The popular methods I’m covering here aren’t nearly as important as they’re often made out to be by the many well-meaning personal trainers and strength coaches who make them a focus of their prorgramming. These methods are certainly not useless, but they’re highly overrated and often overvalued in the program design and training process.
Before we get rolling I wanted to remind you that 1) I’ll be in Brisbane, AUS on December 2nd-3rd, 2016 teaching a two-day mentorship program. And 2) the early bird pricing discount to attend the Brolando Experience with me and Alan Aragon on February 4-5, 2017 in Orlando, FL ends November 30th, 2016.
1. Postural Assessments
Note: Several of the paragraphs below are written by Ben Cormack.
Poor posture is often said to be a reliable and predictable cause of pain and injury, which is why many trainers and coaches use postural assessments. That said, in order to say that a postural issue you spotted needs to be “corrected,” rather than just being a general variance in human structure, posture or function, you must first establish if the issue is actually problematic in the first place.
Being informed by the available relevant research data, which most trainers and coaches aren’t, can help you to learn what may or may not prove to be reliably problematic. And, this doesn’t involve only looking at a singular research study that has results that you like – that’s cherry picking. It involve looking at the wider body of relevant evidence and following it where it leads.
For example, a 2008 systematic review (a study of studies) that looked at 54 studies and concluded that, “Evidence from epidemiological studies does not support an association between sagittal spinal curves and health including spinal pain” (1).
Another 2015 systematic review looked at evidence to determine if thoracic spine posture is associated with shoulder pain, range of motion and function. The main conclusions of the paper were:
- Resting thoracic kyphosis is very similar in people with and without shoulder pain.
- Although, greater shoulder range of movement may be obtained in an erect thoracic posture, increased thoracic kyphosis may not be a key contributor to shoulder pain. (2)
These above results come as no surprise given that a 1997 study found that none – not even one – of 427 people examined showed a resting head posture perfectly aligned with the “correct” posture postulated in many books are articles (3). This helps to explain why, when it comes to postural assessments, nobody ever “passes” those things.
Additionally, it’s important to note that the commonly proposed technique for the correction of the above type of so-called “postural deviations “ or so-called ‘dysfunctions” is to strengthen the “longer weaker” muscles and stretch the “shorter tighter” muscles. Well, a review of resistance exercise and posture realignment found that no objective data was present to support the concept that exercise will lead to changes in postural deviations and it is likely that they are of insufficient duration and frequency to offset daily living activities (4).
Furthermore, research on scapular posture has found that resting static position does not correlate to poor movement patterns (5). According to Mike Reinold, one of the researchers on the study I just referenced, “Several studies have shown that these scapular asymmetries are common in the general population too, so I consider my findings in the overhead athlete relevant to any population. In my experience these same results occur in other populations.”
RELATED CONTENT – Why Smart Trainers Believe Stupid Things: Regression to the Mean
2. Movement Screens
Note: The first three paragraphs below are written by Jason Silvernail DPT.
Using any one of several movement-based evaluation systems has been advanced as a way to discover poor movement patterns that indicate increased risk of injury. While these approaches are well-intentioned, evidence continues to build that these scoring systems have limited ability to predict injury (6,7,8) and that increased scores do not necessarily improve athletic performance (9,10). Proponents often argue that there is some evidence that the use of a cut-off score can show those at higher risk of future injury (11,12) but that validity problems remain – essentially one doesn’t know if the score itself is helpful or if there are other explanations for the injury risk findings in some of those studies.
One such explanation is that individuals with a current or recent injury – a known risk factor for future problems (13) – will tend to score lower. This means that it’s possible the lower score just identifies a risk factor one already knew about.
Now, these systems can certainly be used as a kind of structure for exercise prescription if the client, athlete or strength and conditioning professional is personally biased toward them. However, one who chooses to use them for this purpose must do so while remaining intellectually honest (with themselves and with their clients and athletes) about the reality that current scientific reviews don’t strongly support the use of these systems as general injury prediction or prevention tools. This means not getting too overconfident about the benefit such procedures provide and, therefore avoid looking down on other professionals who reject such methods as somehow providing a lower value of service, as some proponents tend to do.
Additionally, it’s also important to note that other scientific evidence has demonstrated that movement screens comprising of only low-demand (e.g., bodyweight or low-load) activities may not adequately reflect an individual’s capacity, or their risk of injury, and could adversely affect any recommendations that are made for training or job performance that involve higher speeds and loads (14).
