What Exercise Should You Focus On To Ease Pain – Mobility or Stability?
Dr. Jonathan Ruzicka
Are You Feeling Stiff?
Need more mobility, right???
The common thought is you should stretch more OR do some complex yoga move that will loosen up the right areas…
Andrea came into the clinic less than a month ago and she was complaining of dizziness with neck pain. She had neck pain on and off for the last few years, but only recently did it get bad enough for her to start seeking out help from a specialist.
The first Physical Therapy clinic she went to had her do a series of stretches in the morning. She told us that her pain was worse after doing them but that was the plan she was given, so she kept doing them, ahhhhh!!!
We went through all of the stuff she was doing at home and talked about why she would want to do them and why she wouldn’t…
We threw out 80% of the previous plan and she is now pain free after 3 weeks. We should never do exercises that increase pain, never. If they do then we need to walk away and reevaluate if they the right exercises for us or if they need to changed/modified to be beneficial.
In this situation, she was told to do these exercises and she showed me the 5-page printed out list!!
It seems like a tight muscle or a stiff joint should be stretched but that’s not always the case. (rarely is it the case)
A lot of people come in and they want to know what stretches they can do so that they’ll feel better but most of the time stretching isn’t the most important aspect of their rehab.
There is a tug of war between mobility and stability!!
Which Do You Need First?
Are they having problems with their mobility or are they having problems with their stability? What if they are having problems with BOTH?
If we’re extremely mobile in our joints, then a lot of times they’re going to move too much, so we need to make sure that we create stability in those joints to keep them from getting hurt.
There are two things that can happen.
- 1) We will get really loose in our joints and we are going to be able to move them too much; that will cause problems with compression, sheering and some of the joints can pop out of place. If the ligaments become loose, then joint capsules will start to wear and cause a lot of pain.
- 2) The other thing that can happen is when we have too much mobility or we don't have enough stability in the joint, then our muscles will tighten up around it. If our muscles tighten up around it, then most of the time we will be constantly stretching to relieve the tightness.
With both of those situations it’s a weakness problem!
Weakness in the muscles is a stability issue but ultimately it will lead to a problem with joint mobility too.
If we don’t use muscles, then they will get weaker over time and after the age of 50 our average muscle loss is 1% per year. Weak muscles get stiff because they are trying to maintain joint stability… if we are constantly stretching them they will always be irritated.
Rarely do people that have never exercised, “want to exercise”, but a few modifications to their daily activities and a few minor strengthening movements can make all the difference in pain AND Quality of Life.
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