Over the past few years, a growing segment of our industry has become increasingly concerned with “corrective exercise”. Count me as somebody that’s seen the need and value of this growing trend. Not only have I learned and utilized corrective exercise systems with clients, I’ve also created what I believe will become recognized as the best corrective exercise system on the market. It’s safe to say that I’m a fan of correctives.
But conversely, my background and experience also makes me a critic in the whole corrective exercise conversation. I’ve seen amazing approaches and horrible approaches to correctives. Since I have personally witnessed the incredibly vital and transformative role of correctives in many of my client’s lives, my criticisms are rooted in the interest of seeing the great approaches prosper and the poor approaches go away.
One of the main problems associated with corrective exercise is the lack of a consensus definition. It’s hard to argue for, argue against, implement, discard, praise, navigate, understand, ponder, bash or create corrective exercise approaches when we don’t have an actual definition. Before I offer up my attempt at a definition for corrective exercise, let’s first lay out a general overview as to why the body compensates.
Our bodies were designed to naturally choose efficient actions and processes over inefficient ones. Understand that the normal, natural, unflawed mechanical state of the body is one that is remarkably efficient in orchestrating all sorts of movement complexities. Anyone of us that has experienced a short- or long-term symptom of back pain no longer take for granted how complex mundane tasks (walking, getting out of bed, climbing a set of stairs, sneezing, etc.) really are.
So most of us start off moving pretty well and then life happens. Due to overly stressful situations (trauma, injury, nutritional deficiencies, etc.), we acquire our first joint motion abnormality (JMA). One amazing design feature of the body is that it senses this movement flaw and begins using an adapted way of moving to avoid using or visiting the joint motion abnormality. It’s pretty amazing how we are built to do this and do it so automatically. An example of this would be that after we’ve stubbed a toe, we start limping. No need to attend limping classes with other recent toe-stubbers, the body just adapts for the JMA which was caused by trauma and we’re instantly limping around like we’re being paid to do so.
This adaptation is useful in the short-term because it is very effective at causing the body to avoid utilizing traumatized tissue that may need some time to heal.
But, long-term, it’s a problem. This adapted way of moving is commonly called compensatory movement and it is less efficient than the natural unimpeded manner in which we were “all” designed to move. Our physical performances (strength, stamina, balance, agility, coordination, etc.) decline. To make matters worse, once we are compensating, we begin developing imbalances which can lead to more JMA’s that cause us to layer our compensated movements. We become more and more inefficient, injury-prone, inflamed and in pain.
Defining “corrective exercise”
From this whole JMA->compensation->pain/injury/poor performance chain reaction discussion, can we pull out important pieces and create a definition for corrective exercise?
Normal, efficient movement
Joint motion abnormality(s) (JMA’s)
*strong aversion of the body to utilize this position
Adapted movement pattern (compensation)
*less efficient than normal movement but still preferred, by the CNS, over utilizing JMA’s
Higher risk of injury
Additional JMA’s more easily acquired
RESET’s definition of corrective exercise would be as follows:
“Corrective exercise is exercise that restores functionality to joint motion abnormalities, prioritized by most to least recently acquired, so that there is a diminished need for the body to compensate.”
I think it’s super important to note that the most recently acquired joint motion abnormality directly impacts how a person is presently compensating and should therefore be the primary aim of any practitioner claiming to be involved in corrective exercise. We can’t work on a 10-year old pattern until we’ve first dealt with the 2-year old, 6-year old and 9-year old pattern (for example).
Once we restore functionality to the most recently acquired joint motion abnormality, the reason behind a person’s current adapted manner of movement will be resolved. We are then free to uncover deeper and deeper joint motion abnormalities that comprise the complex root system of this tangled compensatory mess that most of us must use as our “posture/movement default setting”. Based on the consistently amazing results that I’ve seen with RESET, in comparison to other systems, I believe that this detangling aspect to be an absolute essential component of a world-class corrective exercise approach.
Here is RESET’s “9 Essential Components of a World-Class Corrective Exercise System”
1. It eschews Right/Left bodily comparisons.
Since nearly all of us are compensating, the idea of comprehensive joint neutrality (centration) isn’t a reality. Basically, most of our bodies can no longer find “true neutral”. Though it may look like it to our eyes (don’t trust those things – clothes, skin, fat, muscle and connective tissue all block our eyes from truly seeing what’s occurring at the joint level), realize that most of us are rarely in a “true neutral” position but instead are operating from an “apparent neutral” position (looks like we’re neutral but there are subtle joint displacements throughout the body which cause a variety of weaknesses/tightnesses throughout our joints).
