Corrective Exercise is Essential

Raise your hand if you know someone that has a nagging injury. Chances are, your hand shot up in the air. That person could be you, a client, friend or relative. Maybe you have knee pain when you squat, or a full-blown rotator cuff tear. Your client might have back pain after doing a deadlift, or elbow pain during the bench press.

These days, it seems more people than ever have some type of physical dysfunction that bothers them during or after exercise.

Why? There are probably two primary culprits at work here. First, people spend much of their day with poor posture while on the computer or Smartphone. This leads to mobility deficits and joint stress. Second, extreme fitness classes are en vogue. So when people do workout, they often jump into programs or classes beyond their physical capacity.

Indeed, the demand for personal trainers and healthcare practitioners to be proficient in corrective exercise is higher than ever. If you make the effort to build your toolbox of corrective exercise techniques, you’ll benefit three ways:

1. You’ll make more money – Being able to identify and correct mobility and strength deficits will allow you to work with a broader range of clients. Furthermore, you’ll be able to charge more money for your services since you’ll be able to perform interventions beyond what a typical personal trainer certification teaches.

2. You’ll build your reputation – Once you become the guy or gal that can help people perform better with less discomfort, word travels fast. Since virtually everyone has some type of nagging physical issue, and since there aren’t many trainers proficient in corrective exercise, your reputation will quickly escalate.

3. You’ll build a strong network with healthcare practitioners – Every week I get asked by physical therapists, chiropractors or orthopedic doctors for recommendations for trainers that understand how to identify and correct mobility and strength imbalances. When you get good at corrective exercise you’ll have a steady stream of referrals from healthcare practitioners. And this, of course, takes us back to the first benefit I mentioned: you’ll make more money.

With those three benefits in mind, I’m excited to announce my latest project that was 18 months in the making. It’s the Corrective Exercise Specialist course that I created for the International Sports Sciences Association (ISSA).

Check out the following video to hear me discuss an overview of my Corrective Exercise Specialist course:

You can find out more information about my 10-week Corrective Exercise Specialist course by clicking here.

“With his course, Corrective Exercise Specialist, Chad Waterbury joins Gray Cook and a very exclusive club of PT leaders who make fitness professionals better trainers — not turn them into clinicians. Crystal clear communication, the most relevant summaries of anatomy and motor learning to be found anywhere, and a painstakingly curated toolbox of high yield assessments and correctives.”  – Pavel Tsatsouline, Chairman, StrongFirst.com

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CW

Improve Your Shoulders with the Elbow Walk

There is no doubt that many people have cranky shoulders. This is especially evident when they try to lift their arms fully overhead, or when they’re trying to military press with proper form. When you see a guy or gal excessively arch the lower back when pressing weights overhead, it’s likely that compensation is due to a lack of overhead shoulder mobility.

During my first year of the Doctor of Physical Therapy (DPT) program at USC, I got to fully dissect a cadaver. I’ll never forget the week I spent on the shoulder region. Once you see how many muscles, ligaments, vessels, and structures are jam-packed within the shoulder, it’s amazing we could ever lift our arms overhead without pain. Furthermore, the timing and sequencing of muscle activation the nervous system must coordinate while reaching overhead is pretty astonishing.

Indeed, when you consider the plethora of structures within the shoulder complex, and the motor control that’s required for smooth, full range of motion movement, it’s no surprise why a lack of overhead mobility is a widespread problem in the fitness community.

It’s worth mentioning here that there can be 100 different reasons why you lack overhead mobility. And this is also why there are over 100 different special tests used by physical therapists and orthopedic doctors for assessing the shoulder complex. But there are a few common problems that most people need to correct.

One of my favorite corrective exercises to improve overhead mobility is the elbow wall walk. The benefits of this exercise are numerous, but there are three primary goals when you do it correctly. First, it activates the shoulders’ external rotators, which helps pull the head of the humerus into its ideal position. Second, the exercise activates the serratus anterior, a muscle that’s essential for upward rotation of the scapula. Third, the elbow wall walk teaches your client to reach overhead without extending the lumbar spine.

Test Yourself

The elbow wall walk is a terrific shoulder activation drill to perform before upper body training or Olympic lifts. Nevertheless, if you or your client has problems with overhead mobility it’s important to determine if this exercise provides the benefit you seek. You’ll perform 3 sets of the elbow wall walk, and each set should last 45-60 seconds.

