Hey hey readers! Happy February, 2024! In this month's blog, I will explain what corrective exercise is, who could benefit, and other general resources and information therein.
So, what is Corrective Exercise?
So, first, just a general definition of what "corrective exercise" (CE) is. CE is a form of training in which the priority is focused on restoring proper muscle kinematics (e.g. resting muscle length, synergistic activations, appropriate strength and power, etc.), so the entire human movement system (aka kinetic chain) can move and exist more efficiently, safely, and without pain or risk of injury during daily life. CE aims to identify how a person's body moves and holds itself upright in static postures, and if muscles are being activated at the right time, with the right force, and in the right sequence. For muscles deemed "imbalanced," integrated strategies are employed to attempt to re-balance the movement system, so that other forms of exercise and daily tasks can be performed with more ease. Most human bodies develop different forms of movement impairment over the course of their lives. A CE specialist (CES) helps to improve and minimize these impairments, so again, that overall movement, in all forms, is more fluid, stable, and safe.
What are Movement Impairments?
The human movement system (HMS) is an integrated system, so impairment in one system very often leads to compensations and adaptations in other systems of the body. Over time, these compensations result in muscle imbalances, in which some muscles are too short/tight/active, and some muscles are too long/weak/inactive. What happens is that these changes in the tissue leads to a cascade of effects. First, the imbalanced tissues can become inflamed, and this inflammation can lead to muscle spasms and adhesions in the muscle tissue. The combined effects of the inflammation, spasms, and adhesions (so-called sticky, tangled spots in the muscle and connective tissue) results in altered neuromuscular control, meaning that the way the brain and the body work together is altered, usually in a way that is disadvantageous for the body. This can very much lead to musculoskeletal pain, increased risk of injury, and injury itself.
The tissues of the HMS have a way that they "prefer" to move and exist at rest, ways in which energy is optimized, safety and stability is enhanced, and overall movement quality and posture is refined. The resting length of a muscle matters for movement and static postures. Muscles that are over-lengthened have a harder time generating force for movement because the cross-linking proteins that connect together and move to create muscle movement are further apart from each other due to tissue being stretched long. Muscles that are shortened also have a harder time generating force because the cross-linking proteins involved in contraction are compressed into each other so much, there is little ability to effectively create any movement. Thus, there is an optimal resting length for each muscle, and beyond this point, in either direction, the muscles simply don't function as efficiently.
Flexibility (aka extensibility) of the myofascia (i.e. muscles and surrounding connective tissue - tendons, ligamaments, etc.) is another huge factor in how the HMS moves and exists at rest. Muscles that are too inflexible, or tight, cannot stretch to their full potential because the tightness prevents the muscle from moving into its full range of motion. Another issue with rigid/tight muscles is that it can cause the nervous system to activate a similar and related muscle to carry out the movement (known as muscle compensation) rather than activating the prime mover itself. This is because the nervous system is highly economical. Nervous tissue and nervous signaling is metabolically very expensive for the body, so the nervous system will tend to seek the past of least resistance to accomplish a movement, and over time, this can lead to pain, injury, recovery, and difficulty with exercise, movement, and resting postures.
The neuromuscular interactions (i.e. the way the brain and nervous system communicate with the myofascia) are also important for movement quality. The nervous system is responsible for activating the muscles to move, including what muscles, with how much force, and in what order. If nervous system connections are faulty, it can cause incorrect motor patterns to be communicated to the muscles, resulting in dysfunctional movement and posture.
Muscle stability, endurance, strength, and power are also important for movement and posture in the HMS. Stability is the ability of muscles and connective tissue to maintain a joint position, allowing movement of appropriate muscles, while minimizing unwanted movement in the joints. Stability is especially important in static postures. Endurance is the ability of muscles to maintain contraction over extended periods of time. Endurance is also important for postural muscle contractions. Strength is the ability of muscles to generate force to overcome resistance. Strength is especially important in daily movements and athletic movements. And power is the ability of muscles to generate force, at the right time, with the appropriate muscles in the right sequence. Power is essentially strength in action, or real-time strength. I wrote a blog about these particular muscle features, so click here if you want know more about each.
CE works to improve these neuromuscular processes and connections, as well as flexibility, resting muscle length, and strength/power/endurance/stability.
What does a CE Session Look Like?
The National Academy of Sports Medicine (NASM) recommends four steps to be included in the CE action plan. The four steps are:
Inhibit
Lengthen
Activate
Integrate
Inhibit. In this first step, techniques are used to reduce tension and decrease activity of overactive neuromyofascial tissues (i.e. nervous, muscle, and connective tissues) in the body. This is typically accomplished with myofascial techniques, such as using a foam roller or therapy balls on tight, compressed tissues. The myofascial rolling helps to soften overactive tissues. A CES will do an assessment to determine what tissues are overactive, and these are the tissues that will be inhibited (or made less rigid, tense, or tight) in this phase. This will allow these extra-tight tissues to move more optimally in the later exercises (as well as in daily tasks).
