strength program

Pattern Quality: The Impact of Exercise Prescription Variables on Overuse Injuries

It is important in prescribing exercise programs to be aware of several variables and the impact the exercise prescription can have on a person that is not ready to execute certain drills, movements, loads and intensities due to lack of training age, poor general fitness and/or  inadequate movement patterns due to lack of mobility and/or stability.  Some popular exercise programs assign exceedingly large loads of volume and/or intensities (resistance, speed and/or range of motion) with little regard to the ability and state of preparation of the end user.  The human body is a superb machine, able to compensate for many inadequacies and still execute some form of the movement, even though the pattern is less than ideal.   Over time, especially with increasingly larger loads/volumes, the body will begin to exhibit symptoms that relate back to these less than ideal patterns of movements.  Poor compensation patterns of movement may ask muscles to do jobs they were not designed to do, in a sequence and order that is not optimal for the pattern, or put joints in poor positions in terms of their designed function.  These symptoms include low back tightness; hamstring tightness and pulls; tendonitis and bursitis in various areas; stiffness in joints; and over time, the inability to execute certain movements due to pain and restrictions in muscles and/or immobility in the joints themselves.

Let me explain.  If a person is unable to squat in a normal squat pattern because they tend to load the front side by bending the knees first (rather than hinging at the hip), collapse forward at the trunk due a weak core or tend to shift onto one leg due to a lack of flexibility in a muscle group or lack of mobility in a joint, is it wise to load them with 40-50 reps, added resistance, speed as in jumps or large range of motion movements?  They may be able to execute the prescribed workload (4-5 x 10 with a 20 pound vest and squat below parallel) and not immediately have any noticeable ill effects.  However, over time, the cumulative effect of repeated poor movement patterns will cause training adaptations that may not be ideal and could contribute to muscle, tendon, ligament, joint and disc problems.

If the professional tasked with prescribing exercise programming is aware of some simple parameters when implementing the exercise prescription, then the program designed for the athlete will not only prepare them for the rigors of their occupation and hobbies, but can also enhance the athlete’s ability to stay fit, healthy and active at an exceedingly high level for as long as they choose.

Observing the athlete moving in any skill or pattern begs the question, is the pattern optimal and clean in its execution.  If the answer is yes, it is ok to execute that pattern.  However, if load is added in terms of speed, additional ROM, volume, TUT (Time the muscle is Under Tension – i.e. heavy and slow, light and fast or medium loads with pauses or stops in the range of motion) or some other variation and the pattern changes for the worse, then the athlete is not prepared adequately. This compensation is due to a weakness, imbalance, lack of mobility or stability and negatively impacts the ability to execute that exercise prescribed. At this point, a decision must be made to either restrict the load/intensity or regress in the progression and periodization of the exercise prescription.

However, in some instances, the movement improves, providing a clue as to the cause of the poor pattern.  If the athlete is unable to perform a decent squat pattern, i.e. collapses forward in the trunk region, but when load is added in the form of a medicine ball or weight held at bent arms length which subsequently improves the movement pattern, this tell us something.  The front of the core (abs) is a spring built for resistance to collapse.  With the addition of external load at bent arm’s length, many times the body will compensate by engaging the core and resisting the collapse, thus causing improvement in the squat pattern in terms of the anterior core no longer collapsing.

As a professional tasked with assigning exercise, if optimal pattern awareness is made a part of the exercise prescription process, then managing the physical ailments by our athletes as they age will be made easier by the type and quality of training the end user does in their younger years.  No pain – no gain is no way to prepare the people we are entrusted with improving their fitness abilities.  No train – no gain combined with train for stability/mobility for enhanced physical ability to bend, rotate and extend with strength, power and fitness is a way to approach program design and exercise prescription for the diverse population that presents itself each and every day.  Pattern, progression and periodization pave the way to optimal movements, continued progress and few injuries.