written by Matt Marchant, Corrective Exercise Specialist
What is Corrective Exercise?
It is a scientifically and systematically structured exercise program built around your physical and biochemical needs. It is designed to restore and maintain correct posture and body movement mechanics. Corrective Exercise gets you back to moving how your body was created to move - freely and without pain.
The main theme of Corrective Exercise:
Move Better, then Move More
Who is Corrective Exercise for?
Anyone looking to maximize their fitness potential. The misconception is that Corrective Exercise is only for those who are working through an injury, whether currently under the care of a physical therapist or chiropractor, or before they re-enter into recreational fitness or sports. While that is true, many people require some form of corrective exercise in order to clear up their joint inflexibility and address their muscle instability.
Many athletes can benefit from visiting and revisiting the assessments and corrections that a Corrective Exercise Specialist can provide. You are only as strong as you are stable. Like the saying goes, “You cannot shot a cannon out of a canoe.” Well, you actually can, but I wouldn’t want to, and I’m sure neither do you.
The Principles of Corrective Exercise
1. Assess the Client
If you do not assess the client’s posture and movement, you will be guessing with their program and results.
A qualified Corrective Exercise Specialist will include the following in a basic assessment:
First: Screen out orthopedic impingements, injuries, or issues.
There are basic tests that can be done to test for the possibility of more serious spinal, shoulder, and hip injuries that are hiding under the surface, waiting to erupt. The same is true of breathing assessments mentioned later on - they can screen out serious breathing malfunctions.
A movement screen is not a movement assessment. In the screen we are hoping not to find anything, but must start here to filter out observable movement dysfunction and client experienced pain. All movement should be pain free. Pain does not mean a noisy joint or tight muscle. Pain may make the technique poor and the movement unbearable.
Screen out dysfunction before the client begins to scream out in pain.
If a movement screen does produce unusual pain or the inability to perform basic movements, the client may need to be referred back to or to their chiropractor, physical therapist or orthopedic specialist. It is rare that this does happen, but when it does the client will be very grateful that we took the time to fully assess their body before starting an exercise program of any intensity level.
One Example of a Movement Screen: How does the client feel by going into a McKenzie Press Up?
Second: Assess the Breathing Pattern
How you breath effects many parts to your body including: 1) your posture, 2) your energy, and 3) your discomfort. If you breath incorrectly while standing doing nothing, you will breath incorrectly while exercising. If this is not assessed and observed, a workout will only serve to help the client breath incorrectly more times than if they just stood there.
Breathing is obviously an essential part to life, and an equally essential part to all exercise. Breathing correctly will help posture, energy, and improve exercise technique.
Breathing right gives the client the right workout, with the right results.
One Example of a Breathing Assessment: How many breathes does the client take in a normal 60 second period?
Third: Assess the Posture
How you stand - is how you move - is how you will lift. Postural issues are the number one reason why a client is in the office for Corrective Exercise. It only reasons that a postural assessment is done. In order to do this the specialist must understand what good posture looks like (qualitatively) and how current posture is measured (quantitatively).
There are many ways to measure posture with the eyes or with tools (qualitatively and quantitatively), and both have benefit. Depending on the clients needs, a postural assessment may be basic or advanced. Either way, posture must be addressed or any exercise will speed up postural dysfunction and possibly speed up the rate at which pain and injury occur.
Posture is assessed from head to toe so that whole body may be pain and injury free.
One Example of a Postural Assessment: What is the client’s Forward Head Posture, as measured in centimeters?
Forth: Assess the Core Function
All human movement emanates from the core. You cannot move properly without proper core function. Even sitting requires the core to work.
The core is described easiest as - the muscles surrounding the entire midsection. More specific, the core includes 5 muscles, 3 of which we need to be in control of with each movement. A specialist will not only test and assess these muscles, but will be able to educate the client on how to properly activate and strengthen these muscles in an appropriate fashion for their goals, age, and condition.
Core function makes all movement functional.
One Example of a Core Function Assessment: Is the client able to draw in the belly button (Transverse Abdominus) while on their back and while standing?
Fifth: Assess the Basic Flexibility
In a basic flexibility assessment we are not looking to measure everything. We are looking at areas that may be tight due to the findings of the postural assessment and common areas of tension for those in a sedentary culture (which is all of us).
Also, in a basic flexibility assessment, we are not looking to measure flexibility against pre-determined “normal” ranges of motion. We are looking for asymmetries first. Meaning is one leg tighter than the other. That is more of a initial concern than if both legs were equally tight.
According to the professional experience of physical therapist Gray Cook, asymmetries are the second leading cause of injury in a workout program. The first being a pre-existing injury.
Not everything needs to be measured. Your flexibility assessment should be based upon functionality.
One Example of a Basic Flexibility/Asymmetry Assessment: How does the client’s right leg differ from the left in a lying straight leg raise?
Sixth: Assess the Movement Pattern
Everything eventually comes done to - How do you move? Measuring knee range of motion while you are lying on your back on a table is a start. How that range of motion actually performs while doing a squat or getting out of a chair is what ultimately matters most.
