A CASE AGAINST CORRECTIVE EXERCISE TRAINING

Some of you are going to read this headline and immediately begin to raise your eyebrows. So before you begin to vilify me, I’m not opposed to corrective exercise training (For the remainder of this blog post, CET will replace ‘Corrective Exercise Training’). In fact, I do believe CET has its place in fitness and can yield some dividends. I personally incorporate elements of CET into my training and that of some of my clients. For those unfamiliar with it, CET, in a nutshell, is a form of dynamic, nontraditional training created for the sole purpose of addressing  biomechanical problems and faulty movement patterns in the kinetic chain.

It begs the question: Who needs CET? Is it for everyone? How often should it be done within the confines of a training program?

CET started to garner mainstream popularity in the early 2000’s and really took off half a decade later. The National Academy of Sports Medicine (NASM) was the first major certifying organization to offer an accredited certification which is now famously known as ‘Corrective Exercise Specialist (CES)’. Talk to any NASM CES and they will tell you it is the be-all and end-all of fitness. Like I previously stated, I do believe CET can improve and enhance movement but we are spending way too much time on it.

While I think everyone can benefit from CET, I don’t believe everyone needs it. Just because a person isn’t able to descend low enough on a squat or another rounds his/her upper back on a push-up does’t necessarily mean you discontinue those movements and replace with CET. In some cases, all that’s needed is simply stretching, doing deep-tissue work and dynamic drills. I’ve never understood the concept of placing an elastic tubing around the knee to correct a valgus-knee squat. Besides the risk of losing balance and falling, the knees are going to cave back in without the band not to mention the hips/knees are being assisted when they should be gradually learning the movement. If my hip external rotators/abductors are tight and weak, asking me to abduct while performing a squat is going to be a tall order. Furthermore, the hamstrings and adductors are two of the biggest stabilizers during a squat. Performing and perfecting a deep squat simply means stretching and activating those muscles on several occasions.

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Many of us, especially those who sit at a desk all day, have internally rotated shoulders ( aka rounded shoulders & slouch posture) meaning our external rotators are tight. If you bench press and do pull-ups on a regular basis, chances are your shoulders are internally rotated. (Try this quick test to assess your shoulder mobility: Stand in front of a mirror in an anatomical position with your hands and palms relaxed and hanging by your sides. Keep your eyes on your left and right thumbs in the mirror. If they point inwards, towards your body, your shoulders are internally rotated.) You don’t have to stop these movements completely, although you may have to lower the intensity and frequency of your bench press and pull-ups if you want to address the issue at hand. Stretching the pectoralis minor and performing shoulder external rotation movements are some of the ways to correct this. But proponents of CET will argue in favor of doing a plethora of  CET exercises and not performing those exercises until the issue is resolved. Where I disagree is that I believe both can be done without discontinuing one completely.

Then there’s this question: How long should one perform CET and to what extent? I’ve seen people, both personal trainers with their clients and regular exercise enthusiasts, who do CET for 30-45 minutes, multiple times a week with no basic movement at all (squat, deadlift, push & pull). The idea is all the body’s weak stabilizers and prime movers must be strengthened before movement can begin. Regardless of how much CET you make me do, I have to perform a skill or movement more than once in order to get better at it. The Principle of Specificity states that clearly. I’ve had first-time clients correct their Deadlifting pattern in one session. It may have required 4 to 5 sets, but they fixed whatever mechanical issues they had at the beginning of the working set. I didn’t have to employ any CET. They simply perfected the movement by doing it over and over and over again.

Here are 4 takeaways:

