In my previous post, I wrote about Joint Mobilizations and how great the course was. It reminded me of the important of what lies beneath the musculature. It is an essential tool for helping to determine why the muscles tighten in the first place. It is important that we look past just releasing the muscles to find underlying causes to help to good prevention strategies.
To review, a joint is the point where a moving bone attaches to another bone. Good examples of this are the shoulder joint, where the arm bone attaches to the outside of the shoulder blade, the hip joint where the leg bone attaches to the pelvic and the spine, which consists of 31 vertebral bones stacked on top of each other with a gelatinous disc between each. Whether it is a wrist/ elbow/ shoulder joint or a hip//knee/ankle joint or spinal joint, where is an inherent about of motion for each. We have evolved to a place where each joint in our body must move a certain amount. If that motion is limited the effect can be muscles being overworked or weakened, nerves may be compressed, tendons may be impinged resulting in reduced range of motion and/or pain.
As a result of the above, one of my primary treatment philosophies have evolved into simply assisting the joints in the body to achieve their full range of motion. That makes a body happy. If you have a sore shoulder, I look at reducing your symptoms but also determine if any of the joints in the shoulder complex are not functioning to their full capacity. The bones that move in the shoulder complex include the upper arm bone, the shoulder blade, the collar bone and the ribs surrounding the shoulder blade the upper 3 vertebrae of the midback. All of these must be functioning to assure that the shoulder can move fully and freely. This can apply to any joint from the feet to the top of the head. I have found that most of my success in treating pain, weakness, overworked muscles, nerve compressions come from just allowing the body to do what it can’t. Once it can do this, then it’s capacity to heal improves dramatically. Any correction of a joint done in a treatment will tend to last for a while but exercises are also given to maintain and improve the effects from the treatment. It’s the importance of including the patient in the treatment so they understand why the symptoms are occurring and empowers them to be part of their success.
With improving the function of the spine, I have found my greatest success is using a more Osteopathic approach. Without the surrounding soft tissue (muscles/ ligament/ fascia) the spine would collapse so it’s integrity, function, strength and position is determined by the tension of the surrounding tissue. So we look balancing the tension of the tissue that surrounds the spine and ensures that there is proper support available for it. The Osteopathic approach has been so good on this level in that is so gentle yet effective.
Allow the body to move as it is designed to do. Be strong, mobile and your body will be happy.
I took a really good course last weekend that covered Joint Play. This is a really important part of everything from injury prevention to rehabilitation. A joint is the place where two bones meet and one of the bones moves around the other in it’s intended range of motion. A great example is the shoulder joint. The main shoulder joint is where the top of the arm bone attaches to the outside of the shoulder blade. As the arm moves around the socket at the outer part of the shoulder blade, there needs to be small motion that occurs inside the shoulder joint. That is the joint play. If the end of the arm bone is the ball and the edge of the shoulder blade is the socket, good joint play range of motion ensures that the ball stays within the socket space no matter where the arms moves to. If that small motion isn’t there, the arm movement will stop and reach the end of it’s range prematurely and can mimic Frozen Shoulder. It’s like a hinge in a door that doesn’t move well, so the door doesn’t close. It feels like it catches or pinches causing local shoulder pain that can begin to travel causing neck, rib pain and headaches. A lot of my success with treating the shoulder is just returning that small essential motion in the joint. These small motions can occur in the jaw (TMJ), the spine, shoulders, elbows, wrists, hip, Sacroiliac joint, knees, feet to name a few. Each of these joints have their own movements and often any limitations can be restored. The treatment for restoring joint mobility is a little different from standardized massage therapy as the treatment is very regionalized but I feel like it is such a crucial part of getting to the cause of dysfunction/discomfort. There is always treatment to the surrounding muscle tissue, especially the symptomatic one in addition to the joint play treatment. I remember one teacher saying that if you have a painful/tired muscle, look to see what joint they move. For example, if you have a sore biceps muscle on your arm, I look at the shoulder and elbow movement. If someone has a sore front leg muscle, I look at the hip and the knee joint. It’s not well known that the ribs are also very mobile during torso and arm movement and breathing, and in our society, the ribs are commonly stiff and can benefit from mobilization. Very often, I have found that treating just the tight muscle may feel good for a shorter period of time, but can return if there is an involvement in the surrounding joints.
Having said all that, there is opportunity for pain to refer away from where the joint is not functioning properly. Neck joints in the spine can cause pain down the arms or produce headaches. Low back spine joints can refer pain into the hip or down the leg and mimic Sciatica. A stiff joint in the foot can produce pain that goes up the leg. There is a thought out there that you find the pain but look for the cause elsewhere.
Having joint play in my treatment tool box has vastly reduced pain and dysfunction with patients, increasing functionality and improving daily activities. It is a gentle treatment and follows with the Osteopathic process, which often reveals very good results. Be gentle and the body will let you do more. As always, the patient’s success is partly what we do in the treatments, but just as much, it is important for the patient to be involved so they can continue to improve at home with stretches, exercises and movement/posture changes. It continues with the philosphy that we were designed to move a certain way and very often dysfunction can occur when we don’t.