Lee Burton: Corrective Strategies

This idea of corrective strategies—what does that mean?

Not all of your clients or athletes need corrective exercise. A lot of people I do the Functional Movement Screen on don’t need any corrective exercise.

They move great.

What they need is a hard workout to get bigger, faster, stronger or improve their endurance. My goal is not just to suggest corrective exercises; the important part of the phrase is strategies.

How do you take people who are not moving well and help them move better? It’s not always about exercise—you might have to take things away from what they’re doing. Make them sit up better, improve their posture or tell them to quit running 10 miles a day.

There are things you can do, without prescribing an exercise, that will help people move better.

To prescribe a good movement strategy, we must create a logical approach.

The first time you see a client, what’s the first thing you do? Don’t you ask them a few questions?
How do you feel?
What is your medical history?
Do you have any previous injuries?
That’s a screen.

We have to be consistent in our first approach and the first things we do so we don’t miss anything. If we have a checklist of things we want to do in the onset of a person’s visit, then we’ll know if we’ve left something out.

Screen and assess and then you can start creating a profile of the clients—what are they good at, what are they not good at.

It’s our job to make sure we really focus on what they need. They’ll tell us what they want. That’s the easy part. And what they want has to be part of what we give them. But we have to focus on what they need. That’s what separates us from the everyday personal trainer or strength coach—giving them what they need in addition to what they want and using our skills in creating a workout.

The hardest thing for us to do is to make someone bigger, faster, stronger, improve their endurance, and improve their efficiency . . . without screwing them up.

Often, we push too far.

We have to correctly identify the primary dysfunction and a lot of us don’t do that. It’s not always about movement. What’s the biggest problem this person has? He benches four days a week and his shoulders hurt. That’s the biggest problem. Take him off the bench and I guarantee his shoulders will be a little looser.

Think about think about some your clients. What’s the biggest issue they have? Is it even related to exercise? We have to identify that first.

Focus on the biggest problem. Is it pain? Is that mobility or stability? Endurance? Strength? Not everybody needs corrective exercise. Develop a program that is going to correct their biggest problem, whatever the biggest problem is.

Our biggest responsibility to our clients or athletes is not to screw them up. Don’t hurt them.

That’s rule number one for us as professionals: Don’t mess them up. We’ve got to push them, but we can’t mess them up.

How many high school coaches have sophomores in high school benching as much as they can, but the kids can’t do a pushup. We have to lay down that foundation.

But here’s one we get a lot, we exercise to improve physical capacity or performance and focus a lot on that goal . . . sometimes too much.

We take the person who can’t move correctly and add strength, add some endurance. She can’t stand on one foot, but she’s going to go run 10 miles. No! Make sure they can move, then add physical capacity.

Then, we have a person who does well on the movement screen but says her shins are killing her. She moves well, so what’s the issue? She gets shin splints. What’s causing the shin splints? That’s a performance-related issue or maybe it’s overtraining. Nothing we can prescribe for that person is going to take those shin splints away, except for rest. Decrease the mileage. It’s a training-related problem. It’s a physical capacity problem.

We’re trying to accomplish quality versus quantity. We have to make sure we don’t put performance on top of a dysfunctional pattern.

We can improve a poor leg raise in about 10 minutes by working on hip mobility. Foam rolling and stretching can increase hip range of motion and we’ll get a positive short-term response. But what happens when the person comes back the next day?

Did the change hold? No.

Most of us are really good at getting a short term positive response—improving mobility or improving stability. The hard part is keeping it!

If you’re not keeping the desired response, that’s not corrective. It’s not corrective if you’re still prescribing that same exercise in a few months. It’s not working. You either didn’t identify the biggest problem, or just need to pick another exercise.

If you get a positive short-term response, that’s a good activity. That’s a good technique. Now you have to keep it; you have to make sure you take that short-term positive response and turn it into long-term adaptation. Take that 10 degrees the range of motion improvement you just gained and use it in some type of activity, so you can hold onto it.

Once we get that long-term adaptation, we want to train that person. We want to push them. We don’t want them to continue to have movement dysfunctions.

