Corrective Exercise Gone Too Far

I will be first to say that I am very pleased with the direction the fitness industry seems to be going. Im not talking about the craziness we see in the big box gyms with 18 year old juiced out kids acting as personal trainers. Im talking about the side of training that seems to be conscious of proper movement and have introduced many different methodologies of screening, assessing, and designing corrective exercise programs. Overall this is much better than what was going on 10 years ago.  Here is a scenario that I would get in my early years of training:

Client: “My lower back is really tight, I worked on my computer all weekend.”

Me: Oh man that sucks, let me stretch your lower back for you.

Client: Yeah that feels better…… Oh wait my lower back is pinching now..

Me: Oh, Ok Lets do some arms today then.

Client: OK, sounds good. Im so glad I hired you Danny, I would have just stayed home. Thanks for stretching me and killing my arms today…

I really wish I was joking, and that this scenario didn’t happen too many times to remember. If you are an old client, please forgive me, I truly am sorry.

Fast forward to what we are now seeing today in studios and trainers that focus on corrective exercise…….

Client: “My lower back is really tight, I worked on my computer all weekend.”

Corrective Exercise Trainer: hmmmm lets go and do a thorough screening procedure I learned over a weekend……… OK here is my diagnosis; your movement tells me that your glute medius isn’t firing on your left side which has caused a compensation and now your shoulder is rotating forward causing sheering forces along your spine. Your vertebrae are now rotating and causing severe pressure on your SI joint which is causing your pain. Furthermore your left ankle is not dorsiflexing at the correct angle and your right big toe is now shifted 3 degrees too far. I also notice that your left ear is bigger than your right ear which tells me you may have a neuromuscular imbalance. I think we should back off and focus on a corrective exercise program for the next few months. We will be primarily stretching you and doing stability drills till you are bored out of your mind, we will then have you practice these drills at home, and when you come in we will do some cool drills in half kneeling with bands, do some cool eye sight drills I read about, and if you are lucky I will let you press a light kettlebell next week. We can then get you on the path to earn the right to swing a kettlebell again. First you need to progress to hinging for about a week then can you start swinging……. possibly….  Sound good?”

I know this may be exaggerated, but in all honesty I have heard of this stuff happening and read the  blogs along these lines lecturing everyone on screening and movement. When I first did my 4 day CK-FMS certification 3 years ago I nearly fell into this trap. Nothing against the FMS, it is a great system, but you can leave there feeling like you have to refer every single one of your clients to a physical therapist, or feel like you have to spend 3 months fixing all of your clients with soft rolling and  half kneeling drills before someone can actually train. You come back on fire with your screening kit and a ton of corrective exercises that you are guaranteed to misapply for a long time. First, we are NOT Physical therapists, we are trainers. This doesn’t just go for the FMS, you can fill in the blank with any other protocol.

Earning the Right to….

These words are re-iterated tons of time in the corrective exercise world. Pretty much meaning; don’t do Y if you haven’t done X first. For the most part this holds true for lots of things. Don’t do Olympic Lifts if you have never squatted or pressed a bar before. Don’t snatch a kettlebell if you have a crappy swing, but sometimes things go too far.  I am all for making sure people are safe in training, and if you run a group training you don’t want to allow a total train wreck into your classes. I don’t care if you do Z-Health, FMS, or whatever form you may choose. If you are spending months rolling and doing pseudo physical therapy you are wasting your client’s money and probably should refer the client out. Don’t get me wrong I spend a good few sessions going over mobility, stretching, rolling, and some fundamental movement patterns especially with someone that comes to me with a laundry list of issues, but they should be training with load within a short period of time. I am sure I will get emails from the trainer that is going to tell me, well what if they had a stroke, and what about the client that suffers from___________. In generalities most people with some pretty crazy situations can be swinging a kettlebell within a few sessions. Many times strength training can fix numerous issues. I see way too many people stretching issues rather than working on strengthening. One of the best things I can do for someone is teach them how to squat and deadlift. We have numerous clients that have scored poorly on the FMS that thrive and get better in our classes. Sure we modify things for them and they focus on basic movements for a long time, but they are training, not doing pseudo physical therapy.

