Basic principles of joint mobility training

First find out the boundaries of your own safety tolerance, and then gradually expand the scope of activities without causing additional damage. Finally, you must serve the functional needs of real life. Any suggestion of "standard progress" and "unified actions" that are divorced from individual circumstances is a scam.

I just treated a 28-year-old patient after anterior cruciate ligament reconstruction last week. I saw in a short video that someone was able to bend his knee to 120 degrees 3 weeks after the surgery. I was so anxious that my wife forced it to break at home. She was sweating from the pain. That night, the knee was swollen even larger than before, and the skin was so hot that it could fry an egg. A follow-up MRI showed that there was leakage all around the graft, which delayed the recovery for a month.

In fact, there are already differences between "radicals" and "conservatives" in the current rehabilitation circle. The American rehabilitation system prefers early weight-bearing and early angle attack. Many professional athletes are on crutches one week after surgery and can return to the training field in six weeks. However, they have a whole team behind them to follow up 24 hours a day, with cold therapy, muscle effect tape, and anti-inflammatory treatment. Ordinary people do not have such conditions at home, and it is easy to overturn if they learn blindly. Many clinical orthopedic surgeons in China prefer to be conservative and let them lie down for a month before moving after surgery.

Don’t listen to the nonsense that “pain is effective”. The safety margin criteria I give patients are particularly easy to remember: During training, there is only soreness and pulling. After stopping, the pain completely disappears within 10 to 20 minutes. If there is no new swelling or tingling when you wake up the next day, then the intensity is appropriate. If it hurts so much that you clench your fists and break out in a cold sweat, or if it still stings every time you exert force after resting all night, then it’s 100% over the line, so don’t take it hard.

Oh, by the way, there are a lot of people who really like to get into trouble and insist on sticking to the standard angle in the textbook. For example, the standard knee joint flexion is 135 degrees. If you practice it to 130 degrees, you will be in a hurry. In fact, as long as you can squat on the toilet, go up and down stairs, and run normally, 130 degrees is completely enough. I once had a 58-year-old aunt. Three months after her knee replacement surgery, the flexion reached up to 125 degrees. However, she had no problem at all when dancing square dances, shopping for groceries, and picking up her grandson every day. There was no need to force the 10-degree bend, but it would easily injure the surrounding fragile soft tissues.

Many people think that joint mobility training is just about changing the angle. This is not true. The angle you create passively does not count. You must actively control it. There was a young man who had his meniscus sutured. His passive flexion had already reached 135 degrees, but every time he squatted down and stood up, he had to hold on to the table. Because he only practiced passive activities, the strength of the surrounding quadriceps muscles did not keep up, and the joints were not stable. Later, he was given two weeks of silent squatting and active squatting control training, and he was soon able to squat on the toilet by himself.

I have been doing rehabilitation for almost ten years, and I have seen too many people who are either afraid of pain and dare not move at all. They end up with joint adhesions and have to undergo surgery to release them, or they try blindly to adjust the deadlift angle, but they are recovering well but suffer secondary injuries. To put it bluntly, this is never about comparing someone's progress faster or having a better angle. Feel more about your body's reaction. Don't compare with others, and don't stick to the standard. After all, the ultimate goal of training is not to get enough angles to shoot a video and post it on WeChat, but to live a good life comfortably, right?