Flexibility- when more is less

Posted on March 26, 2018

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(Last Updated On: March 26, 2018)

When it comes to dealing with chronic issues flexibility is almost reflexively gone to as a solution. Knee pain, shoulder ailment, annoying hip, aching foot, irritated back.

“Stretch!”

But we never think this when it comes to acute issues….

Let’s work our way up the body with some of the most common acute injuries.

 

Ankle sprain

What happened to Steph’s Curry ankle here?

steph curry turning his ankle GIF

It moved too much! In fact, what do we often do for someone with chronic ankle sprains?

Stephen Curry ankles close up full ankle tape job

We brace and stabilize them. We try to stop movement. We don’t want the ankle to stretch like Curry’s did.

Torn anterior cruciate ligament (ACL)

Do we want a knee to move this much?

ACL injury knee valgus turning in

In effect guillotining the ACL:

acl injury animation

Or the ACL might get pulled on too much, causing rupture in this fashion:

ACL injury animation

What happens in a knee with a torn ACL? It becomes too lax. We put a new ACL in there to decrease flexibility.

Knee sprain

Let’s pick on Curry again. His knee:

Steph Curry knee sprain

You don’t want your knee moving that far!

Tommy John (torn ulnar collateral ligament (UCL))

Here is a torn ulnar collateral ligament:

torn ulnar collateral ligament elbowWhich is on the inside of the elbow:

location of tommy john injury

An area baseball pitchers stretch a whole lot when throwing (the hand goes way behind the elbow):

External rotation pitching

Humeral retroversion. (From: http://sph.sagepub.com/content/1/4/314/T1/embed/inline-graphic-3.gif)

From: http://sph.sagepub.com/content/1/4/314/T1/embed/inline-graphic-3.gif

It’s like a rope or cable. Pull on it enough so it gets worn down, then really pull on it to stretch it again, and one day, pop. This is why Tommy John really only happens in pitchers and not position players. Position players aren’t pulling on that area as much. They aren’t throwing nearly as hard, as often.

In other words, they aren’t stretching their UCL as much!

Shoulder Dislocation

We want the shoulder to be mobile, but not this mobile!

Credit: http://www.moveforwardpt.com/image.axd?id=05c9e74f-a2f9-4e3c-b504-f354f6cd7648&t=634638776985670000

Credit: http://www.moveforwardpt.com/image.axd?id=05c9e74f-a2f9-4e3c-b504-f354f6cd7648&t=634638776985670000

What’s the rationale behind most people getting surgery for recurrent dislocations? To “tighten” their ligaments. Or to make the joint deeper and more snug, so the shoulder can move less.

Any broken bone

One side of this guy’s arm got pushed too far compared to the other:

broken arm from arm wrestling gif

The terminology we use

  • “I turned my ankle.”
  • “She rolled her ankle.”
  • “Look at how their knee twisted.”
  • “His knee collapsed.”
  • “The shoulder popped out of place.”
  • “The ligament tore.”
  • “The tendon ruptured.”
  • “The muscle ripped.”
  • “Their bone fractured.”

And the favorite:

  • “I strained….”

All of these mean a structure moved too much. When you stress an area it deals with a force. But it’s not until it strains that it moves. Tug on a stiff rubber band without it stretching and it’s being stressed. Once the rubber band starts stretching though, it’s straining.

So when you strain an area you are quite literally saying “I moved an area too much.”

In many cases chronic issues are no different. They are the result of an area moving too much. The difference being rather than the knee full on collapsing, it might be doing so marginally. Rather than doing it all in one fell swoop, it’s doing it a little bit, with less force, on a regular basis. Hence it’s not as painful as when you blow your knee out. It’s perhaps 30% of that, but on a consistent basis.

Rather than the shoulder full on dislocating, it’s protruding continually. It’s not completely out of place, but it goes a little out of place, often.

While some flexibility can help chronic issues much like it can acute issues -e.g. a muscle which is more flexible might be able to strain more without tearing compared to a really stiff muscle- it’s not typically where you want to place your focus. To help a joint better handle being pushed out of place you don’t really want to be practicing putting the joint out of place. You instead want to be doing the opposite. Get the joint good at not moving out of place to begin with.

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