What To Do When Your Corrective Exercise Doesn't
How many foam rollers does it take to change... anything?
Over the past few years, it's become increasingly common to find people spending 10 to 20 minutes (or more!) releasing, activating, patterning and priming themselves for their upcoming workout. Specific jargon aside, this trend begs a largely unasked and equally obvious question: if you have to keep doing the same stuff, what is it actually correcting? Corrective exercise should be both corrective and exercise. Unfortunately, in a lot of cases it's neither.
Something's Gotta Give
I don't know about you, but if I spend time, energy, or money on something, I like to see a result. And sitting my ass on a foam roller day after day, trying to "release" the same trigger points without making any progress strikes me as akin to paying the same plumber to come unclog my sink every day without asking if he's worth the money.
Be honest with yourself—how many of your go-to corrective exercises are actually making a difference? Put another way, what would happen if you didn't do them for a day or two? Because I'd argue that, by definition, if they're truly corrective then they should eventually become unnecessary. I expect my sink to drain just fine a few days after the plumber does his thing, and if it doesn't—or if he expects me to give him a call every time I do the dishes—then we've got a problem.
It's time to expect more from your corrective exercises (trigger warning): it's time to expect them to actually correct something.
Profit vs. Performance
While I have my issues/concerns with some of the major corrective systems, this isn't meant to attack—or support—any one school of thought. Instead, my hope is to see a more critical eye applied to anything being termed "corrective". What I will say, and I mean this broadly, is this: when there's a conflict between profit and performance, profit typically wins. If you've spent years charging people to become certified or equipped to use your corrective approach, it's hard to assimilate new, conflicting information. Admitting you're wrong—or at least that you could have been more right—is the mark of a scientific mind, not an entrepreneurial one. It's just too expensive.
If you've spent years charging people to become certified or equipped to use your corrective approach, it's hard to assimilate new, conflicting information.
Change the Status Quo, Bro
Most corrective strategies can be boiled down to some combination of the following three methods: SMR (Self Myofascial Release, aka foam rolling), stretching, and activation. I find all three troublesome, at least when it comes to their claims of being corrective. Let's tackle them individually.
What's in a name? Well, in this case, a lie.
Sorry to be so blunt, but that's the reality of it. Check out the stretching mat at your local gym following a spin class and you're guaranteed to find a handful of Karens foam rolling their IT bands. Here's the problem: in order to cause a 1% deformation in this particular tissue, they'd need apply 9,075 Newtons of force—equivalent to around 2,040 pounds of pressure (Chaudry et al, 2008). Karen's spin instructor may have just finished calling her a bad ass, but that's a lot of force. I'm gonna go ahead and say that she's probably not doing much to her IT band.
The effects of foam rolling are largely analgesic; you'll feel better without actually being better. That's not inherently bad, just limited.
At its heart, stretching is a physical answer to a neurological question. Movement may be created by muscles, but it's governed by the nervous system. What we experience as muscle tightness is essentially a protective response. Whether the perceived threat is real or imagined is, at this point, irrelevant. You know what feels threatening to an already-protective nervous system? Trying to force it to do something it's trying to prevent. This makes stretching as likely to exacerbate the problem as it is to fix it, at least when done in isolation and without consideration for other factors.
There are cases when stretching helps, and it tends to come down to one simple filter: people who like stretching are most likely to benefit from it (more on this later).
At it's heart, stretching is a physical answer to a neurological question.
If a muscle is innervated, it's activated.
Your glutes don't get "lazy", and your core doesn't "shut off". Instead, muscle action is alternately facilitated or inhibited by skeletal position. I like to explain this using the analogy of an outboard motor that's sticking up out of the water. You can check the oil, the spark plugs, the fuel line, call in an expensive German mechanic... but unless you change the position of the motor—put the propellor back in the water—you're not going anywhere.
Muscle activation is nothing more than bunch of pointless wiggling, pulsing, and squeezing unless it addresses skeletal position.
I am a firm believer that, when it comes to corrective work, less is more. I've got better things to do, both in and out of the gym. I'm looking for bang-for-my-buck movements, and if they can do more than one thing at once, even better.
In a nice bit of symmetry, I've found that the most effective movement interventions address one or more of the following three things:
Skeletal Position (Particularly Axial)
Autonomic Nervous System
This is where things get interesting—there's a lot of overlap here. Skeletal position can influence both the ANS and the body's breathing mechanics; the ANS can obviously effect breathing patterns, but also skeletal position; and breathing patterns can shift both skeletal position and which branch of the ANS is dominant.
Rather than looking at things piecemeal, as we did with the more traditional approach, there's inherent value and simplicity in taking an integrated approach to these three interdependent systems.
To help guide your efforts, here's a brief and far-from-complete look at how these systems interact. My hope is that, as you read this, it begins to feel redundant as the circles of influence overlap.
