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Joint Mobility: Reader Question Roundup

Posted By Mark Sisson On May 27, 2010 @ 9:00 am In Fitness | 31 Comments

I got a ton of feedback from my series on joint mobility [7]. As comprehensive as I tried to be in my joint mobility series, I couldn’t possibly address every single malady a person might have. In the comment sections, readers discussed their own specific issues with joint mobility or joint pain, and while I hope my general recommendations for overall mobility helped, more targeted, specific advice is needed for targeted, specific issues. I want to help, so here are my answers to some of your questions. Add your own thoughts in the comment board to participate. Thanks, everyone!

Hips

I’m recovering from a hip fracture suffered 18 months ago. Long story short, angulated fix, osteoporosis and post-surgery dvt. I’m trying very hard to regain my earlier active life. I need something gentler to start with. Any thoughts on exercises or anyone with a similar situation willing to share their recovery strategy?

Exercise after deep vein thrombosis is a tricky subject. Most doctors will tell you to avoid exercise, especially strenuous exercise. Anecdotal accounts from places like the CrossFit forums [8] and other exercise communities report success with post-DVT exercise – as long as they avoid pain (and swelling, and anything symptomatic of more DVT). This study [9] (membership required for access) seems to suggest that post-DVT exercise isn’t harmful, and it may even be beneficial to patients looking to resume pre-DVT activity levels. “The results suggested that higher physical activity levels at 1 month may be protective against worsening of the PTS score over the subsequent 3 months.” I wish I could be more specific with exercise recommendations, but avoiding pain is always a good place to start. Good luck!

I have very “tight” hip flexors. Every time I do these exercises (even just the front-to-back swings), I end up with intense pain from my hip to about halfway down my quad. It hurts for several days. Do I work through it?

Sounds like IT band pain. Most IT band syndrome manifests as knee pain, but the band itself extends up to the hip, and if you have tight hip flexors, the pain will reside in the hips and outer thighs. If I were you, I’d focus on hip flexor stretches and IT band foam rolling. For the stretches, try doing deep lunges while letting the hips drop as low as is comfortable (pain-free).

Thoracic Spine

This may sound like a dumb question but- when doing the initial mobility test, does it matter where the pain is? When I do the test, I feel some discomfort but mostly pain in upper arms, especially when my wrists get close to touching the ground.

Yep. That’s a sign of thoracic immobility. Remember, our parts are interconnected and highly interdependent. Immobility in one area manifests as pain in another.

My shoulder width is slightly over 45cm. The foam rollers apparently comes in either 45 or 90 cm length. 90 is just unpractical long. Is 45cm too short for me?

PS: I must say that 45cm seem like a really stupid size…

Spring for the larger size. Move some furniture if you have to. And I agree: 45 cm is a pretty silly size.

Wrist and Ankles

If we’re supposed to be landing with a dorsiflexed ankle during sprinting aren’t we landing with our heels, promoting shock up the bones into the joints? Or is there something more subtle to the form that I’m missing?

Take shorter strides. In barefoot [10] running, you can land dorsiflexed and forefoot first as long as you take shorter strides. Avoid the mindset of longer strides being superior. Remember: running [11] and sprinting [12] aren’t composed of miniature leaps with outstretched legs. You’re pulling yourself along with compact movements.

Thanks Mark, I hope your post tomorrow addresses ankles that have been twisted. I have had some bad ankle twists in the past few years that have left me with poor ankle mobility and prone to more twists.

and

Mark-or anyone else-do you have any ideas? It’s unstable on full heel lifts compared to the left ankle-wobbles in and out-yet the left ankle is the one that I am prone to turning. I’ve done myriad versions of heel lifts, but I don’t think it focuses on the right part. Am I hopeless?

How’s your one-footed balance? Are you still wearing shoes, especially big heavy clunky ones? Work on closed-eye, single foot balance (with both feet, not just the injured one). Do it in bare feet. Try not to use your flailing arms and body weight to maintain balance; instead, focus on “grasping” the ground with your feet and activating your lower leg and foot muscles. Stabilize yourself. Keep doing this until it’s second nature, and your improved foot and ankle proprioception will help prevent any future sprains. Also – learn to function barefoot and stop taping up your ankles (if that’s what you’re doing).

