Joint activity training PPT

The core of joint activity training is never "forcibly tightening the angle", but a plan to restore the physiological range of joint movement and reduce the risk of movement/injury through combined intervention such as passive loosening and active activation within the safe load threshold of the joints and surrounding soft tissues. It is suitable for three core scenarios: postoperative rehabilitation, daily fitness warm-up, and intervention for elderly degenerative joint disease. There is no universal golden template, and all training actions must be adjusted based on the individual's joint foundation and injury history.

Last week, a young man who came to my clinic three months after ACL reconstruction followed an online tutorial to press his legs at home and forced the knee flexion angle to 120 degrees. The pain was so bad that he couldn't sleep that day. The next day, his knee was swollen like a steamed bun. When he checked the angle, he couldn't even reach 90 degrees. Instead, he had to undergo a week of physical therapy to reduce swelling before restarting training. This is also my original intention of making this version of PPT. Don't turn joint mobility training into an "angle competition."

Speaking of this, some people may ask, what training logic should I choose? There are actually two completely different approaches to joint mobility training in the industry. There is no absolute right or wrong, there is only a difference in adaptability to the group of people: One is the "passive mobilization first" commonly used in hospital rehabilitation departments, which first relies on the therapist's Maitland joint mobilization technique. The adhesions in the joint are loosened and consolidated with a small amount of active movement. The advantage is that the angle can be improved quickly. It is suitable for patients with extremely poor muscle strength in the early postoperative period and unable to control the joints. However, if the manual force of the operation is not controlled well, it can easily cause secondary damage to the soft tissue and even loosen the ligaments. ； The other school is the "active activation priority" that is more highly recommended in the sports rehabilitation circle. First, practice the muscle strength around the joints, and rely on the active contraction and pulling of the muscles to drive the joint activities. It is extremely safe and there is basically no risk of secondary injury. However, the disadvantage is that the progress is slow. Many people practice for half a month before the angle increases by 5 degrees, and it is easy to give up due to anxiety. I usually give patients a compromise, such as using passive loosening to quickly break through the basic angle in the first 6 weeks after surgery, and then slowly switching to active activation after 6 weeks, so that it is not easy to rebound if done steadily.

Don't underestimate the impact of the details of the action, as the effect will be completely different. Take the most common frozen shoulder as an example. Many people swing their arms or hang up the horizontal bar when they come up. If you have a problem of subacromial impingement, doing so is equivalent to repeatedly rubbing the rotator cuff. It hurts to the point of crying, and it is easy to wear and tear the rotator cuff. The correct way is to do wall climbing training first. Stand facing the wall and slowly climb up with your fingers. Stop for 30 seconds when you feel a slight stretch. Just do 10 groups each time. Don't rush to the end. Another example is leg compression after knee joint surgery. Many people like to put a pillow on their ankle and put a sandbag on it and forget about it. In fact, this is totally wrong. You have to fix the distal end of the thigh (that is, the section above the knee), otherwise the thigh will sway downward when you perform compression, and all the force will be put on the ligament. It will not be possible to loosen the adhesions in the joint. It is a waste of effort and it is easy to damage the ligament.

The most deceptive misunderstanding is the saying that "pain only helps". I have seen too many people treat tingling and numbness as "normal reactions" and end up causing secondary injuries. The normal training feeling should be soreness and stretching, and the pain will be at most 3 points that you can bear (out of 10 points, 10 points if it hurts so much that you sweat). If you experience sharp stinging, numbness, or radiating pain, stop immediately and don't hold on. There used to be an aunt in her 50s who had periarthritis of the shoulder. She heard from neighbors in the community that shaking her arm would help her get better quickly. She did it for half an hour every day. After doing it for half a month, her shoulder hurt to the point that she couldn’t lift it. She went for an MRI and found that her rotator cuff was torn. Originally, she only needed to do conservative exercises to recover. In the end, she had to undergo minimally invasive surgery, which was not worth the loss.

The training focus of different groups of people is completely different, so don't use random templates. If you are an ordinary fitness enthusiast, you do not need to pursue the maximum angle when doing joint activities during warm-up. For example, as long as the knee joint can flex and extend normally and the hip can be opened to the angle of squatting, the focus is to activate the surrounding muscles to avoid sports injuries. ； If you are an elderly patient with degenerative arthritis, do not do weight-bearing activities such as squatting or climbing stairs. Sit on a chair and slowly stretch your calves. Pause for 2 seconds at the top each time. Just practice 20 groups. This is safe and can maintain joint mobility. ； If you are a postoperative patient, just follow the therapist's progress honestly. Don't compare the angle with others. Everyone's injury situation and surgical methods are different. Others can reach 120 degrees 2 months after surgery. For you, 90 degrees may be normal. Chasing angles will only hurt yourself.

When making this version of the PPT, I deliberately did not include too many obscure academic terms. Each page was accompanied by real-life comparisons of correct and incorrect actions. I also included three cases of patients that I had followed up on before. After all, no matter how much theory I talk about, it is better to let everyone understand at a glance that "this is wrong, and that is the right thing to do." Finally, I would like to remind you that if you practice at home for 2 weeks and the angle has not improved at all or even receded, don’t force yourself to do it. See a professional rehabilitation therapist for evaluation immediately. Don’t practice blindly on your own and turn a small problem into a big one.