Groin pain, adductor strains and sports hernias are becoming an epidemic among athletes today, and especially among hockey players. Playing the same sport year-round, poor training protocols (or simply no training at all), over-training and faulty movement patterns are all perfect set-ups for groin pain, especially for hockey players because of the nature of the sport.
Before I go any further with my recommendations, I will say this: it is very important to clear out any other possible underlying issues in the first place. Groin pain may be caused, for example, by Femoral Acetabular Impingement (FAI), which would warrant the subject of a whole book in itself. In short FAI is an abnormality (usually a bony lesion) on either the femoral head or the acetabulum itself that creates impingement and may translate into groin pain. But I digress. What I’m saying is to get checked out first to make sure the issue is not coming from somewhere else.
The first step to take with groin pain problem is to stay away from anything that hurts for a little while. If you’re a hockey player and have some groin pain while skating, the first step to take is to stop skating, and I mean completely. I know it sucks being forced to stay away playing, but this is a necessary process to follow, and it will all be worth it in the long run. If you think the injury is not that bad and you’re just going to suck it up and keep playing until it goes away, it’s a BIG mistake. First of all, groin pain, groin pulls and adductor injuries don’t magically disappear, especially if you keep doing the same thing that’s been causing the pain (skating, in this case), and first thing you know is the pain is going to get worse and worse and you’ll have to suffer for months. So as much as it sucks, you need to take that time off.
Foam roll your adductors and your hip flexors. Most of the time, athletes will have scar tissue built up in their adductors and some kind of soft tissue limitation in their hip flexors.
Stretch your hip flexors, glutes and hip external rotators. Because of the nature of a sport like hockey (repeated hip extension, abduction and external rotation), athletes will have a loss in adduction and internal rotation, as well as hip extension range of motion.
Rectus Femoris Stretch (Hip Flexor)
Prone 90/90 Glute Stretch
Strengthen the adductors and the psoas, which is usually the weakest of the 3 hip flexors. These 2 muscles usually are very weak because they are underutilized in different sporting motions, especially the skating stride.
Lying Med Ball Crush
Seated Psoas Lift (make sure the thigh is above 90°)
Using this approach, you want to make sure to use these strategies at least twice a day, everyday (foam rolling, stretching and activation drills). We’ve had hockey players (and many of them) with pretty bad groin pain getting back on the ice totally pain-free in as little as 2 weeks after they start applying those exact recommendations. The key is really just to stay away from anything that hurts and be consistent with the exercises, and chances are you’ll be back on the ice (or the field) in no time.
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It has been said that 80% of the American population is going to suffer from lower back pain at some point in their life….That’s A LOT of people! The sedentary lifestyle of most human beings in 2012 is probably one of the main causes. If you’re a strength and conditioning professional or a personal trainer chances are you’ll deal with a good number of people suffering from low back pain throughout your career.
The first thing to do is assess the client or athlete and identify where the problem lies. You should also decide if referring out to a another health professional is appropriate. Either way, you’ll want to use appropriate corrective strategies, if appropriate, to make the person correct the source of the problem.
What you won’t want though is to turn the training session into a rehab session. You still want your clients or athletes to feel like they can get a training effect. They definitely shouldn’t feel like a patient; that’s not your job. You want to make them feel like athletes and you should focus on what they can do, rather than what they can’t do.
The big problem with most low back pain is that it limits your lower body exercise options quite a bit. Most of the time any variation of bilateral squat or deadlift will be out. So where does that leave us?
Although every person is different, there are options that are generally going to be safer than others. The first thing I would tell you to do is stick to the “do no harm” rule: if it hurts don’t do it. As simple as that.
That being said here are some options to consider with your low back pain clients and athletes:
Reverse Lunges
Depending on the type of back pain and how severe it is, your athlete might be able to get away with lunge variations using a front squat grip or a back squat grip, but usually DBs are going to be a safer alternative.
Rear Foot Elevated (RFE) Split Squat
In the video above, coach Dan Gabelman demonstrates a bodyweight RFE split squat. If your athletes are pain-free and strong enough, you can load them with 2 DBs or with one DB in the goblet position.
1-Leg Squat
This one might not be an option in some low back clients, but is usually OK with most if you keep a neutral spine throughout the range of motion, even if it means limiting that range of motion. Someone who’s flexion intolerant and has limited hip mobility might round at the back in the bottom position, which could exacerbate the problem. Usually just bodyweight is plenty hard for most people, so you don’t even have to use any external load to make the exercise challenging.
