Personal Fitness Professional Summer 2022

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ASK THE EXPERTS: PHYSICAL THERAPY By Dr. Meredith Butulis

MeredithButulis.com

Ask the Experts: Physical Therapy Why does corrective exercise fall short of client goals?

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s fitness professionals, we are taught that corrective exercise improves movement safety leading to fewer client injuries. Have you ever stopped to ask yourself if this represents the whole truth? The truth is corrective exercise often falls short of clients’ goals. Now let’s dive into 3 big reasons why, and how to bridge the gap.

Myth #1: Corrective exercise fixes movement Corrective exercise typically focuses on one joint or muscle at a time. For example, calf stretching increases ankle dorsiflexion. Bridges activate the gluteus maximus. We spend time on the corrective exercises, yet we don’t see a difference in the client’s movement in the workout that follows. Their bodies rebound to their previous movement habits. Why do clients continue to demonstrate previous movement habits, even after doing corrective exercise? Complex movement is dependent on neuromuscular control (how well the nervous system coordinates the movement). Neuromuscular control depends on how the brain organizes input from the nerve endings in joints, ligaments, tendons, muscles, fascia and skin, to create movement output. This means that you must first recognize that a client’s form is speed and load dependent, and then coach clients for nervous system integration. For example, a back squat, front squat and overhead squat all have different technique. The technique changes based on the load. Because of this, the alignment cues, muscle activation cues and timing cues are all completely different for each situation. Being sensitive to load and speed variations will help you hone in on which cues to provide for the basic kinetic chain check points (ankle, knee, hip, shoulder and head alignment). After embracing form variations, we need to find cues that lead to clients exhibiting changed performance. Cueing options include:  Verbal: What you say to the client.  Tactile: How you use your hands or external objects like bands, balls or rollers to promote proper alignment or muscle activation.  Visual: Feedback that the client takes in through his/her eyes, such as looking in the mirror, or watching a video of his/her movement.  Environmental: How you set the physical space for movement success. Environmental setup is one of the most often overlooked, yet most valuable cueing methods. It allows clients to problem solve and create real movement learning, and many “aha” moments along the way. Environmental cueing is like motivational interviewing to help a

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client’s abilities naturally emerge; instead of telling the client what to do, you set up an environment that facilitates solutions.

Myth #2: Corrective exercise prevents injury Corrective exercise is designed to increase range of motion, muscle and connective tissue length, muscle activation and muscle strength. When these factors are not optimized for the workouts that follow, the deficits present injury risk factors. Injury, however, is multi-factorial. An injury prevention focus requires you, the coach, to address each factor. These factors fall into two categories: intrinsic (factors within the client’s body) and extrinsic (factors outside the client’s body). Here is a quick checklist you can use to audit your injury prevention coaching plan: