Prevention and rehabilitation from injury involve addressing mobility before strength and balance. Mobility is a prerequisite to strength. When joints, muscles and nerves don’t move properly, we compensate elsewhere. This is when injury can occur.
Imagine trying to shoot a rubber band across the room. If it’s as dense as a tire, it will not go anywhere. It doesn’t have the ability to stretch and load energy. Any strength it has is useless because the structure lacks mobility.
Many people have desk jobs that require sitting for long periods of time. Key muscles shorten throughout the day, namely the muscles in the front of the hip and the back of the thighs. If poor posture is involved, the abs, chest and muscles of the back of the neck shorten as well. These restricted muscles are at risk for injury when they are engaged for other activities like gardening, playing catch with the kids, and playing sports.
Many activities that involve holding a position for a long time can cause muscle imbalance. For example:
Biking in a triathlon. The athlete is in aero position for 100 miles and then moves to an erect posture to run a marathon.
Texting. The front of the neck, elbow, forearm and thumb muscles are held in a shortened position for hours throughout the day.
Carrying a heavy backpack on one arm. This creates long term shortening of muscles on one side of the spine and the hip on the opposite side.
Carrying a baby on the same hip for an extended period of time. As with carrying heavy backpacks, this causes muscles on one side of the spine and the hip on the opposite side to shorten long term.
One of the first things I assess when evaluating a patient is how they move. I look for faulty movement patterns that could cause injury or contribute to a current injury. Then I determine which structures are preventing that motion such as muscle, nerve, tendon, fascia, ligaments or all of the above. Then we set about restoring mobility. This may involve the use of deep tissue techniques such as Active Release Technique, neurological dry needling, and/or dynamic stretching, both passively and actively.
Strength, balance and coordination also come into play once a healthy amount of mobility is restored. More on this in our next post!
About Physical Therapy. Physical Therapy addresses function in daily lives whether it’s our ability to unload the dishwasher, walk without a limp, or run an ultra marathon. Physical therapists work not only with injured patients but also preemptively with patients to prevent injury. This can prevent long periods of pain and time off of sports and work. Periodic PT visits focusing on prevention save time and money on the higher frequency therapy appointments required with chronic injury.
