Research Corner - Q&A Four Point TVA Exercise - Wrist Pain by Paul Chek | Date Released : 17 Mar 2003 0 comments Print Close Question: I find Paul Chek's article, The Inner Unit, to be quite insightful. He recommends the four point maneuver and other stabilization exercises that are done in an "all fours" position. How does one modify the four point, for instance, for clients who are strong generally but whose wrists get sore before they complete their second set? Can they put their hands around a dumbbell and point their knuckles to the ground to keep their wrists neutral, or will that throw off postural positioning too much? Should we focus on forearm exercises first? What is recommended? Answer: If someone's wrists become tired or sore, place a small medicine ball under each hand or, as you've suggested, use a dumbbell. The four point TVA activation exercises should only be done until clients can do them standing. The best position to try from standing is the bent-over row position while they rest their hands on their knees. This helps them relax the abdominals, allowing a better stretch of the abdominal wall by the visceral as they inhale, which facilitates the contraction. As soon as possible, you can implement the principles inner unit/outer unit integration described in my Scientific Core Conditioning course. Back to top About the author: Paul Chek Internationally acclaimed speaker, consultant and Holistic Health Practitioner Paul Chek, draws upon over twenty-eight years of experience in corrective exercise, high performance conditioning and integrative lifestyle management. Author of six books, over 60 DVDs and numerous correspondence courses and seminars, he has also developed four advanced training programs for professional development in the health and fitness industry. Paul is the founder of the C.H.E.K Institute, based in San Diego, CA which specializes in Corrective Holistic Exercise Kinesiology (www.chekinstitute.com). He is also the creator of the P~P~S Success Mastery Program (www.ppssuccess.com). 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