Thursday, September 10, 2009
A question I often get asked is whether or not someone can exercise around a restriction or limitation in range of motion/movement. Clients/patients and their coaches/trainers often want to simply train around a restricted joint or pattern. Their rationale is that if there's enough muscle around a limited or painful joint, then the muscle will protect the joint from further injury and hopefully take away the pain altogether.
The problem with that logic is that strength training perpetuates and reinforces existing patterns. So if there's a problem with the way a joint moves, strengthening the muscles around the joint might often do more harm than good.
While there are certainly times when a limitation is unavoidable - due to serious musculo-skeletal irregularities like bony outgrowths, implanted hardware, or completely severed tendons - more often than not, such limitations CAN be dealt with successfully.
- When in doubt, refer back to one of the FMS system's mantras - MOBILITY FIRST!
What sort of mobility are we talking about improving here? Active or passive?
- YES. If there's at least passive mobility, then you know that a joint or a series of joints has the ability to move through a range of motion unimpeded. When a joint is restricted, the body tries to create movement somewhere else in the chain. And that's the essence of compensation. When you have neuro-muscular compensations that cause stabilizers to exert their force to create movement and prime movers that become hypertonic (tense or tight) to add stability, the body starts moving in a manner that it wasn't designed for. This, in turn, leads down the road of self-destruction. Exercise starts exerting greater-than-normal shear forces on joints, and that is NOT a good place to be.
What if stretching, foam roller work, and massage therapy don't work?
- Then maybe you need something a little more hands-on to regain range of motion in the locked-up joint spaces.
Sometimes, what a joint needs most, especially a joint with deep intrinsics that are guarding a pathological positioning or movement pattern, is a passive mobilization that a skilled chiropractor, PT, osteopath, or Tui-Na specialist can provide.
After the mobilization, re-check the movement patterns and see if they improve. If the movement patterns improve overall, you've got your answer as far as the efficacy of the approach!
More later... sprinting off to another hectic day!