Thursday, November 12, 2009

Just Questions...

1. Does corrective exercise work? If so, does context make a difference?

2. Does corrective exercise address the cause or the symptom?

3. If all you're looking for is movement dysfunction, is all you find is movement dysfunction?

4. What happens to the psychology of an athlete when they have to follow corrective exercise protocols vs. the regular heavy training that the rest of his or her teammates are doing?

5. Should my kids get the flu shot; or does it just depend on who you talk to?

6. Is what we know about human gait wrong because we have been skewed by footwear?

7. Athletic training staffs across the country receive information from Perform Better with the latest being a email newsletter: "The Death of the Squat". With Coach Mike Boyle's latest "thought process"... being an "expert" with Perform Better... does this mean that we, as strength coaches who still have our athletes squat, now have to deal with possibly added resistance from the sports medicine staff about 'what we do', because a very well-known coach now says they are bad?

I would love to hear anyone's thoughts to any of these questions. Thanks.

Move.
AS

14 comments:

jleeger said...

Hahaha...ahh..I think you already know my thoughts on these things. But I'm up to the challenge!

1. It depends on what you mean by "corrective exercise." Any exercise can be "corrective," depending on how it's used. Context always makes a difference. When your friend tells you "f-you" it's ok. When a stranger says it, it's not. Or maybe even that depends on the context...

2. "Corrective exercise" as it's used most commonly nowadays only addresses symptoms. I haven't seen any "corrective exercise" prescriptions that include - "Walk at least five miles a day" in them.

3. Yes! To a hammer, everything looks like a nail.

4. They become "sick." If you tell someone they need "correction," and that you're the one who can "correct" them, you do two things. You put them in a victim/disabled role, and put yourself in an expert/fixer role. Everything turns to crap.

5. I personally would say no. But then, I don't have kids...see this blog post: http://fav-seattlechiropractor.blogspot.com/2009/11/to-be-or-not-to-bevaccinated-for.html

6. Thanks for the link!

7. Yes. And it's total bullshit.

Aaron Schwenzfeier said...

All great answers Josh. I really appreciate them, thanks!

Anyone else?????

Mark Young said...

1. Does corrective exercise work?

- I have to agree with Josh. Anything can be corrective if used properly. On the other hand, any exercise can be destructive as well. However, I assume you're talking about "corrective" with respect to smaller movements dedicated to dealing with dysfunction and I agree that these can be useful as well. It is ALL about context.

2. Does corrective exercise address the cause or the symptom?

- Short hip flexors are a product of our seated and sedentary culture. Stretching them (or doing whatever is needed to lengthen them) IS treating the symptom.

Treating the root cause of problems like this one would be magnificent, but in the meantime treating symptoms is the best we can do sometimes. This is a really sad state of affairs.

3. If all you're looking for is movement dysfunction, is all you find is movement dysfunction?

- Absolutely. But if all someone is doing is looking to get people HYOOGE or run fast without identifying potential barriers I think that is short sighted as well.

In truth, a lot of the "corrective" guys I know only use this as PART of their practice. Once assessed people can do their corrective work within their workouts.

4. What happens to the psychology of an athlete when they have to follow corrective exercise protocols vs. the regular heavy training that the rest of his or her teammates are doing?

- They pay us to tell them what needs to be done not what will make them feel cool with their buddies. As mentioned earlier, I think a corrective part of a workout should be brief and heavy lifting can follow. I don't think it has to be a case of either/or.

5. Should my kids get the flu shot; or does it just depend on who you talk to?

I got mine and so did my pregnant wife. Seriously, it's just a little shot and I'm not walking backwards yet.

6. Is what we know about human gait wrong because we have been skewed by footwear?

Absolutely! You actually turned me on to this fact when I first started reading your blog.

7. Athletic training staffs across the country receive information from Perform Better with the latest being a email newsletter: "The Death of the Squat". With Coach Mike Boyle's latest "thought process"... being an "expert" with Perform Better... does this mean that we, as strength coaches who still have our athletes squat, now have to deal with possibly added resistance from the sports medicine staff about 'what we do', because a very well-known coach now says they are bad?