Sled Drag
What I really like about sled drags for athletes or clients with low back problem is we can use so many variations of them, and also still load them pretty significantly without any negative effect on the low back.
Again, the “do no harm” rule is king. Make sure you don’t do anything that hurts your athletes. You should also be smart about what you prescribe them, make sure it’s not making their problem worse, and when in doubt refer out!
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With any exercise, at any point, form is everything. It’s basic concept behind weight lifting. If you’re not lifting with good form, you increase your risks of injuries, not only in the weight room, but also on the field. Getting stronger without consideration for perfect form is really just reinforcing bad movement pattern.
The major lifts are all occasions to reinforce good movement. This is really what the premise of strength training is about; improve the way you move, and get strong in those “good movement patterns”. All the mobility work, corrective exercises and foam rolling are tools to help you achieve that very goal. But it doesn’t need to get more complicated that that.
Whether it’s because of the physical stress that life puts on us, the overuse trauma that certain activities exert on our bodies or the sedentarity of our lifestyle in 2012, our bodies build up dysfunctions. Playing sports definitely increase the overuse stress on our body, and is really good at making dysfunctions worse. Displaying maximal effort and energy at high velocities as it is commonly seen in sports, will make your body use the path of least resistance; your body doesn’t “think” about good movement. It just does whatever it is asked to do. That’s why it’s something that needs to be reinforced.
Achieving good movement and understanding it is the first step, then you perform repetitions, and lastly you start loading to solidify those movement patterns. With practice and added strength, your brain will start to make the connections, and the automated response of quality movements under high velocities will happen.
That’s what strength training is all about. It’s not about who’s going to be able to jump on the highest box. It’s not about who can perform 50 snatches from the floor the fastest. And it’s definitely not about pushing yourself when your form becomes shitty.
I’m not pointing any fingers here.
Or maybe I am….
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It’s this time of year at Endeavor where our hockey players are slowly coming back for the off-season training. During the next 2 months or so, we’ll progressively welcome back our players, and by the time June rolls around we should be at full capacity and be extremely busy throughout the summer.
In the meantime, the current phase of the off-season is what we call “the early off-season” for the guys that are already back with us. These guys have the advantage of having a long off-season and plenty of time to not only improve their performance, but undo the damage they’ve put on their body throughout the season. And God knows how much damage a long hockey season can put on your body, especially on your hips. That’s why our early off-season phase focuses a lot more on re-establishing balance than it is about improving performance.
Hockey is a rotational sport, just like baseball, football (for quarterbacks), lacrosse, tennis and golf. One thing to understand is that the rotational movements occur almost exclusively in one direction. Over the course of a season, this accounts for many rotations when making passes and taking shots during all the practices and games the athlete takes part in. Rotations in the opposite direction are almost non-existent, and if you want to ensure better symmetry and balance throughout the body, there is definitely a need for rotational work on the non-dominant side.
The core exercises in a training program can be a good tool to help re-establish better balance. Even though our exercises are not purely rotational in nature (actually they are just the opposite; anti-rotation), the movement pattern and the muscles recruited are the same; they just happen to work in an isometric fashion.
That being said, instead of working both sides equally, we’ll double or triple the volume on the non-dominant side for all the anti-rotation core exercises we’re using. Just about any anti-rotation exercise can be used, but 2 of my favorites are the Belly Press and the Chop, both in the 1/2 kneeling position.
I really like the 1/2 kneeling position, especially in the early off-season because you get some lengthening of the hip flexors and some hip stability in the end range of motion. We’ll usually do 3 sets on the non-shooting side, and only one on the shooting side.
The concept can also be expanded with the rotational power work, with medicine ball throws and the like. Adding more sets on the non-dominant side will help re-establish some sort of balance around the hips, the shoulders and the core.
The early off-season is a good time to work on major imbalances and the damage done during the season before getting into heavy strength and power work throughout the summer, so it’s important to take advantage of it.
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We live in a funny world, don’t we? Most athletes, parents, clients and a lot of people around are judging your work as a strength coach by how tired you can make them during training sessions. Following a Crossfit, P90X or other non-sense training system, people always seem satisfied with the results because they work hard. After all, isn’t it what it’s all about?
These quotes make plenty of sense, don’t they…..