RELATED CONTENT – Responses to the Top 10 Arguments Against Science-Based Training and Nutrition
3. Corrective Exercise
Since providing constant guidance and feedback (i.e., coaching) on exercise execution is “corrective” in nature, (Example: telling a client to avoid allowing their knees to cave in when squatting, or having someone perform squats while pushing against a min-band loop that’s around their knees), many fitness professionals will argue that one has to be ‘corrective’ in order to be an effective trainer or coach. Therefore, arguing that corrective exercise and general exercise practices that are foundational to the training and conditioning field are essentially the same thing. However, this is a self-defeating argument. In that, if general exercise practices of safe training and individualizing exercise prescription are by nature already “corrective,” there’s no need for any trainer or coach to use the term “corrective exercise” to begin with.
In other words, it defeats the purpose of using the term “corrective exercise” to describe practices that one is claiming are already inherent to using the general exercise practices that are foundational to the fitness professional.
The fact is corrective exercise is different than the general exercise practices that are commonly accepted as “good training.” Although general exercise practices (i.e., practices that are foundational to the personal trainer or strength coach), and corrective exercise practices both utilize flexibility exercises, strength exercises, coordination exercises, etc., corrective exercise isn’t as much about the exercises you do – it’s about why you prescribe the exercises you do. And, t’s about why you take the programming direction you take.
That said, corrective exercise practices are founded on the use a formalized evaluation (i.e., assessment or screening) procedure in order to first identify so-called “dysfunctions” and then use special corrective exercise interventions in attempt to “fix” the so-called dysfunctions one believes they’ve identified. However, as I covered above, the factors corrective exercise proponents are often focusing their exercise prescriptions on correcting aren’t necessarily problems that need correcting to begin with – they’re more likely just normal human variations in structure and function.
RELATED CONTENT – Corrective Exercise: Science vs. Experience: What Anecdotal Evidence Does and Doesn’t Prove
4. Core Strength Training
A 2015 systematic review and meta-analysis concluded that, “Trunk muscle strength plays only a minor role for physical fitness and athletic performance in trained individuals.” The authors of the paper stated that, “Core muscle strength appears to be an effective means to increase trunk muscle strength and was associated with only limited gains in physical fitness and athletic performance measures when compared with no or only regular training” (15).
Now, this certainly doesn’t mean that the trunk musculature is not an important area to train. If that was the case I would have never produced my Core Training: Facts, Fallacies & Top Techniques (digital download) course. It simply means the benefit that trunk muscle strengthening has on performance is often misunderstood and overstated by many trainers and coaches. So, although core training exercises should still be included as a component of your training, there is no need to view or treat core training exercises as an aspect of programming that requires any type of special emphasis.
By the way, squats and deadlifts work the heck out of the posterior core muscles, but research shows they don’t activate the anterior core muscles (abs and obliques) very effectively. Therefore, squats and deadlifts should not be used to replace exercises targeted at the activating anterior core muscles (abs and obliques), but rather used in conjunction with them.
RELATED CONTENT – Core Confusion: The Truth About Squats and Deadlifts
5. Core Stability Training
Although many health care providers will state that 1) low back pain is a multidimensional, socioeconomic public health problem with almost 85% patients being diagnosed with “Non Specific Low Back Pain” (NSLBP) and will readily admit that 2) treating chronic low back pain (CLBP) – a high recurrence of low back pain leads to chronicity – is complicated as neither specific diagnostic nor treatment-based approach has been shown to be absolutely effective; many practitioners often prescribe motor control (spinal stabilization) exercises almost universally to people with low back pain issues.
A 2005 randomized controlled trial of patients with subacute and chronic non-specific low-back pain, compared a general exercise treatment with a combination of general exercise and spinal stabilization exercise. The results of this study were that a general exercise program reduced disability in the short term (i.e., immediately after treatment) to a greater extent than a stabilization-enhanced exercise approach in patients with recurrent NSLBP. And, no differences were found in other outcomes or at follow-up time points. So, stabilization exercises do not appear to provide additional benefit to patients with subacute or chronic low back pain who have no clinical signs suggesting the presence of spinal instability. (16)
Additionally, two studies (both from 2016) that used a tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment (i.e., a groups of patients with a shared diagnostic pattern or prognosis that might benefit from specific motor control exercise interventions). Both studies found that motor control exercise and general exercise appear equally effective in the patient subgroup. Disability in LBP patients was reduced considerably by both interventions. (17,18)
Now, the following words from the researchers of one these studies are very important for fitness professionals to pay special attention to:
“It is possible that the type of exercise treatment is less important than previously presumed; that the patient is guided to a consistent long-term exercise lifestyle is of most importance The results of our study support previous findings that exercise in general, regardless of the type, is beneficial for patients with NSLBP.”
