Physiotherapist Jenny Blizzard is trained in manual therapy, acupuncture and women's health. Here's her advice on joint preparation and how to maintain good joint health.
Wherever two bones come together in the body a joint is formed. Ligaments stabilise joints and blend with the joint capsule that encapsulates the joint.
Cartilage is found at the ends of bones and its function is to reduce friction between the two surfaces and also provide shock absorption.
KEY FACT 1
The nutrition to most joints in the body is from synovial fluid found within the joint capsule. This fluid requires movement in order to pump it around the joint, to provide lubrication and nourish the cartilage.
All joints have what we call physiological movements and accessory movements. Physiological movements are what we can actively create ourselves using movement for example, by bending and straightening our elbow or knee or rotating the head to look over our shoulder.
Muscles acting on the joints produce these movements. Lesser known but very important are the accessory movements of the joints known as “spin, roll and slide”. These are fundamental to achieving a normal physiological movement but you cannot really produce these movements yourself.
Without the spin, roll and slide, joint movements are compromised, become compensatory and excess stress causes hot spots in the cartilage and degenerative changes start to occur. Muscles also have an important role on joint health; stability around a joint is achieved by excellent muscle control and this helps to ensure that there is an appropriate amount of spin, roll and slide at the correct point in any given movement.
KEY FACT 2
It is a common misconception that joint pain is due to “wear and tear” of the cartilage. Cartilage does not have a nerve supply so is incapable of producing pain.
Pain sensitive structures such as the joint capsule and the muscles attaching to the joint are more likely to be the source of pain.
Tips For Good Joint Health
• ‘Motion is Lotion”.
Ensure that you move all of your joints through there FULL range of motion daily in order to ensure good lubrication with synovial fluid and maintain the spin, roll and glide. Whole body yoga sequences are perfect for this and it needs only to be 10 minutes of focused work.
• Prior to running, make sure you do a dynamic warm up to ensure that your joints are well lubricated, your accessory movements are ready for action and to prevent early cartilage degeneration
• Work on muscle strength to provide good stability around joints
• Be very skeptical of flippant diagnoses of “wear and tear” without investigation via imaging.
Unless the degeneration is so bad that the cartilage on the ends of the bone has disappeared and the actual bone end is devoid of cartilage, it cannot be the source of your pain. Seek out a physiotherapist who understands running biomechanics to investigate all other sources of pain.
• Got a “blockage”?
Nearly always it is an accessory movement that needs restoring. Physiotherapist’s are experts at seeking out and restoring these movements. My personal favourite mobilisation is for hip joint stiffness.
Very quick to restore, creates lots of imbalances along the joints in the leg and back and needn’t do!
Compression, decompression and gliding movements are the normal mechanisms for providing nutrition to the cartilage. These all occur during running!
Running is good for you as long as your biomechanics are sound. Don’t therefore stop due to pain, but instead seek help to resolve pain and improve your biomechanics. Even better, get a biomechanical screen ahead of pain starting.