As a strength coach or a personal trainer it’s very easy to exploit these training systems or use other training methods to make yourself look good to the uneducated crowd out there, who always believed that working hard is the only thing it’s about.
Since that stuff sells and attract a lot of athletes and weekend warriors, it’s not easy to drift away from those training methods and still make your athletes and clients feel like they’re accomplishing something, even though they don’t crawl out the door with not an ounce of energy left.
Let’s face it, what’s easier?:
- Beating your athletes to the ground every training session, and leaving them with the feeling they’ve worked hard? Or;
- Letting your athletes leave the weight room with some energy left, and sometimes even feeling refreshed, and having to sell to them why it is better than beating them to the ground when they’ve been led to believe otherwise all their life?
It’s an art to periodize your athletes’ training, and even more of an art to stick to it. When you’ve planned to back off the weights at the beginning of the off-season to give your athletes some time to recover and take care of the imbalances they’ve created during their season, do you really stick with the plan? Or do you get overwhelmed by the feeling that you should work them to the ground?
Managing training loads and volumes is critical, especially with high level athletes. If you think that training hard and crushing your athletes is the way to go, you’re going to have a serious problem working (and being successful) with College and pro athletes. I think I remember Sean Skahan, strength coach of the Anaheim Ducks in the NHL, saying that he feels more like a “recovery coach” than a strength coach at times. I couldn’t agree more with him.
There are times during a training year where it’s all about maximizing recovery and handling training loads so the athletes can still perform at the highest level and avoid getting hurt. Overtraining will drastically affect your performance level and make your risk of injury skyrocket. The in-season and early off-season phases are perfect examples; athletes have a lot of stress put on their body with a lot of games, practices every day, travel, school (in the case of college athletes), etc. That’s why they need a lot of recovery, injury prevention and corrective strategies during those times. A certain level of strength can be maintained, but the volume must remain pretty low.
Make sure you don’t take the easy way out. Do what’s right for your athletes, plan accordingly and resist the urge of just crushing them for the sake of it. They’ll become better, stronger and more injury resistant athletes in the long run.
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Being a strength and conditioning coach or a personal trainer requires many qualities. One of them is the ability to pay attention to details. When coaching exercises, there are many different body positions and subtleties in movements that one needs to be aware of. Just demoing the exercises and throwing a couple coaching cues up in the air is usually not enough to get the result we want from our athletes and clients.
A coach (or trainer) needs to be able to identify and understand the subtleties in the different movement patterns to be able to coach the exercises in the most optimal way possible. Here are some of the subtleties that a coach needs to be able to distinguish and correct (in no specific order):
1. Thoracic Spine Extension vs Thoraco-Lumbar (T-L) Junction Extension
I covered that in a previous blog post, but the “chest up” cue is not always interpreted the right way by the athlete or client. Basically what we want to see when calling “chest up” is an extension at the thoracic spine so that the athlete maintains a more neutral spine. Often times, the extension will come from the T-L junction which will put more stress on the lower back, will cause the anterior lower ribs to flare out and put the diaphragm in a less than optimal position. That pretty subtle substitution will too often go unnoticed if the athlete is wearing a loose shirt.
Barely noticeable T-L junction hyperextension because of a loose shirt
2. Hip Flexion Compensation
In most athletes the psoas ends up being the weakest hip flexor. The reason being that it is the only hip flexor effective above 90 degrees of hip flexion. In most athletic endeavors the hip ends up being flexed above 90 degrees rarely, if ever; that in turn causes a higher recruitment of the 2 other main hip flexors, the TFL and the rectus femoris, and the psoas ends up weak. It is a good idea to include psoas activation exercises in a training program to re-establish hip flexor strength in the end range of motion. When doing these drills, athletes will be tempted to compensate because they are pretty weak in that position. The seated psoas lift is one of my favorite psoas activation drill, but can be cheated pretty easily if not coached properly.
Often times, athletes will either lean back or hunch over to try to get the knee up as high as possible. But in both situations, you’re really avoiding the above 90 degrees end range of motion; the angle of the hip flexion will be less than 90, and therefore you’re not getting that psoas activation you’re going after.
Bad Form- Leaning back will prevent your hip flexion to be above 90 degrees
Bad Form- Rounding of the lower back will also avoid that end range of motion
The same problem can occur if you perform a standing psoas hold, or any other type of exercise of that nature.
