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23 January 2019

CORRECTIVE EXERCISE, HYPE & HYSTERIA?

by Jacob Schepis 0

Recent years have seen a rise in the popularity and thus implementation of corrective exercises. It’s no surprise that due to the decrease in activity levels and prevalence of sedentary lifestyles in modern society, that many individual’s movement

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A critical appraisal of corrective exercise

Recent years have seen a rise in the popularity and thus implementation of corrective exercises. It’s no surprise that due to the decrease in activity levels and prevalence of sedentary lifestyles in modern society, that many individual’s movement is sub-optimal and it isn’t uncommon to see folk struggle to function correctly in everyday life or in the gym. Moreover, many athletes and serious lifters fail to appreciate the importance of technique on multi joint lifts, use loads that exceed their ability levels and end up in pain and reaching frustrating plateaus in their performance.

When these ‘issues’ arise, intervention is often the first point of call for coaches, and ‘corrective exercises’ have been a knight in shining armor for many.

But what qualifies an exercise to be corrective?

How do we know that these ‘corrections’ are indeed necessary?

And most importantly, are they as beneficial as what we really think?

THE PURPOSE OF ‘CORRECTIVE’ EXERCISES.

Now, as the name suggests, corrective exercises are designed to ‘correct’ issues relating to movement. Whilst the terminology has been heavily debated of late, I’m inclined to concern myself with terminology and semantics only so far is it benefits practitioners. And I think the use of the term ‘corrective’ is just fine, given that it implies improvement from ‘incorrect’ or ‘wrong’ movement, which generally requires addressing issues related to movement.

The issues relating to movement that will require intervention will be on or more of the following:

1. Joint function – mobility and stability

2. Neuromuscular activation of a muscle

2. Skill acquisition (strength: control of mobility and stability factors and position of bones)

3. Load management – stress distribution across joints/tissue(s).

SO WHAT MAKES AN EXERCISE ‘CORRECTIVE’?

As mentioned above, corrective exercises generally aim to help activate a specific muscle, improve range of motion or stability at a joint, increasing awareness and control of a specific joint or the relationship between a number of joint(s). These exercises are often movements that are isolating a single muscle or joint, meaning they are very basic, simple and regressed from more complex difficult movement patterns whereby a greater number of joints and muscles are at play. Simply put, corrective exercise is aimed at isolating a joint to address any issues before the joint is integrated back into more complex, demanding exercises. For this reason, corrective exercise has commonly been employed in rehabilitation, prehab and warm ups.

An example of a ‘corrective’ exercise is the dead bug aiming to teach awareness and function of the anterior core to prevent excessive extension of the lumbar spine and pelvis. A common intervention for individuals who experience back pain when squatting.

But what differentiates the dead bug and a cable crunch?

DEAD BUG

CABLE CRUNCH

Both train the core’.

Both isolate the ‘core musculature’ and

Both can improve awareness, control and strength of the core.

The obvious difference is that the dead bug is training anti-extension of the spine and the cable crunch training spinal flexion, generally using greater loads. But as you can see, there are a number of similarities between the two.

So, could not the cable crunch also be an effective tool in correcting a movement a deficiency in the squat if it:

  • Improves awareness and control of the rib:pelvis;
  • Strengthens the muscles of the ‘core’;
  • Improves performance in the squat

If so, is it not then a corrective exercise?

Why is it that dead bugs fit under the umbrella of corrective and a cable crunch does not?

What is the criteria for an exercise to be corrective and who is making this sh** up?

And most importantly, are these highly regressed exercises really effective in eliciting a training effect that has immediate and real transfer into high force output training such as squatting, benching and deadlifting at near maximal loads?

I’m not arguing that the cable crunch is inherently better than the dead bug, nor am I saying that they are the same thing and I’ve also seen first-hand the immediate improvements that corrective exercise has to offer in alleviating discomfort and pain and improving movement quality in my athletes on the gym floor.

But I’m not yet convinced that corrective exercises are all they are hyped up to be…

UNDERSTANDING THE ROLE OF ‘CORRECTIVE EXERCISES’

One of the most fundamental characteristics of a ‘great’ coach or practitioner is not only what they do, but their rationale for doing it. A critical element of movement is having the competency, requisite knowledge and qualifications to diagnose and accurately identify what it is the needs to be corrected, and personal trainers, S&C coaches and exercise scientists are certainly not qualified to do such.

