Corrective Exercise Theory
We should jump straight into a couple of quick definitions lest anyone immediately find themselves lost in any technical jargon from the start. Corrective exercise (CE) is the intentional application of an exercise, or selection of exercises, to specifically improve biomechanical dysfunction. Once more, this definition requires yet another. Biomechanical dysfunction is any developed decrease in joint mobility and/or joint stability, which in turn, tends to cause skeletal malalignment, musculoskeletal pain, and/or nervous system compensation. If employed early enough, CE aims to either improve or completely rectify the dysfunctional problem of focus. If CE is employed too belatedly (beyond the “degradation event horizon”), its role becomes to maintain and stave off any additional deterioration of functional capacity.
CE is both a term that I love and simultaneously loathe. I absolutely love CE because when it is prescribed intelligently, it can truly produce some seemingly miraculous results. Being able to assist people achieve pain-free movement is the holy grail of physical rehabilitation. The level of improvement in one’s quality of life when physical function improves, and pain is removed is quite remarkable. However, I find myself often struggling with the more conventional concept of CE because—as is always the case with fitness—the industry has contaminated its true essence. If we are to correctly understand and apply CE, we need to first understand the stepwise origin of how dysfunction develops:
1. Lack of Specific Overload (i.e., muscle- & position-specific disuse)
2. Muscle Degradation (i.e., cross-sectional & longitudinal atrophy)
3. Movement Dysfunction (e.g., decreased mobility/stability, pain)
When the body is removed from a complete variety of physically demanding tasks, it begins to degrade. It is this degradation that leads to dysfunction. Expressed another, very simple way:
Behavior —> Morphology —> Function
Now that we have established the root cause of developed dysfunction, we can easily derive a logical solution to the problem. If a lack of overload (which causes weakness) is the culprit, then the resolution to the problem is quite simple. The obvious antidote to weakness-related dysfunction is strength training (overload). Now, the cure to the problem is not as simple as general strength training. It is much more complex and nuanced than that. Because it is a lack of specific overload that initiates the cascade of events, we require very specific strength training to improve developed biomechanical dysfunction. Moreover, strength training is the only type of true CE—every other modality is merely attempting to treat the symptoms rather than rectifying the underlying cause of the problem.
Improved joint mobility is created via muscle-, length-, and vector-specific loading (strength training) which leads to the longitudinal growth of target muscle tissues (i.e., the muscles grow in length). Similarly, improved joint stability is created via muscle-, position-, and vector-specific loading which leads to cross-sectional growth of the target muscle tissues (i.e., the supporting muscles grow in thickness) that control the joint. Additionally, both joint mobility and stability require considerations that pertain to muscular balance (both intra- and inter-muscular) and regional interdependence (the health/function of any given joint depends on its neighboring joints to also be healthy and well-functioning).
As already stated, muscular adaptations to physical activity and exercise are exceptionally specific. It is for this reason that it is quite common for (mostly) strong people to have minor weaknesses that go unmissed. Without an adequately comprehensive and well-programmed strength training program, it is possible to become impressively strong in traditional movements (e.g., squat, bench, etc.) and develop a hidden weakness that leads to diminished joint mobility and/or stability, which will eventually lead to dysfunction that requires correction. This means that CE acts as a common ground between everybody—people of all ages and fitness statuses require CE to either defend against or reverse out of biomechanical dysfunction. This also means that not all strength training programs are created equal. The best programs simultaneously develop performance while minimizing any of these potential hidden weaknesses.
To conclude, CE is a subset of strength training that involves highly informed exercise programming. This strategic exercise selection and application aims to improve local muscle and joint function to further improve global bodily function. While unfortunately common, CE does not utilize any specialized gadgets, gizmos, or any other “gym toys” that are repeatedly demonstrated to waste your time (e.g., the infamous foam roller). All that is required is intelligent, goal-oriented adaptations that improve neuromusculoskeletal function. Be sure that your strength training program is not only created under the lens of performance, but also includes a strong corrective/injury preventative perspective.
Takeaway Points:
>Corrective Exercise is the application of strength-based exercise(s) to improve biomechanical dysfunction.
>Biomechanical Dysfunction is a developed decrease in joint mobility and/or stability which can lead to various musculoskeletal symptoms (e.g., pain & compensation).
>The culprit of these dysfunctions is weakness. Specific strength training is required for complete resolution of the problem. Everything else is a bad Band-Aid that will keep falling off.
>CE-based strength programming must consider local and regional joint mobility, stability, and balance. Loss of function is characteristic of decreases in longitudinal and cross-sectional hypertrophy.
>Even the strongest people have hidden weaknesses. These weaknesses can cause problems for even the fittest individuals. High-quality strength training programs are needed.