So What Is Corrective Exercise?
The term “Corrective Exercise” has become one of those popular buzz words in the health and fitness industry of late, just like “Core” was 5 years ago. Some health and fitness professionals will use the term corrective exercise in relation to correcting ones movement patterns, dysfunctions or more specifically related to an individuals injury status or ongoing recurring history with injuries. These days we are seeing a combination of professionals (personal trainers, osteopaths, exercise physiologists, strength & conditioning coaches, strength & conditioning coaches, physiotherapists and chiropractors) prescribing so called “corrective exercises”. So what is a corrective exercise? When we break the two words down into their specific definitions, corrective can mean “tending or intended to correct” (sourced: http://www.thefreedictionary.com/corrective), exercise can be defined as “Activity that requires physical or mental exertion, especially when performed to develop or maintain fitness” (sourced: http://www.thefreedictionary.com/exercise). I am sure that if I was practicing as an Osteopath 20 or 30 years ago, exercise prescribed that were related to ones injury or musculoskeletal dysfunction or complaint were probably just called exercise or rehabilitation exercises.
The What, Why and How
When it comes to prescribing an exercise that we have defined as corrective exercise, we need to firstly ask the What, Why, How?
1. What is it we are trying to correct?
2. Why are we trying to correct this?
3. How are we going to correct this?
If we cannot answer those three questions, then I don’t think we as health and fitness professionals should be trying to prescribe corrective exercise. As an Osteopath (and I assume this also includes Physiotherapists, Chiropractors and Exercise Physiologists who are working with similar clients), generally our clients are those who are currently in pain, have been in pain and have had some form of musculoskeletal injury and they are wanting us as professionals to help rid them of this pain or prevent further injury. Part of our role should include prescribing the appropriate exercise to help correct any relevant dysfunctions are part of the clients presenting complaint.
A common example of this could be a client who injures their back and develops:
1. Acute back pain that resolves within 0-2 weeks
2. A fear avoidance of spinal flexion.
3. A change in movement patterns that results in abnormal movement patterns developing from the initial injury and fear avoidance behaviour.
4. Compensating movement patterns and behaviours resulting in some muscles overworking and others becoming inhibited.
5. Some joints stiffening up whilst others over work.
6. Resulting soft tissues and joints overworking and becoming part of the problem and presenting to the client as pain, stiffness, weakness and further dysfunction.
Our role as an Allied Health Professional (Osteopath, Physiotherapist and Chiropractor) is to help the client return to normal everyday activity and general well being without any pain or underlying dysfunctions. Easier said than done I must say. So what and how does this relate to corrective exercise? Well, following a detailed case history, assessment and treatment, hopefully the Osteopath, Physiotherapist, Chiropractor or Exercise Physiologist has been able to determine what, why and how these dysfunction developed and prescribe the appropriate soft tissue/myofascial release technique, stretch, strengthening and movement to correct these. Like any form of exercise, it takes time to see results. Often in the first 2-6 weeks the individual will see changes as a result of improved neuromuscular control and improved grooving of movement patterns and reduction in areas of stiffness or soft tissue or joint restriction. Strength gains will start to be seen more clearly from weeks 6-12 if the program has been designed correctly and implemented with consistency. Like any program, there needs to be the right amount of progressive overload to stress the body create change. Rest is also a big part of this so to avoid over training.
What About General Activity & Exercise?
I have seen many clients who present to the clinic with various musculoskeletal complaints also find that their injury improves and recurrence of injury reduces when general activity levels increase. This could simply mean adding some general activity to help improve cardiovascular fitness (walking, jogging, cycling, swimming, cross-trainer, rowing) and some form of stretching and strengthening program such as pilates, yoga or resistance training. There are many clients who’s complaints improve greatly through regularly undertaking exercise 3-4 times per week. The challenging thing for the client is knowing whether or not their injury or complaint will improve with general exercise or whether they require more specific assessment and prescription of specific exercises. My advice to those clients is to go and see your Allied Health Professional (osteopath, physiotherapist, exercise physiologist or chiropractor) and have a consultation to find this out.
Osteopath Heath Williams is the owner and director of Principle Four Osteopathy, one of Melbourne City CBD 3000 leading Osteopathic clinics. At Principle Four Osteopathy we offer a number of different services, ranging from Osteopathy consultations, Functional Movement Screening consultations and Exercise Prescription & Rehabilitation consultations. If you would like to find out more about these consultations, then please check out www.principlefourosteopathy.com.
The Osteopathy clinic is located at 29 Somerset Place, Melbourne City CBD 3000 (just near the corner of Little Bourke & Elizabeth St). The clinic is open Monday – Friday and there are 2 Osteopaths available for appointments. To find out more about the clinic, please go to www.principlefourosteopathy.com. Appointments can be made by calling 03 9670 9290 or booking online at www.principlefourosteopathy.com