Poor Mobility and Injury Risk
I’m fascinated by the human body, its unlimited potential and resiliency to injury. However, one of the main factors undermining resiliency is a lack of mobility. Mobility refers to a joint’s (ankle, knee, hip etc.) ability to access its entire available range of motion without restriction or compensation from local or regional muscles and/or joints.
Take the hip, for example. Optimal hip extension is around 15°-20°. That means your leg should be able to move behind your body 15°-20° without movement of other joints. In contrast, sub-optimal mobility would be anything less than that. Signs of less than optimal mobility would be excessive arching of the lower back, rotation or side-bending to the side of the moving leg or failure to keep the leg completely straight when walking.
In a perfect world, each joint in our body should be able to move throughout its entire range of motion. Optimal mobility allows the muscles crossing these joints to function with improved efficiency and strength. When mobility of a joint is lost, the human body compensates by forcing other nearby joints to move more. The human body will get the desired movement completed even if it sacrifices integrity and quality. Restoring mobility to the affected joint will (more times than not!) improve symptoms such as pain, decreased strength and stability!
Revisiting the earlier example, the lower back is the next area in the body chain that is forced to compensate for the loss of hip extension. It does so by extending itself, enabling more motion to occur at the lower lumbar vertebrae than normal. Over time, due to the accumulation of micro-trauma to the local tissues, the lumbar spine can begin to become painful. This sets in motion a vicious cycle of compensatory joint and muscle reactions to maintain function and equilibrium. I liken it to the old phrase, “Robbing Peter to pay Paul.” The body “robs” the lumbar vertebrae of some of its motion (in actuality, forcing it to do MORE) to “pay” the hip for its lack of extension. This can be acceptable in the short-term, but is not a long-lasting solution. Especially if that solution involves pain-free movement! Restoring proper hip extension mobility is the key to reducing excessive stress on the lower back, breaking that cycle of compensation and getting out of pain!
The same principles apply for most, if not all, of the joints of the human body. That’s why the painful region may not be the location of the solution. For every joint that doesn’t move enough, there is a joint nearby that is moving too much. Too little or too much movement creates dysfunctional muscles, perpetuating the cycle! Finding a skilled movement professional who understands these concepts is crucial to getting out of pain.
As the “Human Performance Mechanic,” its my job to recognize asymmetries, address them and provide long-lasting and permanent solutions to pain. In the current example, this may mean targeting the hip muscles with manual therapy to loosen them up prior to mobilizing the hip joint. I tell this analogy to my clients to help them understand the complex relationship between mobility and compensations that arise contributing to pain:
“If we’re talking about relating our body to corporate infrastructure, the joint is ‘mid-level management’ and the muscles that cross said joint are ‘low-level employees’. The joint provides information to the muscles in a top-down fashion, leaving the muscles crossing the joint to react to what the ‘orders’ are. ‘Low-level employees’ reactions can include increasing tone, giving the feeling of ‘tightness’ and ‘cramping’ commonly reported with reduced mobility. Both the joint and the muscle are underneath the ‘CEO’, the brain. The brain not only receives feedback from the muscles and joints, but is capable of giving ‘orders’ to either, showing its place at the top of the proverbial corporate infrastructure. When there is a lack of mobility in one joint, the ‘CEO’ will look to see what other ‘mid-level management’ is available to accomplish the objective. This command is given without consideration of the long-term consequences.”
Return to long-lasting pain-free movement requires addressing the entirety of the “corporate infrastructure”. If a significant change is required, it has to come from the top-down! That’s why its important to strive for optimal joint mobility because it keeps the entire “infrastructure” in homeostasis. Without adequate mobility, the ‘low-level employees’ get conflicting orders (think increased tone compared to normal, further reducing joint mobility) and the ‘CEO’ has to deal with the fall-out!
This is the reason why I do a full-body mobility screen with everyone that sees me (except for post-operative management). The screen serves two purposes – I can look at the area in pain and determine if mobility is restricted as well as pre-emptively addressing areas lacking mobility that may be causing stress but are not yet causing pain. From the full-body mobility screen, I get a ‘big picture’ view of the client’s movement resulting in a more comprehensive and systematic treatment plan. With a full hour one-on-one with my clients, I have enough time to address both local and regional mobility deficits and get them pain-free faster than traditional care.
In summary, a lack of mobility is a problem that can manifest itself as pain in other regions. Its not uncommon to have knee pain as a result of a lack of motion at the ankle, hip or back. A full, comprehensive assessment and intervention plan to address a lack of mobility will improve resiliency, reduce or prevent future injuries and get you back to experiencing the joy of pain-free movement!