As much as we like to believe we can train to prevent injuries, it is more realistic to understand that we can only train to minimize the damage when injuries actually do occur.
There are some great tools out there that can identify asymmetries, mobility, stability, balance deficiencies, and incompetent movement patterns, but just because we can correct those in a controlled environment, doesn’t take away the external factors involved in sports, work, and life...such as that patch of ice under the snow, the unexpected tackle, or that quick reach to grab your child on the swing.
So when we talk about training for injury prevention – which should be fundamental in any training program and in the return to work/sport/life phase of any injury rehabilitation - we still need to think about training structures of the body independently.
We should be able to flex, extend, and/or rotate at EVERY joint in the body to varying degrees, depending if it’s your toe, ankle, knee, hip, spine, shoulder, etc.
A few examples:
- Your lumbar spine should be able to flex 40-60 degrees, with movement between each vertebrae
- Your ankle should be able to dorsiflex 20 degrees (toes to shin)
- Your shoulder should be able to flex 180 degrees overhead without your chin poking forward or ribs flaring.
No matter the joint or the direction it moves in, the goal is full range, pain-free, smooth, and non-compensatory movement.
This statement doesn’t mean to start forcing a toe touch, doing exercises with a rounded back, or straining yourself to get into a flexed position, but rather work - ideally with guidance by a professional! - to build that independent segmental mobility at all joints, after figuring out what your body actually needs.
We often hear that people stretch “all the time”, but don’t see progress. Maybe that’s because it’s the joint, not the muscles that need the help!
All tissue in the body is made up of various types of cells, in different ratios, depending on what that tissue needs to do. All of these cells will respond to any type of force – external (manual therapy provided with a specific intent by a clinician) or internal (movements, active muscle contractions). When this load/force is put into a tissue, that tissue is going to adapt, and produce more quality tissue. After an injury, scar tissue continues to be formed and laid down for months – the earlier in rehab stages you can start guiding that (aka Day 1), the better - even if it’s indirect to the surrounding segments or directly with small range specific joint circles or manual therapy. Even if you aren’t specifically trying to
rehab something, that regular force input will continuously remodel tissues, and they will become more resilient.
To increase tissue health, joints need to be prepared. This means that they need to be moved through a full range of motion, on a regular basis.
A great example of this is what we call, "Controlled Articular Rotations." By emphasizing blocking compensatory movements in every other segment and joint, and isolating the target joint to move to the end of full or pain-free available range of motion, we get numerous benefits, including: increased blood flow, increased joint fluid resorption, tissue remodelling, affects the joint capsule, We start this with unloaded movements in pain-free ranges, then progress to various forms of tension and load, weight-bearing and non-weight bearing.
Then we can train for Positional Awareness – can your tissue respond in a shortened or lengthened position? And by “respond” we don’t mean that you’ve taught your nervous system how to avoid that position or pull yourself out if it. We mean have those tissues adapted over time, to be able to accept force in that position.
If they have that capacity, there will be minimal tissue damage when you are inadvertently put into that position. If the tissues haven’t adapted, and load exceeds capacity, injury and tissue damage will occur. This process begins with graded intensity isometrics, then progressing to dynamic exercises at those end ranges.
In this respect, we should briefly address posture. The “bad postures” are any posture that is prolonged. Every day we want to move each joint through it’s full range of motion. Not only for the benefits already outlined, but also as a self-assessment tool.
As your joint moves through their full range of motion, we want to look for pinch points and discomfort vs stretching/pulling sensations. If you have recurring pinch points, that’s an indicator to adjust your workout accordingly, and consider seeking further investigation.
It doesn’t mean completely stopping - continue your activities in the pain-free range is generally ok (assuming there was no traumatic injury!). Just “slice off” the part of the circle that causes discomfort.
Try to start getting into a self-assessment routine, to take control of your joint health.
Discuss these findings with your coach or therapist to make necessary modifications, get suggestions on how to work through it on your own or when a referral is necessary.
photos by Marissa Naylor Photography