Integrated vs isolated exercise. what type should you include in your program?
To integrate, or isolate, that is the question.
When creating a rehabilitation program or a general exercise program, a major decision is what type of exercise you should include. Many programs will include exercises that isolate particular muscle groups (isolated exercises), and other programs will spend more time on exercises that include multiple body regions (integrated exercise, also known as functional exercise). Both have their benefits and depending on the focus of your program you may choose either option.
To help you decide which type works best for you (surprise, one size does not fit all), I will discuss each type, and then also tell you what type we choose to spend more time on.
Isolated exercises focus on contracting one muscle group at a time.
Ask me 5 years ago about gym exercises and I would list bicep curls, sit-ups or lat pull-downs. These are examples of exercises that focus on activating and building strength in one main muscle group. They are commonplace in most gym programs because they are a great way to isolate muscle growth when prescribed appropriately.
In our programs, we use isolated exercises when you are first learning to activate a muscle group. They provide an easy avenue to build coordination without having to focus on too many moving parts. But our Lower Back Program aims to get you back to performing everyday activities, so the focus will always shift to combining multiple joints to put you in a more functional situation. This is where isolated exercises fall short. Because they don’t challenge multiple regions at once, they don’t build the body’s coordination for everyday activities to the same degree when compared to integrated exercise.
Just remember, movement in everyday life is a fluid motion - it’s not isolating one muscle after another.
Integrated exercises are more relatable to everyday activities
Integrated exercises combine multiple muscle groups, across multiple joints, to create a movement that is more demanding on the body.
Don’t get me wrong, isolated exercises can become very demanding if you add more weight and resistance (etc.) to the exercise. But integrated exercises challenge us in many different ways, from our balance and coordination to core stability and general muscle strength.
For most people experiencing Chronic Lower Back Pain (CLBP), they don’t have goals like “I want to have stronger lower back extensors”. Their goals are focused on everyday activities, and will sound more like “I want to pick up my kids again”, “I want to run/walk again”, or “I just want to be able to pick things up off the ground without pain”. They are movement or activity-specific, not muscle specific.
If you want to build strength and control that will relate to everyday activities, include more integrated exercise.
Example of an integrated exercise.
An exercise we use in our Lower Back Program is a Unilateral Stance Romanian Hip hinge (pictured).
This exercise challenges core stability, glute strength, hamstring length and strength, and shoulder and upper back strength. It sounds complicated and technical, but if all these facets are required when you have to pick something up off the floor. This is something all of us have to do every day, and this exercise is perfect for it. Using a stride stance makes this exercise even better because now you can spot any asymmetries.
But here is a list of isolated exercises you would have to include to work similar muscle functions:
Core stability: plank
Glute strength: a side-lying clamshell
Hamstring: Hamstring curl machine
Shoulder strength: seated row
Instead of a single exercise that challenges multiple body areas, you now have four different exercises with individual functions. On top of that, you lose the most important aspect of the exercise - building coordination between different body regions.
Integrated exercises help with chronic pain.
We have discussed why chronic pain is far more complex than most people think (See post on Chronic Pain). In summary, the longer a pain episode, the more sensitive your pain system becomes, and the more you become to fear movement.
In our programs, we include exercises that purposely challenge you in the type of movements we find that are commonly avoided in CLBP. Being exposed to these movements through integrated exercise over time of course improves the strength of the muscles involved. But more importantly to us, it improves people’s confidence in their bodies.
We find that gradual exposure to these more complex integrated exercises helps to return a sensitive pain system to normal (Again, see post on Chronic Pain).
Both integrated and isolated exercises have their place.
Here at The Physio MVMT, we focus our programs on integrated exercises because they challenge the body in ways that are similar to daily activities. But we also use isolated exercises because they are useful tools to help build coordination.
The key takeaway is that both integrated and isolated exercises have a distinct role in a person’s rehab process. But to help people achieve their goals, integrated exercises should be at the forefront of any program.
