Fountain of Youth IX: Mobility and Flexibility of Joints and Muscles

December 24, 2009 at 7:13 AM | Posted in Fountain of Youth, Health and Fitness, Psychological Wellness | 1 Comment

In any rehabilitation or exercise program, soft tissue work is an absolute must. I’ve been talking about soft tissue work for the last 5 posts in this series, so it’s time to move on. I’ve numbered this one as 9, however, because the other 4 I haven’t done yet. They are details on how to self-massage common trigger points in the upper body, but it’s been a daunting task and videos are necessary, so it’s taking some time. In the meantime, I’m moving onto the next topic.

Soft tissue work gets your muscles moving freely and properly again. However, what it doesn’t do is return your muscles to their proper length or help your joints move freely. Thus enters the next logical step: conditioning your joints for full mobility and your muscles for flexibility. This is step two of the list below, which is the basic list you must follow, in order, to return your body to health.

1. Soft Tissue Work: Foam rolling, trigger point therapy, self-massage, etc. This is Fountain of Youth I – VIII.
2. Mobility and Flexibility: Stretching, activation drills.
3. Toning and Strengthening: Actively using weak or inhibited muscles in order to return them to their normal length and proper function.
4. Active Lifestyle: Once your body is working properly again, continue to use it to a reasonable degree in order to feel better, maintain activity levels, and achieve whatever other goals you have for yourself (losing weight, gaining weight, getting stronger, increasing testosterone levels, etc.).

First off, there’s a difference. Flexibility describes the “passive tone” of your muscles. For instance, imagine that you lie down on your back on a bench. Someone else takes your leg and bends it at the knee. If that person can bend the knee through its full range of motion without causing you any kind of grief, then you have full flexibility. However, the motion was passive because you weren’t actively contracting or lengthening any muscles. In order for you to have full mobility, you need to be able to cause your knee to actively move through its full range of motion. Even if you have full flexibility, you don’t necessarily have full mobility.

So above, I mentioned you’ll be needing to stretch tight muscles and activate loose ones. I’ll go through some common postural problems so you can see just what I mean, but the basic idea is to do soft tissue work on tight muscles, subsequently stretch them and then strengthen the inhibited muscles. Stretching isn’t worthwhile unless you do soft tissue work on the muscles first (assuming they’re the tight ones).

1. Anterior Pelvic Tilt

Without a doubt, anterior pelvic tilt is the most common postural problem in the developed world.  That might sound like a bold claim, but I challenge you to dispute it with evidence.  Anterior pelvic tilt is usually due to sit-down jobs, extended time being lazy watching TV or messing around on the computer, etc.  It can also be caused simply by having poor postural awareness or losing control of the stabilizer muscles, something that most everyone has done to some degree.  ATP affects performance in any sport, and it can cause extreme pain in the groin and low back, and sometimes the neck.  Here’s a picture.

Anterior Pelvic Tilt

Note the effects of ATP: distended appearance of the gut, ugly protuberance of butt, forward head, and the appearance of a caved chest.

Tight muscles in this alignment are

  • Psoas major and minor
  • Quadriceps, especially rectus femoris
  • Spinal erectors
  • Quadratus Lumborum
  • Adductors (sometimes, but other postural problems might cause them to be normal length)
  • Sometimes, other hip flexors are tight (TFL, pectineus, etc.)

Weak, lengthened and inhibited muscle groups are

  • Gluteals (all three of them, usually)
  • Abdominals, especially transverse abdominus
  • Hamstrings

Many people don’t realize exactly what’s happening here.  There are two major joints in the pelvic region.  One is obviously the hip joint, where the femur meets the pelvis.  Everyone knows about that one.  The other one, however, is the lesser-known sacroiliac joint (SI joint for short).   Here’s a picture:

SI Joint

The SI joint is the part where the sacrum (the triangular part) connects with the pelvis, specifically the ilium.

As you can see, the pelvis can rotate relative to the sacrum.  This is what happens in APT (or PPT) – the pelvis rotates backwards, so it faces down in the front.

