31 Corrective Exercise: Bridging the Gap Between Rehab and Fitness
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Dynamic Chiropractic

Corrective Exercise: Bridging the Gap Between Rehab and Fitness

By Perry Nickelston, DC, FMS, SFMA

Chiropractic is not simply about pain relief, adjusting subluxations and restoring spinal health. Your obligation as a frontline health care professional is to educate, teach, mentor and transition your patients to an all-inclusive healthy lifestyle.

Optimizing healthy living through a systematic program of care ranging from pain relief to rehabilitation, corrective exercise and fitness should be your goal.

Bridging the gap between rehabilitation and physical fitness can be a slippery slope if you are not familiar with the underlying principles of corrective exercise strategies. Ultimately, you want clients to demonstrate functional movement patterns with balance between proper mobility and stability before they engage in strenuous activities.

Without optimum balance and symmetry, you are introducing a degree of compensation patterns with increased risk of injury. I am often quite surprised at how few health care professionals actually use corrective exercise in their practice. The exercise obtained by patients from performing everyday activities and functions is often inadequate. Many conditions treated by chiropractic adjustments could greatly benefit from exercise, as thousands of traumatic low back pain cases are treated annually by exercises alone.

What It Is

Corrective exercise is a form of exercise that strives to bring the body back into perfect postural position. As you know, the body is designed to perform at its most advantageous level when it is in a position of ideal posture and bilateral symmetry.

Corrective exercise is designed to undo mobility and stability imbalances, thus guiding the body to work in synchronization without pain. Through corrective exercise, you will be working toward re-educating the body to move as it was designed so that it can function at its best.

Specific movements improve body biomechanics and remove negative micro-traumatic stresses that have led to dysfunction. Corrective exercise reintroduces proper function, which restores correct structure. When the body stops compensating for imbalances, clients are able to move freely without restrictions and pain eventually disappears. It all comes down to movement!

Each doctor will develop their own preferred way to look at movement issues with specialized methods to arrive at solutions based on their practice paradigm. Unfortunately, highly specialized isolated movement examinations have been one of the biggest errors in assessing global patterns of compensation. This isolationist thought process is then carried over into rehab, exercise and fitness.

The body functions as a whole. The anatomy books have it wrong. The body does not simply function with action from an origin to insertion point. Everything is interconnected and one area of dysfunction will cause a compensation and a myriad of symptoms somewhere else.

Correctives combine the scientific principles of biomechanics, physics, motor control and human physiology to correct the cumulative stress of life. Even very small structural changes, if they occur over time, alter the muscles' and joints' ability to perform properly. This is because no muscle works alone; each is connected to another part of the body. Because corrective exercise focuses on fixing the cause of pain, instead of just addressing symptoms, it works where many other remedies fall short. So, even if you've tried everything else to help a client feel better, now is the time to introduce an effective strategy for pain relief.

Health care and fitness practices often neglect fundamental movement, paying too much attention to the superficially obvious. Weakness and tightness are often attacked with isolated and focused strengthening and stretching protocols that don't work.

The majority of musculoskeletal pain syndromes, both acute and chronic, are the result of cumulative micro-trauma from stress-induced by repeated movements in a specific direction or from sustained misalignments. The body develops a motor learning pattern for improper movement.

Without corrective exercise designed to teach the proper motor control patterns, patients will often develop bad technique from inferior neuromuscular coordination and compensation behavior. For example, when someone complains of chronic knee pain, we are quick to find solutions to treat, rehab, and exercise the knee. However from a corrective exercise perspective, we want to address movement in the entire kinetic chain: ankle, hip, core, thoracic spine and bilaterally symmetry. This is a much more all-inclusive, full-body system for exercise and the long-term benefits of functional movement.


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