When Strength Training Comes Last
Most of the time patients coming in are in pain, have some sort of “injury”, and our initial care falls under the heading of “relief” care (See “Back Pain First Aid”). In that context our first series of take-home activities deals with reducing inflammation (how to do ice and what not to do) and healing, then gradually the activities (“exercises” if you will) that we recommend deal with keeping the joints that I adjust moving between visits. Only after that, and after a patient is out of pain and beginning to hold their adjustments, can we talk about what most people think of as exercises. That is we can if the patient wants to.
(Personally, I try hard to interest patients in the evaluation of their quality of movement next. If you don’t move correctly exercising doesn’t really make much sense – and the odds of eminent relapse goes up if you do exercise.)
The typical patient can then begin thinking (if they want to) about doing exercises to “rehabilitate” their “injured” back. That ends up in conversations about “core” training and we introduce (one at a time) the Big Three and a few other important exercises – in the best of circumstances these recommendations will be based on our doing tests that reveal specific weakness in either postural alignment, strength, flexibility or control.
The point is that strength training comes last in these cases (most patients). First the “core” strength, then the rest of the body.
When Strength Training Comes First
On the other hand, most people who are not in pain – might be well served to focus first on building strength. (There are a bunch of assumptions build into that, e.g., they move well, they don’t need to be adjusted, but that list is the subject of another Post.)
From this Post you can gather that there is a spectrum of relative fitness capability that goes from a painful inability to do much of anything to fully functional and fit ready to fight. There is only one exercise that covers that whole spectrum: Tai Chi Chuan... in case you were wondering:-)