DVD Review: Training = Rehab, Rehab = Training by Dr. Charlie Weingroff

weingroff-dvd

“People always come to workshops looking for the “house”.  They just want all the fancy exercises that they can throw at their clients and patients.  Today, I am going to give you the blueprints to the “house”.” - Charlie Weingroff

Day 1 (Discs 1-2)

Day one begins with the quote above and of the 6-DVD set discs 1 and 2 are the most important in the entire collection.  I’d go so far as to say that if you were to watch only 2-DVDs in this entire set, make sure it is those ones!

On day 1, Charlie discusses the principles, thought process, and “big rocks” that represent the physiology behind the training approaches he believes in and teaches to his patients and clients.

Charlie begins this workshop by discussing some of the philosophy behind the FMS and SMFA, as well as touching on the concepts of Vladimir Janda, developmental patterns, Shirley Sahrmann, and the principles of PNF.  All of which blend to form Charlie’s unique approach to training and rehabilitation.

As the title of the DVD states, Charlie is seeking to not only establish a common language between medical and exercise professionals, but also a common thought process that allows for an appropriate delegation of authority when working with clients/patients who are currently experiencing pain.

Just as Charlie states in the DVD – “Some professionals, both rehabilitation and exercise, may not agree with my approaches to training on days two and three.  However, if they are good at what they do, then they need to agree with and understand all of the principles on day 1.  If they understand that stuff then they can make up their own system and as long as it honors those principles then it should work.”

Day 2-3 (Discs 3-6)

With discs 1-2 representing the “why’s” of Charlie’s system, discs 3-6 cover all of the “how’s”.

Discs 1-2 = The blueprints to the house
Discs 3-6 = The HOUSE

Discs 3 begins by covering the SFMA, which for those who are unfamiliar stands for the Selective Functional Movement Assessment.  Simply put, the SFMA represents the medical version of the Functional Movement Screen (FMS) which is used by health care professionals for pathological individuals and serves to develop a road map for both diagnosis and treatment.  The audience in this DVD is a group of trainers and not medical professionals, and the real goal of this DVD is show the common ground between professions and help develop a “team approach” to treatment; therefore, Charlie does not go through the entire SFMA, but rather, he presents his “SFMA with Restrictor Plates”.

An FMS Gone Bad

For those that aren’t familiar with the FMS it is a seven step test that screens the quality of very fundamental movement patterns and looks for three things (in order of importance):

  1. Pain with movement
  2. Movement Asymmetries
  3. Poor movement quality

Obviously numbers 2-3 can be addressed with appropriate exercise, and one of the things that the FMS can be helpful with is the development of an exercise road map to help improve the qualities that are lacking.

Number 1, pain with movement, is a more important and serious issue.  The “rules” that are taught in the FMS course is that when their is pain with movement exercise professionals must refer out to a medical professional to ensure that things are assessed properly.  The reason for this is because in the presence of pain, an individual will change their motor program, move differently, and even if the movement looks good, will be achieving it via a different method (a high threshold strategy) which will only lead to more harm than good in the long run.

Charlie’s thought process in this DVD is to establish rules for exercise professionals so that they can work side by side with the medical professional during these situations by understanding what their role is in the process and by allowing the medical professional to address the necessary components.  Enter the SFMA with Restrictor Plates.

SMFA with Restrictor Plates

The SFMA with Restrictor Plates comes into play when an individual states that they have pain on any of the seven FMS tests or during any of the three FMS clearing movements.  Once this happens we defer to the SFMA, which (in the simplest sense) is a set of seven more primitive mobility patterns because if we continue to use the FMS for a painful individual, we will not be able to differentiate between poor movement creating pain or poor movement because of pain.  Thus, our corrective approach may not be appropriate and may lead to more harm than good.

Rather than using a 0-3 scoring system, as done in the FMS, the SFMA qualifies movement in one of 4 ways:

  1. Functional/Non-painful
  2. Functional/Painful
  3. Dysfunctional/Non-painful
  4. Dysfunctional/Painful

The “restrictor plates” for exercise professionals consist of the following rules:

  1. Anything wrong with the neck and you automatically refer out.  So that means any time the neck is dysfunctional/non-painful, dysfunctional/painful, or functional/painful it warrants a referral to a medical professional.  The cervical spine is highly important, extremely delicate, and must be addressed by a professional with manual therapy as there really are no corrective exercises for this region.
  2. Any patterns that are painful, either functional or dysfunctional, you need to refer out to a medical professional for an evaluation.  We can’t train painful patterns because of issues with motor programming, so you need to have some one qualified to address this.
  3. There are no “break outs” in the restrictor plates system.  In the actualSFMA a medical professional will break out patterns of pain or dysfunction as a means to determine the underlying issue that is causing a virus in the pattern.  This helps to make the diagnosis and serves as a platform to base treatment off of.  Because exercise professionals are not allowed to make a diagnosis, the break outs are left out of the assessment process.

