Breathing patterns determine the physiologic response in the cardiovascular and autonomic nervous system (ANS). Specifically, the physiologic and biochemical response is driven by the length, depth & pace of our breathing and whether we’re mouth breathing or nasal breathing.
The title of this article is a quote from UK physiotherapist Adam Meakins. The context is that one does not need to exhibit or use “proper exercise technique” constantly throughout daily life or even during physical rehabilitation for pain or injury.
Now, this at first sounds counterintuitive to what the majority of fitness professionals and even physical therapists are taught and believe. The mantra of “poor exercise technique leads to injury” has been spouted for decades… but there is absolutely no proof of this in medical and fitness-related academic research.
Yep, your absolute most favorite go-to coaching point as a FitPro is pretty much bunk. So, do we throw the baby out with the bathwater and let our clients lift just however they please? No, not exactly, context is king.
If you are working with an athlete, which includes body builders, stricter exercise technique is beneficial to a high degree (esp. with physique athletes who require symmetry and maximal muscle development) but real-life sport doesn’t look anything like the gym when it comes to movements. Some variation in technique is beneficial as it will expose the athlete to forces in various, and more realistic fashions that provide greater benefits on the sport field or ring.
If you are working with general population, mostly healthy clients, “proper” exercise technique should honestly not be force fed initially, as this can be both physically uncomfortable for the client as well as demotivating if they’re “still not able to keep the back flat on a deadlift.” Find whatever movement pattern is natural for them and coach from there.
I used to be a hardcore stickler for technique, now, not so much. Instead, I coach my patients to lift in a manner that “feels stable, safe, and powerful” for THEM. The result? Better client engagement, better client results, and far less stress on them and yourself during the coaching session.
Now what about medical fitness and physical therapy? While strict joint actions may be required during some phases of physical rehabilitation or other therapy, we must consider how a client naturally and instinctively moves and wants to move. We need to understand any fear-avoidance behaviors they might have developed previously, and we certainly want to know their beliefs about physical activity.
So, if “improper” exercise technique isn’t to blame for gym and sport injuries, then what is?
We don’t have a firm answer, but we can say with a high degree of certainty that it’s a combination of physical and mental stress, distractions, nutritional state, hydration, focus in the moment, and how well prepared the individual is for that movement they are about to engage in. Simply not getting a good night’s sleep before deadlifting the next day can potentiate an injury, but that’s not a guarantee either. Load management and recovery are far more important when it comes to injury prevention than anything else, and this is why you should be writing and logging client training plans and sessions and not winging it. Otherwise, you have no historical record with which to troubleshoot things with which will only frustrate you and your client.
I sincerely hope that I have ruffled some feathers and also have given you some food for thought. There’s a time and place for everything, including strict exercise technique, it just takes some insight and thought to determine if “this” is the appropriate context.
Reprinted with permission from the Move Well, Live Well blog.
Joshua Slone is an Exercise Physiologist and Pain Therapist. He serves as Rehab Team Lead/Physiologist at the Center for Health in Yucca Valley, CA. His clinical expertise includes chronic pain management, joint replacements, sport and orthopedic injuries, complex medical condition management, geriatrics, degenerative neurological conditions, and psychiatric disorders. Visit his website, movewelllivewell.org
Warm Up. There are many schools of thought about warming up, however it is generally accepted that warming up muscles that will be used for a specific activity is a good way to avoid injuries such as muscle tears. A good warm up routine to use is to perform the activity you’ll be doing at about 1/3 to ½ the speed or intensity for 5 to 10 minutes.
Her insurance benefits had just run dry, we were at a critical point in her rehabilitation and recovery following a Spinal Cord Injury (SCI) from an automobile accident. “What should I do?” she asked me as we neared the end of a therapy session. “Why don’t we meet up and just keep exercising.” I replied and the rest was history.
There are countless other stories with other patients at the time that could have easily pointed me in the same direction. “I am being discharged with a home exercise program, but I want to keep working on my Stroke recovery.” or “I have been using a wheelchair for the past 20 years and I want to maintain my health and function as I continue to age but every time I go to a gym it just does not work out.” or “I wish there were a way I can be active besides adaptive sports.”
In my case, it was the former, a patient of mine with so much potential for continued outcomes was being prematurely discharged from physical therapy due to insurance limitations — the start of my personal journey into adaptive fitness began.
