Practical Science on Movement and Pain

Better Movement in the Joint

Nutter's MusculoSkeletal
Slide don’t roll the ball in the socket

Why does pain often occur in the joint? There’s a lot that can go wrong in a joint. Here’s a post on the subtle small movements in a joint that might make a big difference.

Movement at a joint requires the bones to rotate, spin, roll and slide smoothly and safely around other bones, tendons, ligaments, joint capsules, muscles, cartilage and most importantly nerves.  As we age, many of these “obstacles” to safe movement become rougher and larger through injury and normal degenerative aging processes. Performing a full range of motion movement at a joint without bumping or grinding any of these obstacles might require a very subtle and precise movement. The more accurate the movement, the less bumping and grinding. The less precise the movement, the more wear and tear on the joints, causing irritation to nerves, inflammation, microtrauma, stress, loss of energy, etc.

Take the example of shoulder abduction, or lifting your arm out to the side and over your head. Abduction is primarily accomplished by contraction of the deltoid muscle on the side of the shoulder. If the deltoid muscle contracts without any stabilizing help from the rotator cuff muscles, it will tend to roll the ball of the arm bone up in the shoulder socket until it bumps into the acromion process, pinching the soft tissues and nerves in between. In order to prevent this from happening, the rotator cuff muscles need to contract at the proper time, to exert a downward force on the ball of the upper arm that keeps it in the middle of the socket where it belongs. That way, the ball spins in one place in the socket instead of rolling upwards. It’s a very subtle and small difference, but incredibly important because it prevents impingement, which can cause pain and injury. Of course, similar impingements or traffic jams can occur at every joint because of similarly small deviations from perfect form.

So how do we train precise joint movement? One simple way is by paying very close attention to what is happening in the joint during movement and using that feedback to improve the quality of the motion. This necessarily requires doing simple movements very slowly and mindfully, as in the Feldenkrais Method or Z-Health. For example, if you are trying to improve a dumbbell press, you can do the move without weight in slow motion while tuning into the subtleties of how the motion feels in the joint. You should be curious about the following questions  Is there any pain with the movement? Is there even the slightest discomfort? Is the movement arc smooth or ratcheted? Do you need to speed up and use momentum to skip over an uncomfortable part of the movement? Is the movement smooth and easy or labored and filled with tension? Are you moving with the effortless quality of a great athlete, a dancer or a little child? What would it feel like to move perfectly? Do you feel tension in non moving parts of your body such as your face, jaw or hands? Can you do the movement incredibly slowly? As fast as possible?

If you grab a dumbbell after this exercise and press it you will probably notice that it feels easier and smoother than it normally does. This is partly because your brain has just received lots of novel, interesting information about what is going on in that shoulder joint during a press. In other words, you just improved your proprioception, and the brain therefore has a better map of the shoulder.

Of course you can do the same or similar exercises for other joints and movements. Some great movement programs that are built around slow, mindful and exploratory movements are the Feldenkrais Method, Z-Health, tai chi, and somatics. Yoga done properly counts as well, provided you are not placing excessive focus on quantity of motion instead of quality.

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9 Responses to Better Movement in the Joint

  1. Hey Todd.
    Finally found something you posted that doesn’t quite sit too well with me. Been on your website and had a look at this Z Training programme you talked about in the article. I have a few questions which it would be great to hear your thoughts on when you get the chance.

    Firstly the Z training focuses on slow and deliberate movements around a certain joint. To me this does not follow function. I have no doubts that you have had great success with a variety of people in the past with it but it does not sit with how the body moves in everyday life.

    As you are probably aware 99%of all movement is sub concious and in many cases, throwing, punching, kicking etc the movements are not Performed in a deliberate controlled way. With this in mind then if you were looking to rehab the shoulder of a baseball pitcher who feels pain when pitching, your ultimate goal with that athlete must be to return him to the pitching motion free of pain. Obviously the severity of the injury determines how far away from the action f pitching you go but surely when assessing you need be including the other muscles, bones and joints involved withe the pitching action before you can properly diagnose the problem. He may well be able to go through the motion slowly and controlled but it might be the extra force brought about by the momentum of the action which is causing the problem. Also many, many shoulder injuries are a direct result of poor T spine mechancs, due to the scapula attatchments having to do touch work because the T spine lacks the neccessary rotation or lat flexion.

