Optimal Movement: The Truth About Corrective Exercise

Part 1 of the “Optimal Movement Series” discussed several reasons why it’s so important to have an assessment process in place and identified a few ways in which structural changes will influence movement. If you missed that, you can check it out here: Structural Adaptations: Not Just a Hockey Problem

Today we’ll continue the discussion by delving into the topic of corrective exercise, what it means and when it’s appropriate to use.

The Truth About Corrective Exercise

I first started hearing the term “corrective exercise” about 7 years ago. Typically, it’s used within the context of basic mobility exercises or lower level stability exercises thought to help restore balance in mobility and stability across joints and improve “awareness” to ultimately improve movement quality. The general rationale here was to take exercises used in the rehabilitation of certain injuries, and integrate them into training programs in a pre-emptive effort to help minimize the risk of these injuries ever occurring. This made sense to me then, and still makes sense to me now, to an extent.

One thing that has become more clear to me as I’ve had opportunities to attend FMS, PRI, and DNS courses, among others, is that in order for something to be truly “corrective”, there needs to be some sort of test or “audit”. In other words, if you’re telling someone to do an exercise to “correct” something, how do you know if it’s working? Thinking in this way has really changed the way I think about the entire training process (as I’ll discuss more in a future piece).

As an example, if you’re familiar with the FMS Active Straight Leg Raise test, you know that the test is scored as a 3, 2, or 1 depending on how high the individual can raise his/her leg while maintaining the specified alignment or a “0” if the individual has pain. These zones are separated by measuring the distance between the ASIS of the hip and the mid-patella, and then marking half of that distance (roughly the mid thigh). Anything above the midpoint is a “3”, anything between the midpoint and the mid-patella is a “2”, and anything below the mid-patella is a “1”. If it’s painful, it’s a “0”.  As a general rule, the desired goal here is to get “2’s” on both sides.

Active Straight Leg Raise

Active Straight Leg Raise

 If, for example, someone had a “1’s” on both sides, and you integrated a Supported Single-Leg Lowering exercise into their program as a means of helping them achieve 2’s on both sides, this could appropriately be called a “corrective exercise”. You have a test, and you’re programming a specific exercise to improve a quality that you can then assess the effectiveness of by retesting.

Band-Supported Single-Leg Lowering

Band-Supported Single-Leg Lowering

 As another example, I’ve seen a good number of people that have a limited Adduction Drop Test (see video below) on the left, that also have less Active Straight Leg Raise motion on the left compared to the right. This is likely because of the position of their pelvis, which is oriented to the right and forwardly tipped on the left, placing the left hamstring complex under tension.

PRI Pelvis

A picture taken from PRI illustrating the pelvic position most humans gravitate towards

 In this situation, a Left Adductor Pullback may be sufficient to reorient the pelvis to a more neutral position, which would then clear the Adduction Drop Test AND the discrepancy in Active Straight Leg Raise.

 These examples highlight two situations where exercises are being used to correct a pattern. Importantly, the goal here is to now integrate the newly acquired function (be it mobility, stability or both in nature) into more “functional” or capacity-based exercise. For example, once we’ve established a reasonable amount of symmetry within an Active Straight Leg Raise pattern, we have a green light to progress to double- and single-leg loaded hip hinge variations (e.g. trap bar deadlifts, 1-leg stiff-legged deadlifts, etc.), and if appropriate for the individual’s training goals, more explosive movements within this pattern, such as broad jumps, kettlebell swings, hang cleans, etc.  These are just a few examples; obviously there are other factors that need to be accounted for in exercise selection, but the idea is to progress beyond corrective work.

This idea of Assess -> Correct -> Reasses has a different end-goal, in most cases, than integrating exercises like glute bridges, miniband walks, front planks, etc. into programs. The latter can be considered more “activation” in nature, or really simply fall into the broader bucket of what I think of as core training. If you call any miniband walk a corrective exercise, the follow up question should be “corrective for what?” There may be an answer for that, depending on the athlete. Athletes that are well trained and have established a quality squat, deadlift, and single-leg patterns may do mini-band walks with the intent of activating the lateral hip musculature almost within the same context as a warm-up. In contrast, an athlete whose knees touch while squatting may benefit from the neuromuscular cuing that the band provides to engage the glutes and lateral hip musculature to maintain better alignment during the movement. One is warm-up; one is corrective.

The reality is that in most cases the goal is to do as little true “corrective” work as possible, and quickly progress to training that will enhance physical capacities (e.g. speed, power, strength, conditioning, etc.). In many instances, depending on the dysfunction, I think it should be a quick journey to individual-specific full training clearance. The waters get a little muddier when programming is attempting to counteract positions the athlete/client spends time in outside of the training facility.

It’s for this reason that I don’t think it’s a bad idea to continue incorporating exercises designed to be corrective on an ongoing basis. For example, having a guy that sits hunched over in front of a computer all day do a couple sets of glute bridges and thoracic spine rotations is unlikely to hurt, and very likely to help. If they continue to pass your reassessment, the exercises can be viewed as reinforcement, warm-up, activation, neuromuscular cuing, etc. If they aren’t passing the reassessment, then you have to consider (among other things):

  1. Does the corrective exercise actually work for THAT individual?
  2. Do you need to discuss alternative strategies for the positions/postures that individual spends the majority of their time in away from you?
  3. Do you accept that you may never “win” the corrective battle for a given individual, but continue to program specific corrective work in an attempt to “minimize the bad, and maximize the good”?

In the last year, I’ve heard a few people “in the industry” with whom I have a lot of respect dismiss the term “corrective exercise”, and I completely get it. Corrective exercise is being thrown around a lot, often to simply refer to low-level activation exercises, which may not be correcting anything. There are two major problems with this:

  1. If there is too large of a disconnect between corrective exercise and the individual’s functional activities, the correctives won’t stick.
  2. Some people in training professions get so caught up in trying to correct everything that they forget their job is to improve physical capacities.

As an example of both, sometimes range of motion is restricted as a protective mechanism if the individual doesn’t possess the stability/control or strength to own that range. In these (and many other) circumstances, strength training with traditional exercises may be the most corrective thing the person can do.

The important take homes here are that corrective exercise needs to be programmed to correct something, and there should be a way to assess whether it’s working or not. Corrective work doesn’t always need to be in the form of low level activation exercises, and not every low level activation exercise needs to be programmed with a corrective intent. As with every exercise in your program, you should ask yourself, “Why am I programming this exercise, and is it producing the intended results?”

In a couple days, I’ll be back with the third part of this series, “Individualizing Corrective Exercise and Movement in a Group Setting”. In the meantime, don’t forget to check out the Optimizing Movement DVD set, which you can get for a $20 discount until next Saturday (December 7th), as part of a special “Extended Black Friday Sale”. Click the link below for more information!

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To your success,

Kevin Neeld

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