Corrective exercise is becoming a larger part of medical exercise services. For some fitness professionals, corrective exercise is their primary focus. For the Postrehabologists, corrective exercise is one of three (3) primary services:
- Post rehab training,
- Medical exercise training, and
- Corrective exercise training.
Roughly 50 to 60% of clients in your medical exercise services practice are Medical Exercise Clients (one year or more post rehab); 20 to 30% are Post Rehab Clients (less than one year post rehab) and the remaining 20% are Corrective Exercise Clients.
The Corrective Exercise Client exhibits postural and/or muscular imbalances but reports no trauma, injury or surgery as the cause of the imbalance. These clients will have functional deficits and limited function, but should not demonstrate ‘red flags’ on assessment. A history of trauma, injury or recent surgery should immediately result in a referral to or communication with a medical professional.
I certainly understand many corrective exercise specialist are excellent examiners; however, in the case of trauma, injury or surgery, the need for advances diagnostic tests may be necessary. These tests require a physician’s referral. This requires, you, the Postrehabologist, to refer the Corrective Exercise Client with a remarkable medical history for trauma and/or surgery.
Even with the referral of post injury, trauma and surgery clients, there are still a wide range of clients in need of corrective exercise services. Clients are in abundance. Examples include:
- Rounded shoulders,
- Forward head,
- Significant muscular tightness and weakness.
When you realize the wide range of potential clients for corrective exercise referring the post injury and/or surgery client won’t significantly hurt your practice. If anything, it may lead to more referrals if your provide the client with a written letter of referral and recommend a specific medical professional.
When managing the Corrective Exercise Client a thorough history must be completed prior to any activity/exercise. The history should go beyond the Par-Q and include a organ systems review. This review will allow you to clear systems beyond the musculoskeletal system as the source of the client’s imbalance. Remember, musculoskeletal symptoms may result from vascular conditions, joint structure dysfunction, and/or in some cases, cancerous lesions. If these non-musculoskeletal causes are ignored during the history and examination, there is possibility of missing a significant component.
Once a thorough medical history and assessment is complete, develop your exercise program. Establish clear and measurable goals. Revisit these goals at least once per week with Corrective Exercise Clients. If progress is not noted after the initial 3 sessions, re-assess for components you may have missed initially. The hallmark of any good corrective exercise practitioner is the ability to always consider, “I may have missed something.” This happens even to the best clinicians. They overcome this by constantly asking themselves, “…did I miss something?”
Once the imbalance is stabilized and the client has reached the program goals, he or she may graduate into a group training program and/or a medical membership. The client can certainly continue on with the Postrehabologist, but the cost per session should drop as the muscular imbalance has stabilized. Price your corrective exercise services using a similar method I recommend for medical exercise and post rehab clients. For a corrective exercise session charge 20-25% above the average rate in your region for personal training. For the corrective exercise assessment I recommend a fee 50% above the average regional rate for a personal training assessment of a healthy client.
Corrective exercise is a growing modality in the medical exercise services practice. Be careful to properly clear all organ systems during your assessment and history to ensure a non-musculoskeletal system lesion is causing the imbalance. In closing, remember no changes in the postural imbalance after 3 sessions means you may have missed something. Re-assess and determine if referral to a medical professional is necessary or simply revising your program will give you a positive outcome.