Movement

Mobility: What is it and what inhibits it?

Movement always comes first. Good movement will allow you to retain your mobility and is one of your greatest allies in the fight against chronic pain and performance dysfunction. You can do all the mobility work you want, but if your movement remains biomechanically unsound, the stiffness, pain, and bad posture will only return again. And oftentimes, it returns worse than before.

However, should you find yourself unable to move your arms and/or legs very far without moving your spine around, that is probably an indicator that you need to work on your mobility.

Having mobility means having the freedom to express independence of movement in order to accomplish work. Humans are built to move, and movement should never cause harm to your own body. But our bodies are also under constant stress, if only via gravity. Whenever you go for a walk, sit in a chair, or lift heavy weights, your body will adapt to the stress of the activity, and that adaptation will be as intense as the activity. And while many of these activities may make you stronger from a certain perspective, they will also make you stiffer and limit your range-of-motion (ROM).

Having tight tissues and less-than-optimal ROM means less power due to the shorter distance you can safely travel. And if you force that ROM, you risk tearing your tissues to bits. Imagine a competitive swimmer, or any sports player whose sport demands that they take their arm overhead repeatedly, and at high-intensity. Now imagine that athlete, in a rested and non-stressful environment, can only raise either arm to a 45 degree angle over their head. So half way between straight out in front of them, and straight over their head. And if they try to move it higher with a neutral spine, it creates pain in the shoulder. Now, this individual could bend their spine, lean back and make their arm appear to be straight up and down relative to the ground, but that relationship needs to be relative to their body and shoulder. Ordinarily, this individual will be told that he/she has tight shoulders and needs to stretch more. Coincidentally, this may be the same advice the individual has been given for several years, and they are still having the same issue. This is common. We have this idea that static stretching is all one can do to improve flexibility. And if this method does not work for a particular person, then that person just has genes that have pre-determined they will be a tight human being. All this sort of thinking does is demonstrate a lack of understanding about the things that actually create and inhibit human mobility. Using genetics as an answer is nothing but a convenient EXCUSE.


So when this competitive individual participates in sport, a few things happen: goal orientation and stress/stress hormones. This individual is focused on achieving their goals in competition in order to win, or help the team win. At the same time, the stress of the physical activity and of the competition itself stimulates the release of adrenaline, as well as other stress hormones. Adrenaline helps your body to increase certain attributes, such as strength and endurance, while blocking out the sensation of pain.


Tunnel-vision and short-term pain immunity. With these two things, it becomes easier for the athlete to explode through their already limited shoulder ROM without feeling anything. He/she has chosen to sacrifice a part of their body in order to achieve a goal. But what really happens to the shoulder, or any body part, when it is forced to repeatedly move farther than it normally can without stress. This depends on what is causing the lack of mobility. This is where most of the chronic pain and dysfunction of the athlete comes from. Why is a part of my body tight? And more importantly, what can I do to fix it so I do not have to worry about present chronic pain any longer, or about developing chronic pain later on? This is where we need to understand a few different factors that inhibit mobility. There are four major factors that we are going to focus on in this post. These four are relatively easy to understand, and once you are armed with this knowledge, you can proceed to work on your mobility in a significantly more effective way than just hanging out at end-range with no real intention or results.


One of the rules of mobility is to prove that what you are doing is actually working towards your goal. You need to be able to see with your naked eye (NOT with a laser goniometer or other device used to measure joint angle) that your body can move farther than it previously could without sacrificing good body mechanics.


#1. Neural tension.


The spine comes first. Always. It is a hard and fast rule to prioritize and optimize spinal position before, during, and after all movements (http://www.ehmobility.com/blog/getting-started-with-your-own-self-maintenance-plan-part-2-start-loving-your-spine). Will you always be able to perform with a perfectly neutral spine? No. But you need to learn to, and be able to, brace your spine into the best position possible for your activity, whether that is picking up a pillow or a 400lb weight. Basically, you need to understand that trying to move around with a disorganized spine is something that your brain does not like. Especially if you are under a load, but even if it is only your body weight, your brain will stiffen up your tissues around your spine to help stabilize it and prevent disk herniation. The first thing to do to maximize your mobility is to go through the bracing sequence: Squeeze your butt, squeeze your belly. Then, with your belly still squeezed, unclench your butt. That is it. That sequence establishes a braced and neutral spine, which will release a lot of neural tension that may have been present.