There are a lot of articles available on how to fix ATP.  Most of them go through specific stretches, exercises and weightlifting moves you can perform in order to correct the deficiency.  However, your progress will be much slower and harder without the inclusion of soft tissue work, and a lot of programs neglect to mention this.   Here are a few good articles:

http://www.mindandmuscle.net/node/286
http://www.hesfit.com/men/comment/losing-your-gut-anterior-pelvic-tilt/
http://lolfitness.wordpress.com/2009/03/25/anterior-pelvic-tilt-repair-workout/

Since the point of this article isn’t to give you programs for each particular postural problem, I won’t be doing that. The point instead is to offer you a general strategy for going about mobilizing joints and making you aware of what that even means.

So, here are joints that most people lack full mobility in:

  • Ankle
  • Knee
  • SI Joint
  • Thoracic Mobility
  • Scapular Retraction
  • Scapular Depression

Of course, it’s possible to be lacking mobility in any joint in the body, but these are the most common.  So, I’ll elaborate one-by-one.

Ankle Mobility

Ankle X-Ray

This picture shows what the ankle SHOULD look like at the end of your stride.

Do a little test for yourself. Get up, make sure you have plenty of room and walk around a little bit. Take note of how your ankle moves or doesn’t move during walking. If it doesn’t move, great news! You’re just like everybody else and you seriously lack ankle mobility. Full ankle mobility should mean that you don’t even have to think about it – they just move and do their own thing. Ideally, what you want is at the beginning of a step, your heel is in contact with the ground first. As you move your body weight onto that foot, the foot rolls gently to become flat on the ground. Now, as you move your weight off of the foot, the foot gently rolls forward and your toes leave the ground last. You repeat this “rolling” motion of the ankle as you walk. Now, I’m assuming you either don’t have full ankle mobility or you cheated to get it, so here’s the muscles you need to work on.

Foam roll: Gastrocnemius (the meat of the calf), soleus (behind gastrocs), outer sides of the calves (peroneals), and the front of the calves (tibialis, mostly). It’s likely that you need a lot of trigger point work done in the meat of the calves, so use a tennis ball and roll around until you find the extremely painful spots. If you suffer from restless leg syndrome, this can also be cured by regular tennis ball/foam rolling efforts through the calves, particularly in the soleus.

Strengthen: Tibialis anterior. This is a tough muscle to get to. You can do toe lifts if you don’t want to go to the gym, but be sure your gastrocs and soleus are very loose, otherwise they will create an imbalance between your weakened tibialis. You might also suffer from shin splints for this same reason.

Here are a few good articles for ankle mobility drills. They explain each one, usually by picture or video.

http://stronglifts.com/how-to-improve-your-ankle-mobility/
http://recoveryourstride.blogspot.com/2008/05/ankle-mobility-drills-can-they-improve.html
http://www.strengthcoach.com/public/1298.cfm
http://ericcressey.com/the-importance-of-ankle-mobility

Knee Mobility

A lot of people don’t have full knee mobility due to tight hamstrings or a tight fascia lata. If you’ve got any kind of knee pain, you undoubtedly don’t have full mobility. Here’s what you need to do.

Foam roll everything. Foam rolling isn’t the end of your soft tissue work here though. What you’ll end up needing to do is hit the very tight muscles with concentrated work using a tennis ball or a Thera-cane. If you’re lucky enough to have a Thera-cane, use the tiny knobs on the main piece of it to dig into the quadriceps, and concentrate around the outside of quads and the rectus femoris, which is in the middle. Here are some trigger point diagrams to give you an idea of what I’m talking about.

Vastus Lateralis Trigger Points

These are trigger points on the outer thigh you can get by foam rolling and tennis ball. They tend to cause a lot of leg and knee pain.

Be careful with this picture.  The most incredible spot for massaging pain in your knee and returning mobility is labled TrP1 in the picture.  It looks like it’s on the side, but it’s not.  The muscle wraps around to the front.  You can reach this point by applying LOTS  of pressure somewhere about an inch or two above the kneecap and an inch or so towards the outside of the leg.