Before we get started, a very cursory look at the autonomic nervous system is in order. Comprised of two branches—sympathetic (fight or flight) and parasympathetic (rest and digest)—the autonomic nervous system regulates all the things the body does without any conscious thought from us; breathing, digestion, etc. In addition to the well-known and oversimplified fight or flight/rest and digest characteristics of each, there's also a direct effect on our conscious (somatic) movement
Sympathetic dominance limits movement alternatives (mobility) in favor of speed, strength, and power.
Parasympathetic dominance, on the other hand, limits speed, strength and power in favor of variability and ease.
The Big Three
In considering skeletal position, I'm primarily concerned with the axial skeleton: the skull, spine, ribcage, and pelvis. Collectively, these bones provide structure to our bodies and protect our vital organs. It's no accident, then, that the shape they take can be so influential. Beyond its direct impact on the appendicular skeleton (arms and legs) and its movement options, the gross shape of the axial skeleton both reflects and informs breathing and autonomic regulation.
When the axial skeleton is in a state of relative flexion, control of the autonomic nervous system shifts towards a more parasympathetic state, and breathing patterns both reflect and contribute to this. When the skeleton is in a state of relative extension, a more sympathetic tone is dominant. These postures then, have both a direct (via joint position) and indirect (via the ANS) effect on movement options.
Neither one is right, as both come with trade-offs. The key is to understand the task, the context, and how to safely and effectively approach it.
Let's start with an exercise: I want you to stand up and take 10-15 short, quick, and shallow breaths. Notice how you feel, and how you're standing. Now take your time and take 5 deep, full breaths, in through your nose and out through your mouth, focusing on taking your time and allowing for both a full inhale and a complete exhale. Again, notice how you feel, and how you're standing.
It's a pretty stark contrast, and it's an easy illustration of how breath—something we do an estimated 20,000 times every day—can influence our nervous systems and our posture. But beyond this neat little party trick, the diaphragm is anatomically unique in that its position influences its action, and its action influences its position.
With attachment sites along the bottom of the ribcage, the anterior aspect of the spine, and on the central tendon, the diaphragm can act as a muscle of inspiration (breathing in), but it can also act as a spinal extensor. Paradoxically, when in extension, the diaphragm becomes less effective at driving breath and better at driving extension.
Considered within the context of our previous discussion around the autonomic nervous system, you start to see how breathing and posture reflect and inform each other.
The Autonomic Nervous System
Let's use this this as a chance summarize: when we're in a posture with more relative flexion we're more likely to use our diaphragm (to a point) to breathe, more likely to be in a parasympathetic state, and as a result, to have more movement variability at our disposal.
When our bodies are in a more extension-driven posture we increase our reliance on skeletal muscles to breathe, we're more likely to see our sympathetic tone increase, and in turn to trade mobility and freedom of movement for speed, strength, and power.
Find a Handle
I argued earlier for an integrated approach. It's a nice buzzword, but what I really mean by it is this: start wherever you can.
Each of these three systems represents a potential hand hold for a smart coach or trainer. I'd recommend going after the low hanging fruit—I'd look for the biggest problem, or the easiest to influence.
If you can get someone to breathe differently then you may be able to influence their posture and their nervous system. If you can get someone to put their thorax in a different position then you're likely to change things as well. And for some people, something like stretching or foam rolling may have just enough of an effect on the nervous system to actually cause some downstream change. As long as it works, and it's reproducible, I'm in on it.
Two Birds, One Stone
As I've shifted my corrective approach to a more integrated model, I've found that, not only are my interventions more effective and longer lasting, but I'm able to incorporate them into more traditional strength training movements. A few examples:
A single arm dumbbell row can target more than the lats; done correctly, and with a modicum of thought, it can help address thoracic position, scapulohumeral rhythms, and breathing mechanics.
Split squat variations are among my favorite for lower body hypertrophy, but they also represent an opportunity to reinforce pelvic position, hip mechanics, and some of the dissociative and reciprocal elements of gait.
Everyone loves arm day, and even the simplest change in position—say a hook lying or tall keeling position—can elevate even the basic bicep curl by adding an element of postural control to the exercise.
Corrective exercise can be exercise, and doesn't have to be relegated to the sidelines of the weight room floor. By giving appropriate consideration to position, breath, and their relationship to the autonomic nervous system and movement variability just about anything can be "corrective".
So, do you need to throw your foam roller away? Maybe not. But should you worry if you don't have one handy? Again, maybe not.
Chaudhry H, Schleip R, Ji Z, Bukiet B, Maney M, Findley T. Three-dimensional mathematical model for deformation of human fasciae in manual therapy. J Am Osteopath Assoc. 2008 Aug;108(8):379–90.