  • Do you lack the ability to reach your arms fully overhead? Perform an overhead reach and have your buddy take a picture of your end range of motion. Measure the shoulder joint angle using one of the many Smartphone apps. After that, perform the elbow wall walk, and then retest (and remeasure) your shoulder joint angle to determine if it improved.
  • Shoulder pain when reaching or pressing overhead? Find the overhead position that causes discomfort, and rate it on a scale of 1-10 with 10 being “emergency room” pain. Perform the elbow wall walk, then retest the overhead position and see if the pain intensity has decreased.
  • Poor shoulder stability when holding weights or a barbell overhead? Perform the elbow wall walk, then retest the exercise to determine if your shoulder stability has improved.

The elbow wall walk requires a TheraBand or some type of light resistance band that can be wrapped around each hand. Be sure to “walk” the elbows up the wall very slowly during this drill, and follow the cues outlined in the video below.

Give this activation/strengthening drill a try and it will likely decrease shoulder discomfort and improve overhead performance.

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CW

Align Your Pelvis to Increase Performance

The term “core” is thrown around a lot these days. Most people think of the core as being the abdominals, or midsection. But if we consider the classic definition of the word, which is “the central part of something,” it means your body’s true core is the pelvis. The pelvis is where the upper and lower segments attach, so it’s the central part of your body.

This also means that if your pelvis is out of proper alignment, it can create unwanted compensations up and/or down your body’s chain. Indeed, problems in the pelvis can cause knee or foot pain, and it can cause low back or shoulder pain.

What’s relevant here are three of the articulations within the pelvis: the two sacroiliac (SI) joints, and the pubic symphysis. These joints make it possible for parts of the pelvis to rotate or tilt, due to the attached muscles being shortened (i.e., overactive) or lengthened (i.e., weak/inhibited).

Now, it’s important to mention here that these joints don’t allow for much motion. In fact, some clinicians still question if they can move at all. But anyone that has a hypermobile pelvis or SI joint pain will tell you they can move. And when they move the wrong way, pain and poor performance follow.

The Postural Restoration Institute (PRI) teaches courses that focus heavily on restoring pelvic alignment. I’ve taken their Myokinematic Restoration and Pelvic Restoration courses, and I recommend them to any progressive trainer or clinician.

Nevertheless, becoming proficient at assessing and correcting pelvic alignment can be a complicated task. There are a myriad of muscles, ligaments and tendons in play, and any one of them can be the culprit. Physiotherapist, Diane Lee, is one of the experts that’s giving seminars to help progress this area of practice. I’m talking here about something called “muscle energy techniques,” which simply means you’re activating key muscles to improve function within the body.

Test Yourself

Before we get to the muscle energy technique that I use to restore pelvic function, it’s important to begin by testing yourself (or a client) so you’ll know if the drill worked. I recommend tests similar to the ones I outlined in the Ultimate Glute Development article I wrote last week.

  • Stiff hamstrings? Do a standing toe touch assessment, then perform the pelvic alignment correction and immediately retest it.
  • Knee or low back pain? Do a movement that causes you to feel the discomfort, then perform the pelvic alignment correction and immediately retest it.
  • Need more hip mobility for the squat, lunge or deadlift? First perform the pelvic alignment correction, and then test if your hips/low back feel looser during the exercise.

For the following Pelvic Alignment Correction, you’ll need a PVC pipe or strong dowel, as well as a basketball or light medicine ball that’s a similar size.

When should you do this drill? First in your workout. It doesn’t make any sense to warm-up, with even a light jog, if your pelvis is out of alignment. To paraphrase Gray Cook: Don’t put fitness on top of dysfunction.

Give the following drill a try before your next sprint, squat, deadlift or jump session, and your hips and alignment will probably feel much better.

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CW

Ultimate Glute Development

Everyone wants better glutes, whether you’re a guy or gal, athlete or non-athlete. That’s because glutes that are awesomely developed not only make your body look better, but they can also drastically improve your performance. When the glutes are strengthened and built using the correct combinations of exercises, you’ll run faster, jump higher and improve the strength of all your lower-body lifts.

In order to build a muscle to it’s highest level of size and performance, all of its fibers should be recruited by the end of a workout. The glutes are a tri-planar muscle, which means it can function in all three planes of movement:

  • Sagittal plane = hip extension
  • Frontal plane = hip abduction
  • Transverse plane = hip external rotation

The problem is that most people only train the sagittal plane function of the glutes: hip extension. I’m talking here about the typical squat, deadlift and lunge variations.