#2. Joint Mobility.


Joint mobility refers to two things: Joint capsule mobility, and joint position. Your joint capsule is a fibrous membrane that surrounds your synovial joints (Joints that are not directly joined and have a cavity filled with synovial fluid. This includes your ankles, knees, hips, wrists, elbows, shoulders and others). When this fibrous sac surrounding the joint is not moved either frequently, or through full ROM, it stiffens up just like most of your other tissues. Stiffness in the joint capsule, which limits how far your bones can move around, contributes a massive amount to total mobility.


In addition, if surrounding tissues are tight, a joint can be pulled tight in a particular direction. This can mean that the two joint surfaces have been pulled together to squeeze out synovial fluid, and the surfaces will grind together against the socket or adjacent bone. Which hurts. A lot.




#3. Sliding Surfaces.


Sliding surfaces in my experience is a factor that is extremely easy to fix for most, is quite easy to understand, and also can have a tremendous impact on your ability to move. The concept of sliding surfaces means that your skin, muscles, nerves, blood vessels, lymph vessels, and bones should all be only loosely attached to each other. Their should be some loose fascia holding everything together, but these structures should all be able to slide and glide around each other smoothly. But if connective tissue builds up and adheres these structures together, it can become more like Velcro, with large amounts of friction, and irritation. Nerve endings can become inflammed, blood vessels can be placed under excess pressure resulting in varicose veins, and lymph vessels can become swollen. This can occur in basically any part of the body which does not move often enough.


#4. Muscle Dynamics


Sometimes a muscle simply has adapted to a shortened position and does indeed need to get stretched out. Alternatively, the brain/nervous system can literally lock down on certain tissues and prevent them from extending passed a certain length. An idea about why this happens is that the brain has been led to believe (probably due to lack of movement) that it will be dangerous to move beyond a certain range. It has become scary, unexplored territory. This is where PNF (proprioceptive neuromuscular facilitation) stretching, or contract-relax as we will call it, comes into play. This is when you take a body part to its current end-range, tense the muscles around the area to stimulate the nervous system for a few seconds, inhale, exhale, relax everything and allow the body part to move farther. If the nervous system really was inhibiting the movement, tensing your tissues at end-range will essentially be telling the brain that it is alright to do work at that range- nothing is going to be injured- and that it can relax.


Why should you have a mobile body? A body that can move through full ranges of motion effortlessly? Because it allows you to have strength. To have speed. To have endurance. It can help you to prevent just about any type of chronic pain humans can develop (http://www.ehmobility.com/blog/getting-started-with-your-own-self-maintenance-practice-part-1). Having mobility means you can get to the ground and stand back up. By yourself. Increased athleticism, pain management, and independence of movement. That is why you should want a mobile body.


In my next blog, we will begin exploring the different tools I use to clean up poor mobility and enhance human performance. As well as show some easy methods of using each one to help your body right away.

The Third Rule of Movement: The One-Joint Rule

First off, let us recap the first two rules of movement:


Rule #1: Prioritize your spine.

This almost always takes the form of the bracing sequence. However, even for shapes and movements that demand global flexion or extension in the spine, the position still needs to be braced. If you cannot squeeze your butt and belly, you have gone into local flexion or extension. You have kinked the hose. This means that you can no longer stabilize your position on your own. If you cannot consciously squeeze it, you cannot use it.


Rule #2: Torque

Create rotation in your shoulders and hips. External rotation if your limbs are in flexion (in front of your body) and internal rotation if your limbs are in extension (behind your body). Creating torque gets your skeleton in a better position, and winds up your muscles to stabilize your skeleton in that better position, primarily in your shoulders and hips. This extra stability allows you to much more easily maintain a good position while are in motion.


These two rules can be done by themselves in a static position, which is where they can be taught first. But you have to learn to display these rules while moving, and especially while under stress. This is where the third rule comes into play.

ule #3: The one-joint rule

The one-joint rule states that the spine does not move while changing from one body shape to another. The rule of maintaining a neutral spine not only applies for static positions, but also, and more importantly, it apples for dynamic positions and movements while you are under stress (including exercising). This is the one-joint rule. When you are moving, your spine should be treated as one solid lever. There are no joints in your spine any longer once you have braced yourself.

After getting braced, I place one thumb on my sternum, and the other at my waist. 

