Some people believe that if their joints don't hurt, they're fine. In fact, the disease can develop painlessly, manifesting itself through another symptom - limited mobility.
In some cases, along with loss of mobility, hot and cold swelling, redness and swelling appear.
Limitation of mobility is divided into two types: reduction of active and passive movements. When active movements are limited, it is difficult for the patient to move the joint independently, but under the influence of a stranger, the joint rotates easily. When passive movements are limited, even with the help of a stranger, the joint is difficult to bend and straighten.
Causes of limited joint mobility
Arthritis
A group of inflammatory diseases that lead to thinning of the articular cartilage, deformation of the joint capsule and ligaments. Arthritis most often affects the knees, elbows, fingers and toes. It is difficult for the patient to bend and straighten the affected joints; in the later stages, with knee arthritis, it is difficult to walk; with arthritis of the elbows and fingers, it is difficult to hold even light objects.
Bursitis
Inflammation of the joint capsule occurs due to injury, prolonged excessive load, as a complication of arthritis. The joint is very painful, swollen, and limited in mobility.
Arthrosis
Premature aging of the joint, which is accompanied by thinning and cracks of the cartilage of the head of the bone. At an early stage, the joint hurts and often crunches, then mobility decreases and the joint becomes deformed. At a later stage, the cartilage completely disappears. There is no inflammation or swelling with arthrosis.
Text of the book “Motor activity and health. From therapeutic gymnastics to parkour"
Flexibility
Flexibility is the ability to perform movements with a large amplitude. The term “flexibility” is more acceptable if we mean the total mobility in the joints of the whole body. In relation to individual joints, it is more correct to say not “flexibility”, but “mobility”, for example in the shoulder, hip or ankle joints. However, using the term “flexibility” refers to one of the standard characteristics of ODA structures.
Good flexibility ensures freedom, speed and efficiency of movements, increases the path of effective application of effort when performing physical exercises. Insufficiently developed flexibility makes it difficult to coordinate human movements, as it limits the movement of individual parts of the body.
According to the form of manifestation, flexibility is distinguished between active and passive. With active flexibility, movements with a large amplitude are performed due to the own activity of the corresponding muscles. Passive flexibility is understood as the ability to perform the same movements under the influence of external tensile forces: the efforts of a partner, external weights, special devices, etc.
According to the method of manifestation, flexibility is divided into dynamic and static. Dynamic flexibility is manifested in movements, and static flexibility is manifested in postures.
There are also general and special flexibility. General flexibility is characterized by high mobility (range of motion) in all joints (shoulder, elbow, ankle, spine, etc.); special flexibility - amplitude of movements corresponding to the technique of a specific motor action.
The manifestation of flexibility depends on a number of factors. The main factor determining joint mobility is anatomical. Limiters of movement are bones. The shape of the bones largely determines the direction and range of movements in the joint (flexion, extension, abduction, adduction, supination, pronation, rotation).
Flexibility is due to the central nervous regulation of muscle tone, as well as the tension of antagonist muscles. This means that the manifestations of flexibility depend on the ability to voluntarily relax the stretched muscles and tense the muscles that carry out the movement, i.e., on the degree of improvement of intermuscular coordination.
The following external conditions significantly influence flexibility:
– time of day (in the morning flexibility is less than in the afternoon and evening);
– air temperature (at +20–30°С flexibility is higher than at +5–1°С);
– whether the warm-up was carried out (after a warm-up lasting 20 minutes, flexibility is higher than before the warm-up);
– is the body warmed up (mobility in the joints increases after 10 minutes in a warm bath at a water temperature of +40°C or after 10 minutes in a sauna).
A factor influencing the mobility of joints is also the general functional state of the body at a given moment: under the influence of fatigue, active flexibility decreases (due to a decrease in the ability of muscles to completely relax after a previous contraction), and passive flexibility increases (due to less tone of the muscles that counteract stretching). ). Positive emotions and motivation also improve flexibility, while opposite personal-psychic factors worsen it.
