Precautions for joint mobility training

Don’t hold yourself back by other people’s standards, don’t push through the pain, and don’t neglect preparation and finishing movements. All the remaining details are practical rules extending around these three points.

There are actually two schools of controversy in the rehabilitation circle. One school is the "angle priority school", which believes that joint mobility must return to the pre-injury or average level of healthy people as much as possible, otherwise long-term problems such as adhesions and compensation will easily occur.； The other group is the "function-first group" who believe that as long as it can meet the needs of daily activities, a difference of more than ten degrees is not a problem at all, and there is no need to suffer for angles. I think there is no absolute right or wrong between the two. The key depends on your own needs - if you are a professional athlete and will rely on your body for food in the future, then it is indeed necessary to adjust the angle. ； If we ordinary people just want to go to and from get off work normally, squat on the toilet, or have tight shoulders and just want to put on and take off clothes without difficulty after anterior split surgery, we really can't afford to spend every day in a group of patients to benchmark the progress of others. I have been in contact with a 28-year-old patient with an ankle fracture before. I saw that the patient in the same ward could lower the angle to 90 degrees two months after the operation. I had to keep up with the progress even to the point of crying. As a result, I suddenly suffered talar cartilage damage. I could have been off crutches in three months, but it was delayed for half a year. It was completely unnecessary.

What's more pitiful than random benchmarking is that many people have been brainwashed by the slogan "No pain no gain" and push forward despite the pain. First of all, we need to make a clear boundary: it is normal to feel soreness and slight pain during stretching, but if there is a sharp stabbing pain, radioactive numbness, or even pain that lasts for more than 2 hours after training, and the joints are still swollen and shiny when you wake up the next day, it must be an overdose. In the past, some old-school rehabilitation practitioners believed that "mild inflammatory response can stimulate tissue remodeling." However, the current mainstream sports medicine consensus does not encourage deadlifts that exceed the pain threshold, especially for middle-aged and elderly people with degenerative arthritis. Articular cartilage is already worn, and hard lifting will only aggravate synovial inflammation. Just like Aunt Zhang in our community. She heard people say that squatting can improve the range of motion of her knees. She grinned every time because of the pain and still insisted on counting. After practicing for half a month, her knees were swollen like steamed buns. She went to the hospital to drain two tubes of effusion, but the gain outweighed the loss.

Oh, by the way, there is another little detail that many people don’t pay attention to: don’t hold your breath when training. Many people subconsciously hold their breath when they exert themselves, which will tense the muscles and greatly reduce the effect of stretching. Just breathe normally and at a steady speed. When you stop at the extreme position, take two breaths slowly to relax more.

In addition to grasping the speed during the training process, many people will also ignore the two key steps before and after training, which is equivalent to opening a frozen door lock without applying oil, and twisting the key hard will only destroy the lock cylinder. It is best to prepare for 5 minutes before training. Either use a hot water bottle to heat the joints, or do 3 minutes of low-intensity aerobics, such as walking in place, swinging arms and legs. Wait for the synovial fluid in the joint capsule to be fully secreted and the flexibility of the surrounding soft tissues to increase before doing activity training. The effect will be good and it will not be easy to strain. Don’t just pat your butt and leave after training. Especially for people who are prone to edema after surgery, it is best to apply an ice pack for 1-2 minutes and then wrap it with an elastic bandage for half an hour to avoid subsequent swelling.

I once met a young man who was working out. In order to practice yoga to open his shoulders, he pressed against the wall at home every day. He wanted to press his shoulders to the ground. As a result, he developed acromion impingement after practicing for half a month. It was difficult to even lift his arms to put on clothes. It took more than three months to recover. He just made the mistake of only practicing passive stretching. He only relied on external force to open the joints, and the surrounding muscle strength did not keep up. Not only did the angle bounce back not long after the break was completed, it was also easy for the joints to become unstable. The best model is to combine passive release with active training: first use manual techniques or foam rollers to loosen the surrounding tense muscles and fascia, and then do active activity training on your own, such as climbing walls and pendulum swings for people with tight shoulders, and dorsiflexion and resistance training for people with stiff ankles. Only the range of motion gained can be retained.

To put it bluntly, joint mobility training is a process of talking to your body. You have to understand the signals it gives and don't compete with it or be too lazy. If you are really not sure where your speed is, it is better to spend some money to find a reliable rehabilitation practitioner for an evaluation, which is much better than groping blindly on your own.