So, you may have seen or heard me refer to corrective exercise previously and maybe said I am doing a PT session with a corrective exercise client. You probably weren’t sure what that meant. Often referred to as Postural Analysis and Corrective Exercise or (Functional) Movement Screening and Corrective Exercise. It is a process of Static (stationary) posture assessment and dynamic (movement) posture assessment followed by a programme of exercises to correct imbalances/weaknesses that have been highlighted in the assessment process. Often it is aimed at fairly active people such as athletes/sports people that are prone to injury or feel restricted in their movement. And therefore, the movement assessments used are usually through a large range of movement such as a deep overhead squat.
However, for many people with injuries these movements are totally unrealistic and unnecessary as it is not a movement they are ever likely to do. A sit to stand exercise is however a reasonable assessment of an everyday movement as is going up and down a step which is more functional for most people than doing a lunge. Just watching a client walk or run will also tell us a lot about muscle imbalances and often explain a foot, ankle, knee or hip pain; which may even be the result of an imbalance in the back muscles. For the upper body a row type pulling exercise can tell us a lot about how the upper body functions.
Once we have the information that observing static
and dynamic posture of a client gives us we can work out an exercise routine to address the imbalances/ weaknesses that have been highlighted. Often these exercises may initially be based around doing these same assessment movements in the correct manner. This may be as simple as moving a person’s feet to a better position and getting them to practice the movement in that position. However it maybe slightly more complicated to get them to use the right muscles for the movement they are trying to perform.
We will use the sit to stand again.
We have all seen the person who when getting out of a chair pulls them self up on the arm or places their hands on their thighs and pushes down on the legs they are at the same time trying to push up with, and then they are left in a bent over position and then have to straighten up their back. This is a classic example of someone not using their gluteal(bottom) muscles and is very common. This is a group of quite large and very powerful muscles whose main function in life is to straighten us up from a flexed (bent) position at the hip such as when we are seated or squatting. They also do quite a few other things but together with the hamstring muscles hip extension is a major function. Simply teaching a person to keep their shoulders above their knees and push their hips up and forward as they stand makes this difficult task for some become much easier.
We will use the row (pull towards).
There is a heavy box on the table or kitchen side, you pull it towards you to lift it off the side and carry it to somewhere else. As you pull it in to your chest or waist do your shoulders come up and your back round a little, perhaps your head and neck also come forward. All of which puts a huge strain on your neck, back and your balance. What we need is to keep our shoulders back and down by pulling our shoulder blades back and together to create a position of strength and balance. Using our Rhomboid and lower trapezius muscles to put our shoulders in a position that uses our large and powerful Lat (Latissimus Dorsi) muscles properly. Practicing this exercise will make all lifting exercises easier, and also improve general posture.
(to view the row exercise click here)
Once we have the basics of good posture correct, we can then work on developing more advanced movements.
So, in the case of a dancer I am working with she needs to be able to jump/leap in the air but still using the right muscles to do it effectively, efficiently, safely with minimal risk of further injury.
In the case of a runner with back problems we have had to work on exercises to improve his general posture and correct his running posture/stance so that there isn’t the same stress on his lower back.
Corrective Exercise is about re-educating the individual and their body to move in the way it should, and I say re-educate because as children we will generally learn to do most of these movements naturally, but poor habits overtime alter our posture which alters our movements, which leads to pain.
Once posture and movement is corrected the client should be aware of good movement patterns and how to incorporate them in to all their movements whether they are activities of daily living or performing in high level competition.