3. Full Hip Extension Compensation
The complete hip extension is definitely something important in many different exercises that are part of a training program. An incomplete hip extension can expose some pretty serious problem going on around the hips. Whether the problem is caused by a hip flexor restriction, a lack of glute activation or just poor coaching, this is a problem that a coach needs to be aware of to be able to prevent injuries with his athletes. This is another movement that can be very subtle and if you don’t pay attention to it can be missed altogether. The incomplete hip extension can present in a wide variety of different movements, with posterior chain exercises (deadlift variations, pullthrough, slideboard hamstring curls, etc) being some of the most important ones. An athlete not being able to finish his movement at the top with full hip extension will usually compensate with a hyperextension at the lower back.
Again, if no attention to details are paid during a deadlift (or just from coaching from different angle) this is something that can easily be missed.
4. Scapular Protraction vs Elbow Extension
This is something even more subtle. The correct technique for pressing exercises is to keep the scapulae packed back together. If unable to get a full elbow extension, the athlete might compensate by protracting the shoulder blades to get the end range of motion at the top.
Good Form- The shoulder blades stay packed back while getting full elbow extension
Bad Form- Protracted shoulders compensating for incomplete elbow extension
The biggest problem I see with this compensation pattern is for the following reps; if you’ve lost your packed scapulae position, when going for the next rep your shoulders are not going to be in a stable position to press a heavy weight anymore. That can in turn have deleterious effects on the shoulders.
5. Feet Position
This is one that will go unnoticed more often than not. One of the main reasons is that the shoes your athletes are wearing might simply hide what’s going on at the foot and ankle. During lower body exercises like squats, deadlifts, lunges and the like a lot can happen at the foot that might be detrimental to an athlete’s health because it will either cause problems further up the chain, or it might be in itself the result of a problem going on somewhere else. An overpronation, or a loss of the arch of the foot are good examples.
Relatively neutral feet in the bottom of the squat
Feet overpronating at the bottom of the squat
In this last picture, it is easy to realize that it is something that be completely missed when the athlete is wearing shoes. (As a side note, I am not necessarily recommending that people squat without shoes on, but it clearly reveals a problem that might have otherwise been missed.)
This is really just a quick list of some of the most subtle body positions and compensated movement patterns you can see in athletes and clients. Paying careful attention to details is such an important part of a coach or a trainer’s job because in the end, it plays an extremely important part of the injury prevention component of an effective training program.
Isolation training really doesn’t exist, whether it’s in bodybuilding or in rehab. The concept of isolating a muscle has long been associated with bodybuilding purposes to increase the size of the different major muscle groups individually. This has led the whole fitness industry to follow stupid training principles for years, and even today if you step foot in a commercial gym, 90% of people, including most personal trainers, use bodybuilding concepts (working every muscle separately, using body part splits, etc). But I digress.
Even Spiderman is following the trend
You can also notice a certain muscle isolation mindset in most rehab protocols. One of the most popular ones is the isolation of the VMO in knee pain and injuries. How many times have we heard “he has knee pain because his VMO is weaker than his vastus lateralis”. In an effort to cure every knee problem imaginable, we started isolating the VMO…or should I say “trying” to isolate the VMO.
Because of our understanding of the fascial system and how muscle interact together at this point, we now know that isolating the VMO is a flawed concept. But somehow we’ve managed to keep trying to isolate small muscles in the hope that it would cure our shoulder, low back or hip problem.
This guy clearly needs some VMO activation exercises
As Charlie Weingroff recently said: “If you don’t believe in isolating the VMO, why are you trying to isolate the serratus anterior?” To me this is a quote that makes plenty of sense. It’s just how your body works, you can’t isolate just one muscle, whether it’s your VMO, your biceps brachii, the serratus anterior or the lower trap. Isolation just doesn’t exist.
Does it mean that you can’t reinforce a certain movement pattern that will facilitate the recruitment of certain muscles? No. But you shouldn’t think about “isolating one muscle” and think more in terms of movements. And in the end, the goal is be able to perform integrated movement patterns with optimal joint centration and the right muscles will do their job- as long as we don’t have movement restrictions.