Up until the start of this journey in 2005, the majority of activities for individuals living with or recovering from disability was limited to adaptive sports… Wheelchair Basketball, Quad Rugby, Wheelchair racing, etc. The availability of fitness programs, group fitness, and even accessible gyms were very limited.
The idea that there was a trainer that was performing one-on-one fitness training with an SCI client and that the individual was excelling to the point that once therapy resumed, newer goals could be addressed by the therapists leading to better outcomes, spread throughout the rehabilitation halls and soon more folks wanted this type of training in addition to therapy.
What initially started as a temporary fix to aid a patient in need, has led to redefining my own career and sharing through experience and education what adaptive fitness is and how adaptive fitness trainers can bridge a huge gap.
Adaptive Fitness has really blossomed and now (thanks to social media) Adaptive Fitness Trainers, clients, and facilities are able to share training experiences to the public.
Wheelchair users can highlight their fitness workouts, PRs, and other fitness trends and challenges. Facilities can highlight client success stories, and brands can and have sponsored wheelchair athletes.
For the purpose of this article, I would like to highlight education and standards as I identify what adaptive fitness means to me.
Group Exercise, Virtual Group exercise, Seated Exercise, Adaptive Crossfit, one-on-one personal training can all be identified as Adaptive Fitness and really anyone can lead a group exercise class for any and all abilities… but should they?
Understanding the needs of a participant who is living with Multiple Sclerosis, Transverse Myelitis, Cerebral Palsy, Stroke and SCI in the same group class is extremely important for the safety of all individuals and should not be taken lightly.
Adaptive options presented to one participant may not work for another. Some folks may need specific cueing to maintain safety while others may be able to accept any challenge without adaptive needs.
Understanding risks, precautions and limitations to maintain safety in the group class setting but still make it an effective class is vitally important, and is why having the proper education to lead such classes is a must.
Working one-on-one with an adaptive fitness client who is focused on neuro recovery following a neurological impairment is not a cookie cutter type workout. You can use exercises you may know of, but the set and rep schemes differ entirely and blow traditional routines with 4 sets of 10 reps out of the water. There are specific strategies that can be utilized to effectively challenge someone working on improving neuroplasticity, but how you implement those strategies is dependent upon the individual, the diagnoses, and the strategy being utilized. Having an understanding of all of the above is imperative to your success as an adaptive trainer and their success for their outcomes
The same can be said for an adaptive client working on functional mobility. If floor transfers or stair climbing is a challenge then working on movements and exercises to improve those abilities is a must, but it’s important to have an understanding of how to guard, how to support, how to transfer, how to use your adaptive trainer body to aid your adaptive client in successful progressions toward achieving the movement they are working towards.
An understanding of adaptive training, adaptive accessories that can be used, equipment that can be modified, and strategies that can be used to make an adaptive client successful in the pursuit of their goals should be your goal as a Medical Fitness Professional. So that you become that trainer that should be leading adaptive fitness classes/session and not the trainer that is leading the classes/sessions but shouldn’t be.
Become an Adaptive Fitness Specialist
The Adaptive Fitness Specialist online course is designed to provide the knowledge needed to safely and effectively design and implement adaptive exercise programs for individuals living with or recovering from a physical disability or disease.
Devon Palermo is a leading authority on Adaptive Fitness for those living with or recovering from a disability. He is the Founder and Principal director of DPI Adaptive Fitness, A company focused on safe and effective adaptive fitness for individuals living with disabilities. With over 15 years of experience in both fitness and rehab, He is the go-to resource for clients, therapists, and doctors in the DC, Maryland and Virginia area looking to maximize the benefits of adaptive exercise to improve strength, balance, function and abilities. dpiadaptivefitness.co
Recently the FDA announced plans to grant Leqembi, a new Alzheimer’s drug, full approval in July 2023.
With an annual cost of $26,500 USD, you would expect the drug’s effects to be dramatic. And researchers were thrilled to report that Leqembi… slowed cognitive decline by 27% over 18 months.
Finding time to relax is a struggle for many. We underestimate our need to unwind and decompress, and our busy lives sometimes make it impossible. But, 5-10 minutes a day can really go a long way toward forming new habits for healthier well-being.
We are all on the eternal hunt to looking good, moving well and feeling young – however as responsibilities (job, school, family, friends) increase the time allocated to health and fitness often decreases. Surprisingly we expect the same results with less time in the gym but is this really even possible?
Perhaps it is.
Enter…..biohacking!
Biohacking, as the name suggests, is “hacking” or finding a way to more efficiently manipulate human biology. This can include areas of sleep, nutrition, mental health, strength, recovery.
