Therex vs. Barbells | Combating The Corrective Exercise & Therapeutic Exercise Mindset in the Clinical Rehabilitation & Fitness Settings With Dr. John Petrizzo
If you're a physical therapist, chiropractor, or personal trainer struggling to know when and how to choose multi joint exercises, like the main barbell lifts, over single joint isolation therex, this episode is for you.
In this episode we discuss the benefits of starting at the top with our exercise selection (the main barbell lifts) instead of the bottom and why we feel therapists and coaches default to isolation or therapeutic exercises. We further discuss if there is a difference between training and rehab and how do we bridge the gap if there is.
In our discussion with Clinical Coach and Exercise Science profession, Dr. John Petrizzo, PT, CSCS, SSC, PRSCC, we have engaging and exciting discussions answering the following questions and much much more:
Is the functional movement screening or other movement screening system contributing to false beliefs about the client’s ability to perform higher level exercise?
Do we need to spend time working on specific isolation exercises if the person has the functional prerequisite to perform the main squat, bench, deadlift, and overhead press or close variation thereof?
How do we screen someone’s ability to perform movement?
Should we use isolation/therapeutic type and mobility exercises to address injuries or movement maladaptations in strong barbell trainees?
Why is the single joint exercise/therex mentality so pervasive in physical therapy?
What is the unspoken advantage of utilizing large multi joint barbell exercises into rehabilitation?
In what situations would you try to start with a barbell or multi joint exercise and in what situations would you default to starting with isolation exercises?
What are the biggest problems we see in the rehabilitation realm when it comes to exercise?
What’s the problem with “return to sport” or “discharged from PT?”
Is there a difference between rehab and training?
Dr. Rori Alter, PT, PRSCC, SSC: [00:00:38] So we got two questions for this podcast episode, and we're talking about isolation exercises versus large multi-joint or compound exercises in rehab and fitness settings. So we got two questions for this podcast. So I'm going to put them out there now, and then we'll dive into the meat and potatoes of the episode, and then we'll kind of revisit the questions at the end. So the first question we got was, when shouldn't you be doing isolation exercises? So I actually really like that question. So we're going to talk about that.
Dr. Rori Alter, PT, PRSCC, SSC: [00:01:23] And the other question we got was, can you talk about patient language? I might be biased from previous or past experiences, but some patients will blame one specific structure, muscle, etc., as the source of the problem. Then every session is specifically targeted at that specific area. How can new grads be aware of that when diagnosing and then explaining what's going on to the patient? So that isn't necessarily part of this topic. Still, I think it is because there are tons of therapists and personal trainers out there who focus on utilizing this specific exercise to fix this specific problem or target this specific muscle. And there's so much on social media that physical therapists and chiropractors and, you know, people who personal trainers who get random or not random, but like certifications that make them think that they're rehab clinicians, licensed rehab clinicians.
Dr. John Petrizzo, PT, CSCS, SSC: [00:02:29] Corrective Exercise Specialists.
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:32] There you go. Yeah. There's this whole corrective exercise world where people buy into that you have to use this exercise for this problem or this muscle or this exercise to fix that. And you have to do this before you can do that. And it does put these narratives in people's heads that you can't do the squat and you can't do the bench press. You can't do the overhead press or the deadlift until you have done these foundational isolation exercises to address issues in your body before doing the main movements or variations that are most appropriate for the person given their history: surgical, medical, and all that stuff. So in this episode of the PRS podcast, we're going to talk about combating this corrective exercise narrative. So we can say or combat the idea that we need to utilize isolation exercises or basic TherEx so bands like little things like clamshells or internal and external rotation or bridges or things thereof before we can do anything else. So we're going to talk about why it's more beneficial to utilize the main barbell lifts or variations as primary exercises in rehab, fitness, and powerlifting settings. Because we see coaches and athletes, and even clinicians default to utilizing a different exercise to fix a problem or issue that they're having in the main barbell lift. So we're here with our usual lovely co-host Dr. Alyssa Haveson, and I'm Dr. Rori Alter, head clinical coach here at PRS. But we are joined by the awesome BROfessor, Dr. John Petrizzo, another clinical coach here at Progressive Rehab & Strength. And he just waved at the camera, which we can't see on the podcast.
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Web: https://www.progressiverehabandstrength.com
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