Precautions for joint activity training

First, the current physiological activity limits of the joints must not be exceeded. Second, acute periods of inflammation and injury must be avoided. Third, all movements must be consistent with one's underlying disease and old injury history. All other detailed requirements are essentially an extension of these three items.

I have been working in rehabilitation for almost six years, and I have met too many patients who have stepped on these three red lines. The one that impressed me most was a young man in his early 20s last summer. In order to practice yoga, he forced the instructor to sit on his crotch and press him. He heard a "click" in his crotch on the spot. Later, the MRI showed that the acetabular labrum was torn. It took him half a year to walk normally. Many people think that joint mobility means "forcing yourself". In fact, this completely contradicts the logic - the upper limit of joint mobility is jointly determined by the bone structure, surrounding ligaments, and muscle tension. No matter how hard you press a person with a naturally deep acetabulum, you cannot split a horse as low as a person with a naturally shallow acetabulum. The result of hard work will only be soft tissue wear and even structural damage.

When it comes to whether there is pain during stretching, there are actually two voices in the rehabilitation circle. The traditional massage school often says that "pain means there is no way", and it is believed that stretching can only relieve pain when there is pain. Many experienced rehabilitation practitioners break the joints of patients with postoperative adhesions. The patients are sweating from the pain, and the effect is indeed good. ； However, the current mainstream sports rehabilitation view advocates the "pain-free principle", that is, there should be no more than 1 point of pain during the entire training process (out of 10 points, 1 point is counted as soon as you can feel the pain), and as long as there is pain, the intensity should be reduced immediately. In fact, both statements are correct, but the applicable groups are completely different - the former is only suitable for patients who have already developed joint adhesions and contractures, and must be operated after evaluation by an experienced operator, while the latter is the golden rule for ordinary people's daily training. Don’t just follow a rehabilitation blogger who says, “Pull until it hurts to be effective.” The people it’s suitable for may be patients whose knee joints can only bend to 90 degrees three months after surgery. It’s not the same thing as you, an office worker who sits for a long time and wants to relax his crotch.

When practicing joint activities, many people always think that "the bigger the range, the better". Some people like to compare themselves with the people next to them. If you can turn your shoulders 180 degrees, I will turn 200 degrees. They completely forget whether they have any old injuries. Last week, an aunt in her fifties came to me and said that her shoulder had been hurting for half a month and she couldn't lift it up. After asking, I found out that she practiced "shoulder throwing skills" with the fitness team in the community. Others can throw her back to touch the ear on the opposite side. She had an old injury of periarthritis of the shoulder and she just followed it, which directly pulled out the edema in her rotator cuff. Here is another warning: you must not move blindly during an acute attack of inflammation. Whether it is the painful period of gout, synovitis, or frozen shoulder, the soft tissues around the joints are already in a state of edema and congestion. If you move to a large extent, it will only aggravate the inflammation and infiltration. The problem can be cured in a week, but if it becomes chronic pain, it is not worth the gain.

Oh, by the way, there are also the effects of basic diseases that are easily overlooked. For example, elderly people with osteoporosis should never do that kind of drastic bending, shaking their necks, or pressing their legs. I once met a 68-year-old man who pressed his legs during morning exercises. When he pressed down hard, he fractured his femoral neck. He lay down for more than three months without fully getting off the ground. There are also patients with rheumatoid arthritis. Joint mobility training can only be done in a small range within the pain-free range that they can bear. Don't force it, otherwise it will easily accelerate joint deformation. People always ask me if it is good for the cervical spine when I turn my neck and crack it. In fact, it is the sound of the negative pressure bubble bursting in the facet joints of the cervical vertebrae. It is fine if I crack it occasionally. If I crack it deliberately every day, it will easily cause the joint capsule to loosen, which will make the stability of the cervical spine worse and worse. Don’t look for trouble for yourself because of that little pleasure.

In fact, after all is said and done, joint mobility training really does not have so many fancy requirements. The core is not to compete with your own body. If you feel comfortable during practice and your joints feel relaxed after practice, then you are right. ； It hurts so much that you grit your teeth during practice, and if it hurts for several days after practice, it must be something wrong. If you're really not sure how to practice, find a reliable rehabilitation practitioner for an evaluation. It doesn't cost much, but it's better than spending tens of thousands on surgery after you get injured while practicing blindly, right?