  1. STRETCH, FOAM ROLL & DYNAMICALLY WARM-UP: It sounds very easy and simple but I’m a firm believer that a lot of our tightness and weaknesses can be addressed via stretching and foam rolling. Stretching the hamstrings/adductors can yield a more efficient squat. Likewise, regularly stretching the pectoralis minor/major will pull our shoulders back and enhance posture. Dynamic warm-ups like X-Band walk, scapular wall slide, cradle walk, high-knee walk and walking spiderman are some of the best activation drills for the glutes, hip abductors/adductors, hip flexor muscles and shoulder girdle. Keep in mind, in order to get the most bang-for-your buck reward via foam rolling, it must be performed routinely and extensively. FullSizeRender
  2. PRINCIPLE OF SPECIFICITY: To be a good cyclist, you must cycle. The point to take away is that a runner should train by running and a swimmer should train by swimming. It’s as simple as that. The Principle of Specificity states that to become better at a particular exercise or skill, you must perform that exercise or skill routinely. Sometimes being unable to perform a movement doesn’t mean there’s a mechanical issue. It could simply mean that movement has to be performed a few more times to achieve perfection.
  3. STRENGTH TRAINING CAN BE CORRECTIVE: The Goblet squat, box squat and many TRX exercises are corrective in nature allowing two birds to be killed with one stone. Take the Goblet squat for example. Placing the elbows inside the knees during descent pushes the knees out leading to an externally rotated hips, which is required to perform a standard barbell back squat. The eccentric phase of a box squat (pushing off out of a seated position) requires more hamstring and adductor firing which can also carry over to a back squat. The TRX Row can promote external rotation of the shoulder while the TRX-assietd squat can teach diagonal neutral spinal alignment.

    4. POST-REHABILIATION CASES: Certain specialty situations may call for a load of CET early on. Athletes and recreational exercisers who tear their ACL or severely injure their shoulder may need to rehab via CET for quite some time before returning to conventional training. Due to the nature of these injuries, modified, regressed and dynamic exercises and drills is the best way to strengthen the surrounding tendons and ligaments.

CET has a rightful place in fitness and can have a great impact on a lot of people. It is definitely here to stay. However it should only be called upon when necessary and not overly implemented. Far too many people continue to use CET even after the issue has been corrected. Dynamic warm-ups and activation drills are very effective in loosening and firing tight and weak areas in the body and should be done on a regular basis. Performing a movement pattern incorrectly for the first time may not necessarily indicate an issue. It very well could mean it needs to be done again and again until perfection is achieved.

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Simple ways to fix muscle aches and pains

I can almost certainly say with conviction that virtually every person I know has some type of body ache, discomfort, pain and/or inflammation. The fact of that matter is as impactful as exercise is on the body, it inevitably won’t prevent us from experiencing some sort of muscle ache or pain at some point in our lives. For the majority of us, the stress and demands of life, work, school, companionships, family time and even gym time will ultimately fatigue the body and cause it to function less optimally in most cases.

How many times have you or someone you know felt a back ache, shoulder tightness or hip discomfort and wondered where it came from? That’s because when muscles are stressed repeatedly via strength training, home chores, manual labor, prolonged seating to name a few, the deep fascia of muscle fibers (innermost muscles tissue that surround bones, nerves and blood vessels) become wound and tangled up and begins to limit movements which can affect range of motion. On the contrary, superficial fibers are what we stretch on the surface and body of the skin like a basic lying hamstring stretch for example.

Here are 4 ways to to permanently fix and cure your aches and pains:

1. Soft Tissue Work: If you don’t already include soft tissue work in your exercise program, you ought to. Foam rollers, lacrosse/tennis ball and deep tissue massages make up this elite category. I believe it is one of the most underestimated areas of body care and maintenance. Soft tissue work can be unpleasant. In fact, it isn’t pleasant at all. If you’ve ever used a foam roller or lacrosse/tennis ball on your self, you know the feeling I’m referring to. Though painful and uncomfortable, soft tissue work allows collagen fibers of those deep fascia to untangle and loosen up, thus promoting efficient blood flow in muscles. This in turn translates into warmer and more relaxed muscles and better mobility in the joints.

2. Stretching: We all need to stretch more. It’s as simple and blunt as that. It’s quite alarming how many seasoned fitness enthusiasts lack adequate flexibility (Don’t worry, I’m one of them!). Part of the problem is that when it comes to relieving stress and endorphins kicking in, stretching pales in comparison to traditional strength training and just ins’t considered “fun”. As a result, many of us do it infrequently and when we do, it’s quick and fast. Here’s the thing: Stretching may not yield the benefits of a barbell squat or bench press, it is a vital component for movement patterns. To move efficiently and effectively, we must stretch. Tendons connect muscles to bone so in order for a joint to function well, the muscles around it must be stretched. Passive and PNF stretching are the best types and can be done anytime. While it’s important to stretch the entire body, emphasis should be placed mostly on tight muscles.

