27 Aug Why We Need Mobility Before Stability
by Dr. Matt Fontaine “THE MOST COMMON PATTERN OF MOVEMENT DYSFUNCTION WE SEE IN RUNNERS AND ATHLETES IN GENERAL IS POOR MOVEMENT, A LACK OF STABILITY & MOBILITY AND MOTOR CONTROL, RESULTING IN REPETITIVE MOTION INJURIES AND JOINT PAIN SYNDROMES” -DR. MATT FONTAINE It is important to note that your overall treatment plan is an ‘all encompassing’ approach — not just an exercise video — not just therapy or exercises — it’s a multi-pronged approach. We use a combination of Manipulation, Manual Therapy (Active Release Techniques and Graston Technique, Dry Needling) to address restricted mobility of the joints and soft tissues. We then prescribe exercises to help stabilize the changes we make in clinic, as well as advise on proper nutrition to optimize your physiology. These all complement each other, and if any are missing, treatment success will not be optimal. Have you ever baked a cake but left out one of the ingredients? How did the cake turn out? Physical medicine is no different. We need to implement all ingredients at the right time to get optimal results. For most patients and athletes we see in clinic, their PAIN IS NOT THE RESULT OF A SINGULAR INCIDENT. Rather it is the result of a PROCESS and several things finally coming to a point where you perceive pain. So with that as a backdrop, the exercise component in treatment is only PART of the foundation necessary to resolve your key issues, but they ARE NOT the total picture, they are only a part of the total process. Key point- We are dealing with an injury that involves joints, muscles and movement patterns. The common error is the failure to identify and address all three aspects individually and collectively. You need the right tool for the right job. For example, proper rehab and exercise can assist to correct movement faults, but will NOT correct a joint problem. Conversely, attempting to perform a chiropractic adjustment for a soft tissue or movement issue will fail to achieve the desired results. For more on this topic, we have a blog article here: proper sequencing in rehab Our number one priority for treatment early on is to restore mobility with ART and joint manipulation. This supersedes everything else. 3 Key Things to the big picture surrounding your issues: 1. Joints: You have some joints that are fixed and not moving enough. We need to get them moving. This is where manipulation comes in. You have some joints that are too loose and not stable enough. We need to stabilize them, and that’s where exercises come in. 2. Muscle and soft tissue: some muscles have been chronically overworked and are tight. We need to release those with Active Release in clinic. Doing mobility homework with foam roller, Lacrosse balls and band assisted stretches helps to maintain the new mobility we create in clinic. Some muscles have become weak and are not working hard enough. We need to activate and strengthen them with exercise. 3. Corrective Exercise Rehab: The BIG KEY here is that the rehab exercises help to stabilize the changes we make through the manipulation and ART. Basically some muscles have become weak and need strengthening. The key here is to train your muscles to develop better motor control in order to stabilize the joints to prevent re-injury. With regard to functional corrective exercise it is vital to remember that the devil is in the details. And the order and time frame in which they are prescribed makes all the difference. After your pain is reduced and your mobility is improved is it then appropriate to begin some exercises to strengthen muscles and improve motor control. . If patients are consistent with treatment and their homework, then the treatment outcome should be a home run and they should get back up and active and exercising PAIN FREE. Because of using a Triad approach to care, we expect patients to begin to feel some results quickly, but remember that we are not only concerned with PAIN. It is vitally important that we improve your function to prevent this injury from recurring. It is important to note that your overall treatment plan is an ‘all encompassing’ approach — not just an exercise video — not just therapy or exercises — it’s a multi-pronged approach. We use a combination of Manipulation, Manual Therapy (ART) to address restricted mobility of the joints and soft tissues, exercises to help stabilize the changes we make in clinic, and proper nutrition to optimize your physiology. These all complement each other, and if any are missing, treatment success will not be optimal.