As a physical therapist, I spend a large part of my time educating clients on their bodies. I'm not talking about the body they saw in a magazine, or the body they had 20 years ago. Rather, I educate them about the body they walk in with.
When attempting to figure out a body’s movement history and how we’re going to change the direction of the story, it’s important that my explanation makes sense to them. Otherwise there will be minimal to no follow through after they leave my office. Without a true understanding of the “why” and how it relates to function, no amount of printed off exercise programs will have an impact on helping someone move better and without pain. Maybe it's my psychology major or my love for creating associations and images with words, but I often teach by creating a funny visual, alliteration, metaphor, or motto.
In this time of COVID-19 quarantine and the explosion of self-improvement blog articles and free get-fit programs available on social media and the internet, I thought this would be a good time to share with you one of my PT mottos: You need Algebra before Calculus.
Okay, stick with me here. Picture walking into a calculus class and the teacher hands you a test. You realize that you somehow forgot to take Algebra I or II and that you have no idea how to do the math problems. You cannot suddenly gain all the concepts you need from Algebra. And no amount of staring at the paper or plugging in different derivatives of logarithms will get you the right answer. Without the prerequisites, the only way to pass the test is to cheat.
Just like math, exercise requires some basic prerequisites such as core control, balance, and flexibility. If these aren’t trained well before you start a program, your body will cheat (i.e., compensate) by using other muscles to do the work. These compensatory muscles aren’t meant for that job so eventually they will fail. Tissue failure often leads to pain, injury, and abnormal movement patterns.
Many of the exercises being promoted on social media right now feature big movements. They often involve fast movements. And they’re being performed by perfect looking people who didn’t get those fit bodies by doing a 30-day online program. They got that way by focusing first on their prerequisites, and then building on that foundation. They probably also follow a strict eating plan... and use good lighting!
Fitness programs are typically designed by people who have an understanding of how the body moves. But they don't always show how to modify the exercises for people based on the prerequisites they may or may not have. This is where a physical therapist can help.
Here are a few guidelines and some examples of how these prerequisites apply to some common exercises. This isn’t a comprehensive list, but it's a good place to start.
- If you can’t do the exercise with perfect form slowly, you shouldn’t do that exercise at a higher speed or with more load (weight).
- Squats: If you can’t do it with good form, doing jump squats, box jumps, or weighted squats could cause injury.
- Bridges: If you can’t keep your pelvis level with a 2 legged bridge, don’t progress to a single leg or marching bridge.
- If you feel discomfort in a body part that the exercise isn’t targeting, you’re probably cheating.
- Planks: If you're feeling your low back or hip flexors working, you are probably compensating and not using your deep core.
- V ups (teasers), bicycles, leg lowers: If you feel it in your back or are unable to keep your lumbar spine in neutral, you don’t have a strong enough base for this exercise. If your stomach is pooching out, you’re not using your deep core.
- No exercise is best for everyone and modifications don’t make an exercise less effective.
- A plank on your knees where you activate your core is better than a full plank that compensates with your lumbar spine.
- Walking with good core control is better than running with poor control.
- Abdominal exercises-if you can’t do the high level core exercises correctly bringing your legs in closer to your body, or doing toe taps is more effective if you can do it while using your core.
- Push ups- doing them on your knees, or against a countertop with correct form is more effective than doing a full push up with compensations.
So, what now? Check in with your body, with the program you’re doing, and these guidelines. Do you know if you have the prerequisites for the exercise program you’ve started? If not, that’s okay! Check in with your PT.
Physical therapists are movement experts who specialize in assessing your current body and all the components and prerequisites you need to move well. And if you’re currently in pain, we’re really good at helping you get on the right track for exercise.
Disclaimer: All calculus references were Googled. It would be false to assume the author remembers much from her college calculus classes!
Disclaimer: The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.
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ABOUT THE AUTHOR:
Rhonda Dodge is a physical therapist and certified Racquetfit practitioner with over 20 years of clinical experience in outpatient orthopedics. She works at Activcore in Denver, Colorado, located just a mile from the popular Cherry Creek Shopping District.
As an all-around active person herself, Rhonda has a background in general orthopedics and post-operative care, with a special interest in treating the "Colorado weekend athlete" who enjoys tennis, hiking, running, snowshoeing, skiing, and other sports. Rhonda holds a Bachelors degree in Biology and Psychology from Greenville College, as well as a Masters degree in Physical Therapy from Washington University in St. Louis, ranked among the top 10 PT schools in the country. She also has advanced post-graduate training in specialized methods such as trigger point dry needling, myofascial release, neuromuscular activation, kinesiotaping, and ergonomic assessment.
Rhonda is among less than 1% of all physical therapists recognized by the United States Professional Tennis Association (USPTA) as a Certified Racquetfit practitioner, making her exceptionally equipped to treat tennis players and other rotational athletes of all genders, ages and skill levels. Racquetfit is the tennis equivalent to the more widely known TPI golf certification. Additionally, she is recognized nationally as a leading authority in the application of Redcord, a suspension exercise system designed to help you develop a smarter, balanced body through the power of neuromuscular activation. [READ MORE]