In the previous edition ( CLICK HERE to read) dsof this 5 part series on Corrective Exercise, we explored the “whys” of Corrective Exercise. This helped us to understand its importance. Now we will turn our attention to the actual strategies used to make the corrections.
I find that even though people know Corrective Exercise is important, they aren’t doing it. One of the major reasons is that they just don’t know how to improve the poor movement skills that their clients possess. They coach and teach, over and over and very little success or improvements in movement quality. I can relate, because I have been there.
A few years ago, I began really researching this idea of movement quality and how to improve it. What I found was that once I began to understand how the body works to create movement, I was able to break it down and make significant changes to movement quality. A major breakthrough for me as when I realized that ultimately much of the movement dysfunction that we see can be attributed to the nervous system. Without proper motor control, it is impossible to move well. That’s not to say that at times the people that you work with aren’t hampered by true joint restrictions and/or tissue extensibility dysfunction. But, even true mobility restrictions often point back to a hyper active and overly sensitive nervous system.
Finding some ways to “trick” the nervous system to get what you want is one key to improving movement. In the first part of this series, I used the analogy of sledding in the winter to help illustrate how the nervous system “grooves” new patterns. This can be good or bad, depending upon how well they move. If they move well, all we have to do is continue to build and refine the pattern. If it is not so good, then we have to figure out a way to get out of the “groove” and begin to make a new, more desirable one. This can be harder than it sounds and typically won’t occur with mere coaching feedback or cues because their pre-determined motor pattern will almost always win out over newer ones.
One very effective tool for changing movement quality is Reverse Patterning. Essentially, you are doing something that your body views as completely different from the pattern that you are trying to correct. In reality, we aren’t going to do something “completely different.” Rather, we are going to train a similar pattern, but do it in a way that seems very foreign to our body.
We have to do it this way, because we need to “get out of the groove,” so to speak. If we just try to modify the movement, we won’t ever get out of the bad pattern that we want to change.
So, as the name implies, we are going to reverse the pattern. By training the movement in reverse, our nervous system sees the movement as something completely different. Thus, the movement won’t be affected by the qualities that they possess within the poor pattern. Also, reverse patterning usually takes better advantage of angles and leverage to improve movement quality and cues in on infant neuro learning patterns.
The best example of effective reverse patterning that I can think of is training the squat. We all have a squatting movement pattern that we perform without ever thinking about it. If this movement strategy is poor, we obviously need an intervention.
Reverse patterning the squat means that we are going to train it from the bottom up. If we reverse pattern the squat and start at the bottom, we take advantage of our infant motor learning pattern. This is because when we squat for the first time, we do it from the bottom up, not the top down. This is how we are wired. By reverse patterning, we also allow them to start in an optimal mechanical position in the bottom, as well as eliminate the eccentric portion of the squat (eccentric contractions are by nature difficult for the body to perform).
If you use this technique to your advantage, you can phase back in the top down squat once they have started to “groove” the pattern from the bottom up. In this video, we discuss how to use reverse patterning to correct the squat. This technique can be used to simply refine a good squat, correct a very poor squat, and even re-introduce the squat to a post surgical patient.
In the next part of this series, we will discuss Reactive Neuromuscular Training or RNT and how it can successfully be used to improve movement quality.