Instead of advice to “sit up straight”, evidence-based posture exercises are about creating awareness and learning how to vary your positions with control, whether you’re static or moving. Each person and injury has different “ideal” postures at different times, and what works for one person may not work for another. Chiropractors are experts in the assessment of posture-related issues, and research shows it is more effective to receive person and condition-specific posture assessment and advice.

Knowing what positions we tend toward, how to notice them, and how to modify so we can evenly distribute stress across different tissues is a very helpful skill when it comes to reducing pain and improving daily function.

This type of exercise often works best for people who like on-the-go exercises, who have repetitive static or repetitive motions throughout their day, and are looking to increase body awareness and function in general.

Mobility exercises include both passive (holding a stretch) and active stretching, depending on your goals.

If your goal is to improve range of motion, then both passive and active mobility are helpful. If you want to reduce symptoms like pain and tension, then active mobility is more effective by introducing more blood flow through movement.

This type of exercise often works best to help speed up recovery and reduce pain during an acute episode, as a transition point to condition tissues before strengthening, and as a preventative exercise that can be done even after recovery to keep tissues moving well and pain free.

Muscle control training involves identifying helpful versus harmful muscle activation strategies, creating awareness and learning how to use more supportive strategies, and then incorporating them into daily movements to support tissues, reduce pain, and improve function.

Like posture exercises, muscle control training is very person and condition specific. What one person needs may be very different from another. For example, for some people low back pain happens because we lack core activation to support our spine, while for others excessive core activation and bracing is making their back pain worse by compressing the spine throughout the day. Chiropractors are experts in assessing and treating issues related to muscle activation strategies.

This exercise approach is often most helpful in chronic issues, and can be a significant part of reducing pain and risk of reoccurring flare ups.

Since this exercise therapy is a relatively new concept with evolving research, below is a brief explanation if interested:

In general, the muscle control strategies we use during acute pain are often helpful, protective, and usually go away as symptoms reduce (think of moving slowly and cautiously while still in pain to help protect the area). While in chronic pain, research shows that our automatic protective strategies are often unhelpful, and a major source of pain and disability. Essentially what worked during an acute flare up no longer works to help support the tissue over a longer time period. More often than not we’re not aware of these strategies since they are so automatic. Bringing awareness to them and retraining more helpful muscle control strategies has been shown to help reduce pain, improve function, and reduce risk of chronicity.

Strengthening can be a very helpful part of reducing pain and improving disability related to both new (acute) and persistent (chronic) injuries.

In the case of tissue trauma, it is often needed to help an injured tissue fully heal. Often symptoms alone are not a guide that full healing has occurred, and failure to re-strengthen a torn muscle (for example) increases risk of re-injury.

In chronic issues, strengthening a weak muscle can often fix a lingering issue if that muscle was contributing to the problem.

Strengthening muscles also helps to protect and take pressure off of other structures, like joints, discs, and ligaments. Even if there is no muscle weakness present, the resistance or load applied during strengthening is often very analgesic (pain-relieving) when done in the right “dose” and at the right stage of healing. As a result, strengthening is not just helpful for muscle issues but for a wide range of pain and disability issues.

Depending on the severity of tissue trauma, or the nature of the chronic issue, strengthening is often best done in a graded or progressive way with pain and pacing guides to reduce risk of re-injury and help ensure full healing.

Strengthening exercises can work well for acute issues, chronic issues, and as helpful prevention following recovery.