All Exercise is CORRECTIVE

As a PT, much of my world has revolved around anatomy, physiology, and health sciences. This is good and important information. When folks show up with issues, limitations, and pain, you need to be able to understand the rationale for why their experiencing such problems. This will help you connect and communicate with them.

I said connect and communicate, not heal them.

You see, a good deal of PT is based on an overly simplified mechanical model (view) of pain. Your IT band hurts: therefore, you must have medial glutes. Your shoulder has been giving you some issues so it’s time to get out your green therapy bands and fire up the external rotation protocols.

Many “corrective” exercises are based on the idea that you can isolate a muscle, work it a little bit, and it will help the issue.

Furthermore, if something hurts, you should isolate it and stretch it. I’m not sure where this comes from but it’s unreliable at best.

Perhaps it’s because the real answer is probably complicated and, ain’t nobody got no time for that.

Know Pain, Know Gain

It takes time to explain the complicated relationship between pain and tissue damage (assuming there is one). It’s hard to delve into the fear avoidance model, only to recognize that you took a wrong turn back in Albuquerque (please tell me you get that).

So, it’s easier to slap a few banded external rotations on an achy shoulder and call it a day.

What about what the shoulder is actually responsible for on a daily basis?

Want to know a great exercise for the shoulder?

How about the deadlift? Picking up a “heavy” bar sucks the head of the humerus right into the shoulder socket in a way that bands can’t replicate. This places a great demand on the cuff musculature in a comfortable position. Furthermore, maintain control of one’s shoulder blades during the deadlift is also of great benefit (see kinesthetic awareness).

What I’m trying to say is that going to the gym and lifting weights IS THERAPY.

In most cases, you don’t need some fancy diagnosis (there are of course red flags that need to be addressed by a health care provider) as most of our pain is generalize, non-descript, comes and goes, and likely had no traumatic origin.

It just hurts when you move it.

I know you don’t want to hear this but… move it anyway. Just move it in a way that doesn’t make it worse. Moving it in a way that results in the same intensity / frequency / and duration of your current symptoms IS progress.

Do just a little. Monitor, same or positive feedback? Do just a tiny bit more. Wash, rinse, repeat.

Stop looking for that one weird trick or exercise. Just do the basics, squat, push, pull, hinge and you’ll be good to go over time.

How do I know? Because we do this everyday at the gym. We’ve worked with so many folks that come in experiencing pain I don’t’ even get excited about it anymore.

I just say, “you need to train”. They either agree or walk out.

If they stay, we get started.

We find an entry point and get to work. It’s often some combination of the basic barbell lifts, squats, presses, and pulls.

If they stay for a while, they do this 3 times per week, adding just a bit of weight here and there.

Over time, they get stronger, and (almost always) feel better. Their function improves, I know this because the weight goes up and the range of motion (almost always) increases.

I’m not saying barbells are the only therapy, I’m just saying they are also therapy.

Don’t sleep on that. Hope this helps.