Body in Motion, Part 2

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Treating for Better Flexibility and Range of Motion in the Lower Extremities

 

Last month, Jaffe Sports Medicine informed blog readers about optimal range of motion (ROM) of the upper extremities. Part two of this series will discuss the lower extremities and what you can do when optimal motion cannot be achieved.

Anytime you experience pain with motion or loss of movement that worsens over time, these are both signs that there may be something more serious going on within the joint.

Remember, there is always a reasonable concern when our bodies are not moving the way they should. Let us look again at the proper range of motion guides to help in understanding more about where your motion is limited.

Lower Extremities

The lower extremities consist of your hips, knees, and ankles. Decreased motion can occur after an injury, a fall, impact sports, working out, or wear and tear on your joints from repetitive motions over time.

Obesity can also play a part in the decreased motion of the lower extremities—considering that all your weight is resting on your hips, knees, and ankles, which are weight-bearing joints. Excess weight will always affect these weight-bearing joints.

One indicator that ROM is compromised in the lower extremities is an altered gait or the stride you walk. To determine if your gait is altered, your doctor will analyze your gait to look for irregularities. Observation may indicate:

  • A nerve or muscle problem that is causing a limp.
  • An ataxic gait, which is characterized by poor balance, unsteady or weakened stride, or veering.
  • A dropped foot due to weakened muscles in the ankle joint.

Hips

Have you ever noticed that there is a stiffness in your hips after sitting for a long period? The stiffness will typically go away after taking steps forward; however, you may notice a pronounced “waddle” in those first few steps.

For some patients, an affected gait may be one of the first symptoms that hip strength and motion are on the decline.

The hip’s range of motion is produced by the hip joint–the ball and socket that join the pelvis and femur.

This ball and socket fit together to produce the fluid motion that allows the legs and torso to move. Good ROM in the hips is measured in degrees as in the graphic below:

Evaluations look at passive motions, which is how much you can move your ship around the joint with the assistance of a healthcare professional. Active range of motion also evaluates motion but puts the patient in control of the motion.

If ROM is affected, we will take an X-ray, CT, or MRI of the joint to determine deterioration, joint disease, infection, or a fracture. If there appear to be none of these problems affecting motion, we will recommend conservative treatments like at-home stretching, physical therapy, steroid injection, or other pain management options.

Suppose you are looking at just a mild stiffness in the hips rising from a seated position. In that case, we often recommend hip flexors to strengthen the joint and increase the ability to produce better motion in the hip.

Knees

Our knees are the ultimate bearers of all weight. The knees are the most injured joint of all sports-related injuries. Outside of sports, our knees can be injured through a fall, obesity, misstep, or strain while walking on uneven terrain or stairs or overextending while performing daily tasks.

Good ROM in the knees is needed for balancing and support. Good rotation is necessary for stability while the legs are in motion. ROM that is normal looks like this:

 

Again, your doctor will look for passive-active ROM to determine if motion has been compromised. Additional testing may be needed to determine the extent of any cartilage, joint, or patellofemoral damage. There are successful treatments for regaining good motion in the knees that JSM can recommend depending on the extent of your loss of motion.

Ankles

The ligaments, tendons, and bones of the ankles can become injured quite extensively. There are simple sprains and strains, tendonitis, and much more in-depth injuries such as a fracture or torn ligaments. Good ROM in the ankle will appear as in the graphic below:

 

Dorsiflex is raising the foot, and plantar flexion is pointing down with the foot.

Limited ROM can have additional symptoms that include swelling, throbbing, sharp pain, intermittent pain outside or inside of the ankle area, and bruising.

Again, the ankle is a weight-bearing joint and can easily become injured or strained by falling, rolling, or overstepping, balance problems, jumping, and other impact sports.

A good range of motion benefits includes decreased pain, better flexibility, strength, better blood flow, more vigorous movements, and bodily actions, and lower potential for injury.

Treatment Options

If you are experiencing pain that prevents good movement of any joint, we consider you to have a limited range of motion.

Jaffe Sports Medicine understands a good range of motion includes decreased pain, better flexibility, strength, better blood flow, more vital movements and bodily actions, and lower potential for injury. We work individually with each patient to ensure that their health and wellness goals are met. We focus on all aspects of the body, including alignment, movement, and postural habits.

With a blend of physical therapy, interventional pain management, and additional sports medicine strategies, we will help you protect your body and prevent further injury.

At Jaffe Sports Medicine and Rehabilitation, we help our patients recover quickly, regain strength, and improve their range of motion while avoiding painful, expensive surgery. To schedule an appointment at one of our locations, contact Jaffe Sports Medicine today.