And even as I bend over to get ready to pick something up or to squat, the distance between my hands remains constant. My spine keeps its shape throughout the entire movement.

Understanding how to do this is more important than I can stress in text. Because it is movement of the spine under stress that creates most of the back pain people experience, developing some strength and proprioception (the ability to sense where and how your body is arranged in space) can save you from massive amounts of dread and unneeded medical payments.


The only places in your body where you should see large amounts of movements are in your shoulders and hips, and the joints outside of them. This also means that your shoulders and hips need to be able to move through their full range of motion (ROM) without pulling on and altering your spine.


Start with bracing yourself. Now with that braced position active, you need to be conscious of maintaining that position while you squat, lunge, deadlift, reach overhead, reach behind you, and while you carry weight, etc.. This takes practice. Unless you have been trained to move like this your whole life, it is going to be a new skill for you to learn. But as with any other skills and practices, once you train it consistently for a few weeks, it becomes automatic. Utilizing the one-joint rule, both in the gym and in your day-to-day life, will be a habit that will reward you for the rest of your life. Imagine never having to worry about dealing with low-back pain. Imagine never having to worry about developing sciatica or a shoulder impingement. Embody these concepts of taking care of your body, and they alone will drastically reduce your chances of many common ailments that plague so many people. And be sure to check out the video below for more visual cues about how to utilize the one-joint rule, as well as the previous two rules!

Deadlifting. It's not a lower back exercise. It's not specifically a gym exercise. It is a basic movement you use all the time to either pick something up or put something down. When people can't or won't perform this movement and position well, this is a huge factor for why 80% of all Americans develop low back pain.

Getting started with your own self-maintenance plan. Part 3. Protecting your joints

Bracing your spine is the first part of creating optimal position, and the bracing sequence alone can be a life-saver. However, it really only affects your trunk; the bracing sequence does nothing to help create stability in your limbs. So along with the bracing sequence, we also need a way of bracing our joints. And this is done by creating torque in our shoulders and hips.


Torque is defined as a twisting force that tends to cause rotation. If you hold one arm up in front of your body, and rotate it to turn your palm up and to the right, the tension you will feel in your shoulder is torque, or torsion. And as it turns out, your wrists, elbows, shoulders, hips, kness, and ankles not only flex and extend, but also all rotate as well. This means they all have capacity for generating torque for stability.


In my own experiences, torque is the most difficult concept for people to understand, and therefore to implement. But if you can specifically practice creating torque as a skill during your movements, whether in daily life or in the gym, you can quickly and easily have massive improvements in your strength, speed, range of motion, and safety. In fact, if you do not create torque in your joints, or you create rotation in the wrong direction, you will actually set yourself up to not only be weaker and less flexible, but will be setting yourself up for injury, in such ways as an ACL tear, a labrum tear and rotator cuff tear, among others. But learning how to create torque in the right direction is relatively simple, and follows a basic pattern.


Flexion= external rotation
Extension= internal rotation.


If your arm or leg is in flexion, meaning in front of your body, you create external rotation to create stability, and internal rotation to create instability.
If your arm or leg is in extension, meaning behind your body, you create internal rotation to create stability, and external rotation to create instability.
 

As you can see in this picture, the two ligaments anchoring the two sides of the knee together in the center of it have an X shape to them. When you create external rotation in a knee, the ligaments stay tight, keeping the knee stable. However, if you internally rotate the knee, these two ligaments will unwind, adding significantly more stress to the knee.

As you can see in this picture, the two ligaments anchoring the two sides of the knee together in the center of it have an X shape to them. When you create external rotation in a knee, the ligaments stay tight, keeping the knee stable. However, if you internally rotate the knee, these two ligaments will unwind, adding significantly more stress to the knee.

These patterns are actually seen in your daily life, and have been present your entire life. How do your turn a door knob, or key for your cars ignition, or use a screwdriver to tighten a screw? You always turn your arm to the outside, creating external rotation. If you are in the front seat of a car and you want to reach behind yourself to grab something in the backseat, do turn your palm up or down to have the most flexibility? Down, which creates internal rotation in the shoulder. You can't get very far if you keep your palm up. What about a boxer, when he throws a punch from his back hip? His back leg turns inward, again, creating internal rotation, because you cannot punch very well if your back leg is turning outward.


