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Appropriate Actions for Mobility

by Dr. David Williams

Published 04/30/09

One of the more common areas for joint problems is the shoulder. As one becomes more sedentary (couch potato might be a better term), very often he or she no longer performs motions that require raising the hands and arms above the head. This lack of movement results in areas of the "sponge" that don't get the opportunity to dispose of waste material or receive needed nutrients. In turn, hyaluronic acid and lubricin levels decline. In these areas, the cartilage begins to deteriorate. It can eventually roughen and thin to a point that the person experiences a grinding sensation as well as stiffness and pain.

(Although joint surfaces may not have a blood supply, the joints themselves have a very rich nerve supply. The vast number of nerves allows the body to precisely determine exactly the position of each joint in the body, which is essential for standing, walking, picking up objects, et cetera. Unfortunately, this also makes us acutely aware of any inflammation, swelling, or damage to our joints.)

The first order of business for maintaining healthy joints is to move each one through its complete range of motion (ROM) several times every day. The ideal time is in the morning. This will help preserve your joints as well as help get rid of the stiffness most of us experience.

Stiffness is actually a normal phenomenon. At all the nerve endings in joints, muscles, and tendons there are sensors called proprioceptors that constantly provide information about joint angle and muscle length and tension so that your brain knows the body's position. If you stay in one position for an extended length of time (sitting, sleeping, et cetera), your nervous system doesn't get any new information-so it begins to tighten your muscles as a protective measure. Moving your joints through their ROM first thing in the morning wakes up these proprioceptors and resets your nervous system for the day's activities-which is why mobility exercises can have such profound effects on your overall wellness, particularly when it comes to joint health.

With inactivity, not only do the joint surfaces begin to suffer, but the ligaments and connective tissues that support joints will also begin to shorten and adapt to this inactivity. It used to be common for doctors to prescribe complete immobilization of an area for months after a fracture. After the cast was removed, it often took several months of additional therapy just to be able to straighten the area on the body where the broken bone was located. During the inactivity, the supporting connective tissue shortens to support the new joint's position. The same thing happens when you continually fail to move the joint through the ROM.

Strangely, there hasn't been a lot of published material that focuses on mobility exercises or ways to take your joints through their full ROM. Volumes have been written on stretching, which actually has to do more with muscle flexibility than it does with joint mobility. With the mobility exercises I'm going to describe, you may not even feel much stretching. Keep in mind that this is perfectly okay. Again, what we want to do is put each joint through its normal range of motion. It's not necessary to become a circus contortionist.

(If you have past joint injuries, it may require some gentle stretching and persuasion to regain your full range of motion. Scar tissue from old injuries or surgery will create adhesions and shrinkage of connective tissue. Some people have used Rolfing or some other form of deep-tissue massage to get rid of adhesions.)

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