Mobility Training

Mobility may be a bit confusing but I want you to think of it as your ability to move. Your ability to move is having the requisite joint range of motion(ROM), flexibility of tissues comprising and surrounding the joint(s) and the general strength (or stability and motor control) to move through a ROM as would be needed for a given sport.  All joints have normal range of motion but also have a requirement for a creating functional ROM given the type of movement needed for that tasks. Take a softball catcher for example, she has to not only bend her knees to a full maximum ROM but also have the ability to dorsiflex and pronate her ankles with flexion and rotation her hips to achieve the required ROM of the position played aka a “catchers squat”. This may be quite different than the individual who plays a sport such as golf which does have those similar motions but maybe not to the same extent.

The Benefits of Mobilization Training

1. Injury Prevention & Joint Health: One of the biggest things I see in the clinic is a patient who comes in with neck, upper back and even low back pain and who sits for a large portion of their day. As we live in a world that progressively uses computers and cell phones and as we live in a post COVID world where we seemingly no longer need to be as active within our jobs as “it can be all done online” we becoming more and more glutted to as screen. The problem is that the human body does not like to be stuck immobile for that long. The human frame was built for movement and as we sit at a desk for 4-8 hours a day without a mobility break, our mechanics and tissues begin be break down. As we sit for this long, our thoracic spine begins to flex further forward which can actually decreased the requisite overlap of the myosin-actin chains of our muscle units. This means we get weaker in our back muscles. To counter that, we get increased overlap of these chains on the front of our torso leading to tightness. This can eventually lead to myofascial pain syndrome, altered shoulder mechanic thus shoulder pain, a forward head posture which can lead to improper head movement, thus headaches, jaw pain, and even nerve pain.

2 .Pelvic floor, The Core, Breathing Mechanics: The ability to move and stack our rib cage over our pelvic is a key element to begin able to generated proper pressure from which to operate as an athlete. The core muscles include: the diaphragm, our primary respiratory muscle, the transverse abdominus, the muscle who has a key role in becoming support, the lumbar multifidi, the muscles that play a key role in lumbar support and the pelvic floor muscles, the muscles that play a key role in holding and controlling the above abdominopelvic contents. The collection of these muscle provides our ability to generate power, expel solids, liquids, gases, and biological objects from our body and they all work in tandem to help use operated from a place of stability. However, just like anything else, they too have a needed range of motion. If too tight, pain can be felt and general function such as normal breathing, pelvic pain, hip pain, back pain, and general dysfunction can occur.

3. Quality of Life: Have you ever seen someone who simply could not bend over to tie their shoes? Unable to get out of bed? Get off the floor? Get off the toilet? Reach for something overhead? Some of these can be linked to injury, lack of strength but in many cases it is linked to the simple inability to move a body part through its needed ROM due to tissue stiffness or lack of joint range of motion.

When to Mobilize:

When preparing for a workout, sport game or event, we want to structure that workout or event in such a manner that we prepare the tissue(s) for the demands of the sport or in such a way that we are able to take advantage of the increased body temperature which can help improve range of motion due to an increase in the elastic properties of the collagen within the muscles and tendons.

Types of Mobilizations

1. Joint Mobilizations: These are typically done by a physical therapist and can be graded from 1-4. Each with a different intention can help reduced pain and or improve the joints ability to move through space. A grade 5, typically a quick thrust mobilization, which more often is completed by a chiropractor. This type of mobilization, can have neurophysiologic effects on pain.

2. Soft tissue Mobilizations: Can be in the form of massage therapy or in physical therapy. Here we are creating pressure and/or stretch to the skin, fascia, or muscles in a way that can have pain modulating effects, promotion of tissue healing, or in the effort to reduce swelling or edema.

3. Stretching: There is Hold Relax, Contract Relax, Static, or even Ballistic. The first three can help improve joint range of motion and are more common in the therapeutic realm. The last, ballistic, is typically discouraged however may be implemented as a part of plyometric training.

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