Do corrective exercises work?
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 some movement dysfunction or limitation 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 them. Depending on my mood that day, I either go ahead and demonstrate it anyhow, or I try to contain my smile and ask them to show me. More often than not, what they show me is a very poor version of the exercise.
- The manual therapist only spends 5 minutes demonstrating and coaching 5 to 10 exercises 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 50:1, so there is no time for proper coaching.
- Is your client feeling the corrective exercise where they should? Let’s assume that you picked the right exercise, and you coached it properly. Does that guarantee it will be felt where it should? Absolutely not! The human body is an incredibly complex system with built-in redundancy. Virtually every movement you can do with the body has a primary muscle and at least one backup. The backup, is like the spare tire in your car: It is there when you need it, but it isn’t as good as the primary muscle. But unlike the spare tire, it’s not always easy to turn off the backup muscle and give control back to the main muscle. This is a common problem with corrective exercises. Your client may do it perfectly, but the backup muscle won’t let go. In this case, the corrective exercise is actually reinforcing the poor movement.
To get back on topic, the reason continuing education is so important for trainers, is that sometimes great new ideas arise that debunk 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 the wrong corrective exercise recently. The trainer asked me if there was a small rubber ball at the gym that they could use to put between their client’s knees during a leg press to keep them 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 was a much more appropriate correction. The correction she was about to use would have had the opposite effect that she was looking for: The muscles that squeeze the ball are the same ones that collapse the knees. Conversely, the band around the knees will temporarily force the knees further into collapse, but the body will sense that this new position is wrong and will send a message to resist the band – or move the knees apart. This super cool corrective exercise approach is called RNT or reactive neuromuscular training.
I think there are a few reasons for this:
I’m sure there are more reasons. It’s really a big problem. Without proper cueing and instruction, it’s entirely possible that the exercise given to correct a dysfunctional movement will encourage that dysfunctional movement if done poorly. 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.
Elsbeth Vaino is a personal trainer in Ottawa, Ontario, Canada.