One Example of a Movement Pattern Assessment: How well does the client perform a squat movement or how well do they move getting up from a chair?
** This may seem like a lot in one session, but these assessments should be quick and easy to observe.
Some clients may need a more advanced assessment, and that will be based upon one or more of the following: 1) the nature of the injury being rehabbed from, 2) the findings in the basic assessment, or 3) upon recommendation from a chiropractor, physical therapist, or orthopedic professional.
2. Create Spinal Mobility
Once an assessment is completed, it is time to mobilize the body. The assessment will not tell us who needs mobility, it will tell us how much each person needs. Why the distinction? We are all sedentary. We sit to drive to work, sit to drive home, sit to eat, and most sit at work. Even if we have a job that is spent up and moving, it tends to be repetitive and we still sit too much for how our bodies are designed to move. Therefore we all tend to need more mobility.
This lack of mobility is seen mostly in the spine. There are well defined angles with which the entire spine should be in while moving, standing and even sitting. When we lose spinal mobility, we create what pioneer of Exercise Physiology Vladimir Janda described as: Upper Crossed Syndrome and Lower Crossed Syndrome.
Upper Crossed Syndrome is also called “Rounded Shoulder Pattern”, and Lower Crossed Syndrome is also called “Fat Back Pattern”. Whether by themselves or when combined together, they create flexion of the spine - meaning: they bring us back into the same fetal position that we as infants struggled to get out of.
A Corrective Exercise Specialist uses a combination of Joint Mobility and Corrective Mobility exercises to continue the work of maintaining the spinal mobility that you and your Chiropractor or Physical Therapist have achieved.
A Corrective Exercise Specialist knows exactly which muscles need more mobility, and which do not. Some will need more stability (covered in the next step).
3. Produce Spinal Stability
Now that we have sufficient mobility within the spine, we are ready to use Corrective Exercises to retrain the Core muscles.
Thomas Hanna, PhD. coined the term - “Sensory Motor Amnesia”. This is when a muscle “forgets” how to contract. In fact it is not the muscle that forgets but it is the motor program that starts within the brain that gets temporarily “turned off”.
Imagine that each of your muscles are like a room with motion sensor lights. When someone is moving within the room - the lights are on. No movement - no lights. Just like the use of motion sensor lights are a way to save energy, our brain (nervous system) “saves energy” but reducing the signals it sends to muscle that we consistently do not use.
This is why staying in one posture (not just sitting), or only using one specific movement pattern (like swinging something from only one side all day) repeatedly, can quickly “turn off” important stabilizing muscles.
A Corrective Exercise Specialist knows which muscles make up the “Inner Unit” of the Core, and exactly how to re-train them to fire and function properly.
A Corrective Exercise Specialist knows which muscles of the midsection and spine not do need more exercise, for they are already overly tight (over-facilitated).
4. Correct the Movement Mobility
The Spine, it’s mobility and stability must be addressed first since all movements originate from it. The legs and arms are only as strong as the spine is mobile and stabile. Next we progress onto improving the mobility of the “Four Knots”: the shoulders and hips. These are the next priority in Corrective Exercise program, and we must have sufficient mobility of a joint before we can create usable stability of the same joint.
Using the same Joint Mobility and Corrective Mobility techniques, we improve adequate mobility in the shoulders and hips, and then move outward towards the elbows, knees, wrists and ankles.
Creating mobility is essential if we want proper technique in our Corrective Exercises. If we do not know how to do this, a Corrective Exercise program can quickly turn into a dysfunctional exercise program that may have even been the reason the patient came in originally to see their Chiropractor of Physical Therapist.
A Corrective Exercise Specialist knows what areas need mobility and what do not in order to create better movement mechanics.
Mobility is needed for Stability. Mobility and Stability are needed for proper Exercise Technique; Exercise Technique is by far the most important factor in a Corrective Exercise workout. (It is actually the most important factor in any type of workout)
5. Correct the Movement Mechanics
It all comes down to: Are you moving 1) with less pain? and 2) with better posture?
A Corrective Exercise program continues that basic premise originally addressed by your Chiropractor and Physical Therapist, and helps transition you into a comprehensive and consistent exercise program. For most injuries, they were a build up of chronic postural stress. This means that a consistent exercise program of at least 3 months, will be required to make substantial long term movement progress.
A Corrective Exercise program works on an monthly assessment schedule, making sure to add in more or to scale back, based upon how quickly the client’s movement mechanics are improving.
A Corrective Exercise Specialist will prescribe exercises for a client based upon how much they challenge the client’s nervous system and improve movement of the 7 Primal Movement Patterns. A Corrective Exercise Specialist may also use a series of Developmental Movement Patterns to enhance over-all movement mechanics.
A Corrective Exercise Specialist prescribes exercises based upon their fundamental necessity , not because they are fundamentally hard.
Your exercise program should do more than make you sweat harder, it should make you move better.
6. Add Resistance and Sophistication to the Movement
Muscles are dumb pieces of meat; they contain no intelligence. The brain on the other hand and its messenger, the nervous system, produce the intelligence to move more gracefully and free. Since infancy, your nervous system sought out ways to move in more sophisticated ways. Notice I did not just say, "move more". Sophisticated movement is the key, and sophisticated movement need not be "hard" in a traditional exercise sense. In some cases the adding of resistance to a movement will make sense, in other cases it may not.