TEXT BY M. HIATT

 

 

 

Body in Motion

Written by

Treating for Better Flexibility and Range of Motion in the Upper Extremities

Part 1-Upper Extremities- Range of motion is an important topic, so we will focus on the upper extremities this month and move to the lower extremities next month, so look for that article to come soon.

Movement, flexibility, and motion work together so our body can perform at an optimal level. Pain and discomfort will sound the warning alarm to alert you that something is off. Perhaps you notice stiffness in your knee while walking, or you cannot write with a pen or pencil for more than a few minutes due to cramping hand and wrist pain.

Aside from typical aches and pains, you may be experiencing loss of motion and flexibility, which prevent movements that are natural to your body. Maybe your elbow will not bend properly, or you’re not able to fully extend your arm while reaching, causing a sharp pain in your neck or back.

Pain with motion and loss of movement that worsens over time are critical indicators that there may be something more serious going on with the affected area. So, there’s a reasonable concern when our bodies are not moving the way they should.

To better understand your pain, you need to know how your body is designed to perform. For this, we look to the proper range of motion guides to help in understanding more about your limitations.

 

Upper Extremities

The upper extremities consist of both left and right wrists, elbows, shoulders, and hands. Decreased motion can occur after an injury, impact sports, a fall, working out too hard, or wear and tear on your joints over time from repetitive movements.

Repetitive motions can occur in various settings and are commonly referred to as Repetitive Strain Injuries (RSI). Some examples of this include:

  • Work-related movements that cause you to reach throughout the day
  • Assembly line work
  • Grocery store checkout clerk, bagger, or stocking shelves
  • Construction or labor type work
  • Using a computer mouse, typing
  • Exercising and sports training–boxing, weight training, football, basketball, gymnastics, etc.

 

Elbows & Shoulders 

Your shoulders are the least stable and often least moved joint on your body. If you are sitting at a desk all day at work, consider stopping your work for a few minutes each hour to perform flexibility exercises. By improving your passive range of motion, you will find the stiffness and pain in your neck, back, and shoulders will significantly improve.

To test your range of motion in your shoulders, you will first need to stand straight, without arching your back; or you can lie flat on the floor if standing straight produces back pain.

From this position, relax and inhale.

While exhaling, begin to slowly raise your arms, reaching above your head and past your ears.

To test your shoulders, you should be able to raise your arms 180◦ flexion and hyperextend your arms slightly behind the ears, abduction to raise and lower. To test your elbows, follow the diagram of outward and inward rotation and flex inward and outward as you would if you were holding a barbell performing bicep curls. You will also feel this motion in your shoulders.

To increase your motion and obtain maximum motion, remember to work on your flexibility with upper extremity stretches throughout your workday and before and after workouts.

To reduce the risk of injury, use proper techniques while stretching and move slowly.

Wrists & Hands-

The wrist moves along two axes and can move by extension, flexion, adduction, and abduction.

There can be pain in the wrist for a host of reasons, and a diagnosis strongly depends on the symptoms you are experiencing with the loss of motion.

 

Rest your forearm on a table.

With your hand hanging down, follow the graphic to test the range of motion of each wrist.

If you are experiencing loss of motion, tingling, sharp pain, or swelling in the joint, contact Jaffe Sports Medicine for an evaluation.

 

 

Hands-

To test your hands, open and close each hand as you see in the abduction and adduction graphic below.

 

 

You should also periodically perform this exercise and stretch your fingers with opposing thumbs throughout the day. If you cannot touch your thumb to the base of your fifth finger (pinky finger), there may be an underlying cause.

 

If you have a loss of motion in your fingers or thumbs, this information is a helpful start in our determining the cause.

 

Treatment Options

If you cannot complete any of the exercises above or are experiencing pain that prevents the movement of any joint, we consider you to have a limited range of motion.

Jaffe Sports Medicine understands a good range of motion includes decreased pain, better flexibility, strength, better blood flow, more vital movements, and bodily actions, and lower potential for injury.

Jaffe Sports Medicine works individually with each patient to ensure that their health and wellness goals are met. We focus on all aspects of the body, including alignment, movement, and postural habits.

With a blend of physical therapy, interventional pain management, and additional sports medicine strategies, we will help you protect your body and prevent further injury.

At Jaffe Sports Medicine and Rehabilitation, we help our patients recover quickly, regain strength, and improve their range of motion while avoiding painful, expensive surgery.

To schedule an appointment at one of our many locations, contact Jaffe Sports Medicine today.

TEXT BY M. HIATT