What does joint mobility training include?

From the practical perspective of clinical rehabilitation and mass sports training, joint mobility training is not as simple as "breaking joints" as everyone thinks. It is essentially a combination of three types of training centered around joint range of motion, active control capabilities, and scene adaptation capabilities. The core purpose is to make joints moveable, stable, and easy to use.

If the joints are compared to the hinges on the door, the first thing to do is usually passive training, which is equivalent to applying oil to the rusty hinges to loosen the strength. You don’t have to use your own force during the whole process. It depends entirely on the techniques of the rehabilitation practitioner, the CPM machine (Continuous Passive Mobility Device) or the assistance of family members to drive the joint movement. It is generally a must-have exercise after surgery and in the early stages of severe sprains. It is mainly to avoid joint soft tissue adhesion and maintain the basic range of motion of the joints.

Once the soft tissues around the joints have returned to a certain strength and the muscles have gained basic strength, you can slowly transition to the power-assisted or active training stage. For example, if a patient with frozen shoulder initially feels pain when raising his arm and sheds tears, he can use his good hand to pull the affected wrist upward slowly, or use an elastic band to lift it, and then slowly remove all assistance, and then he can complete the movements of raising his hand and turning his shoulder. At this time, the training is not only "to what angle it can move", but also the ability of the muscles around the joint to stabilize the joint at all angles to avoid pain and shaking when moving.

Many people think that if the joints can move independently at all angles, they have achieved adequate training. In fact, the most critical functional movement training is still missing. Well, I met a young man who had undergone anterior cruciate ligament surgery before. He could bend his leg to the same 135 degrees as the unaffected side while lying on the treatment bed. However, he still limped when he walked, and his knees did not dare to bend when going up and down steps. It was because he lacked this part of the training. Functional training is to practice joint activities in actual use scenarios. For example, the knee joint needs to practice squatting, standing on one leg, and going up and down steps. The ankle joint needs to practice walking on uneven roads and jumping in place, so that the joint activities can adapt to the actual needs of daily life and sports. After all, we do not practice range of motion just to lie on the treatment bed and change angles to show others, right?

Oh, by the way, there are actually differences in the industry about the timing of passive training intervention after different injuries. Take rotator cuff repair surgery as an example. One school of thought believes that small-scale passive activities should be started 1-2 days after surgery to avoid adhesive capsulitis.； Another school of thought believes that it should be fixed for 2-3 weeks first, and then moved after the repaired tendon has grown strong to avoid secondary damage. The specific choice depends on the individual's injury degree and the firmness of the surgical fixation. There is no unified standard answer. Do not follow the online tutorials on your own. There was a little girl with a sprained ankle. Just 10 days after the injury, she forced her ankle to pull the ligaments. The swelling that was about to subside turned out to be like a small bun, but it took half a month to heal. It was really not worth the loss.