Corrective Exercise, Prehab, making sure you don’t hurt in the morning. Whatever you would like to call it, it’s an essential part of movement; and understanding the process is crucial to understanding what you should be doing with your time in the gym. The foundations of corrective exercise are what we use to make sure that the people leaving MadLab Performance every day are feeling better than when they walked in. But why is it important that you understand the principles behind corrective exercise? Well, I’m a big proponent of the idea that knowledge is power. And in this case understanding human movement faults is the key to understanding how to go about making someone feel better. So that’s exactly what we are going to take a small dive into today. What are some of the basics to understanding human movement faults and what it may mean for you.
For context, we are going to be using the National Academy of Sports Medicine’s Corrective Exercise Book for a lot of the ideas and information in this post. First and foremost, and if you have ever talked to your local physical therapist, human movement faults rarely involve just one structure. In fact, impairment of one system often leads to a multitude of compensations and adaptations in other systems. (Clark, 2014) This leads to what is called the Cumulative injury cycle, which goes as such:
Tissue Trauma -> Inflammation -> Muscle Spasm -> Adhesions -> Altered Neuromuscular Control -> Muscle Imbalance
And then the cycle repeats back to tissue trauma, which goes back to inflammation, and so on and so forth. Tight muscles, improper muscle function, and all around feeling like crap. Whether you are a professional bodybuilder or work from home, we all have likely had some experience with this cycle. For instance, this can be seen very easily with one example: when the gluteus medius is under active, the tensor fascia latae (TFL) will kick in and potentially become what is called synergistically dominant to produce necessary force to accomplish frontal plane stability in the hips. In layman’s terms, the TFL starts shouldering the load of movement for the inactive glute med., which leads often to an overactive TFL, excessive IT band tension, and potentially chronic hip and knee pain. (Clark, 2014) This is something runners are normally very familiar with.
Three overarching principles that we want to be concerned about are Static Malalignments, Altered Muscle Recruitment, and Dynamic Malalignments. In order to understand the whole puzzle, we will need to break down these three key dysfunctions.
1. Static malalignments can be categorized as simply as joint dysfunction and adhesions that come from poor static posture. Basically, how you are at a resting position for a consistent period may be causing problems for you. (Where are all my desk jockeys at?)
Joint Dysfunction -> Altered Length Tension Relationships -> Altered Force Couple Relationships -> Altered Movement -> Structural and Functional Inefficiency
Once again so that this can all be more digestible for the everyday person, what this means is that when you are at a rested state or static state for an extended period of time this can cause changes in your muscles’ length and tension that will have an effect on how you feel over for the rest of the day; and eventually, how you feel on a daily basis. This is why we preach that motion is lotion. The more you move, and the better you move, the less pain you will be in.
2. The second is altered muscle recruitment. That good ole’ static malalignment that we were just talking about? Well, it gets better. As you have just read it leads to altered length-tension relationships and joint dysfunction, but what that eventually leads to is altered muscle recruitment patterns. (Clark, 2014) Aka. eventually your muscles will fire in a less optimal way because of the previously mentioned dysfunction. This can lead to that synergistic dominance that I had mentioned before. Once again, we will use the TFL as an example. The TFL is the synergist in hip abduction (leg coming away from the midline), and when the gluteus medius (the prime mover) is not being recruited optimally, it will compensate and take over to try and perform the movement. Think Robin trying to take over for Batman. This can lead to improper joint alignment and eventually hip, knee, and potentially even back pain or injury.
3. Dynamic malalignments are the final piece to the puzzle. Once you are dealing with a static malalignment, which causes altered muscle recruitment, you are left with the unwanted cherry on-top which is dynamic malalignment. This will cause impaired movements from an entire kinetic chain perspective and only give you accruing dividends of dysfunction and pain throughout an entire system of muscles. This can typically be categorized in two ways: Lower Extremity Movement Impairment Syndrome and Upper Extremity Movement Impairment Syndrome. Both of which have a myriad of potential injuries such as plantar fasciitis, lower back pain, and rotator cuff impingement. You get the point. By having one dysfunction it will eventually lead to a fault in the system. That’s why it is so important once again to have strength, range of motion, and proper muscle neural firings in order to feel better.
You may be asking yourself, “cool Alec, well now that do I do with all of this information?” And truthfully, it’s an incredibly loaded and complex answer to an incredibly simple question. That’s also why we do what we do. In order to fix these issues, we first must test and see what the underlying cause is. And another harsh truth: that may not always be evident right away. Test and re-testing movement. Strengthening underactive muscles and restoring proper muscle activation. Making sure you have proper mobility to reach ranges of motion necessary to move well. All of this takes time, patience, and continuous work and understanding. If you feel like you need help, reach out to a professional (I know a pretty cool team who has years of experience dealing with movement dysfunction), and start to dissect the issue that is keeping you from living a pain free and happier life.
I plan on continuing this series with some more information on common dysfunctions and what you can do to help them, so stay tuned.
References:
*Clark, M. A. (2014). Nasm Essentials of Corrective Exercise Training. Jones & Bartlett.