Corrective Exercise & Movement Restoration

NASM's CEx model follows a four-phase approach to restoring movement quality: 1. INHIBIT — Reduce overactive muscle tension using self-myofascial release (foam rolling, lacrosse ball). Hold tender spots 30-90 seconds. Example: foam roll IT band and TFL before squat training if knees collapse inward. 2. LENGTHEN — Static stretching of the shortened/overactive muscles identified in Step 1. Hold 30+ seconds, 1-3 sets. Example: hip flexor stretch for anterior pelvic tilt. 3. ACTIVATE — Isolated strengthening of the underactive muscles. Low load, high intent, focused contractions. Example: clam shells for weak gluteus medius contributing to knee valgus. 4. INTEGRATE — Compound movements that challenge the corrected pattern under functional conditions. Example: single-leg squat after glute med activation to train the corrected motor pattern. This sequence is performed before training sessions—it takes 8-12 minutes and has a significant impact on movement quality during the training that follows.

Vladimir Janda identified predictable patterns of muscle imbalance that affect most modern populations: • Upper Crossed Syndrome: Tight upper traps + pectorals vs. weak deep neck flexors + lower traps/serratus. Presents as forward head posture and rounded shoulders. Extremely common in desk workers. • Lower Crossed Syndrome: Tight hip flexors + erector spinae vs. weak abdominals + gluteus maximus. Presents as excessive lumbar lordosis and anterior pelvic tilt. • Pronation Distortion Syndrome: Flat feet + knee valgus + hip internal rotation. The kinetic chain collapses inward during squats, lunges, and landing. Root cause: often weak posterior tibialis, gluteus medius, and hip external rotators. Key insight: these patterns are predictable. If you see one element (e.g., forward head), you can predict the others and address the entire chain systematically.

Gray Cook's Functional Movement Screen (FMS) uses 7 fundamental movement patterns to identify asymmetries and dysfunctions: 1. Deep Squat — Tests bilateral mobility and stability 2. Hurdle Step — Tests single-leg stance and stepping 3. In-Line Lunge — Tests deceleration and trunk stability 4. Shoulder Mobility — Tests bilateral shoulder ROM 5. Active Straight Leg Raise — Tests hamstring/hip flexor flexibility and core stability 6. Trunk Stability Push-Up — Tests core stability during upper body movement 7. Rotary Stability — Tests multi-plane trunk stability Each movement is scored 0-3. A score of 1 (unable to perform with compensation) indicates a movement dysfunction requiring corrective intervention before loading the pattern. Asymmetries between sides (e.g., scoring 3 on the left but 2 on the right) are flagged as injury risk factors.

An effective corrective strategy follows these principles: • Address proximal stability before distal mobility. Core stability must be established before hip or shoulder mobility drills will "stick." • Train the weakest link, not the strongest. If your squat is limited by ankle dorsiflexion, spending more time on squats won't fix it—spend time on ankle mobility. • Use the Breakout Strategy: When multiple dysfunctions exist, prioritize based on pain first, then bilateral asymmetries, then movement quality. • Minimum effective dose: 2-3 corrective exercises per training session, performed as part of the warm-up. More than 5 creates decision fatigue and low compliance. • Re-test regularly: Perform movement screens every 4-6 weeks to track progress and update the corrective program. Corrective exercises are temporary—once the dysfunction resolves, replace them with new priorities.