Last fall I spent four months working with Christopher Powers, Ph.D., at his Movement Performance Institute (a glute-focused sports medicine facility if there ever was one). I worked with athletes and non-athletes that had a myriad of knee, low back or hip problems.

The early stages of Professor Powers’ system focuses heavily on strengthening the glutes in the frontal and transverse planes – hip abduction and hip external rotation, respectively. Pure hip extension isn’t usually trained until about 6 weeks into the system.

There were two key observations I made after training athletes primarily in hip abduction and external rotation for up to 6 weeks straight:

  • Their glutes got substantially larger
  • Their hip extension strength increased

Their glutes got bigger because they were recruiting muscle fibers that perform hip abduction and external rotation, which had been neglected in the gym from doing nothing but squats, lunges and deadlifts.

Prof. Powers has been a pioneer in research that demonstrates a link between frequent glute activation and a stronger mind-muscle connection, which is an essential component of strength and hypertrophy development. So even though pure hip extension wasn’t trained, that movement got stronger because the brain was better able to recruit the entire gluteal fibers in any future task.

My point here is that ultimate glute development requires a strong emphasis on hip abduction and hip external rotation. Those two movement planes must be frequently trained in order to build the glutes to the highest level of size and performance.

Test Yourself

Before you watch the video where I outline my favorite 7-minute glute-building sequence, test yourself (or one of your clients).

  • Stiff hamstrings? Do a standing toe touch assessment, then perform the glute sequence and immediately retest it.
  • Knee or low back pain? Do a movement which causes you to feel the discomfort, then perform the glute sequence and immediately retest it.
  • Need to improve your squat, lunge, deadlift, sprint or vertical jump? Do the following sequence twice each day for 2 weeks, then retest the exercise you’re trying to improve. Your performance will definitely go up!

The following Ultimate Glute Development sequence requires a mini-band. I use the bands made by Perform Better, which can be found at this Amazon link. Most females should start with a yellow mini-band; males can start with a green. The key is to progress the band tension as your strength improves.

  • Goal for males: perform the entire Ultimate Glute Development sequence with a black Perform Better mini-band.
  • Goal for females: perform the entire Ultimate Glute Development sequence with a blue Perform Better mini-band.

Here’s the Ultimate Glute Development sequence, a collection of my favorite glute-building exercises, all crammed into a 7-minute drill. Do this sequence at least once per day (preferably twice), at the beginning of your regular workouts or as a stand-alone drill.

I highly recommend you make this a foundational activation sequence for you and your clients, for years to come.

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CW

Get Your Feet in Control

The human foot is a marvel of complex engineering. Each one is made up of 26 bones, 33 joints and over 100 soft tissue structures that form muscles, tendons and ligaments. Not to mention the 150,000 nerve endings that you have on the bottom of each foot.

Your body needs all of those components to be working at full capacity in order to achieve an impressive vertical jump, sprint or deadlift. But more often than not, your feet have lost that ability, and the negative consequences can be far-reaching. Indeed, progressive doctors that specialize in treating jaw disorders (e.g., TMJ) look at the patient’s foot posture and control when designing a treatment plan.

Many active people take up to 10,000 steps per day. Pair that with the fact that most people don’t wear properly-fitted shoes, or have stiffness in one or more of the 33 joints, and you’ve got a perfect scenario for lousy foot mechanics that can cause ankle, knee, low back or the previously mentioned jaw pain.

Shoes are often the culprit, because they impair isolated action of each toe. And if you wear high heels or cowboy boots, the situation becomes exponentially worse because your toes are crammed together like clowns in a compact car during a Shriner’s parade. This results in poor motor control of your feet – essentially, your feet become “dumb” since your brain loses the ability to effectively control their joints and soft tissues.

Test Yourself

Here’s a simple, basic test to determine if you have adequate motor control of your feet. Stand barefoot with your feet shoulder width apart. Can you lift the big toe without elevating the other four toes? Can you elevate the four smaller toes while the big toe remains on the ground?

If you weren’t able to pass the test, your feet lack the motor control they need. Practice this drill throughout the day while seated, and then progress to the standing version since it’s more challenging. It will probably take a few weeks to get it right, and at first you might need to use a free hand to hold down the toe(s) that should remain static.

The next step is to focus on the shoe dilemma. Remember, regular shoes will keep your toes from moving freely. The solution is to wear toe socks, which isolate the toes so your brain can reconnect with each one. You can find them on Amazon at this link.

