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“Corrective exercise”: trauma vs. non trauma

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  • “Corrective exercise”: trauma vs. non trauma

    Hey there!

    Just some context...

    As part of my certification for Australian Strength & Conditioning Coaching, particularly with Rugby League, I’ve begun interning with a reserve-grade 20’s+ team and have observed their Physios/strength coaches prescribe exercise for the purposes of rehab post-injury.

    I’m getting better at understanding pain science via Barbell Medicine, and following on Jordan’s IG post “there are no corrective exercises” and the discussions within...is that only in the context of “atraumatic” injuries per-say?

    For instance - one player was prescribed Bodyweight Glute Bridges with a focus on using sliders to straighten the knee out and bend it back in while the hip is extended to condition the distal hamstring. Supposedly this is because he “injured” it during the game. The likely culprit is the heavy lateral stepping they do while cutting past opponents and making tackles. The Physio made the comment that the stronger distal hamstring helps maintain the position of the tibia as the foot comes back and contact to the ground during a lateral step...if this is really the case than does a “bad lateral step” count as traumatic?

    Anyway...in the context of Sport Prep & injury prevention, would BBM still hold in general there are no corrective exercises, and the approach I mentioned above is flawed?

    I’m just trying to wrap my head around it!

    One last question: one coach talked about transitioning out of back squats and moving into partial ROM heavy staggered stance squats as that’s apparently more useful and specific - but wouldn’t track/conditioning cover that anyway and work done in the gym be best trained with a full range to simply build up capacity and tolerance overall?

    Thanks for the long read and I appreciate any input you guys may have!
    Last edited by JacobW; 12-11-2018, 09:26 AM.

  • #2
    Originally posted by JacobW View Post
    Hey there!

    Just some context...

    As part of my certification for Australian Strength & Conditioning Coaching, particularly with Rugby League, I’ve begun interning with a reserve-grade 20’s+ team and have observed their Physios/strength coaches prescribe exercise for the purposes of rehab post-injury.

    I’m getting better at understanding pain science via Barbell Medicine, and following on Jordan’s IG post “there are no corrective exercises” and the discussions within...is that only in the context of “atraumatic” injuries per-say?

    For instance - one player was prescribed Bodyweight Glute Bridges with a focus on using sliders to straighten the knee out and bend it back in while the hip is extended to condition the distal hamstring. Supposedly this is because he “injured” it during the game. The likely culprit is the heavy lateral stepping they do while cutting past opponents and making tackles. The Physio made the comment that the stronger distal hamstring helps maintain the position of the tibia as the foot comes back and contact to the ground during a lateral step...if this is really the case than does a “bad lateral step” count as traumatic?

    Anyway...in the context of Sport Prep & injury prevention, would BBM still hold in general there are no corrective exercises, and the approach I mentioned above is flawed?

    I’m just trying to wrap my head around it!

    One last question: one coach talked about transitioning out of back squats and moving into partial ROM heavy staggered stance squats as that’s apparently more useful and specific - but wouldn’t track/conditioning cover that anyway and work done in the gym be best trained with a full range to simply build up capacity and tolerance overall?

    Thanks for the long read and I appreciate any input you guys may have!
    Hey Jacob,

    We stand by the statement - "Corrective exercises don't exist" and this is similar to my stance rehab exercises don't exist. Exercise selection during patient interactions should be dependent on patient goals. This also detracts from the usual silly bs narratives being disseminated for that one trick exercise you've not been doing to "prevent" injuries and "fix yourself" or correct "muscle imbalances".

    Regarding the hamstring scenario - for a rugby player there is a loading demand of high intensity sprinting and with this and any other similar sport there is a risk of hamstring strains due to overload in sprinting (typically because there wasn't an appropriate ramp up to prepare the athlete in the off season and pre-season prior to on-season). If the athlete has already suffered a hamstring strain then based on current evidence it would be smart to utilize eccentric loading of the hamstrings via nordic hamstring curls, eccentric focused RDls, etc. Although I advocate we use these prophylactically for such athletes in hopes to prep the area for sport demands and mitigate risk for injury but these exercises should still be accompanied with appropriate load management of sport specific tasks. I still would not call this corrective exercise but instead sport specific exercises. Hamstrings are one of the few areas we have solid evidence on how to mitigate sport specific injuries. With that said, this still returns to a load management discussion. We also have evidence that resistance training can mitigate injury risk as well and we've discussed supportive evidence throughout the forum.

    Regarding back squats - this is dependent on the sport demands. For example, jumping based sports we do have evidence on the validity of partial squats. Happy to discuss further.

    Comment


    • #3
      This is all great, I thoroughly enjoy, and honestly, trust what yourself/BBM as a whole promotes. I’m also learning how to engage in these discussions as once I take a more formalised role in S&C with a Australian Rugby (the plan anyway!) I’ll be expected to make calls about exercise selection, return to play for players and I want to do what I believe is best.

      So all of this is useful as discussion points for me to continue to learn.

      Okay - I’ll only take a little bit more time then, with regards to Sports Specific Prep vs. General Physical Prep: sure a full ROM Back Squat trained intelligently over time would help develop hypertrophy, strength and capacity in a player but since “strength is specific”, at what point is any gym work useful for a player outside of general prep?

      For instance:

      There is solid evidence around hamstring injury prevention, but if injury is just “load > capacity”, why wouldn’t any good basic barbell training work vs. specific movements? And with the Squat - would a full ROM squat be not overall more beneficial to a partial Squat due to it training a greater ROM and requiring more work per rep?

      I guess what I’m asking is: we talk about strength being specific, sport should be trained somewhat specifically, but we also need general capacity...can something although being more “specific”, I.e. partial ROM or certain stance, still not matter as much since it’s just gym work and not exactly what happens in the field anyway? Would training economy/time not be best spent getting generally strong/building capacity overall so players can continue to practise on the field and apply their “general” prep to sport movements?

      Just some rambles! Thanks again!

      Comment

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