What are the common types of joint mobility training

Passive activities, active auxiliary activities, and active activities can basically cover all needs from the acute postoperative period to daily maintenance.

I just picked up a 23-year-old boy last week who broke his anterior cruciate ligament while playing basketball. On the third day after the operation, his legs were so weak that he couldn't lift them at all. His knees were as stiff as a frozen board and could only bend to 30 degrees at most. At this time, he was given passive activities - he didn't have to exert any force during the whole process. It was all about me using joint mobilization techniques to drive the femur and tibia to slide relative to each other, pushing away the adhering tissues little by little, and slowly expanding the range of motion. There are always different views in the industry on the intensity of passive activities. Many practitioners think that the pain is enough to make the patient break into a cold sweat. Some recent studies have pointed out that violent leg stretching beyond the tolerance level will stimulate the leakage of tissues in the joints and aggravate adhesions. In the hundreds of cross-exercise cases I have handled, the intensity is generally controlled to the level of slight acidity and swelling that the patient can tolerate, and the probability of rebound in mobility is much lower. Not only post-operative patients, but also the family members of hemiplegic bedridden elderly people help lift their arms, turn their shoulders, and move their ankles. These are also passive activities, specially used for people who are completely unable to exert force on their own.

When your muscle strength slowly recovers and you can exert your strength on your own, you don’t have to rely entirely on others to guide you. Let’s talk about that young man again. About two weeks after the operation, his quadriceps muscles have been able to tighten normally. He can bend his legs to 60 degrees while sitting, but he can’t exert any strength any further. At this time, I will give him a hand when he is approaching the limit of the current angle and add a little more force. Help him push an extra 5 to 8 degrees. He will provide 70% of his own strength and I will make up 30%. This is an active assistance activity, which is equivalent to the hand holding your hand when you are learning to walk. It not only exercises your own muscle strength, but also prevents you from failing to achieve the training goal because of insufficient strength. When many people do shoulder exercises at home, they find it difficult to lift their arms due to pain. They use the unaffected hand to pull the affected arm upwards, or use elastic bands to assist in pulling and moving. These are all types of training, and are a necessary training method in the transition stage from passive to active.

Once your muscle strength and range of motion have recovered to a certain level, you can completely let go of the assistance. When the young man came for a follow-up examination one month after the operation, he could sit by the bedside without anyone's help. He could easily bend to 90 degrees and walk without wobbling. This kind of movement that relies entirely on the force of one's own muscles to drive the joints to complete a full range of motion is active movement. The shoulder wraps and ankle pumps that we usually do when we stand up after sitting for a long time, and the non-weight-bearing joint warm-up before exercise all fall into this category, and are also the most commonly used daily methods for ordinary people to maintain joint flexibility.

In fact, these three categories can be easily applied to our daily shoulder and neck problems. If you are just a little sore after sitting for a long time, stand up and shake your arms to turn your shoulders, that is active activity; if it is so painful that it is difficult to lift your arm, you can use the other hand to help lift it up, which is active assistance; if the frozen shoulder is so severe that you cannot lift your arm at all, and you have to rely on a rehabilitation therapist or family member to help move it, that is passive activity. You don’t need to use a hard-on type, just the one that suits you. I treated an aunt in her fifties before. When she first developed frozen shoulder, she followed the tutorial on the Internet and shook her arms vigorously. Originally, she only needed to do passive loosening, but she ended up carrying the pain and doing high-intensity active activities, straining her rotator cuff. It took her half a year to recover. When in doubt, it is best to seek professional evaluation first, and don’t practice blindly.