And that’s goes back to correctly identifying the biggest dysfunction. Check, then recheck them—did I improve them? If I did, I’m on the right track.

Progression is one of the hardest things we do because there is no exact science. Everybody is different. That’s tough! We have to figure out how to progress them, which is hard enough, and then progress them without messing without altering their basic movement mechanics.

We have to go back to the basics. When we talk about movement mechanics and corrective exercise, it’s built on fundamental movements . . . on growth and developmental motor learning.

All of you reading were able to do all the fundamental movements. You followed a sequential developmental model where one thing came before another. We were very mobile. Then we learned to stabilize. We crawled, then we stood up. Then we started to ambulate. For the most part, everyone follows the same sequence of events.

That is what we want to tap into when we start talking about improving movement or using corrective exercise.

We have to get back into the fundamentals of movement and correction. We improve mobility, then we have to stabilize it. And before we get them standing and doing certain things, we need to get them on the floor because rolling around on the floor is how we learn to stabilize our bodies.

The key is, it’s natural. It doesn’t take a lot of coaching. If we can tap into that same automatic response for corrective exercises, we may get marked improvement.

We have to get back to the basics—get people back on the ground. Help them appreciate hip mobility, feel their knee and foot position on the floor, and then, stand them up.

Everything we do in everyday life is based on three foot positions, so we need to train that way If we’re going to follow our functional progression:
Symmetrical stance,
Single-leg stance, and
Split stance.
We need to focus on an individual’s weakest position.

Our bodies react differently based on the foot position. Some people can do great standing with both feet, but you put them into a lunge stance, and they’ll be all over the place. We need to consider those differences as we design a corrective exercise.

If we’re looking at the fundamentals of movement growth and development, mobility has to come first. Always go back and look at how a baby learns to move and that will give you a good perspective of the fundamentals of movement. Babies are mobile first and they learn to stabilize.

We develop head to tail. The first thing we learned to stabilize is our heads. We stabilize from proximal to distal. We learn to stabilize.

Mobility and stability can get confusing. We hear a lot about core stabilization and lumbar stabilization—”We’re going to stabilize your core.” Great, but what’s the mobility like? I guarantee you if a person doesn’t have hip mobility, they will sacrifice lumbar stability. Start there!

If you don’t have hip mobility, you will sacrifice core stabilization. You can do all the core stabilization exercises, but if you don’t have hip mobility, you aren’t going to use that stability you just worked on. The same thing could be said for the neck. If you don’t have t-spine mobility, you’re going to use your neck more.

Make sure you have mobility first. Proprioceptively, that’s what the body and brain will appreciate.

Quality proprioception has to be built on mobility. If we start will limited mobility, the proprioceptors will become less efficient. Proprioceptors are most active in the end ranges of motion. If we limit that motion because we sit too much or sprained an ankle that didn’t get properly rehabbed, proprioceptors are going to react to that. We have to make sure we have plenty of range of motion so the proprioceptors can work efficiently.

Proprioception creates our stability. Our brain, our nervous system, proprioceptors—that’s what helps stabilize everything. We have to make sure they have everything they need in order to work right.

And one thing they need to work right is range of motion. We make sure we’ve got range of motion, and then we get stability. I didn’t say we shouldn’t have core stabilization; we just need to make sure we have proper mobility first.

Stability does not mean strength. Those are two different things. Stability is reflex-driven; it’s reactive. That’s what the core is designed to do. The core should react and engage based off what the proprioceptors tell it to do: react.

When we land from a jump, we need to have mobility, but we need to stabilize it—get static and then dynamic. That’s what we did as infants and that’s how we learn to move. We learned to appreciate static stability. Get static and then let’s work on dynamic. We skip this too much and go straight to dynamic activities.

Too often we don’t focus on repatterning. We gain mobility and then we go right into some type of activity. We don’t want to skip this step. Sequencing, motor program, get the static stability—put them in a position where they have to react and stabilize it. Clean up the movements.

Gain range of motion, then put them in a position where they have to proprioceptively use it.

Then add some weight . . . then go from static to dynamic. Don’t skip this step.

Once they get moving better, put them in a position where they can use it.

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