Breaking down the "how" of exercise

Cliff Shulman
Guest columnist

Have you ever resolved to exercise to improve your health and well-being, reduce pain, or prevent injury but found you were getting limited benefits from your efforts? Or even worse, actually feeling more strain following your efforts, with more pain in your joints and muscles? 

What’s missing in the formula for success when it comes to exercise? 

Cliff Shulman, PT

Often, there is no error in the exercise program that has been provided to them by their physical therapist, personal trainer, physician or even derived from an internet search. Yet all too often, people either derive limited benefits from their efforts or worse yet, actually exacerbate their problems while performing their exercises.  Why is this?

This is a curious phenomenon that is common and worth investigating.

In all exercise, there are at least two primary aspects to consider:  1) the actual exercise or “what” you are doing, and 2) the manner in which you are activating your muscles and bones to accomplish the desired action, or the “how” of the movement.  This latter aspect is often neglected and makes the difference between improving or aggravating your condition or wasting your time.

In many cases where the exercise produces more pain, if it is not due to an error in exercise selection, the problem can be traced to poor performance. Particularly, if you have some mechanical strain, inflammation or injury, it is important to learn to modulate the amount of force you use when you activate your musculature. 

You must learn to properly distribute the muscular effort through your skeletal structure in a way that does not place undue strain on your joints. Otherwise, no matter how well-intentioned your efforts are, you may not only be re-injuring yourself but actually reinforcing the faulty movement habits that are at the root of your problem. 

Particularly following an injury, compensations develop where you “block off” areas of pain and dysfunction and develop fixations around the region, which then are unable to participate properly in the normal execution of a motion. Unless you learn to move in a way that reintegrates these parts into your normal motion, your benefits from exercise will be much more limited.

Even many trained professionals have the idea that they should isolate a muscle group to strengthen or improve it. While there is some validity to this and it is true that there are “prime movers” involved in any motion, functionally speaking there is no movement we do in our daily life which doesn’t actually involve the ability to integrate the motion of multiple parts versus moving a single muscle. 

With this understanding, it requires a completely different orientation to the performance of an exercise, let alone the type of exercises chosen. You can derive considerably more benefit from a common exercise that is often performed with a limited understanding, try the example below. 

Pelvic tilting is a good exercise that is frequently offered for low back pain, yet often so poorly performed. Most people focus in an isolated manner on the basic movement of tilting the pelvis, with no regard for how the motion affects the rest of the spine. 

Try the following approach. It is important that you don’t strain as you perform these moves. Be patient and allow the motion to gradually improve. 

Lie on your back with knees bent and feet spread comfortably about hips-width apart. Press your feet gently into the floor as you draw your belly in slowly, so you feel your pelvis tilt or roll in the direction of your head. 

Feel how the low back presses into the floor but also allow your attention to spread into observing how the movement of your pelvis travels up your spine towards your head.  You may even feel the head rocking back slightly, with the chin moving slightly away from the chest. How far up the back do you feel the motion travelling? Then release this motion completely before repeating it again a few times. 

Next, push your belly out like a big “Buddha belly” as you arch the low back away from the floor and roll your pelvis towards your feet. Notice how in this direction, the movement lengthens the spine downwards and the back of the neck lengthens, with the chin moving closer to the chest? 

Repeat this motion several times. Then, see if you can alternate rolling the pelvis towards your head, then down towards your feet, allowing the motion to become more and more fluid. 

After completing this, rest a moment on your back with the legs out long and notice how your back feels now.

Are you breathing more easily now and do you have more awareness of your whole spine? Is your low back resting more comfortably on the floor?

Practicing the “how” of exercise is the way to not only get stronger but doing so in a manner that is safe, enjoyable and allows you to reap the benefits of your efforts. 

If you have been injured, it may be useful for you to consult with a professional who has training in assessing restrictions in movement such as a licensed physical therapist who can advise you with your exercises and help you develop new habits that allow you to move with less strain.

Clifford Shulman, PT, CFP, CTP is a licensed physical therapist and director of Black Mountain Physical Therapy.