Lengthen. In this second step, flexibility techniques are used to increase the extensibility (i.e. how well the myofascia can stretch) and range of motion (ROM) of overactive neuromyofascial tissues in the body. Most often, the same muscles that are inhibited in step one are also lengthened in step two. Thus, there are two steps that work to decrease activity of overactive tissue. The lengthening phase is accomplished via different forms of stretching, including static stretching, active stretching, and dynamic stretching (to read more about different forms of stretching click here to read an earlier blog post of mine on this very topic).
Activate. The third step of a CE plan uses techniques to reeducate and increase activation of tissues. These tissues are usually over-lengthened and often weak. This phase works to activate these underactive tissues. This is accomplished via isolated and single-joint strengthening exercises, such as a bicep curl. When a muscle is better integrated and activated with the nervous system, which comes with isolated strengthening exercises, movement and daily postures are more efficient and safe for the body.
Integrate. In the fourth step, techniques are used to retrain the collective synergistic function of muscles, meaning the way in which muscle groups (aka force couples) work together to create movement or stabilize the kinetic chain. This phase uses integrated dynamic movements that are multi-joint and compound. These movements are much more functional and resemble daily living movements, such as squatting while also moving at the shoulder joint.
A CE plan, developed with your CES, can be a standalone workout, or it could be used as a specialized warm-up for a more general personal training plan. A CE plan is also a great idea for off-days from your more intense workouts, such as running, hiking, or biking.
And, CE doesn't only involve the above 4 steps. CE also takes into account your sleep patterns, diet, stress levels, and amount of time per day spent resting and recovering. CE is a holistic, preventative plan that supports and enhances all other movement and positions you do and find yourself in.
Who is CE for?
CE is really for anyone. Most of us develop some type of movement impairment during life from our daily postures and physical stressors, so most of us can benefit from CE approaches. Our bodies work best when our muscles, bones, joints, connective tissues, and nervous system are coordinated and in the correct alignment, shape, length, and sequence. That is what CE aims to restore for a person's body.
What are CE Specialists (CESs), and Where to Find Them?
It is important to note that CE is not at all the same thing as physical therapy. Physical therapy is a clinical practice in which a doctorate level medical provider works to rehabilitate injuries using a medical model. CE is about improving movement quality in other exercises, postures, and daily living tasks. Is is not about improving or treating injuries or post-surgical recovery. If you are rehab-ing from an injury or surgery, consult with your physical therapist to find out if CE would be appropriate and safe for your body.
CE is most typically offered by certified personal trainers or other fitness professions with additional training in corrective exercise. I am personally certified through National Academy of Sports Medicine (NASM), but there are other certification programs for CE from a variety of other fitness agencies, like ACE and ISSA. If you are interested in talking with a CES, I would do a google search of that very thing in your area. You could also search "corrective exercise specialist" and related terminology into social media outlets. Many gyms, healthclubs, studios and wellness centers might also have CES working in those locations, so you could always try to call around to local gymios. Another way to find a CES is to ask your current yoga or group exercise instructor or other staff at a gym you might already be a part of.
Summary
Thanks for reading this post. I love the field of corrective exercise, and I find CE to be amazing for almost all bodies. CE is very individualized and aimed at restoring muscle balance and neurological homeostasis so that pain is minimized and movement quality is optimized. CE is not physical therapy. It is a specialized form of personal training that focuses on identifying neuromusculoskeletal dysfunction, and implementing a integrated corrective strategy to improve that dysfunction so exercise and daily movements and postures are more fluid, stable, and efficient. CE allows you to participate in your favorite movement routines as well as your static postures because it keeps your neuromusculoskeletal system at this best. If you are interested in CE, try googling it and asking around various gyms and studios. Thanks so much for reading this.
As always, the information presented in this blog post is derived from my own study of human movement, anatomy, and fitness. If you have questions about corrective exercise for your body, please follow up with your physician, physical therapist, personal trainer, or CES. If you are interested in corrective exercise, private yoga, and/or personal training sessions with me, Jackie, email me at info@lotusyogisbyjackie.com for more information about my services. Also, please subscribe to my website so you can receive my monthly newsletters (scroll to the bottom of the page where you can submit your email address). This will help keep you "in-the-know" about my latest blog releases and other helpful yoga and wellness information. Thanks for reading!
~Namaste, Jackie Allen, M.S., M.Ed., CCC-SLP, RYT-200, RCYT, NASM-CPT, NASM-CES, NASM-SFC, NASM-SFS
References:
**Most of this information came from my coursework with National Academy of Sports Medicine (NASM) in the Corrective Exercise and Senior Fitness Specialist certifications I completed.