"Corrective" Exercise

Learn more about why a corrective exercise approach may not ultimately have a measurable impact.

The term "corrective exercise" is a bad one. It implies a few things that are less than accurate, potentially leading to worse outcomes for all involved:

1. If I do my "correctives" everything will be ok

One of the negative consequences of the growth of the term corrective exercise is that these additions are often thought of as a cure-all for any sort of compensation or issue. To avoid the semantics argument of what exactly defines a corrective exercise, we will define it like this: activities performed with a low intensity (relative) and a low volume (relative) added on to an individual's training with the intent to fix an issue or compensation. When defining the term this way, it is perhaps easier to see that there are obvious problems. Most practitioners are aware that any exercise performed with both low intensity and low volume will typically have very little effect, but when it comes to corrective exercise seem to disregard this basic concept. It is the term "corrective exercise," and resulting mental model that becomes the issue, not the specific movements or exercises themselves.  The approach would be similar to the belief that a little salt added to a recipe could fix the taste of rotten meat.

Though perhaps obvious for most practitioners, a 2020 systematic review of the literature helps to validate the concept that exercises that are prioritized have the greatest impact: "the increase in strength was greater in the exercises that were performed at the beginning of the exercise session. Placing a given exercise first in an exercise session allows the use of higher external loads in that exercise. The use of higher loads ultimately seems to transfer to greater strength gains in exercises that are performed first" (1). Prescribed corrective exercises are often so limited in their time and effect, that the larger stimulus movements would override any attempt to "correct" and perhaps even reverse the effects of positive adaptations. 

2. Some exercises "correct" things and others don't

Generally speaking, exercise and movement are good things. But the concept of "exercise" itself is a man-made invention designed to systematize and encourage movement as industrial and technological advances have made movement less of a requirement of daily life for humans. Movement is tied to our physical, mental, and emotional health and exercise is the tool we can utilize. Exercise itself only exists to "correct" our current lack of movement as a species.  It is important to understand that all movements and exercises have different physiological effects on our bodies. Everything matters, everything has an effect, and often times the effects of different exercises will have interactions with each other.

All exercises should be prescribed with an understanding of their effect, and with the intent to improve an individual's overall movement, health, and performance. In this context, all exercise is corrective exercise and needs to be prescribed in this manner! Different exercises and types of exercise can inherently expose or emphasize different qualities of movement for a variety of reasons. They shouldn't be prescribed simply because of our personal biases of what we like or what exercises we think are important for everyone, but based on what each individual needs and the potential effects of exercise. With this, the entire training program becomes the "corrective" for that individual. 

3. All exercises are important for everyone

Time is our most limited resource and something that we never get back.  For individuals to simply find ANY time to move or exercise can be extremely difficult. As practitioners, it is our job to identify what exercises or movements are the greatest priority for individuals in order to have the greatest impact in the least amount of time possible. If we view all exercises as corrective and understand their effect, it is easier to realize that not every individual needs to be prescribed everything. The "balanced program" is great in theory but breaks in practice.  If an individual only has 20 minutes, they aren't going to be able to push, pull, squat, hinge, carry, core and corrective... we need to prioritize.  By definition, if everything is a priority then nothing is. The introduction of corrective exercise created the notion that adding additional movements before or after a training regime to address poor movement patterns is always a positive thing. This has enabled practitioners to simply add more to programs when the goal should instead be to remove to save time and be more efficient with exercise prescription.  For professional athletes with more time to train this may be possible (though motivation can be a challenge), but this won't work for most. Everything is not important, and that's ok.  

4. Things can be and even need to be "corrected"

Despite what we may say there isn't one single correct way to move, correct posture, or even correct way to perform a specific exercise; it is a spectrum. Nomenclature is so important to how individuals perceive things and telling an athlete, solider, or patient that they need to perform corrective exercise no doubt gives the impression that there is something they are doing wrong.  It can also give the impression that once things are corrected then everything will be ok. Our goal as practitioners is to keep individuals moving in an efficient manner to allow them to stay healthy and perform at their best.  Perform can be anything from scoring the winning touchdown in the Super Bowl, to completing the mission, to play in the backyard with their grandkids pain-free. There isn't a single correct way to move, and the pursuit of movement efficiency is neverending. 

Conclusion:

The mental model that follows the term "corrective exercise" is flawed as it implies that a few minutes of low-intensity exercise is all that is needed to correct an individual's movement compensations. All exercise is corrective in nature and should be prescribed with a specific intent to address an individual's needs. What exercises or movements that are prioritized will always have the greatest effect, and it is impossible to prioritize everything. If we believe there are exercises critical to enhancing a person's movement, health, or performance it is ok the realize that not all exercises are important.  As we know, there is also no single "correct" way to move, and individuals will often excel despite (or maybe because of) their compensations. The concept of utilizing exercise to improve how people move is correct, it is the term corrective exercise and the implications of it that are misleading and should be avoided.

   References:
  1. Nunes, João Pedro, et al. "What influence does resistance exercise order have on muscular strength gains and muscle hypertrophy? A systematic review and meta-analysis." European Journal of Sport Science (2020): 1-9.