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 Assess and Correct Poor Posture

“Pull your shoulders back”.

ANALYSIS:

That’s a phrase you’ve probably heard a few times. It’s also a phrase I constantly utter to my clients. Maintaining proper neutral spinal alignment is practice I’ve become overly obsessed with over the last few years. We currently live in a society where work demands, personal and family commitments leave us feeling overwhelmed and stressed out. This directly impacts our posture and creates imbalances all over the body. Poor posture can negatively impact movement patterns, affect athletic performance and cause injuries. But despite these concerns, so many of us still struggle with keeping our spine in its neutral curve.

So how do you know if you have good posture?

DIAGNOSIS:

The good news is that poor posture is very easy to fix. The first step towards achieving good posture is identifying the weakness and imbalance. Almost everyone I know has a postural deficiency. A lot of us are born with mechanical disadvantages and spend most of our lifetime correcting it. It isn’t quite known why humans develop poor posture. But what appears to be certain is how we bend to pick up objects from the floor, the different angles in which we rotate the hips, how we carry our handbags and backpacks and favoring certain limbs during activity all impact posture one way or another.

Here are some quick and easy ways to assess your posture.

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Stand with your hands hanging along your sides and have someone take a picture of you from the side. If your view resembles the middle image in the picture above, congratulations! You posture is good. If its similar to the images on the far left and right, it means you’ve got some work to do. From an anatomical position (feet hip-width, shoulder-width apart; hands hanging along your side), if your thumb fingers rotate inwards even slightly, it indicates tight shoulder internal rotators. In a plank position, if the lumbar region hyper-extends or ‘sags’, it is a reflection of weak glutes and various hip extensors. If your head and chin tend to drop forward when standing or walking, you’re in a ‘slouch’ posture.

THE FIX (#1):

This is going to sound a bit weird and crazy but the best way to correct a bad posture is to practice good posture. Coaching cues like ‘stand tall’, ‘brace your core’, ‘pull your shoulder blades back’, ‘squeeze your glutes’ and ‘keep your chin up’ are some excellent reminders that not only can help address poor posture but help in the maintenance of good posture. The challenge is remembering to always apply these cues in our day-to-day activities. Due to stress from work, school and family, it can be difficult to be consciously aware of our posture. This is the only drawback to this solution.

THE FIX (#2):

There’s currently insufficient evidence that support the notion that posture can be ‘fixed’ completely through exercises. More research is being done at this time. However they can be improved and enhanced to a degree. Strengthening the musculature of the upper back and the hip extensors is the the final solution for postural enhancement. The posterior shoulder muscles can be strengthened via a variety of corrective exercises. Keep in mind the objective is to retract or ‘pull’ the shoulder blades forward from a protracted position. The term ‘slouch’ is just a fancy replacement for protraction of the shoulder. With that being said, the scapular wall slide is an excellent choice for correcting rounded shoulders. A wall is all that’s required so it can be done virtually anywhere.

For more on how to perform the scapular wall slide and 4 other fantastic exercises for enhancing posture, check out this blog post I wrote a few months ago.

THE EXCEPTION:

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There are people who were born with partial curvatures and deviations of the spine and may never achieve good posture. Scoliosis, Lordosis and Kyphosis are abnormalities of the spine that leaves a person in awkward positions and angles for life. Although people with these conditions can still improve their posture through strength training and corrective exercise , their curvatures may never be fully corrected. Chiropractors can assist to a degree but the evidence that they can fix the curvatures remains inconclusive. The good news is that traditional exercises and day-to-day activities can still be performed pain-free.

Why You Should Deadlift

Aside from the traditional barbell back squat, no other exercise works the entire body like the conventional deadlift. In fact, some would argue that the deadlift offers more benefits than the back squat. Both exercises are functional in nature and engage nearly the same muscle groups. However the deadlift, which is a a hip dominant exercise, additionally recruits fibers of the upper body musculature and as a result burns more calories. The lower and upper back, anterior core and forearms are greatly engaged. The prolonged gripping of the barbell also helps to improve grip strength. I’ve always maintained that if I only had to do one exercise for the rest of my life, it’ll be this one.

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Contrary to popular belief and societal misconceptions, everyone CAN and SHOULD deadlift. It is not a ‘guy’s exercise’. Although different versions like the Sumo Deadlift, Romanian Deadlift and Suitcase Deadlift exists, the traditional version yields the most dividends and should be prioritized in everyone’s training programs. The deadlift addresses virtually every health and fitness goal from fat loss and lean muscle gain to strength, power, core stability and even postural enhancement.