    Also in your post you mention a bench press exercise. Agan this is the type of exercise that isolates the shoulder joint from the rest of the chain which never happens in sport (other than power lifting). So I reckon that a bench press exercise is about as usefull in developing an athlete for competition as pre game stretching.

    Would be great to hear your thoughts on this. Sorry it’s a bit long winded.

    • toddhargrove says:

      Darren,

      Thanks for the comments.
      You said: “Firstly the Z training focuses on slow and deliberate movements around a certain joint. To me this does not follow function.”
      The point of the slow deliberate movement is to retrain faulty movement patterns in a very precise way. To take your example of throwing a pitch or a punch, it is true that this is done quickly and unconsciously in a competitive situation. In motor learning terms, this means that the movement is autonomous. If the movement pattern is faulty, we need to go back to the beginning of the motor learning cycle to retrain it. To the cognitive stage of learning – this means slow deliberate highly conscious movement – done with “precision” as I use that term in the post above. After precise and accurate movement pattern have been retrained through slow and conscious movement, the new movement pattern will start to become unconscious and autonomous. Further, the athlete will need to eventually perform these reps at game speed – so there is a progression from slow to fast to as fast as possible. Z mobility drills are done at four speeds – super slow (as slow as possible), standard, coordinated and sport specific (as fast as possible.) Each must be mastered for a sports application.
      In addition to being the first step in a progression to retrain faulty movement, slow movement has several other advantages as well including increasing proprioceptive information to the brain and favoring recruitment of muscles closer to the joint.
      You also said: “Many shoulder injuries are a direct result of poor T spine mechancs, due to the scapula attatchments having to do touch work because the T spine lacks the neccessary rotation or lat flexion. “ Agreed. In previous posts I have pointed out that “the body is unit” and that the “site of the pain is rarely the site of the problem.” A Z practitioner will certainly look to the mobility of the t-spine very early in any assessment process of throwing mechanics.
      You also said: “Agan this is the type of exercise that isolates the shoulder joint from the rest of the chain which never happens in sport (other than power lifting). So I reckon that a bench press exercise is about as usefull in developing an athlete for competition as pre game stretching.”
      I was just using the bench press as an example, not recommending it as a good exercise for any particular sport. The bench press is just a tool, appropriate for some goals and inappropriate for others. I certainly would not agree that it has no use in sports. It is a great means to develop upper body hypertrophy, which may be useful for football, basketball, baseball etc.

  2. Hi Todd

    thanks again for the reply was interesting reading and you definitly make some really valid points. on your website i think you only mentioned the slow controlled movements which is why i was under the impression that that was it.

    You have got me interested now though.

    Was only being awkward and a bit of a pain because i knew you could handle it and come back with some good comments. Which you definitly did.

    Would be great to get to know a bit more about this Z Health stuff. can you recommend any websites to look at for some more info. I am always on the look out for new techniques and how they can help my client achieve propper function.

    Gonna stick by the bench press thing though. I can probably give you 20 or 30 different exercises that will achieve the same kind of hypertrophy in that region and are more function to the athlete as they incorprate the core muscles and whole body as a unit.

    I give it to you though I can think of a sport where a bench press is a very exercise but its only Power Lifting.

    We need to share more stuff mate. Myself and a colleague are about to post a whole load of videos on youtube. I will keep you posted when they come on so you can have a look and see what you think.

    • toddhargrove says:

      Darren,

      Some other good sites for Z info would be zhealth.net of course, and then Mike Nelson’s site, which is on my blogroll, and then begintodig, mc’s site. I look forward to seeing your youtube vids.

  3. […] Coaching notes: Focus on precision for part 1 and speed for part 2 Wake your butt up part 2 Movement precision Low carb eating […]

  4. Tim says:

    Hi Todd,

    If one feels numbness in the arm most of the time, can this be caused by impingement? But I wonder how this can get chronic. Can something cause the arm to be constantly pressing upwards agains the acromion process even though the arm rests alongside the body? Or can there be other circumstances that narrows the gap as well? Thanks

    • Todd Hargrove says:

      Tim,

      Sorry to hear about the numbness. I’m not a doc and I can’t diagnose, but there are many places where a nerve might be getting squeezed a little to cause the numbness, including the neck. I have some posts on nerve mechanics which might be helpful in understanding some of the possibilities. Good luck.

  5. William Sole says:

    Blogging keeps me insane. Keep up all the positive work. I too love to blog. I found this one to be very informative

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