Hopefully with these examples you can have a clear image in your head of what I mean when I refer to creating torque, or rotation, within your shoulders and hips. When you create this torque in the right direction, you are actually creating stability by tightening up the joints and engaging all the muscles surrounding the joint. This creates strength while also preserving flexibility. At the same time, it prevents the two sides of a joint from moving independently of each other, placing massive amounts of stress on your
cartilage and ligaments. Hence why ligament tears are so common when people move in certain positions.


A major point to make on the subject of torque is that you only harm the joints if they are rotated in the wrong direction under two conditions:
1. You hold that position long enough to adapt to it, and to also make a habit which will be expressed under stress, or
2. You express this position under a load.


Actually, creating internal rotation while in flexion, and vice versa, is useful for mobilizing the joint capsule and getting fluid into the joint to help improve your overall mobility. But that is a position that you only momentarily pass through, never one that you remain in for any significant amount of time.


This does not mean you have to constantly be creating tension in your hips and shoulders all the time. That would be a ridiculous demand, and would likely end up being detrimental to your health. However, you can display small amounts of torque habitually to maintain good posture in daily life. This can take the form of keeping your feet straight while you walk, turning your knees to the outside when you sit, stand and when going up and down stairs or ladders. It is also displayed as keeping your shoulders back rather than hunched forward. These same positions should also be displayed in the gym.


One major hindrance to creating torque is this: People are rarely taught to intentionally create rotation to their maximum anatomical range of motion, and so the muscles that create rotation, such as the rotator cuff muscles, and the external rotators of the hips, are quite often super stiff and painful to press into. And so mobilizing these tissues, which will come up in later blogs, is important to start with. Because you can understand movement principles to the best of your ability, but if you do not have the mobility to actually express the principles, you will never move optimally. However, movement always comes first, and many mobility problems can be remedied by simply beginning to move correctly. So here is a tip for you to begin incorporating into your daily life as a way of cultivating torque in your body as a habit: every time you step up and over something, or are walking up and down stairs, pay attention to how your back leg moves. Oftentimes, because the hip external rotators are so stiff, the leg will become externally rotated while it is in extension, which we know creates instability. So if you find that your leg is flying out to the side, rather than moving straight under your hips as it comes forward, pay attention to that, and make a conscious effort to keep your leg in. Try to bring that back knee straight up into flexion, not rounding out.

One other point to make about torque is that the way we do express joint rotation, as in the example above about walking up and down a staircase, is often what we have done habitually for years and was never aware of it. For example, there have been several studies, such as the one found here: http://ajs.sagepub.com/content/23/6/694.short, that claim women have many more ACL injuries than men, especially in sports, some claiming anywhere between 4-10 times the amount of tears. Why could this be? How are women taught to arrange their knees from the time they start walking and wearing skirts and dresses? Knees together. Often we will see this expressed with the feet slightly apart, and the knees collapse to each other, or the knees will be crossed over each other. These women are being taught to create internal rotation from a very young age, and it quickly becomes a habit. This is a huge factor for why almost every single untrained female I have ever seen play sports or exercise will jump and land with their feet wide and their knees coming together. Accumulate a few thousand reps of creating slack in the knee and stressing ACL. Remember, external rotation in flexion creates muscular stability. Creating internal rotation while in flexion reduces muscular engagement, and places the stress on the ligaments.

And a final note about torque is that you are primarily aiming to create torque in the shoulders and hips. If your legs are in flexion, you are creating torque in your hips, knees and ankles. But because of how the anatomy in the knees and ankles is arranged, you will never create internal rotation in those structures if your leg is in extension; only creating torque in the hip. Going back to the example of the boxer, or just talking about a simple lunge, the heel of the back foot should come up so that you can pivot on the ball of the foot. You should never create internal rotation in the foot (creating a collapsed arch) or in the knee (wrecking havoc on the ACL and meniscus.

