A common problem is the neglect lifters have toward their orthopedic health. At least until they become injured and are forced to address it. Unfortunately, they turn to theraguns, foam rolling, static stretching, and other approaches that often do little to move the needle. What people often get wrong is their training should simultaneously enhance their performance and address their long term health. In this article I’ll cover how to effectively incorporate corrective work into your training (and no, I’m not talking about spending an hour using therabands).
First, it should be stated that the relationship between athletic ability and health isn’t linear. The higher your athletic ability, the more stress you have to impose on your body to stimulate further adaptations. Since at some point, your adaptive threshold approximates your maximum recoverable tolerance, your risk of injury can increase. Therefore it’s important to take precautions to mitigate risk while simultaneously pursuing higher levels of athletic performance. Movement variability has been shown to reduce the risk of injury, likely due to a reduction in overuse injuries as well as increased exposure to loading through various muscle lengths and joint angles(1). In fact, researchers have found top level athletes often have significant intra-individual variability in task execution(2).
One way to address variability is through exercise variation. In powerlifting everything is done in the sagittal plane (the far left image). But we seldom spend time in the other planes. Since the competitive requirements of a powerlifter don’t necessitate transverse or frontal plane tasks, this is good from a specificity standpoint. However, specificity exists on a spectrum and along that spectrum there are trade offs. For instance, the most specific training a powerlifter can do is competition. However, no one would argue that competing every day is an effective way to approach long term development of strength. By extension we can see several other variables that require consideration when developing a program.
When most people say corrective work, they’re referring to bird dogs, dead bugs, banded shoulder external rotations, etc. Those are all fine exercises which have their place especially when recovering from injury. But if you’re otherwise healthy, I think we can often do much better. When I refer to corrective or orthopedic work I’m referring to actual lifting that addresses the specific needs of the lifter. For instance, one of my athletes struggled with knee pain during the squat. We determined he had insufficient knee extension strength and would often avoid deep knee flexion. So I programmed heel elevated belt squats 2x15-20. Initially he was instructed to go light and bias ROM over load. But by week three he was pushing these sets heavy and to 2 RIR which is brutal. The exercise was less specific than a squat, but it allowed him to train at long muscle lengths, bias the knee extensors, and address a tissue/positional tolerance issue. If we hadn’t addressed it, his symptoms likely would have continued to progress and limit his performance.
I had another athlete who lacked stability at the bottom of her squat. This is where most people lose tension. So I programmed heavy tempo cossack squats for 3x8-10 with a pause at the bottom. She hated them, which was unsurprising, since I selected them specifically to expose her inability to integrate bracing and maintain rigidity at deep hip flexion. But after roughly six weeks her squat looked excellent. This was a low specificity exercise relative to powerlifting competition, but it was highly specific in developing the requisite motor skills she was lacking. Would she have injured herself if we didn’t take the time to correct her movement quality? I can’t say with any degree of certainty. But I know it enhanced her performance, and it certainly didn’t increase her injury risk. Additionally her subjective assessment of how she felt was better and she was more confident hitting depth in her squats, but that’s an N=1 so take it with a grain of salt.
To clarify, this is not prescriptive. My point here is that if you do a good job at identifying the lifters needs you can proactively address issues as they (or in some cases prior to) come up. This can increase the total duration of productive training time throughout the year, and often prevent otherwise avoidable setbacks. And you don’t need to waste time on a foam roller either.
I’ve given two case studies, but I want to highlight the central point I’m trying to get across. Achieving or maintaining certain mobility, addressing bilateral discrepancies, finding muscular imbalances, insufficient technical ability, etc. are all components of effective programming. I don’t have a template stating each lifter must be able to achieve X degrees of external rotation in their shoulders. Nor do I think you could accurately apply static figures to a diverse spectrum of athletes. But I can say that if you’re unable to raise your arms above your head, log press is going to be an issue. If you can’t touch the bar to your chest on a bench press without internally rotating your shoulders, that’s a problem. Most lifters can fairly easily identify things they need to work on that are causing them issues. The good news is you often don’t need to regress to some boring activity (although sometimes it is necessary in the short term). A good program addresses movement quality issues and orthopedic issues in the training itself. It just takes diligence and intentionality.
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