Correct that!

Hi all!  We want to discuss corrective exercise this week.  Both of us have our specialty certification for Corrective Exercise from NASM.  This allows us to perform certain assessment that help to identify incorrect movement patterns and postures as well as the possible muscle imbalances that may be the cause.

Some of the most incorrect postures and movement patterns we see at Bay Area Pain and Wellness are:

  • Forward head position
  • Protracted shoulders
  • Flattening of the lumbar region, especially when seated
  • Knee valgus
  • Feet externally rotated

While those are the most common, they are by no means the only positional issues that we may be able to correct.  Many times these issues cannot be corrected due to deformities within the bones.  However, when it is a muscular issue, we are able to identify the culprits through some assessments that help us to narrow down the area and further to specific muscles.

The most common assessment is called the overhead squat assessment.  With this assessment, we are looking at the whole body.  Each view we use, we are looking at specific checkpoints.  We have the client move through a squatting activity with four specific caveats:

  1. Arms up with feet flat
  2. Arms up with feet elevated
  3. Arms down with feet flat
  4. Arms down with feet elevated

During the assessment, we are watching for:

  • Feet rotating
  • Knees moving inward or outward
  • Rounding or arching of the back
  • Arms dropping
  • Heels raising
  • An asymmetrical shift during the squat

Any of these are indicative of muscle imbalances and through the use of the various positions and checkpoints, we are able to pinpoint where the imbalances are.  Once we have discovered the areas needing work, we can begin using corrective activities.

In the picture above, you can see that when compensation was removed, the knees and feet lined up but there still seems to be a slight asymmetrical shift  that needs further assessment and will also need to be corrected.

Correcting involves:

  • Inhibiting overactive muscles through self myofascial release
  • Stretching overactive muscles
  • Activating under-active muscles

Corrective exercise is something that should be undertaken:

  • After a long period of no exercise
  • Periodically during regular exercise to ensure proper movement patterns
  • Post rehab of an injury
  • Post sport season

Here is a scenario:

A 43-year-old former dancer comes to the clinic complaining of knee pain.  Upon observation of her walking gait, we notice her feet are externally rotated.  We perform the overhead squat assessment and notice that as she squats, her feet will move outward with her feet flat on the floor with her arms up or down.  However, when we place her heels on a board that allows a 2-inch lift, her feet no longer rotate.  We conclude that the culprit is most likely her lateral gastrocnemeus is overactive and her medial gastrocnemeus is under-active on both legs.

The plan for this client is to foam roll and static stretch her lateral calves followed by strengthening of her medial calves.  This would be added into an exercise plan that would be designed to stabilize her whole body prior to advancing to a strength endurance program.

While the overhead squat assessment is an excellent first step, there are several other assessments that we will use to correct compensatory movements and imbalances.  This post only described one specific assessment that we use.

Corrective exercise is an important step in helping yourselves in proper alignment and using proper movement patterns.  It will help to reduce the risk of injury and will stabilize your joints.  We highly recommend you find a personal trainer certified to perform these types of assessments to give yourself the best chance to succeed in your personal fitness goals.