Movement by Gray Cook, (10) Understanding Corrective Strategies, Notes

Post date: Mar 27, 2021 1:23:34 PM

Movement By Gray Cook - www.movementbook.com

(10) Understanding Corrective Strategies

• 1. Common Corrective Exercise Mistakes

     1. No set rules or systematic control.

     2. Protocol Approach - giving exercise prescriptions based on general categories without considering for individual appraisal of movement dysfunction. Movement pattern profiles should determine programming, not sport or fitness goals. First discover and address movement dysfunction. Pain is the symptom, find the cause.

     3. The Basic Kinesiological Approach - following a tidy map targeting prime movers and a few popular stabilizers. This approach can provide a general strength base but fails to incorporate timing. It only assumes weakness and leaves changes in movement to chance as there is little regard for movement patterns or motor control.

     4. The Appearance of Function Approach - Looking at movement but only utilizing light loading or instability. Also, a lack of pre and post testing.

        1. Without movement standards, exercises will be inconsistently imposed. This creates a slippery slope to irresponsibility. The exercise becomes the test, baseline and confirmation. Do not introduce instability to a pattern already identified as poor in a stable environment. This only increases compensation.

        2. Always perform a complete diagnosis before recommending treatment. Expert diagnosis reveals the best possible treatment. Pre- and post-testing is vital. Standard baselines reveal the best approaches. Expert diagnosis reveals the best possible treatment.

     5. Prehab Approach - In this approach rehab exercises are packaged into conditioning programs as a preventative measure to reduce injury risk. Exercises are based on injuries common to particular activities. The problem with this approach is that it does not address bad training or exercise habits, poor mobility or poor training movement. Arbitrarily training a commonly injured body part will not correct or prevent injury unless a true weakness has been identified. Many other regional factors can contribute to injury. For example, spinal function, scapular stability and function of the AC and SC joints.

• 1. The Overpowered Performance Pyramid - Power generation exceeds the ability to move freely within fundamental movement patterns. Performance on mobility and stability assessments is poor, but performance in the second pillar is adequate. Work to improve movement patterns while maintaining power. Be patient. Performance may not improve initially when improving mobility and stability, but it will eventually.

  2. The Underpowered Performance Pyramid - This represents a person who has excellent freedom of movement but whose physical capacity is poor. Plan training and conditioning to improve efficiency, endurance and power without negatively impacting movement patterns. The most beneficial program for this is power, plyometrics or weight training. Such interventions create a buffer zone between the 2nd and 3rd pillars, providing greater durability and effectiveness during performance of specific tasks. If movement ability is adequate, lack of conditioning and strength then becomes the next most important risk factor for injury.

  3. The Underskilled Performance Pyramid - Individual is adequate at movement and power generation but lacks mastery of skill to perform the specific tasks of the sport. For the well conditioned but not appropriately skilled, the best investment is in a program built around skill development.

  4. Using the Performance Pyramids - During training, the performance pyramid will continually change for some. The FMS provides a method to gain the information to construct this pyramid. The pyramid assists in identifying areas to focus on in training. It demonstrates body balance or lack thereof. Use the graphic to help athletes understand the thinking process.

  5. Short Term Response vs. Long Term Adaptation - Response is the reaction to the training stimulus. It is a temporary change in physiology or movement. For example, warming up by elevating the heart rate or movement improvement that comes from a mobility/stability drill or patterning exercise. Adaptation means the adjustment of an organism to a change in the environment. It is a persistent change in structure due to repeated bouts of practice. Both response and adaptation should be noted and given equal attention.

     1. Positive movement pattern responses are indicators of motor learning. Poor movement pattern response reinforces poor movement pattern adaptations.

     2. The groundwork for refined an efficient movement pattern adaptation is laid by exercising versus qualitative minimums as well as by pushing performance numbers. Adaptations are built on repeated positive responses. Compensation occurs when training exceeds movement potential. Not all exercise positively affects movement patterns and physiological aspects can improve without improving the movement pattern.

     3. Always monitor the ‘challenge’ factor when prescribing exercise. Prescribe exercises that can be performed with a good pattern but still provide challenge.

  6. Corrective Exercise Progressions - If the challenge is too easy, make it harder. If it's too hard, make it easier. If it's just right, good job.

• • 1. The exercise is too easy: the person can perform more than thirty reps with good quality.

    2. Challenging but possible: 8-15 reps with good quality with no sign of stress breathing.

    3. Too difficult: Sloppy, stressful, poorly coordinated movement from the beginning and only gets worse. Impossible to breath, to relax and move. Observe the response and act accordingly.