The BIG takeaway here is that personal trainers and strength coaches need not be hesitant to focus their programming on the use of general exercises that are fit to the individual’s ability, medical profile and goals. Unfortunately, many fitness professionals who are unaware of the benefits general exercise has on low back outcomes often end up making their training process, their programs more about trying to play the corrective exercise therapy game. Therefore, not nearly enough actual strength & conditioning gets done in order to create the type of training effect needed to achieve the health, fitness, physique or performance goals of the client and athletes are paying them (and investing their time and trust) to achieve.
Nick’s Upcoming Live Events
In Albany, NY teaching a full day of training workshops at Real [Fit] Life studio on January 15th, 2017.
In Sacramento, CA teaching at the NSCA Southwest Regional Conference on January 27-28, 2017.
In Orlando, FL co-teaching the 2-Day Workshop Brolando Experience with Alan Aragon on February 4-5, 2017.
In San Diego, CA serving as an expert panelist at the San Diego Pain Summit on February 7-13, 2017.
In Cyprus, Nicosia teaching at the Professional Fitness Systems Convention on March 24-26, 2017.
In Toronto, ON, Canada teaching a PreCon and conference class at the Annual CPTN Conference on June 2-3, 2017.
Nick’s 2-Day Australia Mentorship
Click HERE or on the image below for more info and to reserve your spot to attend Nick’s Mentorship Program on December 2nd-3rd, 2016 in Brisbane, AUS.
References:
- Christensen ST, Hartvigsen J. Spinal curves and health: a systematic critical review of the epidemiological literature dealing with associations between sagittal spinal curves and health. J Manipulative Physiol Ther. 2008 Nov-Dec;31(9):690-714.
- Barrett E, et al. Is thoracic spine posture associated with shoulder pain, range of motion and function? A systematic review. Man Ther. 2016 Dec;26:38-46.
- Grimmer K. An investigation of poor cervical resting posture. Aust J Physiother. 1997;43(1):7-16.
- Hrysomallis C, Goodman C. A review of resistance exercise and posture realignment. J Strength Cond Res. 2001 Aug;15(3):385-90.
- Seitz AL, et al. No effect of scapular position on 3-dimensional scapular motion in the throwing shoulder of healthy professional pitchers. J Sport Rehabil. 2012 May;21(2):186-93.
- McCunn R et al. Reliability and Association with Injury of Movement Screens: A Critical Review. Sports Med. 2016 Jun;46(6):763-81
- Dorrel BS et al. Evaluation of the Functional Movement Screen as an Injury Prediction Tool Among Active Adult Populations: A Systematic Review and Meta-analysis. Sports Health. 2015 Nov-Dec;7(6):532-7
- Kraus K et al. Efficacy of the functional movement screen: a review. J Strength Cond Res. 2014 Dec;28(12):3571-84
- Parchmann CJ and McBride JM. Relationship between functional movement screen and athletic performance. J Strength Cond Res. 2011 Dec;25(12):3378-84
- Okada T et al. Relationship between core stability, functional movement, and performance. J Strength Cond Res. 2011 Jan;25(1):252-61
- Bonazza NA et al. Reliability, Validity, and Injury Predictive Value of the Functional Movement Screen: A Systematic Review and Meta-analysis. Am J Sports Med. 2016 Apr 29
- Bushman TT et al. The Functional Movement Screen and Injury Risk: Association and Predictive Value in Active Men. Am J Sports Med. 2016 Feb;44(2):297-304
- Zambraski EJ, Yancosek KE. Prevention and rehabilitation of musculoskeletal injuries during military operations and training. J Strength Cond Res. 2012 Jul;26 Suppl 2:S101-6.
- Frost DM, et al. The Influence of Load and Speed on Individuals’ Movement Behavior. J Strength Cond Res. 2015 Sep;29(9):2417-25.
- Prieske O, et al.The Role of Trunk Muscle Strength for Physical Fitness and Athletic Performance in Trained Individuals: A Systematic Review and Meta-Analysis. Sports Med. Sports Med. 2016 Mar;46(3):401-19.
- Koumantakis GA, et al. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005 Mar;85(3):209-25.
- Gauri A Gondhalekar, et al. Reliability and Validity of Standing Back Extension Test for Detecting Motor Control Impairment in Subjects with Low Back Pain. J Clin Diagn Res. 2016 Jan; 10(1): KC07–KC11.
- Saner J, et al. A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: Short-term results of a randomised controlled trial. J Bodyw Mov Ther. 2016 Jan;20(1):189-202.
