Research Corner - Q&A Corrective Exercise for Excessive Standing by Anthony Carey | Date Released : 03 May 2007 0 comments Print Close Question: I have read some brilliant PTN articles on the corrective exercise you should prescribe a client who spends all day sitting at a desk. What about for those who spend all day standing up (i.e., teachers)? Thank you. Answer: When it comes to corrective exercises, the sitting position differs significantly from standing. The differences go far beyond the obvious. Deviations in one’s structure and function when sitting are magnified when they are standing. Therefore, recommendations for corrective exercises for sitting can often be more generic. When we sit, our center of gravity (COG) is much closer to our base of support (ischial tuberosities) then it is to our base of support (feet) when we are standing. Therefore, more often than not, the more significant postural issues are in the sagittal plane when sitting. This is why we see most corrective interventions addressing the sagittal plane influence of the targeted muscle groups (i.e., hip flexors, spinal extensors). Once vertical, the body has many more variables to address. With the feet as the base of support, we now have to consider bilaterally the subtalar joint, ankle joint, knee joint and hips. The body’s COG is much further from the base of support. The more vertical COG creates a greater need for the body to redistribute the mass of segments to counterbalance shifts in other segments. In other words, the higher the COG from the base of support, the more zigs for the zags. This is of course reflected in postural distortions during standing. Therefore, the decision making process for applying corrective exercises to the standing individual can be exponentially more complex than applying them to the sitting individual. At the very least, we must consider and assess all three planes of motion. We must determine the major contributors to the dysfunction (80-20 Principle) and then apply our corrective exercises with a clear objective in mind. For example, your client may have a sagittal plane deviation while standing, but it could be in flexion or extension and could involve the hip, pelvis, spine, knee or ankle. Or he could have a frontal plane deviation with pelvic obliquity related to a functional leg length discrepancy or relative adduction of the hip. Or in the transverse plane, he could have the pelvis in right rotation forward, creating relative external rotation of the right hip and spinal rotation to the left at the thoraco-lumbar junction. Each of these examples could cause a cascading effect throughout the kinetic chain. The message is that the corrective exercise prescription should be based on a thorough musculoskeletal assessment. Recognizing the functional demands of your client’s occupation, such as with a teacher, is also critical. Corrective exercises are an integral part of the motor learning process. Consider the application of these exercises to all of your clients. Recommended Resources: Advanced Swiss Ball Training for Rehabilitation by Paul Chek Assessing Core Function by Paul Chek Corrective Exercises for Powerful Change by Anthony Carey Exercise Tubing Program: Movement Prep and Corrective Exercises by Gray Cook Functional Movement Essentials by Ian O'Dwyer Functional Video Digest Vol. 1.08 – THORACIC SPINE by Gary Gray Functional Video Digest Vol. 1.09 – CERVICAL SPINE by Gary Gray Optimal Performance Bodywork by Todd Durkin The Pain Free Program: Relieving Back, Neck, Shoulder and Joint Pain by Anthony Carey Ultimate Back Fitness and Performance by Stuart McGill Back to top About the author: Anthony Carey Anthony Carey M.A., CSCS, MES is PFP Magazine’s 2009 Personal Trainer of the Year and owner of Function First in San Diego, California and an international presenter on biomechanics, corrective exercise, functional anatomy and motor control and their relationships to pain and function. Anthony has developed the Pain Free Movement Specialist certification and is the inventor of the Core-Tex®. 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