• 7. Increasing DIfficulty - A more advanced posture, a smaller base, or a more complex or involved movement pattern is the act of repeating actions subject to consistent, specific and objective feedback. Talented people were not born that way but made themselves that way. True talent is knowing how to practice correctly. The most important aspect of anybody’s development is preparation. Look for better feedback. Exposure to the subtle mistakes that most disregard allows for more exacting, and ultimately quicker, improvement. Don’t just rehearse movements, tinker with them until the desired effect (mastery) has been achieved.

  8. Asking the Right Questions - All exercises chosen should meet the individual’s needs. The role of assessment and screening is to whittle down choices to a select few. Within these select few, narrow even further to the progressions that provide the appropriate challenge. Multiple correct approaches can be applied and the ability to use these are gained with expertise. To discuss exercise we need to know the situation, specific goals and problems, as well as current functionality.

  9. What Exercises to Remove from the Program - A movement screen or assessment: suggests what to remove and what corrective exercise to add. The first step is to stop activities most likely related to the problem. Example: If Single leg stance and hurdle step are dysfunctional--discontinue running, jogging and single leg work until improvement in the basic functional pattern occurs. How quickly a pattern changes is usually up to the individual. How dedicated, focused and consistent is the individual? How diligently are they willing to work on their weakest link?

• • 1. If shoulder mobility is the issue, stop all loading and heavy resistance work with the shoulders and arms. If the squat is the issue, no loaded leg work. Good coaching cannot overcome fundamental movement dysfunction.

    2. Make use of regressions to redevelop movement. As long as slow change is noted, do not stop. Most movement dysfunction develops over time and we have to give them time to change. The screen also identifies and allows continued activity in activities not compromised by pain or dysfunction.

• 10. Corrective Exercise is Supplemental - Always consider corrective exercise as supplemental and temporary. The goal is to design programs that maintain movement quality while achieving performance without needing ongoing corrective strategies. Correct approaches remove the need for continuous correction. Examples include Yoga and kettlebell training. Both require expert instruction, patience and personal investment. It is training that requires mindful movement and progression but pays dividends in the end. Fitness is a byproduct of learning high quality movement. Seek movement mastery. Use exercise correctly and stay in touch with movement.

  11. Exercises: Correct vs. Corrective - Corrective exercise is best for dysfunction but not the best preventative measure. We need to construct and teach better exercise techniques. Exercise should be designed around outcomes that yield performance and adequate functional movement patterns. Higher function reduces injury risk. Seek to prevent movement problems in the first place.

  12. Correct Exercises - Correct exercises target weak links based on biomarkers that establish reduced risk and higher performance. Historically, exercise supported endeavors for aggressive and defensive activity or survival situations. They evolved into sports and hobbies that require exercise and training. Physical training has classically been used to improve a physical skill set. Exercise should demonstrate greater physical perfection and durability, foster well being and physical recovery. Correct training methods plus challenging competition equal the best preparation. Focus breathing and the daily moving meditation. Run to survive, compete or reconnect. Relearn how to make the best training choices for health, fitness and athletic goals. Relearn to enjoy exercise for the sake of personal reconnection and well being. It should be pleasurable, productive and offer some variety.

• • 1. First, set physical goals and design the training toward those goals

    2. Next, make time for a healthy diet of movement that re-energizes and reconnects.

    3. Then, maximize the best exercise choices by pairing them with the most effective recovery. The best recovery practices are those that yield normalization of physiological parameters and movement patterns. Hard training and competition lower movement screen scores. Movement systems must be reset or we risk compounding the negative effects of the exertion. Appropriate recovery can accelerate a return of motor control, mobility, posture, and muscle and tissue extensibility.

• 13. Self-limiting Exercise is Naturally Correct Exercise - Self limiting exercises require attention and thought, keeping us connected to exercise and movement. Because the demand for engagement is higher, self limiting exercise develops physical awareness. It requires mindfulness and technique: awareness of movement, alignment, balance and control.

• • 1. (Born to Run) Running barefoot is self limiting. Running barefoot connects us with the sensors in our feet. The soles have a dense distribution of sensory nerves and provide a window into the environment not unlike the hands, eyes and ears. This sensory information helps us to adjust our movement, rhythm, stride, posture and breathing to meet changes in terrain. Oddly, increases in running related injury parallel that of developments in running shoe technology. The extra cushioning and bracing of modern shoes cover weakness. To run barefoot, correct technique must be followed. Overstriding and heel striking are not options. This is what is meant by self limiting.

    2. All technological advances must be tempered against historical facts and time tested principles. Wisdom is logical and simple. Seek out complete practices of movement, assessment and rehab rather than just the latest piece of equipment or technology.

    3. Other Self Limiting Categories Include - breathing , balance, grip strength, correct posture and coordinations.

    4. Exercises that combine multiple self limiting activities have natural selective and developmental benefits. They produce form and function. They provide natural stresses which our anatomy models itself around. These exercises keep us honest and allow our weak links to hold us back, which they should. Self limiting exercise should be the cornerstone training. Self limiting exercise both helps improve movement quality and maintains it as it requires full engagement both consciously and reflexively.

