Corrective exercises have become a popular training tool for many personal trainers in recent years, but do they work?
The corrective exercises are often found in programs in the movement preparation part of the workout, which I like to jokingly say is just a fancy way of saying the warm up. In fact it is a specific warm up, one that literally is intended to get your body prepared for movement. Some of the corrective exercises are basic stretches and activation exercises that manual therapists (I use the term manual therapist to refer to any of athletic therapist, chiropractor, massage therapist, osteopath, or physical therapist) have been using for years. Others are more integrated, born of functional training philosophies, such as the Functional Movement Screen.
I am actually a big fan of corrective exercises. Every client I see who has imperfect movement does them. In other words, all of my clients do them.
But do they work? It depends.
I believe there are three major factors that determine their effectiveness:
- Are you using an appropriate corrective exercise? I hope this is a widespread yes, but alas I don’t think it is. I won’t go too negative here, but if you are a trainer please honour yourself, your profession, and your clients by attending conferences, reading books and articles, and discussing training with other professionals.
- Are you coaching the exercise? I’m going to be blunt here: As an industry, trainers and manual therapists are failing at coaching and cueing exercise. Very often when I introduce a corrective exercise, the client tells me that they know how to do it. Depending on my mood that day, I either go ahead and demonstrate it anyhow, or I smile and ask them to show me. More often than not, what they show me is a very poor version of the exercise.
The reason continuing education is so important for trainers, is that sometimes great new ideas arise that call into question old ideas. When this happens, it’s nice to be in the know. I encountered an example of this when I saw a trainer using what I consider to be the wrong corrective exercise recently. The trainer asked me if there was a small rubber ball at the gym they could use to put between her client’s knees during a leg press to keep the knees from caving in (I’m not a fan of the leg press, but kept that to myself). I suggested that instead of the ball between the knees, that a band around the knees would be more effective. Intuitively the correction she was about to use makes sense – it would have held the body in the alignment she wanted throughout the movement. But consider the other possible outcome: The client will squeeze the ball to hold it in place. The muscles that will squeeze the ball are the same ones that bring the knees toward each other. So the ball trains the knees to continue to move in the direction she’s trying to fix.
What happens with a band around the knees instead? The band momentarily pulls the knees further into collapse which triggers a response from the brain to react to that pull by pushing against the band. The result is that the muscles get trained to initiate the desired alignment. That theory is called RNT or reactive neuromuscular training, and is a very effective way of not only setting up the alignment of the body, but also of training the muscles to provide the alignment so that they can do it on their own.
I think there are a few reasons for this:
- Most manual therapists only spend a few minutes demonstrating and coaching the exercises they give and then provides a one-pager featuring microscopic stick drawings of each exercise.
- People need to be coached through an exercise more than once to really get it, but often they only get one shot;
- People pick up exercises from magazines or websites and don’t quite catch the nuance of what they are doing;
- People attend bootcamps where the ratio of instructor to student is 25:1, so there is no time for proper coaching.
I’m sure there are more reasons. It’s really a big problem. Without proper cueing and instruction, it’s entirely possible that if the exercise is done poorly, it will instead encourage a dysfunctional movement. One exercise where I see this all the time is the bird dog. At least half of the clients I give bird dogs to tell me that they know how to do them. Fewer than 5% actually know how to do them. The purpose of a bird dog is to improve rotary core stability, to work on glute strength, and to work on lat strength. Yet more often than not, the bird dogs I see involve a lot of flailing. Now I’m not a linguist, but I’m pretty sure that there is no root commonality between the words flailing and stability. For those reading this who think they know how to do a bird dog, here’ s a video of how it should look. Note the distinct lack of flailing.
In some cases you can see it, but not always. Truthfully the most effective way to know if your client’s body is doing the exercise correctly is to ask.
“Where do you feel this?”
I find this is a particularly big problem with corrective exercises for the hips and shoulders.I shot a video that explains this and provides a few examples:
The key is that you have to understand what the exercise is supposed to be targeting. If it is not hitting that area as you would expect, try a couple of different ways to position it and to cue it. If that still doesn’t work, try a different exercise.
What should you do if you’re a patient or client and you’re not sure if you’re doing the exercise(s) you were given properly? Ask the person who recommended it where you should feel it. If that’s not where you’re feeling it, then let them know where you are feeling it the next time you see them. That should be enough to get them to
watch you do it and to get you on the right track – likely with some adjustments in form or cueing, or possibly with a different exercise.
Elsbeth Vaino is a personal trainer in Ottawa, Ontario, Canada.