Here are 5 reasons why you should deadlift:

1. Functional Component: If you had to pick up a box or bin from the floor, you would without a doubt hinge your trunk slightly forward, push your hips back, reach down with you arms and then drive back up with the box using your heels. That’s a deadlift in a nutshell! We pick things up from the floor everyday and the deadlift is perhaps the only exercise that mimics that action. By deadlifting regularly, the body continually adapts to picking up dead weighted objects from the floor. This can become extremely helpful in the event a much heavier box had to be picked up.

2. Full Body Work: The deadlift is one of the few exercises that requires lifting a dead weight from the floor. It is a true integration of the upper and lower body musculature due to the simple fact that the entire kinetic chain has to work in synergy in order for any object be picked up from the floor. When executed properly, the quadriceps and dorsiflexors activate themselves at the starting phase and contract to about the middle of the rep. From that point, the forearms, hamstrings, glutes, lower and upper back take over. Although you won’t feel a ‘burn’ in your abs, believe me when I say your core will activate via resisting anti-flexion during the eccentric (lowering) phase

3. Postural Impact: Complete execution of the deadlift requires a lockout at the top of the movement. This means the shoulder blades must retract and hips must fully thrust. Both movements are essential for correcting short hip flexors and tight shoulder internal rotators. The extension of the hips at the top of the deadlift forces the opposing iliopsoas muscle group to get a stretch and lengthen. Simply put, contraction of the hip extensors will correct short hip flexors. At the top of the movement, retraction of the shoulder blades forces an internally rotated shoulder to externally rotate. When performed routinely, this will have a tremendous impact on a person’s posture. Even the dorsiflexors, which activate during the start phase, helps improve ankle mobility by stretching the calf muscles.

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4. Best Upper Back Builder: When it comes to overall development of the upper back, no exercise works better than the deadlift. Traditional back exercises like the pull-up and bent-over row are fantastic choices for adding mass to the back but they pale in comparison to the thickness and density the deadlift provides. Part of the reason for that is because of the constant tension in the posterior trunk muscles during it’s execution. So many exercises can be used to work the back in an exercise program but the deadlift is the king.

5. Power & Strength: Of the 3 primary powerlifting movements, the deadlift has the potential for developing maximal power and strength because it uses the entire body. The bench press and squat can do the same but are affected by shoulder and knee limitations via max load. The shoulder girdle complex can only handle so much weight from bench pressing. Almost every guy I know that regularly bench presses heavy has some kind of shoulder pain. The shoulder is one of two joints impacted during a bench press (the other being the elbow), therefore too much tension on it makes it susceptible to injury. And although the deadlift and squat use similar joints (knee, hip, ankle and lumbosacral joints), the compressive forces on the knee and back in a traditional back squat makes the potential for maximal strength and power minimal compared to a traditional deadlift.

5 exercises that can help improve posture

For many fitness enthusiasts who train regularly, posture and body mechanics are two vital areas of concern. We often hear people say to others, “Sit up straight”, “Pull your shoulders back” or “Keep your spine tall”. The term ‘slouch’ has never been more apparent in our society the way it is today. Thanks in large part to several case studies that have linked poor posture to imbalances in the kinetic chain, back pain and other degenerative diseases like scoliosis and kyphosis.

Those who know me well will tell you that I’m a strong advocate of postural awareness. Before I take on any new client, I put them through a series of movement pattern screening and postural evaluation exercises. So many different exercises can be used to assess and evaluate posture. In my humble and professional estimation there isn’t a best one, although some fitness professionals could make a case for the Overhead Squat.

There is currently insufficient evidence that supports the notion that exercise can correct posture or lead to deviations. More research is still being conducted at this time. While I don’t believe postural training exists, there are few exercises that can help improve and enhance poor posture. It is important to remember that these exercises shouldn’t be relied entirely upon for postural correction. Active stretching, myofascial work and mind-body awareness should be integrated as well.

