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When I was in graduate school for physical therapy, our program had this concept of “remediation”, which was the idea that if you did not get a certain score on an exam, you would have to retake it, and while that may sound like a lax system allowing doctoral students to retake exams, seeing as though the cutoff for remediation was typically in the 80-85% grade range, it could be a little intense in certain classes. Therefore, the term “remediation” was always spoken in hushed tones and with a high amount of anxiety. My program knew what it was doing. This remediation process definitely contributed to our greater learning picture (our class had a 100% first time board pass rate…whoop whoop), but that did not mean it always felt good in the process.
Lately, I have been thinking a lot about remediation in terms of corrective exercises. I prescribe a lot of corrective exercises here, and by that I mean tiny, boring exercises meant to target certain muscle groups. If you have ever come to me you know that boring is a key word, but you also know that after doing them for a few weeks, the boredom translates into “pain-free”. And every time I prescribe one of these exercises to an otherwise strong and highly functional patient, I can feel a bit of animosity as they look at me like, “You know I am capable of so much more than this, right?” And every time I see them at about their 3rd week of treatment and something slips out like, “I think the exercises might actually be helping,” I do my little happy dance inside.
Sometimes a muscle is weak, and sometimes it just is not working properly (we call this inhibited). It is my job to determine which is which, but no matter how you slice it, the solution is typically corrective exercises.
The situation is this: The patient does their corrective exercises. The patient gets better. But what about when the patient shows back up a year later with a similar issue? Surely, they don’t need those same little corrective exercises, right? They should be beyond that. That was a phase, right? Not necessarily. It may be time to circle back to those exercises. It may be time to *gasp* remediate.
Last year, I posted about my journey to improving my running. I will post an update soon, but the short of it is that I was headed down a path of perpetual hip and back injury from running due to a poor and asymmetrical running form. In order to heal my hip and back and change my form, I myself had to do a lot of foot, hip, and back corrective exercises. Now here I am nearly a year later, and by having done these exercises in the past, I am not only able to run pain-free but am also able to do some high-level glute strengthening like barbell squats and deadlifts.
Yet, a few months ago, I began experiencing knee pain while running. Hmm…I have had a lot of orthopedic injuries in my running career but “runner’s knee” has never been part of them. As it turned out, my left glute had decided it was tired of working (inhibited) and was not supporting my knee while doing these lifts, and it is reasonable to think that it was also not supporting me while running. Seeing as though I am training for a marathon, that was a lot of steps of diminished support; my knee was fed up!
When injuries start to crop up again, it is time to go back to the basics. It does not always mean that you have failed. It is your body telling you that for just this one exam, you have been assigned remediation. It’s okay. It does not have to be embarrassing. Just get out that little exercise band and get to work. In the long run, your body will thank you.