And for the times when you want to walk or lounge around the house barefoot, you can find rubber toe spreaders on Amazon at this link.

Now you have a simple way to test, and improve the motor control of your feet. And when you don’t feel like practicing the motor control drill, be sure to wear toe socks or rubber toe spreaders so your toes can come back to life. Your ankles, knees, low back – and maybe even your jaw – will reap the rewards.

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CW

Test and Build Your Glutes

blog sprinter It is difficult to overstate the importance of the glutes for achieving athletic prowess. When they are strong, you can run faster, jump higher and help protect your lumbar spine from injury. Of course, a well-developed set of glutes also make you look damn good in a pair of jeans or yoga pants.

You probably already do a handful of different exercises each week that are intended to strengthen and develop your gluteal muscles. The problem? It’s easy for your nervous system to prioritize the hamstrings and low back muscles, and neglect the glutes, when you do a deadlift, squat or glute bridge. There are two common reasons why.

First, the motor cortex portion of the brain that controls movement devotes very little real estate to the glutes. This is probably one of the reasons why it’s difficult for people to make a strong mind-muscle connection between the brain and butt. Second, since we spend considerable time each day sitting, which requires zero activation of the gluteal muscles, they get weaker and lose their neural input. Therefore, many people have what Stuart McGill, Ph.D., an expert in treating low back pain, refers to as “gluteal amnesia.”

Over the last few months, I’ve been experimenting with a way to easily measure a person’s gluteus maximus strength, based on an assessment that some progressive physical therapists use. Since their version requires a partner, I modified it so you can do it on your own.

Professor Vladimir Janda used to say, “Every exercise is a test.” He was right. And in this case, the opposite is true: the single-leg hip extension test is also a great strength exercise. So you’ll first learn how to use the movement to test your glute max strength, and then we’ll cover the parameters for strengthening it.

Single-Leg Hip Extension Test

How to do it: To test the strength of the left gluteus maximus, first stretch your left hip flexors so you don’t get a false positive. The test should measure your glute max strength, therefore, it’s important to eliminate any soft tissue limitations. Then, lie on your back with your left leg straight and left heel resting on a flat bench. The toes are pointed up, as depicted below.

glute test 2

Next, pull down through the left heel to elevate the hips/trunk as high as possible. The test position (aka, screen) is when your hips are at your maximum range of hip extension.

glute test 1

In order to pass the test, you should be able to hold the left hip in full, end-range extension without any rotation of trunk/pelvis, for 10 seconds (shown above). Repeat the test/screen with the right leg elevated, after stretching the right hip flexors.

Explanation: The gluteus maximus and hamstrings are both hip extensors. Therefore, this exercise doesn’t completely isolate the glute max. However, the hip flexion angle at the starting position creates a favorable biomechanical advantage for the glute max to develop force, so that’s why it’s a good strength test.

As is the case with any glute exercise or test, I always run it by my buddy, Bret Contreras, Ph.D. Here’s what Dr. Contreras had to say about the single-leg hip extension test:

This screen will assess the ability of the gluteus maximus to achieve end-range hip extension, while a rotational load is simultaneously placed upon the hips. If you’re up to par, your glutes will be sufficiently strong to resist being pulled eccentrically into hip flexion. If you didn’t pass, this indicates that you need to include extra glute activation drills into your daily warm-ups until proficiency is reached.

How to fix the weakness: What should you do if you didn’t pass the test/screen? You have two options that revolve around high frequency training (HFT) since the glutes respond especially well to it.

One option is to use the same movement we just covered to build strength. Let’s say you didn’t pass the test for the right glute max. In that case, perform 2 sets of the single-leg hip extension hold for as long as possible at the end-range, using the right leg, twice each day. Continue until you can hold the end-range lockout position for 10 seconds. Of course, the same strategy is used for the left glute, if it’s also weak.

The other option is to use a different glute activation exercise for one, or both glutes. For example, if your left glute didn’t pass the test, you could do 2 sets of the single-leg left hip thrust, for as many full reps as possible, twice each day (shown below). Then, retest your strength using the single-leg hip extension test every 10-14 days until you pass.

blog single leg hip thrust1photo courtesy of Bret Contreras

The purpose of the single-leg hip extension test is not to see if you can stop training your glutes with specialized exercises. Instead, the test helps determine if you need extra glute training throughout the week to correct an imbalance.

Now you have a simple way to do it.

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CW

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