Do you take care of your body by eating right, getting enough rest and exercising regularly, yet still wake up day after day with nagging aches and pains and find you just can’t move as well as you’d like?
If you answered yes, you’re not alone. According to the Institute of Medicine of the National Academies, more than 100 million Americans suffer from chronic pain of some sort. What’s worse, those workouts you’ve been faithfully doing could actually be contributing to your musculoskeletal woes.
Fortunately, there is a way that exercise can correct mobility issues and alleviate pain. Change your workout habits and relief could be just days or weeks away.
The Triangle of Pain: Posture, Movement, Repetition
Think about the things you spend most of your waking hours doing daily. No doubt, sitting, standing and walking are chief among them.
The problem is that exercise is a seed, it won’t grow in poor soil. The specific activities are the seed, but posture and mobility are the soil.
— Physical therapist Gray Cook
Stop for a moment and scan your body posture right now, whether you’re sitting or standing: Is your weight evenly distributed over the right and left halves of your body or are you leaning to one side? Is your spine following its proper, natural, erect curvature from neck to tailbone or are you slouching with your back rounded and head forward? Is your weight centered over your hips or are you leaning out in front of them, using your arms to prop yourself up or leaning backward into whatever you’re sitting on?
These postural grievances can seem small, but when practiced repeatedly for hours day after day, they can cause musculoskeletal changes that rob us of proper stability, mobility and strength. Being the adaptable creatures we are, we find ways to compensate for these dysfunctions, but those compensations ultimately manifest themselves in the chronic pain we wake up with every day.
Now picture your typical exercise routine. Do you walk, jog, bicycle, lift weights or stretch into yoga poses? Whatever you do, chances are you’re doing it with that same imperfect posture and body movement you’ve been “practicing” all day long.
When you add intensity and repetition, as with walking or jogging thousands of steps, cycling for thousands of revolutions or holding stretches or yoga poses for longer durations, you exaggerate those mechanical dysfunctions, making them stronger than ever.
The same is true of resistance training: by adding a load (even your own bodyweight) to a misaligned musculoskeletal framework, you force your body to compensate even harder, creating more pronounced asymmetries and imbalances that can eventually lead to pain and injury.
“Functional exercise” can reverse that negative cycle, however.
Functional Exercise: The Gateway to Wellness
Functional exercise is any activity that properly trains your body to get better at doing the things life requires of you every day. Fitness programs that incorporate functional training use specific exercises that correct dysfunction and teach you to perform basic human movements with proper posture and alignment, while using the proper muscles. Those fundamental movements include bending at the hips, rising from a seated position, squatting to the ground and pushing, pulling and twisting. Sounds pretty basic right?
A good functional exercise program possesses three distinct characteristics.
First, there is an assessment to determine which dysfunctions you may have and what might be causing them. Second, the program should address those dysfunctions using corrective exercises, and possibly soft tissue release or massage as well. Third, once your basic posture and movement patterns have been corrected (and only then), you can return to your favorite exercise activities and address what we commonly think of as fitness — like improving aerobic capacity or building muscular strength and endurance. True fitness cannot exist in the presence of dysfunction.
First Things First
Gray Cook, a physical therapist and founder of Functional Movement Systems, which trains health care and fitness professionals to assess and correct musculoskeletal dysfunctions, stresses that his company’s slogan is “Move Better. (Period) Move Often.”
“That period is key — don’t move often if you’re not already moving well,” he said.
When asked about the preponderance of muscle and joint pain in adults over 50, Cook said: “The number one problem is that older adults find themselves with more time on their hands and they want to make an investment in themselves and their health. They think, ‘If I work out more, I’ll get healthier.’ But the problem is that exercise is a seed, it won’t grow in poor soil. The specific activities are the seed, but posture and mobility are the soil.”
While functional exercise may sound like a long, slow, complicated process, it doesn’t have to be, according to Jeff VanMaanen, owner of Equipt Fitness in St. Paul, Minn., and a Functional Movement Screen (assessment) certified fitness professional (FMS).
“The people I work with actually report seeing improvements in a short period of time,” he said. “Things like getting in and out of the car or getting dressed become easier, they feel less pain when they get out of bed in the morning, and these things can happen after only one or two sessions.”
VanMaanen estimates that up to 90 percent of non-trauma-related musculoskeletal issues are simply the result of moving poorly, so he feels the prognosis is very good for helping adults of all ages reach a highly functional, pain-free existence.
Best Not to Go It Alone
Doing a functional assessment and creating an effective program to correct any issues is not something most of us can do on our own. Fortunately, there are numerous resources to help you find a qualified professional.
As part of its Personal Trainer certification process, the American Council on Exercise (ACE) teaches the Integrated Fitness Training Model, which emphasizes the importance of educating clients about proper posture and movement techniques before ever putting a weight into their hands.
Going beyond the basics, ACE fitness professionals can also earn the Functional Trainer specialty certification. Other accredited fitness organizations have similar programs. The National Academy of Sports Medicine (NASM) offers a Corrective Exercise Specialization and the National Strength and Conditioning Association’s (NSCA) Certified Special Population Specialist credential is geared toward helping adults of all ages and abilities achieve their best level of fitness. (The group defines “special populations” as those with short- or long-term health issues.)
Choosing the Right Person
There are a number of other specialty health care providers that use assessments and corrective and functional exercise, such as physical and occupational therapists, sports medicine practitioners and athletic trainers. To choose the right professional, it’s important to consider your current health and fitness status, your overall health and fitness goals and whether you have an underlying injury or musculoskeletal conditions.
If you’re generally healthy and simply want to improve movement, function and overall fitness, then an FMS or other functional fitness specialist may be a good fit. However, if you’ve recently had surgery or you have a chronic injury or musculoskeletal condition (such as arthritis, scoliosis or osteoporosis), you should first seek the services of a licensed health care professional. If your goals run toward athletic competition and performance, you may benefit from working with a sports medicine practitioner or a certified athletic trainer.
You can find certified and licensed professionals in your area by typing a few keywords into a search engine. Try terms like “certified movement specialist,” “athletic trainer,” “licensed physical therapist,” “functional trainer,” “corrective exercise specialist,” “sports doctor” and so on, combined with your city and state. You can also search for professionals on the web directories of these industry-leading organizations:
- American Council on Exercise
- Functional Movement Systems
- National Strength and Conditioning Association
- American Physical Therapy Association
- NASM and general health and fitness professional directory at IDEA Fitness Connect
Reprioritize Wellness Over Fitness
If the kind of training described above sounds new or unusual to you, that’s largely because fitness professionals tend to focus on what clients ask for — that’s how they earn their living, after all.
As Cook put it, “Clients want to get their butts kicked by a trainer to compensate for their sedentary lifestyle, but that won’t pay good dividends. Learning to stand taller and move properly through a full range of motion is what they should be after.”
According to Cook, if you can’t bend and touch your toes, squat to the floor, or do a prone press-up (AKA Upward Dog pose) without pain or if you can’t balance on one leg for 20 seconds or walk across a balance beam without falling off, that signals dysfunction. This should tell you that you’ve got some wellness work to do before you can start worrying about fitness.
Communicating these new goals to your trainer and asking for a movement assessment is the first step toward a pain-free, functionally fit future.