If you are new the concept of biohacking – please think of this as a positive thing! Don’t get wrapped up thinking it is a mad scientist in his garage implanting computer chips into his own body.
Think of biohacking as a empowering concept which allows one to enhance or improve the efficiency of different aspect of health. It means taking ownership of your body and the aging system.
Absolutely!
In the case of fitness some examples of biohacking include drinking caffeine to give you energy during a workout. Or taking branch chain amino acids after a workout to enhance muscle repair and hypertrophy. Or using kinesiology tape to enhance proprioceptive stimulation and muscle activation.
Seems less mad scientist-y doesn’t it?
One area of biohacking that I am particularly a fan of is the application of barefoot science to improve your workout. As I mentioned at the start of this blog the one thing we never have enough of is TIME.
By integrating barefoot training into your workout you will hack your way into a more efficient workout allowing you to achieve faster fitness goals. Below are my top 4 biohacks integrating barefoot science.
Next time you hit the gym start your workout start with just 5 minutes of trigger point footrelease the bottom of the foot. A 2015 study showed that 5 minutes of manual trigger point release was associated with an immediate improvement in single leg stability and postural control.
Since having someone do the trigger point release isn’t efficient we’ll instead use RAD Rounds by RAD Roller. These small rounds of different sizes can be used to apply pressure to different intrinsic muscles of the foot. I recommend 5 minutes in the morning, evening and before exercise.
View video below
In the world of proprioception whole body vibration is one of the most efficient ways to stimulate the nervous system. Since our foot is also the gateway to proprioceptive stimulation I recommend doing your WBV activation barefoot and using PowerPlate which is a multi-planar harmonic vibration platform.
A 2007 study by Lohman showed that just 3min of WBV at 30Hz enhanced skin, nerve and tendon micro-circulation resulting in enhanced tendon tensile strength and decreased arterial stiffness. All of which is a very powerful response before any workout.
Learn more about WBV and PowerPlate at powerplate.com
To learn more on this topic you can view the following webinar below:
The core. The center of stability and the center of power. When it comes to any dynamic movement or exercise – core strength and stability are critical to the way force is generated or transferred through the human body.
The foot. The base of stability and only contact point between the body and the ground. Studies have shown that it is more efficient to strengthen the core via the foot in what EBFA calls “foot to core sequencing”. The access into foot to core sequencing is via an exercise called short foot.
To learn more about short foot and how to integrate it with exercises please see below:
Postural control and dynamic stability require the integration of four input systems – visual, vestibular, joint proprioceptors and plantar foot skin. Of these four one of the most important but often overlooked systems is the skin on the bottom of the foot.
The skin on the bottom of the foot contains thousands of small nerve proprioceptors all of which are sensitive to different stimuli. One of the most important stimuli coming into the foot is vibration (see WBV above). We use vibration not only to know how hard our foot is striking the ground but also in the maintenance of dynamic balance.
As soon as we put on our shoes our nervous system inherently becomes slower. This delayed neuro stimulation of the foot is small or micro which means it is hard to detect by the average client or patient – however it is happening. Accumulatively this results in micro-trauma and micro-compensation.
To biohack your nervous system whenever you are barefoot training integrate small nerve plantar stimulation with Naboso Technology. Whenever performing barefoot exercises such as short foot or any foot to core sequencing this is the perfect opportunity to pull out your Naboso Barefoot Training Mat.
If you want to bring this stimulation to your shoes, Naboso Technology also makes small nerve proprioceptive insoles which have been shown to improve postural control and stability
Dr. Emily Splichal, Podiatrist and Human Movement Specialist, has dedicated her medical career towards studying postural alignment and human movement as it relates to foot function and barefoot training. She is the Founder of the Evidence Based Fitness Academy, offering continuing education with a focus on foot fitness and barefoot training. Courses included Barefoot Training Specialist®, Barefoot Rehab Specialist® and BARE® Workout Certifications for health and wellness professionals.
Originally printed on the Barefoot Strong Blog. Reprinted with permission from Dr. Splichal.
