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Other/Mixed Correctives and Rehabilitation

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Other strength modalities (e.g., Clubs), mixed strength modalities (e.g., combined kettlebell and barbell), other goals (flexibility)
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Another thread got me thinking of developing a more comprehensive suggestion for correctives. Curious what progressions folks use for correcting and rehabbing weaknesses or injuries.

These are some examples I've done after some of my injuries that I can recall.

Hamstring Injury:

Band Hamstring Curl > Single Leg Deadlift > Windmill > Swing

Shoulder Injury:

Halo > Arm-Bar > Front/Lateral Raises > TGU

Knee Injury:
Band Quad Extension > Bodyweight Squat > Goblet Squat > Lunge or Step-Up > Front Squat
 
I'd put goblet squats before bodyweight squats. A good goblet squat is easier than a proper bodyweight squat.

Also what exercises you use and in what order or progression they are used highly depends on the individual weakness or injury and should be treated individually
Creating a "go-to hamstring"-list like that and then use it on every client just because he/she walks in with a hamstring problem wouldn't be a good choice IMO.
"One man's meat is another person's poison" relates to strength and corrective work, too. There is no "one size fits all"-template. Act accordingly.
 
I'm with @Kettlebelephant on this one. There are injuries and then there are injuries...
A 'pulled' muscle and a torn labrum are both shoulder injuries. Treatment and rehab could be vastly different.
That being said there is usually a group or class of activities that are prescribed for any given injury.
 
I think there can be some generalizations made for correcting deficiencies and the building blocks that make sense. I think range of motion, followed by stabilizing and tendon strength, followed by range of motion strength seems to be what all my PTs have done for me for all my injuries which have spanned a spectrum for each injury location.

On the pre-injury side, I think it's a good idea to have a good swing before worrying about snatching or a good overhead lockout before worrying about a TGU. I would promote crawling before walking or running.
 
In my experience, generally best rehab and preventative work would consist of;

Walking
Taking joints through pain free ranges of motion
Movement complexes
Focussing on dominant posterior work rather than anterior work
Focussing on quality of movement
Loading progressively when pain free and building stability first before ego takes over...

I'd say that list trumps any specific drill, IMO
 
It's next to impossible to do it, just because everyone's movement patterns prior to injury, injury mechanism, pain tolerance, etc. are so varied. You have the right idea in that lots of people may benefit from a similar progression, but working in the rehab field for four years has told me to take nothing for granted. Case in point, it seems backwards but I've had people resolve hamstring tightness with t-spine work.

Best advice, and I say this without trying to be sarcastic, but do the work before hand and prevent the injury in the first place. In times of peace, prepare for war.
 
do the work before hand and prevent the injury in the first place
Thank you, this actually better describes the intent of this thread. What are the limitations and deficiencies that often cause injury that, when corrected prior, can prevent it? I assume those things often look like the things we do after an injury.
 
Well, the FMS data is starting to come out and prove that keeping at least a score of "2" in all seven screens is going to help reduce non-contact injury (which is really all we can somewhat control). That would be a start I recommend for people, along with "good enough" CV fitness, strength following that.

As far as rehabbing injury... sometimes a health situation needs a health solution, not a fitness solution. See a proper healthcare provider.
 
Well, the FMS data is starting to come out and prove that keeping at least a score of "2" in all seven screens is going to help reduce non-contact injury (which is really all we can somewhat control). That would be a start I recommend for people, along with "good enough" CV fitness, strength following that.
Not to be nit-picky, but I'll hazard the opinion that improving strength improves apparent "CV fitness" because it makes everything easier. The example I'm thinking of is when I walk with people who walk regularly, many are still out of breath after climbing a short hill, but that happens much less, if at all, to me because climbing the hill requires much less of my strength than it does theirs.

Alright, so that's nit-picky :) but I think it makes an interesting point to discuss as regards StrongFirst - I would stand by Strong before any sort of cardio.

-S-
 
Not to be nit-picky, but I'll hazard the opinion that improving strength improves apparent "CV fitness" because it makes everything easier. The example I'm thinking of is when I walk with people who walk regularly, many are still out of breath after climbing a short hill, but that happens much less, if at all, to me because climbing the hill requires much less of my strength than it does theirs.

Alright, so that's nit-picky :) but I think it makes an interesting point to discuss as regards StrongFirst - I would stand by Strong before any sort of cardio.

-S-

Absolutely on the same page Steve. Getting off topic, but the thing in this field that drives me bonkers is the insistence of "cardio". The public is just drilled into this message that cardio is important. Gotta get that half our of cardio in. As if lifting weights for 20 minutes doesn't increase your heart rate.

Person A sits on a bike and reads a magazine for 20 minutes. Stays in flexion the entire time, something they do all day mind you. Their heart rate is 110 bpm for the time lets say.
Person B does a routine with mobility work, core work, upright dynamic routine, up and down off the ground a few times correcting major deficiencies for 20 minutes. Their heart rate is between 100-120

Call me crazy, but Person B got a lot better, and Person A accomplished nothing

EDIT: I'm a little harsh in saying nothing, but definitely not as productive
 
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I would disagree with you there... I'm convinced that there are major benefits to cardiovascular health and condition with steady state cardio like walking/running/cycling. Getting the heart rate up with lifting weights is not the same. However, both are important.
 