Getting Started with your own Self-Maintenance Practice. Part 1

“All humans have the right and responsibility to perform maintenance on their own body.” -Dr. Kelly Starrett.
So here is how most people handle their own self-maintenance. You wake up one day and have some sort of pain. Your knee is swollen, you have a rash, your arm keeps going numb. And what do you do? First order of business: rest and hope everything goes away on its own. If that doesn’t work, you ice it or take medication. And if THAT doesn’t work, you go to a doctor who will then first prescribe rest and ice/medication. After that comes surgery, and then more chronic pain, scar tissue, and problems.
An important topic to understand when it comes to pain management is the categories of pain and injury. Once you understand these categories, you can begin to self-diagnose whether or not the problem you are having should be addressed via the movement and mobility tools coming in later blogs, or via a physician. These categories are:

  1. Pathology- This refers to diseases. People get sick; it’s a part of life. Different diseases can rear their ugly head in different ways. Symptoms include, but are not limited to: fever, nausea, vomiting, dizziness, night sweats, changes in bowel/bladder function and diarrhoea. If you are experiencing any of these with any regularity, you should probably see your physician.
  2. Catastrophe- Shit happens. Sometimes an external force that is out of your control comes at you and severely injures your body. You are playing soccer and someone lands on the side of your knee and the whole joint shatters. You’re walking up a staircase, trip, land with your hands, and your wrists break. It happens. If you break a bone, rip a muscle in two, or have profuse bleeding, please go see your doctor.
  3. Motor-Control- This means your posture in any given activity. Whether you are just standing, or running, or squatting double your bodyweight, if you move poorly and have bad posture, then your body will break down at an accelerated rate and you will likely eventually have some serious issues down the road.
  4. Mobility- Sometimes parts of your body are under too much tension. This restricts your ability to move even if you have impeccable motor-control in your movements. But flexibility is much, much more than just how short or long any given muscle is. Rather, it has much more to do with your hydration, body temperature, joint capsule mobility, sliding surfaces and even tension in your nervous system and brain. Any, and all, of these factors can contribute to lack of range of motion, and this lack of mobility accelerates damage in joints, decreases overall energy levels, and significantly increases your chances for injury.
A decent squat position. Note the feet are parallel, and the knees are being shoved out.

A decent squat position. Note the feet are parallel, and the knees are being shoved out.

A much-less-than-optimal squat position. This collapsed knee position is an example of using body position as a leading indicator. We know this position unwinds your ACL and PCL and creates slack in the knee. This slack allows the tibia and femur to move more independently of each other, and drastically increases the possibility of an ACL tear.

A much-less-than-optimal squat position. This collapsed knee position is an example of using body position as a leading indicator. We know this position unwinds your ACL and PCL and creates slack in the knee. This slack allows the tibia and femur to move more independently of each other, and drastically increases the possibility of an ACL tear.

Diseases and catastrophes happen. They are just a part of life and cannot be controlled as well as we would like. Fortunately however, according to Dr. Kelly Starrett, pathology and catastrophe only make up 2% of your everyday problems. Your posture and your mobility together make up the other 98%, and are 100% in your control if you are willing to start paying attention to your own movements. What this means, is that if you can understand what a good position is, and how to fix a lack of good position, then you can prevent the vast majority of physical problems you will ever likely have.
This is why I do not want to use pain as a diagnostic tool. Pain is a lagging indicator; you don’t actually feel pain until AFTER you have experienced some damage. In fact, you may never feel any pain in your knee until after you tear your meniscus from squatting so poorly. And that is a difficult injury to come back from. Another point about pain is that you never really feel pain when you are adrenalized. If you are playing a sports game, working out, or on a military mission and are under a massive amount of stress, then you may not feel any pain from impacts or punctures until after your stress hormones settle down a bit. So we do not want to use pain as a diagnostic tool. Instead, I want to use a LEADING indicator; something that tells me trouble is coming if things persist as they are. This leading indicator is position.
Creaky knees, stiff shoulders and a tight upper back, collapsed arches and an achy lower back. 98% of the time, these are problems that are fixed through fixing your ability to get into good postures. Ask yourself these questions the next time you are feeling chronic pain:
-Did you suddenly wake up and things were awry, or was there some clear cut incident that caused the pain?
-Are you sore because you performed a hard workout or a different set of movements than you are used to in general, or could you have been exposed to an illness?
Hopefully this will get you to think about why you might be feeling what you are feeling, and if a doctor visit is really necessary. In the next two blogs, we will cover how to fix motor-control problems, and how to fix mobility problems, and also how to prevent problems from all together happening. Low back pain is a 10-15 billion dollar a year problem in America. The vast majority of cases are completely preventable. If you understand how to fix and get into good body shapes, then you can do just that- prevent back pain, and most other joint and muscles injuries.