Making the resistance level on an exericse, as hard as possible is rarely reasonable.
Making an exercise look more like a juggleing act at the circus, may not get you laughing.
What does a typical Corrective Exercise appointment look like?
From the outside, it may look similar to other exercise or fitness programs, but the design and intent prove to be much different. A Corrective Exercise program looks to improve quality of movement not the quantity of movement.
Moving more does not help if you are still moving poorly.
A Corrective Exercise program gets the client back to moving in real life movement patterns, not just getting the client to move. The program moves from basic to sophisticated movement. How fast the client moves along in the coming weeks is up to many factors such as 1) nature of the injury, 2) age, and 3) commitment level. I have seen quick results from clients who are well into their 80’s, and serious about moving better.
A typical Corrective Exercise session will move towards covering the 7 Primal Movement patterns of all humans, and eventually within the 3 Dimensions of Movement. Since life happens in 3 dimensions, and our movements always contain some form the Primal Movement Patterns (squat, bend, lunge, pull, push, twist, and walk), your workout program will benefit you the most if your movements are true to life.
Sitting on a leg press and pushing weight will help you get stronger only at the leg press. Learning and strengthening the movement of the squat pattern will help you everytime you pick something up from the floor, and for all the times you get into or out of a chair.
Exercise selection can make you movements "smarter" or "dumber".
The Corrective Exercise session may look like this:
1st: Test a Movement
Example - Testing the client’s squat movement.
This is done to assess the starting point for today’s workout and to observe any progress from the last session. Estimated time required: 1-2 minutes.
2nd: Mobilize the Movement
Example - Moving stiff joints & mobilizing tight muscles that are inhibiting a proper squat.
This is done by using a combination of Joint Mobility and Corrective Mobility techniques, many of which the client performs by themselves with instruction of the specialist. This helps the client learn to mobilize their own body. Estimated time required: 5-10 minutes.
3rd: Learn the Movement
Example - Using tubing or another exercise tool to re-learn proper form for the squat.
This is done by using a combination Technique Reinforcement with bodyweight only movements and Reactive Neuromuscular Training (typically with the use of exercise tubing which teaches the muscle how to move properly). Estimated time required: 5-10 minutes.
4th: Test the Movement again
Example - Testing the client’s squat movement same as before.
This is done to mark the effectiveness of the mobility and learning process. If there is sufficient progress proceed to the 5th step, if not, go back to the 2nd. Estimated time required: 1-2 minutes.
5th: Strengthen the Movement
Example - Using bodyweight, more weight, or more imbalance in the squat movement.
This is done by using resistance (weight) or adding in sophistication (making the same squat more of a challenge without extra resistance), to enhance the strength in the movement or the balance of the movement. Estimated time required: 10-15 minutes.
6th Decompress the Movement
Example - Stretching the right muscles that need to recover from the workout.
This is done by using Compensatory Yoga poses or basic stretch protocols, to decompress (or relax) the muscle tissue after the tension it undergoes during normal resistance training. Estimated time: 5-10 minutes.
** All of this can be and should be done in a 30-60 minute Corrective Exercise Training session.
How long does someone need to be on a Corrective Exercise program?
That depends on many things. It may sound like a copout from answering, but it is just too personal to answer with any specificity until an assessment has been made. Factors that play into this equation include: the age of the client, the nature of the injury/musculoskeletal dysfunction, and commitment level to the program.
In most cases, the injury or dysfunction did not happen over night (even if it was an acute injury, there may have been prior mitigating factors). Therefore, getting the body and its movement patterns back to 100% will take time.
I generally recommend that clients commit to at least a 3 month Corrective Exercise program.
In my personal and professional experience, each element listed is essential in developing a concise and comprehensive Corrective Exercise program.
This has been the Marchant Training Method’s version and presentation of Corrective Exercise. If you are in need of a program or assessment, please contact Matt Marchant for a complimentary appointment at (714) 342-0359 or email@example.com.
Resources to learn more:
“Movement” by Gray Cook, 2010.
“Becoming a Supple Leopard” by Dr. Kelly Starrett, 2013.
“CHEK Exercise Coach Advanced Training Program Manual” by The C.H.E.K Institute, 2009.
“The Back Pain Revolution” by Gordon Waddell, 1998.
“The Endless Web: Fascial Anatomy and Physical Reality” by R. Louis Schultz, PhD., 1996.
“Somatics: Awakening the mind’s control of movement, flexibility, and health” by Thomas Hanna, 1988.
“Anatomy of Breathing” by Blandine Calais-Germain, 2005.
“Fitness for the Pelvic Floor” by Beate Carriere, PT, 2002.
“Free to Move” by Scott Sonnon, 2008.
“Prasara Yoga” by Scott Sonnon, 2007.
“Super Joints” by Pavel Tsatsouline, 2001.
“Relax into Stretch” by Pavel Tsatsouline, 2001.
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