Home Blog Making Sense of Bad Rehab and Fitness Advice

Making Sense of Bad Rehab and Fitness Advice

Written on November 26, 2017 at 3:42 am, by Eric Cressey

"Don't assume; it makes an ASS out of U and ME." It's one of the most hackneyed expressions of all time, but it's a lesson many folks in the fitness industry - and casual observers to this industry - will never seem to learn. Assuming an exercise or methodology will help or hurt someone is one of the biggest mistakes I see across all training programs. Perhaps the most readily apparent example is in individuals with back pain.

“Your back hurts? You should try yoga.”

“Back pain? Just give up squats and deadlifts and only do single-leg work instead.”

"Your low back is cranky? Try McKenzie press-ups and it'll fix you right up."

You know what? I’ve seen people whose back pain got considerably worse when they took up yoga. I’ve also seen people whose low backs feel better when they avoid single-leg work and stay with bilateral exercises like the deadlift. And I've seen extension-intolerant individuals integrate McKenzie press-ups on a friend's recommendation and flare up their symptoms.

That doesn't mean any of these recommendations are inherently bad, or that the ones giving the recommendations aren't well intentioned. It's just that you're going to a podiatrist to get dental advice; it isn't a qualified recommendation, nor is it backed by a solid sample size of success.

Sometimes, the exercise selection is the problem (the wrong yoga poses).

Other times, it’s the technique is the problem (your squat form is horrific).

Occasionally, the timing is the problem (disc pain is worst first thing in the morning, so it's probably not the time to test out deadlifting for the first time in six months.

Often, the volume is the problem (maybe it would have been good to run 1/2 mile pain-free before trying to jog ten miles).

Rarely does an entire discipline (ALL of yoga or ALL of strength training) need to be contraindicated.

We need to avoid assuming that all back pain is the same and instead dig deeper to find out what works for each individual. The same can be said for shoulders, hips, knees, ankles, necks, and just about every other musculoskeletal malady we encounter. Good assessment and a solid library of knowledge from which to draw both help to solidify recommendations as sound.

 

Here, we basically have a missing infraspinatus. That's your largest - and likely most important - rotator cuff muscle. It's secondary to a suprascapular cyst. I usually see 1-2 of these in professional pitchers each offseason, and while most are usually completely asymptomatic, it has a dramatic impact on the way we approach their offseason arm care programs. We want to them to REMAIN pain-free. 😮 Here, we also have a friendly reminder of why you should always, always, always do upper extremity assessments shirtless (or in a tank top/sports bra, with females) if you deal with overhead athletes. 🤔 Never miss a big rock with your assessments. Know your population. #cspfamily #shoulderhealth #shoulderpain #rotatorcuff #SportsMedicine

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Injuries and conditions are usually very multifactorial. We rarely hurt simply from an isolated traumatic incident; rather, it's the accumulation of various aberrant movements over the course of time that bring us to a symptomatic threshold. And that's why we need to build broad skillsets that encompass assessments, programming strategies, coaching cues, and an appreciation for how all the pieces fit together in determining whether someone hurts or not.

That's what Mike Reinold and I aimed to do with our Functional Stability Training resources; give both rehabilitation specialists and strength and conditioning professionals the tools they need to help keep people healthy - or, in the clinical sense, help them get healthy in the first place. This four-part series is on sale for 25% off through Cyber Monday at midnight; for more information, check out www.FunctionalStability.com.


 

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  • Charles

    Would this be appropriate for athletes as well? I’m not a coach but I’m trying to revamp my own training and address whatever problems have led to long term lumbopelvic dysfunction.

    Thanks

  • Spot on!

  • George Myers

    Right on as bad advice costs nothing but pain and is a waste of time and perhaps money $$$$ so stick with an educated trainer or a Sports Medicine Doctor like my daughter. Proof is in the pudding !!!!

  • Eric Cressey

    Charles,

    It sure could be!


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