There is a big buzz in the Health and Fitness industry about Corrective Exercise Training. So what exactly does this entail? The premise upon which this practice is built is that everyone has some degree of muscular imbalance or movement impairment. If left uncorrected, these imbalances and movement impairments can lead to injury.
Our daily occupational or sport activities can predispose us to developing or exacerbating these imbalances. For example, desk and computer workers have been shown to exhibit a high incidence of Upper Crossed Syndrome characterized by a forward head posture (FHP), rounded shoulders and increased thoracic kyphosis (hunch back). This is often accompanied by neck pain and headaches
Recently, the use of computers or smart phones has become increasingly common, and their use has made FHP more common (Kang et al., 2012). In another study conducted by Nejati et al. (2015), it was found that there is a direct correlation between forward head posture and neck pain among office employees, especially those who work with computers.
Client with static postural deviations.
Athlete or anyone involved in physical activity who exhibit the above postural deviations as well as others [ winging of the scapular, excessive lumbar lordosis (lower-back arch), anterior pelvic tilt, knee valgus(knock-knee) or knee varuum(bow legs), foot tun out (duck-foot) during functional physical activity] may have underlying muscular imbalances. For example, if an individual has duck-foot either during a static postural assessment or transitional or functional assessment, it may indicate that the gastrocnemius, soleus and peroneals may be tight and overactive and the muscles on the other side of the joint such as the anterior tibialis may be lengthened and weak. These muscular imbalances, postural abnormalities and movement impairments and can lead to pain and injuries such as, Plantar Fasciitis, Achilles tendinitis, patellofemoral pain, ACL injury, hip dysfunction and lower-back pain and dysfunction.
The Corrective Exercise Specialist (CES) conducts Postural, Transitional and Functional Movements Assessments to identify movement compensations which are indicative of muscular imbalances. Combined with a quantitative assessment of Joint Range of Motion (ROM) and Manual Muscle Testing (MMT).
The CES develops a systematic strategy of inhibition of tight neuromyofascial tissue with foam roller or other devices, lengthening with isolated static or PNF stretching to increase the ROM of the neuromyofascial tissue, Isolated strengthening to re-educate intramuscular underactive tissue and integration exercises to teach all muscle groups to work in synergy to accomplish functional activities without risk of injury.
Without knowing where your imbalances are, you may continue to strengthen muscles that are already overactive and tight and lengthen muscles that are already underactive and weak. This in turn will increase the degree of muscular imbalance, create asymmetry, increase movement compensations, lead to chronic pain and increase the risk of injury. In a recent very large randomized controlled study by Seidi F et al. (2014), sixty participants with thoracic hyper-kyphosis, they found that both the local and comprehensive corrective exercise program resulted in statistically significant reductions in thoracic kyphosis angle compared to the control group. This finding is supported by another large randomized controlled study by Ruivo et al. (2016), which shows that Corrective Exercise Training in addition to regular physical education training was more effective in correcting forward head posture than physical education training alone.
Corrective Exercise Training can positively impact the muscular imbalances that lead to postural deviations, movement impairments and chronic injuries. It is intelligent training that should complement all areas fitness or athletic training.
Ava T. Donaldson, MS
Corrective Exercise Specialist
NASM-CES, NASE-CSS, AFAA-CPT, AFAA- Grp-ex-Inst
Polstar/ Balance Body- Certified Pilates Trainer
Other Certifications: Spinning-MADDOG Athletics, Kickbox-AFAA, Zumba, TRX, Jillian Michaels BodyShred, WERK Dance Fitness, PLYOGA.
- Kang J., Park R., Lee S. et al. (2012).The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med, 36, 98–104.
- Nejati P., Lotfian S., Moezy A & Nejati M. (2015). The study of correlation between forward head posture and neck pain in Iranian office workers. Int J Occup Med Environ Health., 28(2), 295-303
- Seidi F., Rajabi R., Ebrahimi I., Alizadeh MH & Minoonejad H. (2014). The efficiency of corrective exercise interventions on thoracic hyper-kyphosis angle. J Back Musculoskelet Rehabil, 27 (1), 7-16.
- Ruivo R., Carita A. & Pezarat-Correia P. (2016). The effects of training and detraining after an 8 month resistance and stretching training program on forwardhead and protracted shoulder postures in adolescents: Randomized controlled study. Man Ther, 21, 76-82
- Clark, M., Lucett, S & Sutton, B. (2014). NASM = Essentials of Corrective Exercise Training. Jones & Bartlett Learning, Burlington, MA.