Seems we did get a bit off topic here. I think @Bro Mo 's original post was about rehab and correctives. The value and benefits of CV training is most likely a different subject (For which the answer may be... it depends...)

Back to the original intent...
I came across the following today about rehabilitation for shoulder impingement injuries (context: rock climbing)

IMG_0539.JPG
 
I would disagree with you there... I'm convinced that there are major benefits to cardiovascular health and condition with steady state cardio like walking/running/cycling. Getting the heart rate up with lifting weights is not the same. However, both are important.

Anna, don't get me wrong - keeping the heart rate elevated for x/y/z amount of time is ideal, or course. I don't want to belittle this concept. But does it have to "look" like cardio to still get cardiovascular benefit? What makes steady state, repetitive motion cardio a different cardiovascular stimulus than a dynamic warmup routine? This is what I meant to say. This question fascinates me endlessly. I don't think I know the answer yet.

@offwidth love that pyramid. fundamentals first!
 
It fascinates me too! I agree there is definitely a blurry line, not always a clear distinction. For example, a C2 rower with a hard and strong stroke is not that much different from a repetitive kettlebell deadlift, continuous swings, or even snatches.

Dr. Kenneth Jay has talked about it on podcasts recently; he says weightlifting has a very different effect on the cardiovascular system than traditional cardio like running and cycling, even if the HR profile is the same. Effect on blood pressure, fast-twich fiber vs. slow-twitch, aerobic fueling vs. glycolytic/sugar fueling and enzymes... just a few of the differences. He also talks about the thickening of the left ventricle of the heart (weightlifting) vs. making it more elastic and increasing its volume (traditional cardio).
 
Very cool - I didn't know he had a podcast. The blood pressure variable I considered, but I failed to consider the potential physiological change on the heart itself...

When I saw your comment on fast/slow twitch, I almost immediately thought to myself, I would much rather train fast twitch...Both necessary, but when I think about older individuals, I see decreased power and strength output. Now, I think much of that could be traced to mobility or motor control dysfunction, but potentially underdeveloped fast twitch fiber as well. You're giving me much more to think about now!!
 
PS @Bro Mo apologies for somewhat derailing your topic! But the pyramid figure is such a good representation of the proper path to follow. It almost exactly replicates the FMS "Performance Pyramid". Health, then competency, then capacity/performance
 
I don't think the thread was derailed at all. I think CV health is a foundational component to prehab and rehab of the body. Why wait for a heart attack to fix it? Not to mention the effects it has on the ability to prepare the body to do more volume of everything else that's good for you. The way I understand easy steady state cardio is different is how it keeps the muscles less contracted and allows the capillaries to expand deeper into the tissue. I believe this is also the reason for ballistic A+A vs other strength movements. The time under tension is low enough to promote that same effect. I think the value in steady state cardio can come from the massive volume it allows. One could walk/jog/cycle for many more hours per week than snatch.

Re: the pyramid (above or FMS),
Does one stay at the top of the pyramid until something goes wrong? Otherwise, how often does one scale the pyramid and to what degree of immersion? I think the reason I like the TGU so much is because of how it immerses into that pyramid so well. I also see value in barbell overhead squats (a movement I am not very good at) at varying intensities as they relate to that pyramid.
 
The pyramid above (from what I understand) was specific to rehabilitating injuries. There is a bunch of additional detail that goes into each phase that is directed to recovering from a shoulder injury. Specifically impingement.

It's not exactly a training modality, however it does look like it would be adaptable to that as well
 
It fascinates me too! I agree there is definitely a blurry line, not always a clear distinction. For example, a C2 rower with a hard and strong stroke is not that much different from a repetitive kettlebell deadlift, continuous swings, or even snatches.

Dr. Kenneth Jay has talked about it on podcasts recently; he says weightlifting has a very different effect on the cardiovascular system than traditional cardio like running and cycling, even if the HR profile is the same. Effect on blood pressure, fast-twich fiber vs. slow-twitch, aerobic fueling vs. glycolytic/sugar fueling and enzymes... just a few of the differences. He also talks about the thickening of the left ventricle of the heart (weightlifting) vs. making it more elastic and increasing its volume (traditional cardio).

Last time this came up, I invited the person that offered it to go actually look at the studies Mr. Jay cites as supportive of his assertions of maladaptive LV hypertrophic remodeling. Of course, nobody did. So I'll tell you straight out: there is no, none, nil, zip, zero, evidence that, in the absence if a disease process, the heart remodels itself as he describes in his blog.

Maybe we could kill that notion, douse it in lyme, and bury it in a shallow grave alongside the baseless fear that training in the glycolytic energy system damages mitichondria.
 
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