4 Reasons You MUST Understand Corrective Exercise and Post-Rehab Training
Written on December 4, 2011 at 11:59 pm, by Eric Cressey
Over the years, I've probably become best-known for my writing, consulting, and presenting in the corrective exercise field. It's become a great niche for me; I get to help people who may be frustrated with injuries, bad posture, or movement limitations that prevent them from doing the things they enjoy. And, I'm able to have fun in the process and make a good living while doing so.
With that in mind, I wanted to devote today's piece to my top four reasons that you, too, should make a dedicated effort to become knowledgeable in the world of corrective exercise. The timing is quite fitting, as our Functional Stability Training series (which provides thorough insights into the corrective exercise field for rehabilitation specialists and fitness professionals alike) is on sale for 20% off through tonight (Sunday) at midnight.
Anyway, without further ado, here are my top 4 reasons you ought to get involved in this component of the fitness industry.
1. Health care quality and quantity are changing all over the world.
The push toward universal health care has dramatically increased the need for qualified people to fill the gap between "healthy" and "injured" populations. When more people have health insurance, but there aren't any more providers, not everyone can get access to what they need - and certainly not nearly as quickly. Two stories come to mind in this regard:
a. A guy I know in Canada actually waited nine days to have a ruptured patellar tendon repaired.
b. An online consulting client in England who sought me out after a hip surgery reported that he had to wait three months for the hip surgery following the point at which they concluded that physical therapy wasn't going to get the job done.
While the push for universal health care in the United States is still being sorted out (and it's certainly not a topic to be covered in this blog, as I have no interest in taking this down political lines), the truth is that we've seen a "crack-down" on what insurance companies afford folks in terms of physical therapy visits for a given condition. Very simply, physical therapists rarely have the time to do everything they want to do to get people truly healthy, so folks often have to just settle for "asymptomatic."
In the U.S. and abroad, there is a huge need for qualified personal trainers and strength and conditioning coaches to step in and take the baton from physical therapists in the post-rehab setting to help improve patient outcomes. And, there is certainly a big need for these fitness professionals to step in and help people who may move terribly, but not have symptoms...yet.
2. New expertise enables a fitness professional to tap into a new market and carve out a niche.
Roughly 85% of our clients at Cressey Sports Performance are baseball players; it's a population we've really gone out of our way to understand for years now. Specific to the current discussion, baseball players have the most extreme collection of upper extremity injuries you'll encounter (on top of lower back, oblique, hip, and knee issues) - so demand is never lacking for our services.
This just one sport, though. Almost every golfer experiences lower back pain at some point. Hockey players have load of hip issues. Swimmers have so much laxity that their shoulders are always banged up. The opportunities to carve out a niche in a specific sport or population are endless - but you have to know your stuff first.
3. Everybody is injured - whether they know it or not.
I've written quite a bit previously about how absolutely everyone you encounter has some kind of structural abnormality on diagnostic imaging. This applies to lower backs, shoulders, knees, and every other joint you'll encounter in your professional career.
The importance message to take from this knowledge is that even though everyone is "injured," not everyone is symptomatic. Rather, the ones who hurt are those who have poor mobility, stability, and tissue quality. They're in pain because they simply don't move well.
Taking away someone's pain is a tremendous way to win them over for life - and I can assure you that keeping them out of pain when they know they should be in pain isn't far behind on the appreciation scale.
4. Structural abnormalities are becoming a part of normal physical development.
I work with a lot of 10-18 year-old athletes, and I'm constantly amazed at how we are "de-evolving." Kids' movement quality is worse than every nowadays, as they're sitting too much and playing too little. And, their yearly athletic calendars lack variety because of early sports specialization.
The end result is that our society has created an epidemic of injuries (e.g., ulnar collateral ligament tears in pitchers, ACL ruptures in soccer/basketball players) and conditions (e.g., femoroacetabular impingement, atrocious ankle mobility) that were much less common in the past. Getting involved with corrective exercise education is a way to not only help understand why this is happening, but also to manage it and hopefully prevent it from continuing.
I'm speaking very broadly with respect to the need for significant corrective exercise education in order to make a difference in this industry, but the truth is that it is a subject that warrants a ton of detail. Fortunately, Mike Reinold and I delve into this topic in great detail in our Functional Stability Training resources: Core, Upper Body, Lower Body, and Optimizing Movement. You can learn more - and save 20% through the end of the day today - at www.FunctionStability.com.
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December 5th, 2011 at 7:39 am
Very good piece.
There really should be a bridge between physical therapy and real life.
Well put.
December 5th, 2011 at 8:37 am
EC,
Great stuff.
Post Rehab is a huge trend.
Well more than a trend.
It is the future of health, fitness and performance.
Rick Kaselj
http://ExercisesForInjuries.com
.
December 5th, 2011 at 9:26 am
I work as a medic and hip replacement surgery patients is a group I see a tremendous number of. This whole previously “hidden” acetabular impingement condition, I fear, is going to be the next “new” condition to catch and treat early on. With any luck, with more pre-emptive work, fewer cases of degenerative hips will develop.
December 5th, 2011 at 9:37 am
As a trainer I meet people everyday who are in pain due to an injury. They go to physiotherapy for a bit where they don’t really find any relief, the list for surgery is up to a year wait and there is no light at the end of the tunnel for them. For fitness professionals, learning more about corrective exercise is one of the best investments you can make.
December 5th, 2011 at 9:38 am
Eric,
Great Article and food for thought. Thanks for your dedication to the field.
December 5th, 2011 at 9:39 am
Thanks for more great information!
December 5th, 2011 at 9:48 am
Great stuff Eric…..