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I’ve blogged about the importance of breathing patterns many times in the past, and for a good reason. Breathing patterns and the muscles responsible for breathing affect so many things in our bodies, yet we too often ignore their importance. In the presence of a faulty breathing pattern, accessory muscles will compensate for the diaphragm not doing its job properly. We then see hypertonic neck muscles (scalenes, sternocleidomastoids, upper trap, etc) which can also lead to neck pain and headaches, referred pain in the shoulder, etc. But this is only the superficial stuff.
If the diaphragm isn’t working properly, chances are that it’s also not positioned optimally. We could debate which one causes the other (dysfunction causing faulty positioning or faulty positioning causing dysfunction), but it would be a case of the chicken or the egg.
The thing to keep in mind is that when the diaphragm isn’t positioned properly there are also surrounding structures that are affected. The lower ribs flare out, the T-L (thoraco-lumbar) junction is stuck in extension, and the whole rib cage is positioned differently. This in turn will affect the positioning of the scapula because it sits on the rib cage, and therefore the positioning of the whole shoulder girdle will be changed.
Faulty breathing patterns can also affect structures lower down the kinetic chain. Because of the attachment of the diaphragm and its fascial connection through the psoas, that goes through the hips, the positioning of the hips can be affected. And if the hips are positioned differently, everything below (femur, tibia, foot) might be in compensated positions.
Not the best picture, but you can still see the convergence of the psoas and diaphragm
Before this turns into an anatomy course, I’ll stop here! The goal was just to make you understand how powerful breathing patterns can be and how it can affect the whole body. That is why school of thoughts such as the Postural Restoration Institute put such an important focus on breathing patterns and diaphragm function to treat all sorts of problems (overuse injuries, low back pain, shoulder pain, flat feet, etc, etc). All of their corrective work involve very specific breathing patterns. They have a bunch of different exercises incorporating breathing patterns to get you back into a “neutral alignment” as they would put it.
I have learned a great deal from PRI and started including a lot of their stuff with my athletes, which has worked almost like magic in many cases. Here is one of my favorite exercises that I stole from them to teach proper breathing patterns:
The position: Lying on your back with your feet up on the wall and your knees and hips at 90° angle, squeeze a foam roller or a small medicine ball between your knees. Dig your heels into the wall and posteriorly tilt your pelvis just enough to get tail bone slightly off the floor. Get your right arm straight up and reach with the palm of your hand towards the ceiling.
Execution: Take a deep breath trough your nose, Blow out through your mouth as hard as possible trying to inflate the balloon as much as possible. Blow all your air out in the balloon. When you have no more air in your lungs, pause for about 4 seconds while pushing your tongue against the roof of your mouth (your teeth should not be clenched). Then, breathe back in through your nose, and repeat the sequence. You can do anywhere from 5 to 10 breaths, but start on the lower end, and make sure you control everything.
Cues: Make sure that the tail bone remains slightly off the ground the whole time and the heels keep digging in the wall. When reaching up with your right arm, you only want to reach as high as your arm will go, meaning you don’t want to lift your upper back off the ground to reach higher. The pause with the tongue against the roof of your mouth is probably the most important step. Do not repeat on the opposite side.
We only do it on one side because the diaphragm on the right side and on the left side are shaped and positioned differently; we want to facilitate the air going into the right side to re-position you in a more neutral position. This is again part of the PRI philosophy that the human body is assymetrical for a host of different reasons; we have a heart on the left side above the diaphragm, we have a liver on the right side under the diaphragm, the left side of our brain manages motor control, etc. I’m not going to get too deep in the PRI philosophy as it could be the subject of an entire different blog post, but hopefully you get the concept a little bit.
Don’t overlook breathing patterns and make sure that it’s part of your assessment protocol with everything else you assess for.
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Baseball is one of the sports that puts the most stress on your joints, especially if you’re a pitcher; the throwing shoulder is under tremendous stress. With the crazy velocities at which you throw a baseball, and with the volume of pitching that accumulates over the years, by the time a pitcher gets to the professional level, he probably has a lot of overuse damage to it (soft tissue restriction, ligament laxity, partial labral damage, etc).
Last Saturday I played in a fund raising dodge ball tournament in Philadelphia. Having not played dodge ball since middle school, and not being a natural thrower (my main sports growing up were hockey and basketball) made me a little worried about my dodge ball performance. As expected I sucked pretty bad, but at least I stole the show with my purple cobra entrance before every game…
A little less glorious when you get hit in the face 30 seconds later, though!