Since we have no guarantee of “true neutral”, all Right to Left comparisons should be consider illogical and unreasonable. Trusting otherwise would be analogous to trusting a see-saw with an off-center fulcrum.
Common R:L comparisons in the industry are AROM (mobility), PROM (flexibility), strength, skill (think unloaded overhead squat and you’re watching for one or both knees to subjectively dive in too much. How much? You know, too much!). Due to joint displacement and the nearly countless ways for the body to adapt, these comparisons are invalid.
Instead of viewing the body as a R vs L proposition, begin seeking to identify patterns of movement that encourage efficiency (restoration) and patterns that encourage inefficiency (compensation) and begin “working” within that thought process.
2. It uses BASIC, SENSIBLE and REALITY-BASED foundational patterns (part A).
The RESET system uses four patterns. These patterns are based upon the concepts of pronation (deceleration), supination (acceleration) and the four obvious quadrants of the body (upper right & left, lower right & left). They also reflect the primal ways of moving that are “blueprinted” into us.
“Sit” – all quadrant pronation
“Stand” – all quadrant supination
“Right Step” – lower right & upper left pronation; lower left & upper right supination
“Left Step” – lower left & upper right pronation; lower right & upper left supination
If your current system utilizes more than or is divergent from these patterns, ask yourself this question “can my current ‘foundational patterns’ be broken down more simply into RESET’s common denominator patterns?”. If so, you should be able to see the value in keeping a broader perspective with the RESET patterns over your current patterns. If no was your answer, ask yourself a follow up question like this – “do my patterns make sense in light of how humans tend to move?”. I’m guessing the answer to that would be no.
3. Understands that confounding interpretations of ROM results exist.
In #1, we already covered how using R:L comparisons (whether it’s ROM, strength, skill, etc.) are illogical. Another reason to not use ROM assessment findings to plan a corrective strategy is that a joint lacking ROM tells you “how” but not “why”. A lack of ROM can come from at least 2 opposite causes.
a. Protective muscle guarding
b. The bones of the limited ROM joint are already approximated (not neutral to begin with)
These 2 ROM limitation causes are polar opposites. For example:
i. The pelvis is displaced into a very mild (unobservable to the eye) posterior tilt (hypertonic spinal flexors and hip extensors) resulting in a limitation of hip flexion.
ii. The pelvis is displaced into a very mild (unobservable to the eye) anterior tilt (hypertonic spinal extensors & hip flexors) resulting in already approximated hip flexion which looks like a hip flexion ROM limitation.
These are two polar opposite example scenarios which can each present themselves as limited hip flexion. These conflicting interpretations of ROM are why I believe that they are the most confounding tools in our industry.
Drop the ROM stuff as a guide and instead only use it as a pre- and post- corrective session validation of positive changes that you’re helping deliver.
4. It USES basic, sensible and reality-based foundational patterns (part B).
If your current approach doesn’t seek to view identified dysfunctions through the lens of movement patterns, much perspective can be lost. When perspective is lost, you might be zigging when you should be zagging. Consider the following example, if you aren’t viewing dysfunctions through a movement pattern “view finder”, you may think that “dysfunctional” R hip extension is THE problem when, in reality, R hip extension and all of it’s associated movements are encouraging inefficiency. This would make it a part of this clients’ current compensatory pattern. Doing R hip extension work for this person would actually encourage compensation.
Truly corrective exercise systems desperately need basic, sensible and reality-based foundational patterns to bring perspective to your observations.
5. Identifying and addressing the most recently acquired joint motion abnormality (JMA) is the key to truly corrective exercise.
Since the body’s acquisition of a JMA is the root cause behind an adapted or compensated way of moving, no system can rightly call itself “corrective” if it can not or does not accurately identify the body’s most recent JMA. Period.
*Accurately categorizing compensatory and restorative patterns of movement.
*Accurately identifying the JMA within the restorative pattern.
*Addressing the JMA and then checking your work to ensure positive outcomes were achieved.