I’m always wondering how much corrective exercises is needed in program intergration. As I look, ponder and review what you’ve written in mine, I alaways ask myself “why did EC do this, why did EC choose this or that”….
December 5th, 2011 at 12:01 pm
Good stuff, as always, Eric,
Good job deftly remaining non-political on the healthcare issue.
I’m glad you brought up the “de-evolving” of our youth. It makes me sad because not only will young people fail to reach their full potential, BUT they are also experiencing injuries that people their age have no business having. And – I think – it’s all due to the lack of activity in their lifestyles.
December 5th, 2011 at 8:49 pm
Eric,
You are right in your assessment that a huge number of patients are discharged from physical therapy before they are at an optimal point, secondary to insurance limitations. When I worked in a large, insurance based orthopedic practice, my hands were tied. Now I am self-employed, and I spend an hour one-on-one with my patients, in a 100% Cash Based practice. By and large, my patients want to get better, and they are willing to pay upfront for treatment. I also transition my patients to wellness services when that is appropriate (wellness appointments are not reimbursed by insurance, but the patient either wants or needs guidance on their exercise program). Please know that there are PT’s out there who really take quality time to work with patients, and we are always looking for outstanding trainers to refer our patients to. From my experience and what I hear from other PT’s, the hardest thing is to find a highly qualified trainer in the geographical area who is personable. There are numerous things that I could recommend for trainers to do, if they really have an interest in this niche. There is a certain way to go about building a relationship with a PT that would be mutually beneficial. We can all really work together for the best result for a client throughout their active lives.
Ann
December 5th, 2011 at 9:01 pm
Eric I enjoy your articles but I have to point something out. In Canada we DO NOT wait 9 days to repair injuries as you described. Not sure what happened to the person you know but that type of thing does not happen. If it did then alot of people would get fired. Please don’t make this political.
December 6th, 2011 at 6:19 am
Mark,
It was definitely an isolated incident, but I can’t count how many people I’ve interacted with who have been disappointed with how long it takes to get “non-urgent” care. I think I made it pretty clear that it was an example, and that I certainly didn’t want to have any political undertones to the article.
Thanks!
December 6th, 2011 at 6:20 am
Ann,
Outstanding post! Thanks for your contribution!
December 6th, 2011 at 7:14 am
This post made me question my interpretation of terms such as “healthy” and “injury”. I would consider myself healthy but I see that a PT might not define me in the same way, reading what I think of as occasional, normal back pain as an injury that needs to be treated accordingly. Very interesting.
December 6th, 2011 at 2:57 pm
Eric,
More than happy to do a guest post at some point on simple ways trainers can build relationships with PT’s (from the PT perspective!)
You can email me directly if interested.
Thanks,
Ann
December 7th, 2011 at 12:22 pm
Great post, Eric! It’s my belief that every trainer should have a solid foundation in corrective exercise and knowledge of precisely how the body should work, before they delve into some of the complexities of training purely for performance. If they don’t, what happens if something goes wrong? They have no idea how to iron out the issue and keep building on consecutive successes on the way to the overall goal.
Your post actually inspired my latest blog entry on corrective exercise. I feel that clients should just as well know why we do these things, and the reasoning behind it if they are truly to believe they are being helped. http://wp.me/p1pj2F-48
Once again, great work as always!
-Shelby
January 4th, 2012 at 3:40 am
Nice article, thanks! I’m sure I’m going to include some rehab/prehab stuff with all my clients 🙂
January 9th, 2012 at 11:37 am
Intriguing. I guess I can always pay someone to understand it better than I can!
April 6th, 2012 at 4:07 pm
Eric,
I know I sing your praises on Twitter and on Facebook, but you deserve all accolades possible. Your understanding of all aspects of physical training is phenomenal. Thank you for graciously sharing that knowledge.
April 7th, 2012 at 6:28 pm
Eric;
I whole heartedly agree that as Personal Trainers, we need to become well versed on Post Rehab training. Not all clients will be symptom free and injury free for that matter. We would be doing a diservice to our clients if we turned away from the opportunity to broaden our education and our ability to provide the highest quality service possible.
October 7th, 2014 at 7:24 am
Eric,
Bang on as always – so many out there train heavy with many limitations that ought to be addressed first. As strength coaches we owe it to our clients to do them the best service we can in the face of all training modalities. My only worry here is that many trainers that are already on the bubble of injuring their clients further, will take to the physical therapy side without really knowing what to do and cause some really bad stuff to happen. How are we to limit even more de-evolving when a trainer has caused many overuse injuries in youth – then says they can correct them when really they have no idea they caused them in the first place!?!?
October 7th, 2014 at 8:15 am
Eric,
Great post, and surely a niche that is needed. I completely agree with Ann on all of her points, in that most times we as PTs are looking for a good strength and conditioning coach to be able to refer patients too once they are “graduated” from PT. At our facility, have the benefit of having 3-4 PTs and then 6-7 strength and conditioning coaches all under one roof and also an ATC for transitioning between the two. It’s been a system that has worked very well for those who want to continue training or have other goals with regards to competitions ahead of them after their PT is over. I would love to see a guest post from Ann so take her up on that for sure! Keep the good info coming!
October 7th, 2014 at 3:45 pm
Brett,
She already wrote it!
http://ecressey.wpengine.com/personal-trainers-fitness-professionals-5-tips-marketing-physical-therapists
October 8th, 2014 at 9:58 am
Deans book shows $87 not $30.
October 8th, 2014 at 3:42 pm
Mark,
Really tough to say. My experience has been that some athletes do better with more aggressive treatments, and others need it lighter. And, skin response is a very individual thing.
October 8th, 2014 at 3:43 pm
RT,
It’s $30 OFF, not just $30.