Panel Discussion: How important is corrective exercise?
How important is utilizing a corrective exercise strategy as a warm-up? There are several schools of thought regarding whether corrective exercise is necessary, whether we should stretch before we train, or whether it is in our scope (personal trainers) to correct movement…
Moderated by Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS
This Panel Discussion was originally posted on my facebook page - https://www.facebook.com/brent.brookbush - on February 11th, 2011
Shawn Fears, February 11 at 12:42pm I can't see not doing it. It doesn't make any sense to strengthen dysfunctional movement patterns. As personal trainers it is within our scope if there is no injury present. I think the biggest issue is knowing exactly what to do. I can easily spend a whole hour session on correction and mobility without even doing strength work. It’s been my experience that we need to choose one or two things that address the biggest issue…kind of a Gray Cook mentality. Pick the worst movement pattern and address it then work back from there, all the while not taking away from the core of the workout.
If you don't understand what corrective strategies are then don't do it, refer out to another trainer. We need to know our own limitations as professionals.
Mikal Payne, February 11 at 1:35pm: I do a warm-up with my classes and do corrective and stretching at the end, I am one of those people who don't stretch cold muscles. But I work with a Sixty plus population. Health issues abound.
Michael Consalo, February 11 at 2:06pm: If we train clients to keep training with poor posture or muscle imbalances it only leads to synergistic dominance , pattern overload, poor body symmetry. I try to avoid the static stretching before since it has been proven to lead to injuries if the muscles aren't at least warm. But dynamic stretching has worked well for me and my clients before most activity if the fitness level allows them.
Brent Brookbush, February 11 at 2:15pm: It's funny that a fallacy of sorts has become so deeply ingrained. Warming up a body that is already 98.6 degrees does not change the effects of stretching, further there is no evidence to support injury originating from stretching short hypertonic muscles before stretching.
Michael Consalo, February 11 at 2:30pm: So knowing that how can that help us with foam rolling?
Michael Consalo,February 11 at 3:10pm: So by "warming up" the better way to put it would be make sure there is increased blood flow before stretching to facilitate an increase in ROM and conversely sticking with the SAID principle can help us to utilize corrective exercise for joints that are most in need. However, do external environment stimuli like a hot shower or a hot day increase thixotropy, where body fluids become less viscous, which facilitates lengthening?
Troy Alan, February 11 at 3:23pm To the question about whether correcting movement is within the scope of Personal Trainers: Personal Trainers should be doing two things no matter what their "specialty" might be: 1) assessing function, and 2) improving function. Of course, we should be concerned with correcting poor movement patters. Otherwise, we are reduced to a group of useless workout coaches who professionally condition dysfunction. As long as there is no pain, we are within our scope of practice. Indeed, it IS our primary value proposition as professionals.
Mikal Payne, February 11 at 3:45pm: Point to Troy.
Shawn Fears, February 11 at 5:48pm: I have to jump in here for a min, just the other day I was reading or listening to an interview or something I can't remember, but the point was made that plastic changes are made in "cold" muscles and this is the only time we can truly remodel the soft tissue otherwise we are simply working with the elastisity of the muscle which as studies I have read last for about an hour then return to normal length. That was the first time I had heard that and it is the exact opposite as what the old ACE text and ISSA manual state for flexibility. I do know that there is much research to be done in the field of flexibility and externally valid studies are extremely difficult to design.
With that being said If it hurts me to foam roll I ride the bike for 5 min stretch and foam roll and it seems to be more effective. I talk to Rick Richey about this in class last semester and his response to breaking up adhesions in cold muscle was…as a manual message therapist he doesn't have his clients’ warm up before a message….hmm makes you think huh?
Shawn Fears, February 11 at 7:26pm: I just want to throw in here that In an NSCA Strength Journal article that Stuart Mcgill wrote (volume 32, number 3, June 2010) McGill writes "..trainers should consider the quality of movement patterns in all clients and by default should consider beginning any exercise program with corrective exercises."
I just read this a min ago and couldn't help but post it because of the relevance to this topic.
Mikal Payne, February 12 at 9:21am: Maybe "warm up" is not what we should be say but readiness to exercise?
Brent Brookbush, February 12 at 12:25pm: Shawn… Two points to you… That is a great quote from McGill and I appreciate your points regarding cold muscles. The point was made that temperature was not the issue, but blood flow. This is also, to a certain degree, a fallacy. If you look for research on foam rolling/release techniques it is generally found under trigger point release, or ischemic pressure. That is pressure that cuts off blood flow. Reading Travell and Simmons, or Leon Chaitow you will note that release techniques are believed to work by reducing the blood supply and oxygen to a muscle, or muscle segment, in metabolic crisis. In essence, cutting off the fuel supply to overactive muscles calms them down.
Shawn Fears, February 12 at 4:18pm: The interview I was listening to was from Thomas Myers, it was the link from the previous discussion. He is the one who went into cold muscles and plastic changes. So there seems to be conflicting opinions even among experts, does anybody have any studies I can read that about the topic. It would appear that this topic may need a more research based discussion. Might be time to hit the CALU library. ;-)
Jonathon S., February 12 at 7:10pm I would have to go with rolling "cold". More success in finding tenderness and trigger points since my body is more relaxed into its daily posture. Which helps really pinpoint the desired spot. I also have a more difficult time relaxing and releasing after a warm up, or elevation of the HR.
Back to the original question:
It is a must that trainers take what they are doing serious. No, not everyone does, so maybe they shouldn't be stretching clients out followed up with some 90/90 lunges with a MB twist, and wondering why they don't show for their second session. However, there is many benefits awaiting the clients who's trainer invest time into fully understanding when and how to implement inhibiting, lengthening, activating, and integration techniques. For those client's, the health benefits will stretch way beyond our scope!
Mikal Payne, February 15 at 7:11am: Brent, I talked to the PT at work and though the popular idea body human temp. is a steady 98.6 many factors effect it, body fat, muscle mass, medication. So I would say :warming up" before exercise is a judgment call, even though it is performed practice.
Brent Brookbush, February 15 at 10:49am: Hey Mikal,
I understand where you are coming from, but our conversation was in relation to stretching… I can say with honesty and a fair amount of certainty (research states)… Warming-up does not affect the long-term adaptations to static stretching, and there is no evidence to support that warming up would have a positive effect on release techniques. I utilize activation exercises, core exercises, RNT exercises, and an integrated exercise as a warm-up after flexibility training and before my resistance training protocols. Many would correctly term this movement prep, and I consider it a much needed advancement over the general warm-up of the past. To start with 10 minutes on a treadmill before any corrective exercise is only going to reinforce compensation patterns, and when used in conjunction with movement prep it's just redundant.
Mikal Payne, February 15 at 3:10pm: I have no depute with that I think a warm up before any exercise is a good idea, you jog before you start a fast run, you lift light weights before heavy but you said to my first comment that the human body temp. was 98.6 and I saying it is not always that way for every person. There are many factors that play into a warm up.
Mikal Payne, March 14 at 3:23pm: Well, I do try to include corrective stretching in my cool-down, I am confused about stretching as a warm-up, you read Yes, it's OK, you read No, never stretch cold, so I tend to air on the side of caution. I hate damned if you do, damned if you don’t questions but I will add corrective stretch exercise to a work-out (rotator cuff, lower back pain) to help the client, I have also continued with corrective exercises when a Physical Therapist has recommended me to a client and has given them an exercise program too follow.