SOME BIG MYTHS

Touching the Toes and Swings

I have heard numerous times from trainers that you shouldn’t do swings with  clients until they can touch their toes, and that they need to earn the right to swing. Hands down, for the most part this is B.S. I have found that sometimes teaching the swing and the hinge is the best way to get clients to touch their toes. They understand how to shift weight into their hips and dynamically load their hamstrings while keeping the back strong. This goes for tons of different exercises.

Neck Packing and the Swing and Deadlift

This is another thing that has gone way too far. There are people that freak out if someone’s neck is 3 degrees up during a swing or deadlift. I hear them shouting from the roof tops, and condemning every trainer that would possibly allow an extended neck on these movements. Now let me explain, I don’t want clients staring up into the sky during a swing or deadlift, but the fact that I see trainers freaking out over this and over correcting  is ridiculous as well. Our necks do extend and  flex and it is silly to argue this point with minor variations. Sure, excessive flexion/extension under heavy load is not advisable, but to try and correct a 5 degree neck angle on swing is a waste of time. I don’t think having Franco Columbo look at the ground while deadlifting would have made him any stronger. Just saying…

If strength and movement lived in textbook.
FRANCO look down and pack your neck!!! You don’t know what you are doing!!!

 

 

 

 

 

 

 

 

 

 

This point is even more true under lighter loads and body weight exercises. If someone  slightly rounds their back on a body weight squat the world won’t end and a disc won’t immediately herniate.

There is no load and I am not worried about it. There are too many other things to worry about.

The Turkish Getup Debacle

Lay on your back. Pick up weight and stand up. The dogma around this exercise has completely ruined it for me. I actually didn’t do a getup for 6 months in complete protest, because I saw people flipping out on an instructor’s forum about how someone didn’t have the correct angle when doing a heavy get-up and 50 different comments with the need to coach every single movement. It turned into a moment from Dancing with the Stars where  the person was being judged for every move as if it was a talent contest. I fully understand the get-up can be a complex move that needs to be taken with care so that an injury won’t occur, but this isn’t ballet or synchronized dance! I want to punch a kitten when I hear this stuff (just kidding it isn’t the kitten’s fault). Sure I teach proper form and want to make sure that a few of the fundamentals are followed, but the snootiness with this exercise has gone overboard and it is counter productive.

Clifton Harski Getup:

Not everyone can have the style of Clifton Harski! He gets extra points for the amazing outfit!

Rolling and Crawling: 

First, I want to say that introducing rolling patterns and crawling to my client’s have been life changing for many of them. I had a young girl that was having some major movement issues practice crawling, and whatever switch was turned off turned back on in a short period of time.  She was able to strength train a short time after. How often does she crawl now? Occasionally as a small part of a workout or warmup in our classes, but again this is another time where the pendulum has swung too far. This whole thing of spending an entire workout crawling and rolling on the ground loses it’s intended benefit. I get the fact that our primal ancestors may have crawled on all fours millions of years ago, and that babies should crawl before walking, but we eventually stood up in both situations. Take home point, do some crawling, warm up, and start lifting heavy things, because our primal ancestors lifted lots of heavy things too, they didn’t just crawl around sniffing each other.

I understand that the pendulum can swing too far in either direction. The fad of high intensity training with tons of slop to further work capacity is one extreme, and stopping a movement because you need to take a goniometer out to measure joint angles is the other.

 

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7 Responses to Corrective Exercise Gone Too Far

  1. Mark Toomey says:

    Holy hell.

    “OK here is my diagnosis” Nail head-hit #1. We, as exercise professionals are not diagnosticians, we are exercise professionals. Want to get sued faster than you can say “Squat Rack”? Go ahead, diagnose. You diagnose, and you own the diagnosis…and the accompanying responsibilities for telling someone they had “sacral misalignment” when in fact they had an osteo-sarcoma.

    “You haven’t earned the right to…” Nail head-hit #2. None of us are Gray Cook. Hell, sometimes, I don’t even think Gray Cook is Gray Cook, he’s that smart, BUT you’re not Gray Cook. Tell me I haven’t “earned the right” to deadlift and guess what. I’ll go pay someone who’s a little more interested in me and a little less full of him(her)self.