If you’re wondering where I’m going with this, here it is: I was so freakin’ sore the next day it was unreal! My whole shoulder and arm, starting from the attachment of my rhomboids on my spine going all the down to my fingers, were as sore as I’ve ever been in my upper extremity. Rhomboids, levator scapula, rotator cuff, biceps, and all of my forearm muscles were completely smoked.
Is that a coincidence that these muscles all have fascial connections?
That just made me realize all the stiffness and soft-tissue restrictions that can build up in a baseball pitcher’s arm when he throws around 100 pitches every time is on the mound. Of course there are some adaptations taking place; the body becomes more efficient at it as you build up your arm strength, stamina and improve your technique, and you don’t get sore (like I did playing dodge ball) every outing. But it still makes you think about all the stress that the shoulder and arm are taking on a weekly basis. And when young baseball pitchers throw with their high school team in the spring, play summer league and fall ball on top of that, the accumulated stress on your arm builds up pretty fast.
That’s why taking care of your pitching arm, using injury prevention strategies, and having an smart (and planned) training program are going to be important factors in the longevity and durability of your arm over time. Soft-tissue work on the rhomboids, levator scapula, rotator cuff, biceps, and forearm muscles is going to be an important part of that ‘arm care’ program.
Try and not cry the first time you dig a lacrosse ball in your rotator cuff muscles
If I got stiff and extremely sore in these muscles by playing 6 games of dodge ball (realistically ~10 throws per game), I can guarantee you that any baseball pitcher will build up severe restrictions in those same muscles over time, whether they feel it or not.
Do your dedicated self soft-tissue work on a daily basis, go see a qualified active release therapist on a regularly (once a month, as a bare minimum- but College and professional players probably need more) and you’ll increase your chance of staying pain and injury free, and give yourself the best chance to perform at the highest level.
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Pretty cool blog title, huh? After hours of deliberation, DavidLasnier.com’s board of directors came up with this ingenious title that, I’ve been told, was guaranteed to catch your attention. I’ve even been told that no one would pass on this title without wanting to read the whole post!
My actual board of directors…
All kidding aside, this title is in relation to corrective exercises. If you’ve been reading my stuff for a little bit, you should know by now that I’m a big believer in incorporating injury prevention and corrective strategies in training programs to help my athletes and clients move better and lower their risk of injuries. And I’m not the only one; there is a pretty big trend in fitness world that seems to be going on right now. I think it’s a really good thing that more coaches and trainers are now aware of the importance of the glute function in hip extension, scapular stability in shoulder health, etc. With all the smart minds in this business, new corrective exercises come out every day giving us a really big toolbox to work with when it comes down to corrective exercises.
NOT what I’m talking about!
One thing I feel we don’t stress enough with corrective exercises though is that the way we perform them is crucial. It’s a good thing to include glute bridges in a client’s program that seems to be prone to low back pain. But it’s not going to do much good for him if he’s not performing it the right way, or if he just goes through the motion. Sticking with the glute bridge example, if your client doesn’t know that the whole purpose if the exercise is to squeeze his butt cheeks as he lifts his hips up, he might be compensating with his hamstrings, or even worse, his lower back. If the ribs flare out at the top, or if the client feels the movement in his hamstrings or low back, there is something that needs to be fixed. Anyway, you get the point.
For that reason, switching around your corrective exercises all the time might not be a good idea. You want to make sure that your client masters a certain movement perfectly before moving on to something else; the goal is not always to have him do something “challenging”. It’s still a corrective exercise and it should never be a max effort anyway because that is exactly when your body will look to compensate. Corrective exercises should be kept simple; you should try to reinforce the same ones with a client until there is some sort of improvement. You’re really not doing him a favor if you throw a bunch of new corrective exercises at him every couple of weeks, just for variety purposes. Keep in mind that the client doesn’t know any of that stuff, and for every new exercise, he has 4-5 different things to think about at the same time while he’s perform it correctly. If you need to stick with the good old 2-legged glute bridge for 3 months before your client really gets it and feels it in his butt, that’s what you need to do. Variety or results? Which one are you really after? Pretty simple answer.
Start with the basics, make sure the execution is flawless, that your client feels the exercise in the right spot (if needed), and never progress a corrective exercise until you see progress. In a way, it’s just like a lifting program; it doesn’t need to get fancy schmancy with tons of new exercises in every new monthly program, because you’ll never know if you’re making progress or not.
As you can see, getting fancy is not always your best bet…
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