    5. To avoid the risk of further erosion, acknowledge weak links in training. Self limiting activities provide constant reminders that we cannot become stronger than our weakest links. Exercises should be performed for technical correctness not to failure, or even fatigue.

    6. These movements provide opportunity if the individual is given the appropriate challenge. These activities impose natural obstacles and require technical attention. There is a coordination of attributes such as balance and strength or quickness and alignment. They usually require quality instruction and if not respected, they impose risk. With patience, attention to detail and expert instruction, these activities provide a natural balance of movement abilities. These activities provide mental and physical challenges against natural limitations and technical standards. They provide variety and teach physical poise, confidence and higher levels of movement competence.

• 14. Examples of Self Limiting Activities

• • 1. Pain or discomfort to learn body management: Balance beam walking, Climbing activities, Barefoot running (chi ~ pose ~ evolution), Farmer’s carry

    2. Breathing: Crocodile breathing, Breathing during rolling patterns, Yoga, Martial arts, Pressurized (for power), Seesaw breathing (feldenkrais)

    3. Grip (shoulder and core control): Goblet squat to overhead lift, Climbing activities, Bottom up clean, Tall kneeling bottom up clean and press, Bottom up press, Tall kneeling bottom up press

    4. Balance and small base control: Single leg deadlift, Goblet squat with halo, Single leg medicine ball catch, ½ kneeling and tall kneeling medicine ball throw, ½ kneeling and tall kneeling kettlebell halos, Single or alternating leg jump rope, ½ kneeling bottom up press

    5. Posture and coordination: Jump rope, Indian club swinging, Turkish get up, Kettlebell overhead walk, Farmer’s carry, Surfing and paddle board surfing

    6. Combos: Cross country skiing, One arm push up, Double ½ kneeling press, Yoga, Climbing activities, Sports~games~drills, Trail running, Chop and lift (½ kneeling), Kettlebell bottom up squat~clean~press, Pilates, Surfing and stand up paddle boarding, Running uphill, Single leg squat, Press: bottom’s up~½ kneeling, Double bottom up clean~squat~press, Martial arts, Obstacle course, Running downhill

• 15. Challenging Versus Difficult - Challenge must address quality as much as quantity. Prize technique over bigger weights or shaved times. Tune movement performance. Apply the mentality of fresh, frequent and flawless. Hard work supports optimal movement patterns but only fortifies limited movement patterns. Test the limits but always leave something in the tank. Measure improvements and set new goals. Meet these goals with strategic tune ups. These are key to better test drivers. Workouts are not competitions. They should have sound intelligent programming. Competition in training should be based on individual goals. True training and conditioning is as much about learning as it is about energy expenditure. Opportunities for learning abound: better mechanics, angles coordination, breathing, strategy, emotional management, better alignment, recovery, etc.

  16. The Goals of Corrective Exercise : to resolve or reduce measurable dysfunction within fundamental and functional movement patterns. Sometimes it will require breakdown of supporting mobility and stability within a pattern. Most of the time, mobility and stability will be present and corrective exercise can be worked on to develop movement patterning and motor control.

• • 1. Follow the path. First, screening drives exercise choices. The rules of screening and assessment direct towards the most dysfunctional pattern. Remove all counter productive exercise options. Second, once an obvious movement path has been identified, choose an appropriate corrective with help from the exercise framework. Apply one or two of the most practical corrective from the appropriate category. Third, after application of the strategy, recheck the movement pattern. Once exercise has been taught and performed correctly, check for improvement against the basic movement pattern identified. Fourth, once obvious change has been noted, perform a screen to survey other changes and identify the next priority. If no change is noted, double check the screening protocol, the corrective choice and how it was executed. Don’t waste time guessing the correct path. Under this framework, corrective exercise can be successful.

• 17. Your Development - The screening system is designed to mentor you in your work. Practice the pro skill of correct exercise dosage and program design (deliberate practice). The immediate feedback from repeated baseline comparisons confirms or refutes each exercise choice. The system provides the structure. Base actions on feedback provided by the system. Strict adherence to the system produces individualized corrective strategies. Successfully identifying dysfunction directs to the appropriate group of correctives.

• • 1. First, define whether exercises fall under either mobility or stability. Then create subcategories based on movement patterns. Most exercises use a predominant pattern or combination of two. Categorize those exercises that you know and teach well first. Take appropriate action based on exercise outcome (progress, regress.) The response determines the next step.

    2. Methods should possess exercises that target both mobility and stability. Stay in your professional comfort zone at first, identifying the methods that produce results and those that don’t. From there, build or adapt these methods, slowly adding to the toolbox.