    The Cult of the Get Up. Nail head-hit #3. Lay down…stand up…lay down…now do it with weight…safely. I’ll never forget the day I did a get up with a 48kg bell. A young guy came RUNNING across the room to tell me my right hip was 1/4 an inch higher than my left hip. “Yes, it was. I’m old, the weight is heavy and I have little pieces of metal in my body that weren’t there when I was born. Now go away and harass the guy over there doing the get up with a 12kg bell…and while you’re at it, tell that little kid in the corner there’s no Santa.”

    Toe-touching before swings. Nail head-hit #4. I guess all the overweight patients that get referred to me can’t experience the joy of athletic motion in the swing until they lose enough weight to touch their toes. While I’m on this rant-fest, let me add that NONE of the people I see are 23, athletic, and have 9% body fat as I see in just about EVERY physical therapy video I’ve ever watched. Where do they get these people? Oh wait, they’re PT majors. Thank goodness none of them are adult film majors.

    “Packing” (pick your joint/body part/favorite food). Nail head-hit #5. I’m all for a “healthy” head position. However, what if the guy has a compromised vertebral artery? Ever heard of occlusion? Ever seen some one stroke out? Now, I’m not suggesting you let the guy jam his chin in to his chest, but maybe before we put on our Captain Diagnosis Spy Glasses, we could just let them find a comfortable head position. Most of us train regular people, not professional athletes/powerlifters and a ton of those folks have real structural dysfunctions that could be made worse if we demand they meet the standards of the film stars mentioned above.

    Rolling. Near nail head-hit. Using Planet Earth as the universe’s largest form roller is probably one of the best things I’ve ever done, and I’m glad it’s finding a place in the fitness world outside of grappling.

    Look, I’m old, and like a lot of older guys, I’m broken in some ways. News flash-Some people are broken and the best you can do with them is to find a compensatory pattern that will let them move and do things with a minimum (notice I didn’t say absence) of discomfort. I’ve spent hours and hours in an OR with guys who have spent years in residency, internships, and fellowships and the one thing that’s been proven to me over and over again is that some people are just broken. News flash #2-you can’t “fix” them.

    Danny, please don’t punch a kitten. Instead, the next time an amateur diagnostician takes a guess at what’s wrong, grab a piece of PVC pipe and beat them like Joe Pesci got beaten at the end of Casino.

  2. Right on! Great article! I run an online fitness studio that provides progressively challenging videos specifically geared toward those with abdominal trauma like diastasis recti, hernia, c-section, etc. You’d be amazed at the flack I get for having them do body-weight squats within their first three SHORT routines. While I take crunches and sit ups out of the equation, I’m not trying to create babies. I want to empower “power” in those who move through all 70 of my routines. I’ve got chair exercises and I’ve got Tabata. I’ve got “Pilates in Pajamas” and I’ve got “Functional Fitness” where they are lifting weights (of their choice at home) for 40 minutes straight! As they heal, they move forward. It’s a delight to put the info out there and let them move forward at their own pace. I still get people who write and say they’ve been doing the first workout for 3 months, and … well, okay but let’s get up and start walking now, eh? Babies don’t live on breast milk forever. Let’s get some solids and iron in that diet!

  3. Robert Prieto says:

    Well said Danny there comes a point where you you teach your client how to properly move and once they got it move on. We all just need to get stronger and stop being form Nazis. On another note Franco had no idea what he was doing.

  4. Josh says:

    Great article Danny! I couldnt agree more!

  5. Dave Moyer says:

    I’ve been working out with kettlebells for 2 1/2 years, and I still can’t touch my toes.

  6. Mike Peltz says:

    This is great! There are several very strong dead-lifters that cannot touch their toes. The fact that someone would be told that they do not have the right to deadlift is a travesty. Great job Danny!

  7. People who cannot dead lift a quarter of what Columbo could got no business arm chair correcting his form even if they imagine its going to improve his lift by 3 ounces.

    CT Fletcher did a great video called snap city about this very idea. Worth a watch.

    I see a lot of this movement stuff at my gym but it does not seem extensively practiced by anyone getting stronger…

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