Precautions for joint mobility training

First, choose the corresponding training mode according to your own joint status, control the pain within the range that is tolerable and not tight in the muscles throughout the whole process, and do not blindly pursue the "standard angle". All other details are an extension of these three points.

Last week, I met a 20-year-old college student in the recovery room. He practiced yoga and followed the teacher to forcefully open his shoulders. He had to lift his arms to the "standard position" of 180 degrees close to his ears. He originally had a long-term problem of rounded shoulders. The gap under the acromion was narrower than that of ordinary people. When he lifted it hard, the rotator cuff was directly compressed. It hurt for half a month and it was difficult to even put on clothes. Seriously, don’t believe the nonsense on the Internet about “opening shoulders in 7 days and unlocking full squats in 10 days”. People’s foundations are very different. Some people are born with loose ligaments and can do the splits effortlessly. Some people were injured in their knees when they were young and have scars and adhesions. How can they follow the same schedule?

There are actually two different voices in the rehabilitation circle regarding the ideas of mobility training, and there is no absolute right or wrong. One group advocates "passive loosening first", especially for patients after surgery or long-term plaster immobilization. They believe that external force must first be used to loosen the adhering scar tissue, and then practice strength maintenance. Otherwise, no matter how tight the muscles are, it will be useless if the angle is stuck. ； The other group insists on "prioritizing active activation" and believes that the angle of passive push-out is "virtual". Without muscle control, it will bounce back quickly, and forceful breaking will easily cause new soft tissue damage. My own experience is that the two must be combined. For example, in the first week after the front fork surgery, the cast is removed, and the leg is as hard as a frozen stick, and I can't lift it at all. At this time, I can do two or three professional passive loosenings to help open the adhesions. It's totally fine. ； But if you can already bend your leg to 90 degrees on your own and have your family members press on your leg every day, it will easily tear out the newly grown soft tissue and bleed. Not to mention swelling for a week, and the adhesion will become more serious.

When many people practice, they only focus on the angle of the end, not caring about the stability of the proximal end. This is purely a waste of practice. For example, when practicing ankle dorsiflexion, you force your knees to push forward. Either the knees buckle inward and hurt, or the heels are raised too high. In fact, the root cause is that the soleus muscle of the calf is too tight. You can roll the calf with a foam roller for two minutes, and then slowly press it in the direction of the toes. If it gets stuck, go back and rotate the ankle twice and try again. It is much more effective than trying to force the calf for ten minutes. I have encountered this pitfall when practicing weight-bearing squats before. I had to squat until my thighs were parallel to the ground according to the standards on the benchmarking website. As a result, my hips snapped more and more, causing pain for several days. Later, I simply retreated to my half-squat position without snapping. After practicing the strength of hip abduction for two weeks, I was able to squat to the standard angle without even realizing it.

Oh, by the way, there is also the matter of warming up. There is no need to adhere to the rigid rule of "warming up for 10 minutes". In winter, when the house is cold, the joint capsules and ligaments are as stiff as hard rubber. If you break them directly, you will definitely be injured. You can either jump with a rope for two minutes, or apply a hot water bag to the local area for five minutes, and wait until the joints feel warm to the touch before practicing again. ； The temperature in summer itself is high, and joint mobility is already good. It is perfectly fine to start practicing with light activities. But if your joints are already obviously red, swollen, hot and painful before training, don’t apply heat blindly. Apply ice for 10 minutes to eliminate the inflammation, otherwise the more you apply it, the worse the swelling will become.

Don't listen to the poisonous chicken soup that "painful means effective". What we mean by tolerable pain is the level of soreness and swelling, where you can still breathe normally, and your muscles don’t tighten involuntarily. If the pain is so painful that you can’t help but clench your fists, feel stiff all over, or even break into a cold sweat, that’s 100% a sign of damage. It’s not about “breaking through the limit.” If you really break through, you’ll have to rest for the next half month, but it will be even slower. Don't hold your breath when practicing. Many people's faces turn red when they stretch their legs or open their shoulders. This is especially true for middle-aged and elderly people with high blood pressure, who are particularly at risk. Just grunt twice when it hurts. Don't hold your breath and carry it hard.

Don't sit down immediately after practicing. It's best to do two or three active full-range movements of the joint, and use your muscles to control the newly opened angle. Otherwise, the adhesions you spent a long time loosening will grow back after ten minutes of rest, which is equivalent to practicing in vain. If the soreness and swelling disappear within two hours after exercise, it is normal. If the pain persists until the next day or is even swollen, it must have been exercised. Just reduce the amount and amplitude next time. Don't force yourself to continue training.

In fact, in the past five or six years of working in rehabilitation, I have seen too many people who are eager for success. It should take three months to return to normal, but they have to practice blindly, and they are still not doing well for half a year. A joint is like a rusty hinge. If you forcefully break it, it will only deform the hinge. But if you apply some "lubricant" first - relax the tense muscles, activate the weak stabilizer muscles, and push slowly, it will open smoothly quickly. Really, be patient with your body and it will give you feedback faster.