What Is Corrective Exercise Anyway?

All of our muscles have a proper length in which they work best. Poor posture, repetitive movement, past injury…they all play a role in altering this optimal length. When proper length of the muscle is altered then pain, injury and decreased performance are all possibilities. Corrective exercise is a protocol used to restore then normal length-tension relationship between muscles and improve the efficiency of your movement. 

There are generally 4 phases in this protocol—or the corrective exercise continuum as it’s called.

Phase 1 (Inhibit) uses self-myofacial techniques such as a foam roller to release tension and inhibit overactive muscles in the body. Think of this as getting a deep tissue massage only it’s free!! 

Phase 2 (Lengthen) uses stretching (such as static stretching) to increase the length and range of motion of the tissue.

Off-Topic Alert---if you do phase 1 and 2 before you go to bed, you are going to have a great sleep!

Phase 3 (Activate) is basically strengthening exercises used to activate or strengthen underactive muscles

Phase 4 (Integrate) which is a total-body exercise used to retrain the newly stretched and strengthened muscles to work correctly together. This is the "bringin' it all together" phase.

To identify these muscle imbalances, a qualified professional could use a variety of techniques. I like the overhead squat assessment and, when possible, the single leg squat assessment. There are a variety of shoulder assessments that can be done and of course just plain ol' observing someone’s posture or watching the way a person walks and moves about on their own. I’ve seen people do great on assessments only to find imbalances later on once we hit the gym and watched clients actually performing exercises.

There are several movement impairments that we look for and can correct. One such impairment is the knee caving in---or knee valgus. Let's have a more in-depth loook at that.

 

 

Knees Cave In (Knee Valgus)

1.JPGDuring a squat assessment, it will be easy to identify when someone’s knees move in. We can see an example of the knees coming together in the picture to the left. As with all imbalances, certain muscles are overactive causing the knees to cave inward and certain muscles are underactive and don’t have the ability to prevent the knees from caving in. 

Overactive Muscles 

The overactive muscles causing the knees to collapse in this case are the lateral calf muscle, one of the muscles found in the hamstring (called the biceps femoris) a muscle at the top of the hip called the TFL and the adductor muscles that run inside the thigh

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These 4 muscles, because of their shortened nature, act to turn knees inward. Since they are overactive,  we will foam roll and then static stretch these 4 muscles in phases 1 and 2 with a goal of returning them to their proper length. Phases 1 and 2 will have you foam roll the calves, adductors (inside the thigh), top corner of the hip (the TFL) and the outer hamstrings (Biceps Femoris) followed by stretching the same muscles.

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What Causes These Muscles To Be Overactive? 

Poor posture, poor form while exercising, previous injuries, repetitive movements—they can all cause muscles to become shortened over time. For instance wearing high heels can place your foot in a plantar flexed position. When your foot stays in this position for long periods of time then the calf muscle adapts to this flexed position and it now becomes that muscle’s new normal. In effect, it stays in this shortened position. 

Other reasons these particular muscles become overactive are poor running mechanics, prolonged sitting and substitution for weak glute muscles. Also, women are especially prone to knee valgus simply due to their anatomy. Because women generally have wider hips, this creates an increased angle from the top of the femur to the knee joint. This is known as the Q-angle.

Underactive Muscles 

The underactive muscles are the front of the shin, one of the gluteal (butt) muscles at the side of the hip called the gluteus medius and the big butt muscle, the gluteus maximus. Since these muscles are underactive, they don’t have the proper strength to keep the knees from caving inward. Pictured below are the 3 culprits. Our goal would be to strengthen these muscles during the activation phase of our program. While we do certain exercises to strengthen the underactive muscles in our program, you can certainly include strengthening exercises for these muscles during your regular resistance workout days. 

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Injuries 

Having imbalanced muscles can lead to injuries and pain down the road if not corrected. Possible injuries include plantar faciitis, patellar tendonitis (knee pain) low back pain and hamstring strains. Also, having knees that move inward can cause instability at the knee joint and lead to injuries while running or jumping. It’s important to remember that just because you will have tight calf muscles or tight lateral hamstring muscle, it doesn’t mean that you will feel tight in these areas. Oftentimes, you will feel pain elsewhere in the body. For instance if you have a tight calf muscle, you might feel tightness or pain in the bottom of the foot or at the front of the knee. A tight hamstring might be felt as lateral knee pain or pain in the lower back. 

Just because you feel pain in one part of the body doesn’t mean that is the source of the pain. Corrective exercise seeks to find the source of pain through a proper assessment to find out how well your muscles are working as a group. 

Corrective exercise routines can be performed daily as a warm-up before your regular exercise routine, part of your cool-down after exercising or all on its own. NOTE--this isn't intended to be an hour workout designed to help you lose weight. These corrective sequences should be performed before or after a workout or all on its own to correct muscle imbalances. This routine will generally take 10-15 minutes 

*Demonstration videos are available in your app. Just go to your calendar and click on the corrective exercise* 

Static Stretch Biceps Femoris

Check out the video showing the proper way to stretch the hamstring muscle called the biceps femoris. It's a unique hamstring muscle in that it doesn't cross the hip so it plays no action in hip extension like the other hamstring muscles.                                                           

If you would like to know more about knee valgus (I could write more but the internet only has so much space available) or to find out how to correct this or other impairments just contact me and I will be more than happy to help you out.