3. Corrective Exercise Training: This has been one of the most controversial areas of fitness over the last several years. By definition, corrective exercise training is the fixing of imbalances, weaknesses and muscle pain via traditional and nontraditional methods of training. It has become a staple in many training programs and a mainstream component of fitness. Corrective exercises were originally designed to fix and correct muscular imbalances that affect movement patterns, fix injury-related pain and alleviate chronic muscle tightness.

I’m all for using corrective exercises when warranted. However, it appears many exercise enthusiasts & fitness professionals today design their programs strictly around corrective exercise and that bothers me. If the underlying issue has been corrected, why keep correcting? If you’re unable to hinge low enough in a squat, strengthening and activating your hip external rotators and stretching your hamstrings & adductors should be part of the corrective remedy. Once those areas are addressed, it’s time to squat. Many people continue to utilize corrective training even after the problem is addressed. I’m a proponent of corrective exercise training and I believe it has a place in fitness. But it shouldn’t be overused and definitely shouldn’t make up an an entire workout program. Regardless of the individual or training goals and objectives, compound movements should always take precedence. They’ve been tried and tested over time.

4. Progressively Overloading: Most of us know in order to continue to see results and yield dividends, we must continually add new challenges to out workouts, whether it be more resistance, less rest between sets, more sets and/or more reps. However some of us overload too soon, not allowing the body to adapt to the early demands. Progressive Overload, gradually adding resistance to strength exercises, must be approached steadily. Going from bench pressing 100 pounds in week 1 to 150 pounds in week 2 may be too much of an overload. The central nervous system gets a shock each time we exercise, which forces the muscles of the body to respond by getting strong and growing. However if the shock goes from a mild state to a more severe state, the joints and muscles panic at the arrival of an unexpected tension and that usually causes injury. Think of it as a first time driver who goes from driving at 55 mph in week 1 to all of a sudden 85 mph in the second week. It’s very likely that new driver will be not be comfortable at 85 mph in only his/her 2nd week of driving and may lose control of his/her vehicle. Whether you’re a newbie in the gym or a seasoned lifter who took a month off, always start with a mild to moderate intensity and progressively and wisely overload.

 

Preventing Knee And Back Pain By Improving Hip Mobility

The hip complex is indeed a very complex joint –  no pun intended. It is responsible for almost every action we execute everyday. Like the shoulder, it is a a ball and socket joint which is capable of movements in all three planes of motion. In all my years in the fitness industry, I’ve noticed that the knee and hip joints of people seem to be the most vulnerable to injury. Some of you reading this have had your share of these joint pains. Some of these pains and injuies are due to falls, natural disasters and playing sports. However, many are a result of infrequent training of the hip complex and poor exercise selection leading to compensation of the knee and ankle joints.

If you look at the human body, you’ll see that the hip is located at the center of the body. This makes it come into play nearly every time we perform a task or action. Sitting, getting up, climbing stairs, playing sports, running and a plethora of other activities require hip involvement. But many of us have hip mobility issues, and because the body is one big chain of stack of joints, hip immobility can affect the knee and ankle joints. Many joint aches and pains can actually be resolved by strengthening the muscles of the surrounding joints. Even low back pain can be attributed to poor hip mobility. If the gluteus maximus muscle group is weak, it forces the opposing hip flexors to shorten and subsequently pull on the low back in seated positions. If the gluteus muscles, hip external and internal rotators are not trained often enough, it won’t be long before the knees, low back and even ankles are forced to compensate themselves in hip-dominant activities.

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By strengthening the muscles of the hip, the lumbar spine is better equipped to handle everyday stress of life. Barbell squat, deadlift, single-leg squat, reverse lunges, hip thrust, step-up and certain quadruped exercises are some excellent choices for improving hip mobility and strengthening the muscles. Flexibility in the hip flexors, hamstrings, adductors and hip external rotators is also key to achieving and maintaining a strong and pliable hip joint. Active stretching and myofascial work will help improve flexibility in these muscles while keeping them lose and warm. The foam roller is arguably the most vital fitness accessory because of  its impact in reliving the body of aches, inflammation and tightness. Myofascial work via foam rolling or lacrosse and tennis balls may be advantageous over stretching because of its ability to go deep into muscle tissue.

Whether you’re an all-around gym enthusiast, an athlete or weekend warrior, hip mobility is crucial for long health and prevention of  injury. A training program that addresses strengthening of the hip muscles and improvement of flexibility will successfully achieve this goal.