Shoulders

My husband has been dealing with Adhesive capsulitis (frozen shoulder) in both of his shoulders for almost a year now…. But, my husband is also diabetic which seems to play some roll in it but we’re not sure what….

I know a bit. I know that adhesive capsulitis incidence is elevated in diabetic patients. Inflammation also plays a big role in its development. Is your husband taking fish oil [13]? I’d consider upping the dose to around 5-6g per day to reduce inflammation. Maybe add in some glucosamine, chondroitin, and MSM supplements (or drink your bone broth and eat your tendons). Avoid stress, and do what he needs to do to get plenty of sleep. Eat an anti-inflammatory diet – drop all grains [14], excessive starches, vegetable oils [15], and sugar [16]. Another risk factor for adhesive capsulitis is the presence of autoimmune disease, so you’ll definitely want to avoid grains, legumes [17], and anything containing high levels of lectins or gluten [18]. Anything that can increase intestinal permeability and start the autoimmune chain reaction is to be avoided. Hopefully that will help speed the physical therapy process along. Good luck!

how about everytime u do a pull up or sit up and one of your shoulders makes a popping sound over and over like something in my socket is moving? it doesnt hurt at all, but it feels weird and puts me off doing more reps than i want to.

I’ll direct all cracking and popping questions to Steven Low’s excellent article at Eat. Move. Improve.: “Cracking and Popping and Clicking, Oh My! [19]

I have trouble with my arm going numb when my arm is forward. I have front shoulder pain and know that I have a pinched nerve between my 5th & 6th verebrae. I personal train 3 times a week & other strenuous exercises the rest of the week. This shoulder pain is inhibiting me from my full potential as an athlete. looking forward to your articles

C’mon, man! Your arm is going numb on a regular basis, you have a confirmed pinched nerve, your shoulder hurts, and you’re still engaging in strenuous exercise all week long? Take a full week off. Rest, ice, and start taking fish oil if you haven’t already. Explore your range of motion (without weights) and move on from there. Do the shoulder mobility and stability drills [20], and check your posture [21]. Do you slump forward at the shoulders? Do you sit at a desk or hunch over a laptop [22]? Fix that before you start working out again or you’ll truly risk inhibiting your full athletic potential. Good luck, and don’t be afraid to rest!

Mark, thank you! I have messed up my right shoulder twice now and have sort of become gun shy with weights. I stopped wide angle pull ups and military press because my rhomboid section closest to my spine locks up and twitches. I have been doing a bunch more power yoga to try to loosen it, but even that hurts sometimes. I can’t figure out if it’s my AC joint or rotator cuff that clicks. Do you have any suggestions as to what exercises I could do to help loosen it up?

When you do pull-ups, are you engaging your scapular retraction, or are you going kyphotic and letting your shoulders slump forward? Do the former and avoid the latter. When doing pull-ups, visualize your elbows slamming against your ribcage; this will help you engage your back and keep your scapulas retracted. Avoid jerking movements (like kipping pull-ups), which can throw your joints out of balance if you’re not careful or if you’re already lacking in mobility/stability. Instead, work on slower, controlled, more deliberate lifting for the time being.

I hope these answers helped, and if you’ve got any more feel free to hit up the comment section!


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[9] study: http://www.medscape.com/viewarticle/503029

[10] barefoot: http://www.marksdailyapple.com/flat-feet-treatment/

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[14] grains: http://www.marksdailyapple.com/why-grains-are-unhealthy/

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[16] sugar: http://www.marksdailyapple.com/what-happens-to-your-body-when-you-carb-binge/

[17] legumes: http://www.marksdailyapple.com/beans-legumes-carbs/

[18] gluten: http://www.marksdailyapple.com/gluten-celiac-disease/

[19] Cracking and Popping and Clicking, Oh My!: http://www.eatmoveimprove.com/2010/03/cracking-and-popping-and-clicking-oh-my/

[20] shoulder mobility and stability drills: http://www.marksdailyapple.com/how-to-maintain-shoulder-mobility-and-scapular-stability/

[21] posture: http://www.marksdailyapple.com/improve-posture/

[22] sit at a desk or hunch over a laptop: http://www.marksdailyapple.com/sitting-unhealthy/

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