1. Drink sufficient amounts of water to stay not only hydrated, but flushed.
Suggested amount of water intake is… Take your body weight divide in half for normal daily consumption and add another half of that amount for medium to…
Both physical therapists and corrective exercise specialists help clients alleviate muscle/joint pain and improve their movement capabilities. However, the manner in which these professionals enter a client’s health and fitness journey is very different, and the procedures employed when working with clients are often dissimilar. Physical therapists are licensed health care professionals whose services are typically used by clients to treat a medical diagnosis, physical trauma, or specific injury (e.g., Achilles tendinitis, plantar fasciitis, rotator cuff tear, post-surgery rehabilitation, etc.). Physical therapy is also prescribed as an alternative means to orthopedic surgery, with therapists teaching patients how to prevent or manage their medical condition(s), often lessening the need for prescription drugs and painkillers.(1)
The job of a corrective exercise specialist is quite different. These types of professionals do not (and should never) diagnose and/or treat a medical condition. Instead, their specialty skills consist of assessing and evaluating a client’s musculoskeletal system for soft tissue and movement restrictions, imbalances, habitual patterns, and muscle dysfunction that may affect that person’s ability to move well, exercise effectively and/or perform daily activities (e.g., restriction of the lumbar erector muscles accompanying an anterior pelvic tilt, prolonged seated postures promoting excessive thoracic kyphosis, etc.). This specialized knowledge regarding the musculoskeletal system helps corrective exercise specialists design and implement corrective exercise programs to assist clients in beginning, resuming and/or continuing a fitness program without experiencing muscle and joint pain or movement limitations. (6) When a client’s musculoskeletal issues are not able to be addressed solely with appropriate exercises, or fall beyond a corrective exercise specialist trainer’s scope of practice, the client is referred out to medical experts for treatment.
As a corrective exercise fitness professional, it is important that you clarify your role with clients from the outset with regard to assisting them with their musculoskeletal health and not step beyond your professional bounds. In addition to laws dictating that any professional must remain within their bounds of experience, education, training, and demonstrated competencies, confusing your role with that of a physical therapist, and working outside your scope of practice, can harm your standing with clients and reputation within the fitness industry. (5) Aside from it being a requirement, the primary benefit of working within your boundaries as a corrective exercise fitness professional is that it enables you to practice, perfect and promote the unique talents you have with regard to evaluating the musculoskeletal system for imbalances, and assessing and correcting a client’s movements during physical exercise and activities.
Doctors, physical therapists and other licensed health practitioners are always looking for qualified fitness professionals to whom they can refer patients that need guidance with exercise.(3) According to recent research, two out of the top three reasons patients visit their doctor is for assistance with conditions that could be greatly improved by participation in a program of regular exercise.(4) Unfortunately, these medical professionals are often reluctant to refer patients with musculoskeletal conditions out of a concern that their clients’ problems might be made worse by an unskillful personal trainer. However, when you have specialty qualifications and knowledge in musculoskeletal assessment and corrective exercise, and work within your scope of practice, medical professionals will feel confident in your abilities, which provides an opportunity for you to build strong networking and referral relationships with them.(2)
As you begin incorporating corrective exercise procedures more regularly into client programs, it is highly recommended that you obtain a Corrective Exercise Specialist (CES) credential from a recognized and approved provider. This will advance your skills and can also result in more referrals from medical professionals. As your business network grows, you will also find that holding a reputable CES qualification makes it easier to refer clients to other specialists when their condition lies beyond your scope of practice.
Fitness professionals qualified as corrective exercise specialists know how musculoskeletal malalignments and imbalances of any kind can create pain, injury, and dysfunction throughout the body. They also know how to use the results of individual consultations and assessments to pinpoint clients’ exercise needs so they can start or return to a regular fitness program successfully. In short, knowledgeable and qualified corrective exercise specialists have the skills to competently meet clients’ musculoskeletal restoration needs, and represent perfectly the fitness professional of the future.
MedFit Network (MFN) members receive 20% off The BioMechanics Method Corrective Exercise Specialist certification. Members can get their discount coupon here.
Justin Price is one of the world’s foremost experts in musculoskeletal assessment and corrective exercise and creator of The BioMechanics Method Corrective Exercise Specialist certification (TBMM-CES). The BioMechanics Method is the fitness industry’s highest-rated CES credential with trained professionals in over 70 countries. Justin is also the author of several books including The BioMechanics Method for Corrective Exercise academic textbook, a former IDEA Personal Trainer of the Year, and a subject matter expert for The American Council on Exercise, Human Kinetics, PTA Global, PTontheNET, TRX, BOSU, Arthritis Today, BBC, Discovery Health, Los Angeles Times, Men’s Health, MSNBC, New York Times, Newsweek, Time, Wall Street Journal, WebMD and Tennis Magazine.
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