Rapid Fire : Installment 3

I’d like to dedicate this week’s blog to the youthful and exuberant Diana Gasperoni, who provided me with the inspiration and idea for some of the topics of interest. Nutrition, avoiding female infertility and fixing iliotibial band syndrome are explored in this third installment of Rapid Fire.

Making healthy eating choices will continue to be a challenge for many of us and a struggle for some. It’s a never-ending battle that we must embrace courageously to avoid mistakes. Certain dietary behaviors could impact female infertility. Learn exactly what and what not to eat to be able to conceive. If you’re a runner, you most likely have had IT-Band syndrome at some point. As painful as it can be, there are simple ways to fix it.

1. Don’t Get On A ‘DIET’: We’ve all heard and seen them before: Weight Watchers, Jenny Craig, Atkins Diet, South Beach Diet, and so on. These are some of the commercial diet plans aimed at promoting weight loss. Now many people, including some of my colleagues in the industry, will disagree with me but in my humble and professional estimation, diet plans are a waste of time. They are just another clever gimmick with the sole purpose of collecting money from the public. Now, don’t get me wrong, they can certainly help an individual trying to lose weight, providing that person is also physically active. But losing weight isn’t rocket science nor is it complicated. It requires a simple solution : calories burned must exceed calories consumed. 3,500 calories is needed to get burned for 1 pound of fat to get shed. So for example, in order to lose 2 pounds of fat, you’ll need a caloric deficit of 7,000 pounds.

It’s been ideally concluded that 4 pounds of fat is the most a person can lose in a week. Anything more is most likely water weight which will return to the body once fluids are consumed again. This is how those diet programs capture the audience, promising absurd amounts of shed pounds in a week. Remember, muscle, water, fat and bone make up the body weight. The best way to stay lean and lose weight is to exercise regularly (aerobic and anaerobic training) and eat small meals frequently (5 to 6 a day). This will help continued growth of lean tissue which leads to faster metabolism. So don’t ‘get on’ a diet. Just eat a clean diet. For more on diet and nutrition, read this blog post I wrote a while back.

2. Avoid Female Infertility Through Nutrition: According to the Centers for Disease Control and Prevention (CDC), the infertility rate amongst married women aged 15 to 44 in the country dropped from 8.5 percent to 6 percent between 1982 and 2010. But an alarming 1.5 million women were considered infertile at some point between 2006 and 2010. Though advanced medical treatments have become available over the years, simply eating the right meals and avoiding some is the only remedy needed to avoid infertility.  According to the Egg Nutrition Center (ENC), insulin insensitivity is a major reason for infertility. When insulin is released into the bloodstream, it affects the liver and encourages production of androgen. This results in circulation of testosterone which prevents the release of an egg from an ovary.

To promote insulin sensitivity, the ENC recommends consuming fiber-rich carbohydrates. These meals are slowly metabolized and do not spike insulin in the bloodstream. Low-glycemic index (GI) meals such as vegetables, fruits, legumes and whole-grains are the ideal food sources for women looking to get pregnant. While High-glycemix index meals like rice and pasta are great for post-workout when the body is craving simple sugars, they should be avoided or consumed in very small portions when trying to get pregnant. Additionally, the ENC also recommends a multivitamin (specifically folic acid and iron) and dairy products as ways to optimize female fertility.

3.  Simple Remedy For Iliotibial Band Syndrome: Running is one of the most common and simplest aerobic activity. But too much running, especially amongst long-distance runners and triathletes, can lead to a condition called Iliotibial Band Syndrome (ITBS). This occurs when the IT-Band constantly rubs over the lateral femoral epicondyle  along with continuous flexion and extension of the knee. The inflammation affects the lateral side of the knee and can be very uncomfortable and sometimes unbearable while running. Although the pain goes away once running is discontinued, it arises again during another run.

Here are a few exercises that can help in rehabilitating ITBS:

  • Standing Hip Abduction :

Make sure your torso remains tall and straight and do not compensate by tilting your torso.

  • Box Step Down :

Make sure the spine is neutral and that the hip, knee and heel are aligned.

  • IT-Band Stretches and Foam Rolling : Any IT-Band Stretch should be held statically for 15-30 seconds and repeated no more than 3 times. Foam rolling can last up to 5 minutes.
  • High Plank : This is basically a plank with your hands fully extended, as opposed to resting on your forearms. Aim to do 3 sets of 20 to 180 seconds resting 20 seconds between sets.