So without further ado, here are my top 5 exercises for improving posture:

1. DEADLIFT: I’ve written extensively about the Deadlift in some of my previous blogs. This is arguably the best resistance exercise for improving posture because of it’s functional component. No other exercise mimics the action of picking up an object from the floor. But even more important are the mechanical aspects of it. Setting up for this exercise requires the trunk to be in a diagonal alignment from shoulder to hip which reinforces neutral spine. Flexion of the hips automatically causes activation of the dorsiflexors of the leg forcing the ankle to be mobile. The retraction of the shoulder blades and full extension of this hips  via thrusting at the completion of the movement emphasizes good posture. Retraction and adduction of the scapula will help a person who is internally rotated in the shoulders via external rotation. Likewise, extension of the hips will help a person who has  tight hip flexors and over-lengthened glutes due to prolonged sitting by stretching them at the top of the movement.It is important that you don’t hyperextend the lumbar spine like some people do.

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2. REVERSE LUNGE: The most knee-friendly lunge variation is also a good exercise for those with short and tight hip flexors. When dumbbells are used, the shoulder girdle and upper back region get activated. The hip flexors of the leg that lunges backwards get a deep stretch during execution of this exercise. When I perform this movement, I try to hold the bottom position for 2 seconds to illicit a good dynamic stretch of the hip flexors. When dumbbells are held in each hand, the shoulders ‘pack’ and forced to pull themselves back due the challenge of maintaining good balance. A much farther center of gravity forces the shoulders to externally rotate to prevent tilting forward because of the additional resistance in each hand.

3. SCAPULAR WALL SLIDE: This is an exercise that will garner weird looks from others when you’re doing it. If only those people knew the amazing postural impact it has on the trunk musculature. The good thing about this movement is that it can be included as part of your pre-workout mobility warm-ups or as an exercise in a resistance training program. Stand with your head, upper back and butt against a wall. The heels of your foot should be anywhere from 12 to 18 inches away from the wall. Lift your elbows to shoulder level and press your forearms back against the wall so your elbow and shoulder make a 90-degree angle. Most people won’t be able to get their forearms to press firmly against the wall indicating tight shoulder internal rotators and chronic slouchy posture. With your head, upper back and butt pressed against the wall, fully extend the elbows in a diagonal pattern, hold for a second and return to your starting point. Many will also have a hard time keeping their back flat and will arch quite often early on. The objective here is to continue to keep the forearms close to the wall as much as possible and do your best to keep the back flat. I used this movement to correct extremely tight shoulder internal rotators I battled with for many years. My forearms were 10 inches from the wall when I started this movement!  Though they’re not quite touching yet, they’re about 4 inches from the wall today.

4. DUMBBELL SUITCASE DEADLIFT: This deadlift variation, which was developed through the real life action of picking up a suitcase, is ideal for training the core stabilizers while also strengthening the posterior chain. Though identical to the conventional deadlift, it is different in it’s unique way. Hold a dumbbell of moderate resistance in one hand and stand in front of a mirror in neutral alignment. Your stance should be 3-5 inches less than hip-width apart. Push your hips back and bend the knees as you would do in a regular deadlift. Lower the dumbbell as far as your can without rounding your back or letting your knees cave in. The objective here is trying to remain symmetrical despite the destabilizing forces from the dumbbell attempting to pull you out of alignment. The reason for the mirror is to keep an eye on your symmetry and alignment ensuring you remain neutral all along. Do not allow your trunk to tilt laterally while performing this movement. It is the resistance to tilting that yields the benefits of this exercise. As an added bonus, the core musculature is activated via anti-lateral flexion exercises.

5. WAITER’S WALK: Popularized by the innovative Gray Cook, this exercise is eerily similar to the suitcase deadlift due to the asymmetrical nature of both. The idea behind this exercise came to fruition after witnessing the incredible dexterity and skill waiters display as they constantly hold and walk around with a tray in one hand above their head. To perform this exercise, hold a dumbbell of moderate resistance in an overhead stance. Earlier I talked about ‘packing’ of the shoulder girdle for increased joint rigidity. The same technique applies in the Waiter’s walk. With the dumbbell over your head, ‘pack’ and pull your shoulder back into the scapular without shrugging. Keep your upper arm as parallel as you can next to your ear. As you begin to walk, you’ll feel the weight of the dumbbell trying to pull you out of alignment from all directions. The challenge is to resist these forces and remain symmetrical as much as you can. Do your best to avoid tilting and hiking up the hips. When all the mechanics fall in place, the result is an erect posture in neutral alignment. Begin by walking 20 to 30 yards per arm and work your way up to 40 to 50 yards.

So there you have it. 5 exercises that can help improve your posture. Keep in mind that these are based on my personal experience and years of extensive theoretical studies and research. As always, use good form and work with a moderately challenging resistance. Incorporating active stretches and self-myofascial release will make the process much easier.