t a typical session. This would be more of a restorative session with a conditioning component. In fact you could even program something like this for an off-day or active recovery session.

A client’s training program should be created with a “method to the madness” utilizing primarily movements/patterns taken from lists and categories’ such as these. This is a great system/template to organize a well-structured strength and conditioning program.

In my opinion the goal of the Fit Pro is first and foremost the client and creating smart and balanced programming.

Balanced to me means choosing more standing (open chain) and ground based (closed chain) movements utilizing a good mix of upper and lower body multi-planar and bi-lateral/unilateral patterns. We choose more “pulls” than “push’s”, more hip dominant vs. quad dominant and more unilateral vs. bilateral with the majority of movements performed from standing than sitting.

The main goal is simply to get people to stand up more and MOVE!

This programming not only gives them the training effect they are seeking but also a lot of what they “need” more of.

In most but not all cases an approach like this will inadvertently address imbalances or asymmetries subsequently alleviating if not eliminating all together most people’s common aches and pains.

It’s like magic and I’ve seen it time and time again.

Open or lengthen what’s short on the anterior chain.

Strengthen and activate the posterior chain.

Increase ROM and mobilize joints that are designed for mobility while stabilizing joints that are designed to be stable.

Mobile, Stable and fully able.

If it seems simple it’s because it really is.

The great thing about this approach is that it doesn’t take a two hour assessment a Physical Therapist or a “corrective exercise” program filled with Bird Dogs and balancing acts to address someone’s aches and pains.

Please don’t misunderstand me.

I’m not against Physical Therapy or any other screening or assessments you may be using. In fact we use the FMS and I have a great PT in our own facility and I’m sure she would agree that the large majority of what people are missing could be achieved by improving the quality of their tissue, increasing mobility and simply getting the person stronger.

Most people in our society are simply weak and sit too much.
It’s totally possible to give your clients “correctives”, a good training session and have some fun along with it.

It’s all in the design of the program. Think outside the box and you can improve multiple training qualities all at one time. A little creativity can go a long way.

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