What are the common types of joint mobility training?

Currently, the core joint mobility training commonly used in clinical and daily rehabilitation is divided into three categories, namely active, passive, and assisted joint mobility training. The various derivative trainings on the market are essentially adjustments or combinations of these three categories.

Many people first come into contact with this type of training when they are just recovering from surgery or trauma: for the first three days, patients who have just undergone knee replacement have their legs too soft to lift, and they are too painful to exert force. The rehabilitation therapist holds the ankle and helps to slowly bend and extend the legs. This is passive training. It relies entirely on external force to drive the joint movement. The patient does not need to exert any force. The main function is to prevent joints from being immobile for a long time and causing adhesions. After all, joints that have not been moved for a long time are like hinges that have not been opened and closed for a long time. If they are rusty and try to open them again, they will suffer.

After three to five days of recovery, the patient's muscle strength will gradually return a little and the pain will lessen, so he no longer needs to rely entirely on external force. At this time, the rehabilitation practitioner may hold the calf to provide some strength, and the patient himself may try to use force to bend the legs. This kind of half-relying on external help and half relying on self-strength is called power-assisted training. Many patients with paralyzed upper limbs after stroke will use slings to lift their arms to offset gravity in the early stage of recovery. In fact, it is also a kind of power-assisted exercise. It does not put too much burden on the joints and allows the muscles to slowly regain the memory of exerting force.

When the muscle strength recovers to the point where it can autonomously drive the joints to complete the full range of motion, it can be switched to active training. For example, about two weeks after knee replacement surgery, the patient slowly bends his legs while sitting on a chair, and actively raises his legs while lying down. These movements all fall into this category. They rely entirely on their own muscles to drive joint activities, which not only maintains joint mobility, but also simultaneously strengthens muscle strength, which is the core training content for subsequent return to normal life.

There are some disagreements about this classification in the rehabilitation circle. For example, one group believes that the static stretching and joint circling that ordinary healthy people do every day can also be considered as active joint mobilization training. The other group insists that stretching mainly affects muscles and tendons, and joint mobilization training focuses more on the activities of joint capsules and surrounding connective tissues. The two cannot be confused. In fact, ordinary people do not need to worry about this classification. As long as the joints move smoothly and there is no tingling after the exercise, it can play a maintenance role.

I met a young man who had a sprained ankle a while ago. When removing the cast, he had trouble even hooking his foot up 10 degrees. For the first three days, he relied on passive movement to loosen the adhesions. After a week, he switched to elastic bands for power-assisted training when he could gain some strength. After two weeks, he was able to complete a full range of hooking and stepping movements independently. Within a month, he went back to play amateur basketball. Choosing the right type of training at different stages can help speed up recovery.