Now, with the hamstrings, you face an interesting problem.  Your hamstrings are more than likely both tight AND weak. Normally, if a muscle is really tight, it’s generally overpowering its neighbors.  However, in the classic case of I-am-a-lazy-pile syndrome, the hamstrings need to be rolled (possibly trigger point therapy too), stretched chronically (stretch them daily), used more often and eventually strengthened.  The problem with hamstrings is of course made more confusing and worse by ATP if you’re suffering from that.

I already covered SI joint problems, so I’ll move directly to the next item on the list.

Thoracic Mobility

Spine Diagram

The thoracic spine is clearly labeled as the yellow collection of vertebrae, and there are twelve.

The thoracic spine is the middle part of the spine, above the lumbar/sacral parts and below the cervical (neck) spine.  The picture to the left shows the location of the thoracic spine.  You can think of these vertebrae as the ones the ribs connect to for simplicity.

The test for thoracic mobility is simple.  Lay down on your back and fully extend your arms overhead.  Most, if not all, of your arms should touch the ground comfortably.  You should not feel any strain.  Your wrists should be flat on the ground as well.  If you feel strain doing this or cannot achieve it, with or without effort, then you lack thoracic mobility.

You should care about thoracic mobility because it does a few important things: first off, it helps you regain good posture.  You have been stuck in a bad posture for so long that your vertebrae have become accustomed to it and don’t want to move.  Next, it will help you prevent injuries to the rotator cuff muscles and neck.  It even helps with low back pain.  If you lift, you will improve your form and strength by increasing your thoracic mobility.  Ideally, each vertebra should be able to move “relatively” independently of the next (obviously this is an oversimplification), but chances are your vertebrae don’t have much relative movement at all.

The good news is, thoracic mobility is incredibly easy to improve.  Here are the best two methods:

Easy method (use this when you’re starting off): Take a foam roller and place it on the ground behind you (you need to be seated initially).  Then, carefully lean back onto the foam roller.  You should contact the roller at the top of your lumbar spine (think lowest set of ribs).  Now, roll up and down the foam roller, but be careful not to roll onto your neck or lower back at this point.  Your arms should be hugging yourself in order to move your shoulder blades out of the way.

Improved method: Once you’ve got some strength and mobility back, what you’ll want to be doing next is tying two tennis balls side-by-side in a sock.  Then perform situps, with each rep or two contacting the tennis balls on a separate vertebra.  So, when you lower yourself down on the eccentric portion of the situp, move the tennis balls so they contact a different vertebra.  Ease your weight onto the tennis balls, roll around a little bit and then perform another rep.

There are a lot more things you can do for thoracic mobility if you’re an athlete.  Here’s the best program I’ve seen:

http://stronglifts.com/how-to-improve-your-thoracic-mobility/

Scapular Retraction

Scapular retraction is a very simple movement that most people do not know how to do.  Usually, people end up with protracted shoulder girdle (slumped-in shoulders) because we work with our hands in front of us.  If you type at a computer, write a lot or work with your hands frequently, there’s a good chance you don’t have full scapular retraction.  It’s also possible that your rhomboids, which are primarily responsible for the movement, are either lengthened, weak, angry, or any combination of those and you feel a burning, aching sensation between your shoulders as a result.  Scapular retraction is very easy to restore, but you need to work at it for a while and constantly use it in order to keep it.

Rhomboid Trigger Points

Use the tennis ball in this area. If you've got a Thera-cane, that's even better for getting at this group. It'll probably hurt.

The first step is soft tisue work.  Use the tennis ball on your upper back to get at the rhomboids, which are in the picture on the left.  In order to get a really good, concentrated effort on the rhomboids, you’ll want to lay down and move the arm on the side you’re working on in front of you.  This will stretch the muscle and expose it better.  You’ll probably also want to hit your trapezius, in the middle and lower fibers particularly.