- This drives me nuts because coaches are taking a squat or not squat stance and I'm not sure I get this. What ever happened to assessing the individual and not using cookie cutter recommendations???

I mean, everyone talks about this, but then we're all taking a fixed position on ONE exercise?

Besides, who listens to friggin' doctors when it comes to exercise anyway?

Aaron Schwenzfeier said...

Thanks for the answers Mark, much appreciated!

1. I agree

2. Yeah it is a sad state of affairs. I just wonder how much 'bandaging' will hold, before someone needs to confront the honest truth. I guess it comes down to choices and ultimately acceptance...

3. Completely agree, but my fear is that we've gotten so deep into dysfunction that we continue to chase it until death.

4. Maybe. In my situation they aren't paying me, and I think sometimes psychology plays a large role in athletic/team development.

Disclaimer: I'd like to think I have a decent level of intelligence here, as I don't hammer the pegs into different shaped holes, but...

Do I follow Gray Cook's "rules" of they have no business loading the squat until "such and such" standard is met?

As Josh stated:

"They become "sick." If you tell someone they need "correction," and that you're the one who can "correct" them, you do two things. You put them in a victim/disabled role, and put yourself in an expert/fixer role. Everything turns to crap."

I agree that it doesn't have to be either/or, but what's the message being sent by "experts". And I think very well coached BASICS, can correct many things.

Any thoughts?

7. But it IS because one coach, is taking a fixed position on ONE exercise.

... or against ONE exercise.

Again, I thank you Mark for your answers and would love to hear any additional thoughts.

Anyone else???

Dustin Schlichting said...

1. Does corrective exercise work? If so, does context make a difference?

- Yes, sometimes. Context I would say is the most important part.

2. Does corrective exercise address the cause or the symptom?

- Can be both. Or neither.

3. If all you're looking for is movement dysfunction, is all you find is movement dysfunction?

-Almost always

4. What happens to the psychology of an athlete when they have to follow corrective exercise protocols vs. the regular heavy training that the rest of his or her teammates are doing?

- I like the way J put it. We need to be very particular with what we are teaching these athletes. When I say "teaching" I mean what they walk away with at the end of the day. Working with a younger population they will absorb a lot of what we say but they will also interpret things on their own. First impressions are hard to change.

5. Should my kids get the flu shot; or does it just depend on who you talk to?

- I don't know. Let me know what you find out.

6. Is what we know about human gait wrong because we have been skewed by footwear?

- Makes sense.

7. Athletic training staffs across the country receive information from Perform Better with the latest being a email newsletter: "The Death of the Squat". With Coach Mike Boyle's latest "thought process"... being an "expert" with Perform Better... does this mean that we, as strength coaches who still have our athletes squat, now have to deal with possibly added resistance from the sports medicine staff about 'what we do', because a very well-known coach now says they are bad?

- The more I learn. The more I understand why athletic training is a struggling profession. 95% of the things we were taught was how to treat symptoms. While it is a piece of the puzzle for managing injuries and keeping people on the field. At what cost? How many injuries could have been prevented or how many trips to the training room avoided by spending a little more time looking for the cause? Don't get me wrong there are some amazing athletic trainers out there but they are not great because someone told them how to do something and they listened and took it as law. They are great because they continue to educate themselves every day and ask the questions... is there a better way?

Very seldom is any one thing always good or always bad.

Patrick Ward said...
This comment has been removed by the author.
Patrick Ward said...
This comment has been removed by the author.
Patrick Ward said...

1. Does corrective exercise work? If so, does context make a difference?

Work for what? What are we correcting? I think a lot of trainers want to talk about "correcting" things, when in reality, that is not their job. Their job is to help increase performance and keep athletes from getting injured (durability). Maybe they should stop calling it 'corrective exercise' and instead call it 'competent exercise programming'. You should be able to look at your clients and know what is appropriate or not. I guess if you are doing a regression of a much more dynamic exericse, it is thought to be corrective?