Make sure your system identifies compensatory vs restorative patterns and that your system unquestionably finds the most recent JMA so that you can effectively address and check your corrective approach. This is exactly why I believe that most industry pro’s should and eventually will learn the RESET system.
6. Can your system draw out older JMA’s?
Unless you are content with your corrective approach spanning dozens of sessions for most of your clients (which you shouldn’t be – unethical and bad for business), you will want to be able to draw out older and older JMA’s to identify and address. It’s the proverbial peeling of the onion. All of your clients’ have their own unique mechanical history. You need to be able to accurately and sequentially draw out their story.
Develop methods that will allow a session to “keep going”. Or… learn the RESET system.
7. Corrective exercise should yield immediate change and “corrective homework” duration should be measured in hours.
If you are actually pinpointing each individuals’ most recently acquired JMA’s, part of the reward is the speed and brevity in which JMA’s return to normal functionality. Once you learn how to ensure that you’ve accurately found the most recent JMA, the corrective exercise piece only takes a matter of seconds to properly address the JMA. Seconds! It occurs so quickly because the body is very willing to utilize the position of the JMA once the appropriately chosen corrective exercise allows it to feel comfortable doing so.
On the other hand, if you think that you keep finding “difficult-to-resolve” faulty movements that require weeks and months of the same correctives, more than likely, it’s an indication that you are not identifying and addressing your clients’ JMA’s at all. Chances are that you have not cornered the market on all of the “difficult cases” out there. Be honest and realize that if you feel that you are seeing a lot of difficult cases, it’s probably telling you that your approach is very flawed. I’ve seen all kinds of cases (chronic pain, acute pain, disc herniations, tendonitis, plantarfasciitis, etc.) respond quickly and favorably to RESET and yet I’ve never had to ask anyone to do correctives for longer than a few hours after each session.
8. Assesses the individual – not the condition or the activity.
This mindset is displayed online incessantly and I’m sure you have seen it too. Articles with titles along the lines of: “5 hip mobility exercises that will make you run like a gazelle”, “Have a pain-free basketball season with these easy drills” or “Mobilize the lower thoracic region to clear up your neck pain” are ones that I’ve made up, but you get the idea. Now I’m not saying that the people that write these types of articles are saying anything specifically wrong or that they have never helped anyone with their approach. It’s quite possibly the opposite. They probably have helped some (but nowhere close to all) people with their approach and are now churning out articles for the masses.
Here’s why I think these articles aren’t very helpful and actually undermine truly corrective exercise approaches. A one size fits all approach definitely isn’t what true corrective exercise is about. Each person’s body has very specific needs and a very specific history of compensatory movement. These specific-to-the-sport/activity/condition articles display an obvious lack of understanding in terms of individualized needs. I’m sorry it’s impossible to write practical 1-page articles on corrective exercise that applies to all of us. Also, tailoring it to a condition or an activity is not even close to specific enough where it should be taken as advice by the masses. When an online fitness/rehab “expert’s” sure-fire approach doesn’t help a desperate for help person that could be helped by a solid, individualized approach, their trust and hope has been betrayed. The masses will begin (or maybe they already have begun) to tune out a sound corrective exercise message.
9. Amazing results should be commonplace.
As a corrective exercise professional, your approach should be very regularly delivering amazing results. I’m not talking about 10% or 50% of your clients either. I’m talking the vast majority of the clients that seek you out for corrective help should be walking away, after 1-5 sessions, with a pretty amazing story to tell others.
How can I say this? It’s exactly what I’ve been seeing for years with RESET. If a client is seeking you out for corrective help, they’ve probably already seen at least 1 medical doctor and/or PT that can rule out structural damage. Maybe they’ve already seen a Chiropractor whose area of expertise is restoring the proper structural positioning of joints. So unless the client coming in to see you has an undiagnosed structural issue or some undiagnosed inflammatory disease or a poor diet that’s causing very serious inflammatory response, YOU should be the one delivering knockout punch after knockout punch to these joint motion abnormalities that are causing compensation and some of your clients’ symptoms of pain. If you aren’t getting amazing results with an amazing high % of your clients with corrective exercise, again, it’s highly indicative that you aren’t really performing “corrective exercise”.
Take a very serious look at the first 8 items on this list and honestly ask yourself if your corrective exercise approach is measuring up. If it’s not, fix those aspects of your approach. Or… again, you really should consider learning RESET.