The delegation of work

Because so many people have pain in one form or another, this system helps to exercise professional retain the client and be an active participant in assisting the individual to get what they want (better fitness, better health, etc) without compromising the rehabilitation methods the medical professional is using.  This is done by having a method of delegating the work load.

In Charlie’s system, if the trainer can perform the SFMA with Restrictor Plates, understands that they are allowed to work to improve the dysfunctional/non-painful patterns with the client, this allows the rehabilitation professional to be able to spend more time addressing the painful pattern with manual therapy and other methods.  This gives the client/patient a well rounded program that addresses their needs (improve painful and dysfunctional patterns), in a safe way that is very appropriate, while still giving them what they want (a workout).  This allows everyone to be happy – the exercise professional retains a client, the rehab professional addresses the patients needs to ensure that they can have pain free exercise, and the client/patient gets a comprehensive program specific to their body.

On an interesting note, working on the dysfunctional/non-painful pattern will often have a positive outcome on the painful patterns and sometimes clear them up completely.  Charlie is not shy about speaking about his profession (physical therapy) or other medical professionals (chiropractors, ATCs, doctors, etc) and states very bluntly that if you are an exercise professional that grasps this stuff and honors it properly, you will typically do more good for that person and make them move and perform better (and pain free) than most of the garbage physical therapists and chiropractors out there who don’t get it.

The corrections, exercises, and getting STRONG

  1. Get Long
  2. Get Strong
  3. GO HARD!

This is Charlie’s philosophy in a nutshell and for those that believe that Charlie is only about doing corrective work and breathing for six months, this DVD will surely change your mind – if his 800lb squat and powerlifting total hasn’t already done so.

The DVD lays out a corrective approach for each of the six SFMA movements (only six because we do not address the neck with exercise) taking you from mobility movements, to stability movements, to the more integrated and functional patterns that those movements represent.  Because there are not breakouts in the SFMA with Restrictor Plates, the exercise professional will address all of the main movement segments in the body as they are represented in the pattern you are looking to correct.  However, even without breakouts, it shouldn’t take a genius to realize that once you start moving through the corrective sequences you will find where the individual is more restricted and know to work more on that area then in a different area.

Charlie goes extensively into deadlifting and squatting in these DVDs and shows various methods of teaching and progressing these exercises once the individual is ready for those movements (IE, they clean up their underlying problems).

If I had to explain it simply, the DVD is not just about corrective exercisebut rather, it is about how to use a corrective approach to progress someone to performing larger patterns with load.

As the title states, Training = Rehab, Rehab = Training, Charlie doesn’t believe that any of the corrections or exercises live in either a rehab or training world, but rather are represented in both settings depending on whether or not you qualify the client to do a particular movement.

Conclusion

One of the things I like most about this DVD set is that it isn’t scripted.  This is Charlie Weingroff standing up in front of a crowd for 3 days and teaching – everything is in real time.  In DVDs 3-6 you get to see Charlie screen people, teach exercises, cue people, and coach people.  You get a chance to see what is inside his mind and how he conceptualizes exercise technique and performance.

For rehab professionals, these DVDs will give you ideas and concepts for developing your own thought process and method for creating effective rehabilitation programs and addressing movement, because as Charlie says, “Movement Matters!”.  These DVDs will help to sharpen your axe with regard to putting together movement based therapy interventions, which isn’t something that is addressed in depth in many physical therapy programs. 

For exercise professionals, these DVDs will teach you how to create your own road map to working with clients and most importantly help you to understand the “rules” when a client presents with pain.

Finally, for massage therapists, I believe that this product has much to offer!  As massage becomes more popular in the exercise and therapeutic/clinical world, this DVD series can serve to help massage therapists get brought up to speed with the language of exercise, allowing them to effectively communicate with and understand the goals of professionals in both the exercise and rehabilitation worlds.  Additionally, the assessment process offered in this DVD can give a massage therapist valuable information for planning a treatment session.  If Thomas Myers’Anatomy Trains concept is your “flavor” of approach, the assessments can give you some information regarding the fascial trains and how well they play with one another, as well, the assessment can (and should) be used both pre- and post- treatment to evaluate changes that have been made to the movement system.

Training = Rehab, Rehab = Training is one of the best DVDs I have seen in terms of giving you all the information you need to develop your own methodology (the blue prints to the house) while simultaneously showing you what is in the head of one of the most knowledgeable and dynamic rehabilitation professionals today.

For 6-DVDs and over 12 hours of information, this series is easily worth more than its price tag and should find its way into the library of every exercise and rehabilitation professional.  If you want to take your game to the next level and deliver a product of excellence to your clients or patients I highly recommend checking out Training = Rehab, Rehab = Training

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