2. Does corrective exercise address the cause or the symptom?

Sort of answered in number 1, competent exercise programming should get yield the result that you want. Test the individual, train a little bit, re-test and evaluate whether you are on the right path or not with whatever goals you have.

3. If all you're looking for is movement dysfunction, is all you find is movement dysfunction?

If you go looking for something, you will always find it. Pracitioner/trainer bias is huge with anything. It is tough to wipe the slate clean with each and every client. I try and approach it by just expecting everyone to be perfect and when something odd happens, I just make not of it. But again, we (as trainers) are not assessing 'movement dysfuction'.

A lot of people who use things like the Functional Movement Screen like to talk as if that is what they are doing, but that would be an inappropriate representation of what the screen is. The screen is nothing more than a way to assess risk and tell if whether or not you should be training this person or whether or not they need to be seeing a medical professional (pain during testing, obviously signs of injury, etc).

4. What happens to the psychology of an athlete when they have to follow corrective exercise protocols vs. the regular heavy training that the rest of his or her teammates are doing?

Again, what are we correcting? Why are we not programming properly? Athletes who have limitations with regard to exercise technique or mobility need to do regressions of more dynamic exericses until these issues are better and they show you an ability to perform the more dynamic task competently. They are not paying us to justify their own beliefs on training. They are paying us for results and to keep them injury free. That being said, it should not take forever to clean up an athletes ability to do these things and move on to the more dynamic exercises that others are doing - this comes back to knowing how to write your program, having a way to test, and then re-test the individual to make sure that what you are doing is the right thing (are you getting what you think you are getting from training)?

cont...

Patrick Ward said...

...cont

5. Should my kids get the flu shot; or does it just depend on who you talk to?

Yes. People who are into conspiracy theories give me a headache. So much for critical thinking.

6. Is what we know about human gait wrong because we have been skewed by footwear?

Maybe (probably).

Interesting blog. I just book marked it for future reading. Thanks!!

7. Athletic training staffs across the country receive information from Perform Better with the latest being a email newsletter: "The Death of the Squat". With Coach Mike Boyle's latest "thought process"... being an "expert" with Perform Better... does this mean that we, as strength coaches who still have our athletes squat, now have to deal with possibly added resistance from the sports medicine staff about 'what we do', because a very well-known coach now says they are bad?

Honestly, it shouldn't even be an issue. Every coach has their reasons for doing (or not doing) a specific exercise. It is not my job to cast judgement on people for which exercises they select in their program menu and each individual has their own 'risk vs. reward', which will be different than my 'risk vs. reward' and possibly different than yours.

The problem is that belief systems are dangerous because when you say something loud enough and long enough, people tend to start to acccept it as 'fact' or 'truth'. People have lost the ability to think for themselves and come to their own conclusions. They would rather attach themselves to one pet idea or one single individual and get involved in "group think". I would rather listen to what an individual says and then go back and read the articles, research, books, etc. that they read and review the setting that they are in and come to my own conclusions as to whether or not I should change said training modality in my program as well. I am confident enough in what I know that I can come to my own conclusions. After all, you follow a group of lemmings long enough and eventually you are bound to walk off a cliff.

Patrick

Aaron Schwenzfeier said...

Thanks for the answers Dustin. I agree about athletic training, and is something I see all too often. But I think this can be for any profession.

Patrick thanks for the input, always good stuff.

I agree that folks need to people to critically think for themselves, but it does get exhausting having to constantly validate myself amongst all the belief systems that many hold, because I am not the "expert".

It's not just me doing what I think or know needs to be done. I, like many S&C coaches, have to "sell" my program to coaches, trainers, physical therapists, and athletes. And many of them get their belief systems from "experts".

Thoughts???

Thanks again fellas!

Patrick Ward said...

I agree that folks need to people to critically think for themselves, but it does get exhausting having to constantly validate myself amongst all the belief systems that many hold, because I am not the "expert".

It's not just me doing what I think or know needs to be done. I, like many S&C coaches, have to "sell" my program to coaches, trainers, physical therapists, and athletes. And many of them get their belief systems from "experts".

Thoughts???

Thanks again fellas!