Once you’ve gotten your soft tissue work done, you’ll want to start in with activation drills.  The easiest one is the “scapular wall slide.”

Find a wall with enough empty space to accomodate you, and then some.  What you do is stand with your back flat against the wall, or as close to flat as you can (don’t round your back in weird ways).  Then, take your arms overhead in such a way that your elbows and wrists contact the wall.  Now, slide the arms up and down.  During the ENTIRE movement, be sure that both your elbows and wrists remain in contact with the wall.  This is absolutely critical, otherwise you won’t be using the right muscles.  After you do this for a while, you should begin noticing an unfamiliar muscle recruitment pattern.  You’ll feel the muscles in your middle back and between your shoulder blades working.  Congratulations, you’ve become mentally acquainted with your lower trapezius and your rhomboids!  Quite a feat.

Scapular Depression

Scapular depression is similar to scapular retraction, but the two are different.  Scapular depression relies on your serratus anterior, pectoralis minor and trapezius to work.  It usually works a lot better when the scapulae are retracted before depression.  If you’re one of those guys who only ever does bench and biceps, hopefully you’ve at least taken the time to note proper form during benching.  Every textbook description for benching starts off with this: retract and depress the scapulae.  Back in the 60’s, that wasn’t really an issue for most people.  Now, your average pile wouldn’t have any idea how to do that.

The good news is that you’ve already done a lot of soft tissue work you need to do if you’ve done your scapular retraction work.  The only things you need to add are pec minor work and levator scapula work.  The pectoralis minor is so small and weak in most people that it’s more like a tendon than a muscle.  It’s also usually shortened, tight and perhaps even weak.  You can get to it most easily with a tennis ball/foam roller combination through the outer pec region, but you may need to resort to using your opposite hand to really get in there.  Don’t be afraid to dig in.

Levator scapula is a different beast.  If you’ve got chronic neck pain, I bet you’ve got trigger points here.

Levator Scapulae

These trigger points are very deep. You'll either be massaging yourself with your hands or using the Thera-cane.

The levator scapulae raise the shoulder blades towards the neck/head.  A lot of people stress out too much and subsconsciously shrug the shoulders, especially in the workplace, and end up with short levator scapulae.  Since you’re trying to depress the scapulae, you’ll need to loosen and stretch these muscles first.

The first activation drill you did, with the scapular wall slides, is an excellent trainer for depression as well as retraction.  One more thing you can do without going to the gym is a scapular pushup.  What you do is assume a pushup position of some sort (you can be on your knees if it helps, doesn’t have to be a hardcore pushup).  Now, instead of lowering yourself down to the floor, push yourself up from neutral.  Obviously, your elbows are already as straight as they get, so you’re going to need to do something different here.  The different movement is in the movement of the shoulder strictly.  Here’s a video to illustrate:

Finally, a really good overall scapular mobility program is available here for those of you looking to get a little more advanced or provide defense against potential injury during athletics: http://synergy-athletics.com/index.php/uncategorized/scapular-mobility/

That about wraps this post up.  Joint mobility is critical in a pain-free, healthy lifestyle.  You can get joint mobility by massaging tight muscles, removing trigger points and activating/strengthening weak or inhibited muscles.  This is the part where you need to start becoming a little more familiar with your body and how it prefers to do things, and this post teaches you to feel the differences in the proper and improper working of muscles.  It also teaches you how to activate muscles you didn’t have full control over before.  This step is absolutely necessary for anyone who has led an inactive lifestlye or let the callings of life take over too much.  For athletes, I recommend some kind of regular schedule, perhaps weekly, that includes activation and stablization drills to keep muscles working properly and joints at optimum health.  Even if you aren’t having problems now, you should do it as a form of prehabilitation.

As always, email me with any questions or comments, or post them on the site.

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1 Comment »

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  1. Great blog. I was looking for a psoas stretch and found much more. I will have to take more time to read it but I’m glad I stumbled across the blog.


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