I was in my office working a few weeks ago when I heard a loud thump at the bottom of the stairs. When I went to investigate, to my horror my mother had fallen. She was wearing new socks on the hardwood steps and had slipped on the last two stairs. The first thing that flashed through my head was “Oh no, her hips!” Since falling and hip fractures are a fairly common occurrence for seniors, I prepared for the worst. I ran down to help and to my joy she got up and walked to the couch. She even went upstairs to go to bed to rest for a little bit. It was only later when a little symptom arose, her not being able move her leg, that I went back to my original fear.
After a few hours in the emergency room, I had my confirmation. Fortunately, I knew a good orthopedic surgeon, and after a discussion of options, she had a partial hip replacement. After a quick hospital stay, she went into a rehabilitation center to allow her to regain her function. This is where an all too common picture developed for me about the rehab she was to get. The physical therapists and occupational therapists were great, but had a limited vision as to what they wanted for her. Not to mention, they work within a healthcare system where they can only do certain things and usually have a certain amount of time in which to do it. A common problem that comes to light after a patient is released from therapy and given a status of “functioning”, is the lack of appropriate options allowing them to continue on the road to orthopedic health. The answer to this problem lies in a form of training called corrective exercise.
A fairly new specialty that popped up in the fitness industry a little more than ten years ago is “post-rehab” training. Previously, a person would go through rehabilitation and be able to resume normal daily activities and get involved in a fitness routine, once they had been released. Today, that is far from the case. Growing healthcare costs and gross abuse of the system has led to policy changes that often release people before they have the ability to function at their normal level and enter back into a general fitness program. The results of this are devastating. There is greater susceptibility towards re-injury, an increased likelihood of additional injuries, and degradation in their level of fitness. Many times a person in this situation will try to join a health club and do some type of fitness training and counteract the benefits the therapy has given. These programs are designed for the average functioning person and usually not geared towards making the required program modifications that are specific for the condition and even more specific for the individual.
Seeing the trends that were developing, there were physical therapists and top-level trainers that saw an opportunity in the market to help people regain a higher level of function. This was the birth of corrective exercise. Corrective exercise is not a new type of exercising. It is the merging of principles from multiple disciplines, i.e. physical therapy, Alexander and Feldenkrais techniques, chiropractic, athletic training, personal training, and others. It starts a person at the appropriate “post-rehabilitation” level and progresses them to the necessary dynamic functioning level. It involves physical assessments, modifications in exercise, adjustments in activities of daily living, lifestyle alterations, and good communication with medical professionals.
To get the largest benefits from a corrective exercise program, it should start with an understanding of the procedure or injury that the person has undergone. The musculo-skeletal anatomy is assessed to determine limitations and to establish a starting point. This requires a corrective exercise trainer that has had specialized training in anatomy and orthopedic evaluation. The general fitness evaluations that are normally performed at health clubs and by most personal trainers are great for determining levels of baseline fitness, but lack the specificity to determine the appropriate measures to be implemented to regain normal function. Without this information, corrective exercise programs are at best ineffective and at worst dangerous.
In a comprehensive program, lifestyle and daily living assessments will be performed to determine the required level that the individual needs to get in order to regain normal function and remove any obstacles that may interfere with the recovery. Many times the lack of this component is the one aspect that retards the program the most. The more advanced the person is with activities in their outside life, the more advance the program needs to be and the more specific the goals need to be. I have had amateur baseball pitchers come to me that have back injuries. They have been on conditioning programs that are designed for the average person with no consideration for their specific biomechanical needs. When they practiced and played, they continued to have pain on a reoccurring basis. When I modified their programs and then progressed them appropriately, the players were able to return to their activity pain free. As a part of this, the lifestyle factors really need to be analyzed to see if they are helping the recovery and healing. Many times I have clients doing the necessary work in the studio, but completely lacking in their attempts to supply their nutritional needs and sleeping requirements. In conjunction with a specifically tailored exercise program, the overall program needs to have nutritional recommendations, rest and recovery guidelines, and stress management techniques.
The last factor that makes for a successful corrective exercise program is a good, open stream of communication between the medical team and the corrective exercise specialist. When the patient’s care and recovery is the primary concern, the synergy that develops between all parties is the gateway towards speedy healing. Whenever there is lack of communication, whether from the medical community or the trainer, the program’s effectiveness is challenged. An example is when a client has a change in their medication and that medication produces a muscle pain symptom that then has the trainer chasing his or her tail for weeks to find the cause, thus wasting valuable time in the process.
As my mother is sent home from her time at the rehabilitation center, she does not need to worry about what is in store for her to continue her way back to optimum health. She has an exercise routine, fresh off the drawing board, ready for her to start at Longevity Studios (one of the benefits of being my mom). She is living with my family, so we have the ability to “influence” some of her lifestyle choices and make sure she is resting enough. It will be only a matter of weeks before she is able to perform all those activities she regularly did just a few weeks ago, with some possible modifications. Her and I have already sat down and discussed some of the adventures she’d like to be prepared for this summer. She will be moving her body and enjoying her summer, maybe better than she has in a long time. The only activity that will be completely mandatory is the use of rubber sole slippers when she’s walking down the stairs!
|