_____________

Aaron, that is not true...YOU are the expert! In your situation, you are in charge. You are the one calling the shots. You are the expert.

Convince people why you do the things the way you do them. Have you tried giving a presentation to administration/staff? Maybe doing that and clearly explaining yourself would give them a better idea of what the system you are trying to implement is. Not only that, but explain why you do not agree with the belief systems of those that they are buying in to.

I agree, it is incredibly frustrating and you put in all this time reading and developing knowledge, only to have people tell you what to do. When I need my car fixed, I don't tell the mechanic what to do. Why should someone be telling me how to do my job?

Patrick

Mike T Nelson said...

1) Anything can be corrective, but without a re-assessment, how the hell would you know?

2) Depends if we can find the root cause. Assuming we can, is the athlete willing to change or is is a "cost" they have to pay? Do they even know the cost?

3) If all we see is piss poor movement (just go to the mall or airport), this has a very bad effect on our poor mirror neurons. Perhaps we only see dysfunction because there is so much of it everywhere; but we need to be careful about becoming myopic.

4) Heavy lifting when done correctly and re-assessed can be amazingly corrective. Depends if you are doing high quality work that improves your movement or if the athlete is only working their ego.

5) When science does not have clear cut answers to everyone's satisfactions, watch out for the internet and celebrities to fill the void with crap info wrapped in an emotional package. Drives me nuts

6) You can burn 99% of all modern shoes. Gait testing on a freaking treadmill in stiff shoes is dog poo.

7) Again, without a re-assessment you are pissing in the wind and trying to not get wet. It may be good for some and not others. Many things can work, but it really depends on WHO you are dealing with and their past injuries, current sport, etc. This becomes hard for group training and many times it is just easier to say "X is bad, don't do it" Make sure you are not applying your personal experience on to your athletes also.

Don't get me started on most athletic trainers (ATCs). Of course there are some brillant, top notch ones, but many are too stuck in their current beliefs to try anything new. We know that even in injuries, pain free movement is key. Wrapping/taping while needed at times, is not the solution---far from it. Easiest way to kill a joint is to not move it.

Great stuff guys and I appreciate all the comments from everyone on this one! AWESOME!!!

Rock on
Mike T Nelson PhD(c)
Extreme Human Performance

Brett Jones said...

Late to the game here but here we go...

1. Does corrective exercise work? Yes - if you are aiming at a true weak link.

do ankle tilts and toe pulls count? I mean for a Z trainer to criticize movement screening and corrective exercise does that mean you are putting Z in a different category?

2. Yes Corrective Exercise can address the cause - if you have a consistent standard which "aims" your corrections.

3. No - not if you are using a consistent baseline.
When was the last time you saw a gait without "dysfunction" - yet you will criticize other screening as only finding dysfunction.

4. I have actually found that after a restriction or asymmetry is found and corrected that there is only a positive mental result -
if they end in victim rolls you put them there.
Corrective exercise that is targeted is a brief process and then right back with the team - if it takes weeks and months - look in the mirror.

5. no opinion

6. Yes and no.

7. If you have a consistent movement baseline you can actually have a conversation about exercise - until then it is all opinion.

Do we need to be in the gym and lifting - Do we need to be coaching technique? Yes - after I am sure that there is a good movement base to operate from.

Aaron Schwenzfeier said...

1. Neither. I have been certified in both Z-Health and FMS.

2. But are the "mechanical" issues really the cause? Aren't they just symptoms of a much larger issue?

3. Again both FMS and Z-Health so non-issue between the two. More fitness industry generalization... don't mean to offend.

Yes I agree, consistent baseline/coaching eye, but enough room for idiosyncrasies.

4. I agree that they become this if you put them there.

I think it can be corrective cuing as well.

Maybe look in the mirror, but to expect some things to NOT take weeks, months is not respecting the adaptation process. A dynamic posture takes years to develop and not through just "training sessions", to think it will be only a couple weeks to "fix" is in some cases I don't believe possible. Neurologically we can make very fast changes, but connective tissue
/fascial/structural is a much slower process.