I recently read a quote by former Kansas City Chief Art Still, “Regular exercise may be the single most important lifestyle activity that will make people healthier.”1(web-link to mag) As true as that statement is, those of us in pain my not be able to get the exercise needed to be healthy. This brings me to today’s topic: Corrective Exercise.
Corrective Exercise may be the single most important activity when dealing with an injury. Many therapies, physical rest, and treatments can decrease pain associated with injury. However, if one does not correct the cause and subsequent muscle imbalance that lead to the injury, the pain will likely reoccur. A Corrective Exercise regimen will target the dysfunction, muscle weakness, and overactivity that predisposed one to injury and decrease the likelihood its recurrence.
Injury occurs due to excess stress placed on a joint or muscle. Repetitive activity or movement causes overuse of specific muscle groups and this overactivity inhibits opposing, or antagonistic muscles. When a muscle is overused, or injured the body, lays down scar tissue in response. This scar tissue can cause decreased range of motion, nerve entrapments, and decreased blood flow. Pain results at immediate site, but more often pain is experienced in another joint.
Since Kansas City has a high rate of knee surgeries, medial or inner knee pain can be used as an example. Quadriceps and/or hip flexor dominance produces weakness in the hip stabilizing glute muscles. During activity such as going down stairs, jumping, or running, stress is placed onto the knee since the hip stabilizers are not functioning at optimal strengths. This commonly places the knee in a position that stresses the medial meniscus and ligaments, leading to pain. Many therapies and treatments can decrease the pain, but unless the muscle imbalances are addressed, the pain will likely return.
The National Academy of Sports Medicine (NASM) breaks corrective exercise into 4 categories: Inhibit Lengthen, Activate, and Integrate.2 An effective corrective exercise program will contain these principles and progress though the stages. This process will address the overactive muscles, the tight muscles, the weak muscles, and finally incorporate the whole body to reduce chance of reoccurrence of injury.
- Inhibitory techniques are used to reduce tension or decrease activity in muscles. This can be accomplished by myofascial release techniques performed by a DC, DO, PT, etc. or by self myofascial release with the use of a foam roller. These techniques are Active Release Technique (ART), Graston Technique, FATKR, and many others.
- Lengthening techniques are used to increase length and range of motion of the tissues and joints. These techniques can be as simple as stretching (static or tri-planar) or neurological. Practitioner lengthening techniques are Post-Isometric Relaxation (PIR), Post Facilitated Stretch (PFS), Post Neuromuscular Facilitation and others.
- Activation techniques are used to reeducate and increase activation of underactive tissues. This techniques range from functional rehab to positional isometrics.
- Integration techniques are used to retrain the collective function of all muscles involved in movement. This is done through functionally progressive movements using dynamic exercises. Integration is the last step and involves whole body movements.
A good, effective corrective exercise program is given to incorporate all facets of the problem, not just to alleviate the pain. By eliminating pain, and addressing the cause of the pain, one can enjoy an exercise program to become a healthier and happier individual. After all, “Regular exercise may be the single most important lifestyle activity that will make people healthier.”
Yours in health,
Dr. Justin Hildebrand
1. Still, Art. “Six ways regular exercise can help overall health.” Kansas City Sports & Fitness. March 2012. Pg 10: Print.
2. NASM. NASM Essentials of Corrective Exercise Training. Lippincott Williams & Wilkins; 1 Har/Psc edition (September 25, 2010).