In fact, to my knowledge in the context of diagnosing structural and functional issues is outside the scope of practice for most coaches as their role primarily to facilitate rehab/prehab programs instructed by a qualified professional such as a physiotherapist.

I digress…

As with any topic, the ability able to regurgitate the right answers is all well and good, but knowing how to get the right answer and understanding why it’s right in the first place is equally as important.

This is why it is crucial to think critically about the concept of corrective exercise as the definition, categorization and utility of these interventions are vague, poorly applied and widely misunderstood.

It’s important to remember that everything is on a continuum, all of the time, including exercise and movement. Humans have a knack of thinking dichotomously, it’s how we make sense of things with little cognitive effort. However, unfortunately for those less inclined to exert a mental sweat, biology isn’t black and white. Biology and everything within it, including human movement, is governed by continuum’s and shades of grey.

COMPLEXITY CONTINUUM

As it relates to the health and fitness or strength and conditioning fields, there are far too many coaches and individuals thinking categorically, not incrementally and corrective exercise is yet another example of this.

Instead of thinking of exercise as ‘corrective’ or just ‘exercise’, coaches should be viewing movement as more or less difficult and complex and using this conceptual understanding to provide a framework to appropriately address issues with their clients and athlete’s movement.

In my humble opinion, the utility of and necessity for ‘corrective’ exercises isn’t as great as what many believe them to be and why classification of what constitutes ‘corrective’ is difficult.

Why?

Well, all exercise fits on a complexity continuum, and ‘corrective exercises’ are merely regressions of complex motor patterns as seen in the above graphic, and in many cases we simply don’t need to regress as much as we think.

Especially given that these interventions are often used specifically to help improve movement in very, very basic patterns such as a squat, bench press or deadlift. Seriously, at a gross level of complexity, the exercises we perform in the gym just aren’t that complicated. Compare say a deadlift to throwing a baseball or kicking a football, night and day difference right?

Whilst corrective exercises may have their place in any training program, and again especially when managing serious injuries, I seriously question the magnitude of their utility in the context of resistance training for strength and physique development.

Sure, movement will need to be regressed at times, and most definitely in rehab settings corrective interventions are required, but in most cases, coaches and trainers have become fanatical in implementing ‘corrective’ interventions and erroneously resort to them at the first sign of poor movement or report of pain…

THE NECESSITY AND UTILITY OF ‘CORRECTIVE EXERCISES’

How necessary corrective exercises are is highly dependent on the skill and knowledge of the coach.

If an exercise can be:

– Taught effectively and efficiently;
– Exercises are selected in accordance with the clients/athlete’s ability/tolerance;
– Loads are managed diligently;
– When necessary, the exercise is modified to account for the individual’s orthopaedic profile; and
– The movement patterns progressed at an appropriate rate.

Then the need for highly regressed ‘corrective’ exercises is all but negated.

That’s not to say movement will be progressed in a linear fashion, as what we typically see is that when a certain load threshold is met, often movement breaks down and the load exceeds the tissues tolerance and regression is required.

But instantly regressing all the way down the complexity movement is usually a fool’s errand.

Moreover, a huge issue is that when coaches implement ‘corrective exercises’ there is an inherent degree of difficulty in determining the magnitude of the theorized benefit in improving the client/athletes targeted movement. When it comes to assessing ‘change’ or ‘improvement’ (the primary purpose of corrective exercises) the more variables at play and the more time lapses, the more difficult it is to determine cause and effect. Is it the fact the intervention was implemented that improved the individual’s movement, was it the refinements and adjustments in technique or the fact that they checked their ego at the door and regressed load that led to the dissipation of pain and enhancement in their performance?

And to add to the aforementioned issues, an important consideration is what the potential cost of regression is and will regression in fact assist the athlete/client in getting to a specific end point and goal as it relates to movement.

I don’t know and neither do most coaches…

IN CLOSING:

My advice to any coaches looking to boost their client outcomes is not to use band aids. Eventually, they get all soggy, fall off and something else needs to replace it to mask the wound. Instead, look to fix the wound itself, and there is no better way to develop resilient lifters than to get them strong at the movements they want and need to perform as part of their program.

Oh, and before I leave you all, in every corner of the fitness industry, there are guru’s. You know, those folk who create a problem, have a system for finding the problem, and then sell you the solution for 3 easy installments of $99.99…. Say no to guru’s…

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