The results of few genetic studies indicate a high or moderate influence of genotype on the mobility of the hip and shoulder joints and the flexibility of the spinal column. Thus, a number of forms of genetically determined connective tissue dysplasia are characterized by excessive mobility in almost all joints.
Flexibility develops most intensively between the ages of 15 and 17. At the same time, the sensitive period for the development of passive flexibility is the age of 9–10 years, and for active flexibility – 10–14 years. In this connection, the targeted development of flexibility should begin at the age of 6–7 years. In children and adolescents aged 9–14 years, this quality develops almost 2 times more effectively than in high school age.
Normal mobility has a wide range of deviations (constitutional hyper- and hypomobility). At the same time, mobility decreases with age, and women are generally more mobile than men at the same age. Hence, more mobility can be expected in a young woman, and less active behavior in a middle-aged man (Alter M.J., 2001).
Testing.
Specific movement tests are required to check the quality of joint mobility. To determine the total flexibility of the spinal column, shoulder and hip joints, a bridge is performed tilting backwards (can be done from a lying position). The distance between the heels and fingers, as well as the top point of the bridge to the floor is measured. Divide the first result by the second, the smaller the unit, the better the total mobility of the joints (Fig. 6).
Rice. 6.
A test to assess the total mobility of joints (general flexibility): the distance between the hands and feet
(a)
and from the sacral point to the supporting surface
(b)
. The test to assess the total mobility is complex in execution, and therefore the possibilities of its use are limited, especially for older people.
To determine the active flexibility of the main joints: shoulder, hip, pelvic girdle, the following tasks are performed: 1) circle with arms – arms to the sides – back; 2) standing leg to the side (transverse and longitudinal splits); 3) bend the torso forward, do not bend your knees. The smaller the distance between the hands and the floor, the better the result.
For a comprehensive assessment of the mobility of specific joints, which is directly dependent on the state of muscle tone and flexibility (elasticity of the capsular-ligamentous apparatus), modified tests for determining hypo- and hypermobility according to J. Sachse (1963) are used. The importance of this set of tests lies in the comprehensive assessment of the most general indicators of the organization of the neuromotor system.
Mobility measurements are carried out in three degrees: A
(-1) – hypomobility;
B
(0 or N) – normal mobility;
B
(+1) – hypermobility. The test person carries out the movement independently to the extreme limit of possible volume and the appearance of painful sensations in the final position. Compare movements in paired joints.
As an example, we give the following test options:
•
Shoulder girdle.
The horizontally raised shoulder is brought towards the opposite shoulder.
In grade A,
the elbow reaches only the midplane of the body;
if it reaches half the distance to the opposite shoulder - degree B;
further approach of the elbow to the opposite shoulder –
degree B. In exceptional cases it reaches the opposite shoulder.
Another test - diagonal contact of the hands behind the back - is carried out on both sides. The result is determined by the position of the hand, directed downward. Grade A –
the hands do not touch at all, grade
B -
the ends of the fingers touch;
the phalanges of the fingers touch on the surface of the hand - degree B.
The test is carried out actively, the fingers of one hand should not be interlocked with the fingers of the other. The spine should not be in a position of hyperlordosis.
•
Elbow joint.
When bending the elbow joints, the forearm and hand of both hands should be adjacent to each other.
Then they extend together as far as the joined elbows allow. Grade A –
internal angle of the elbow joint less than 110° (corresponds to flexion of the forearm by more than 70°);
degree B –
internal angle from 110 to 135° (forearm flexion from 70 to 45°);
degree B –
stronger extension.
•
Knee-joint.
The test to limit flexion in the knee joint is carried out in a prone position on the stomach.
Grade A -
the heel cannot be brought to the buttock, the subject involuntarily tries to bend the hip joint (raises the buttock);
degree B –
the heel touches the buttock;
grade B -
the heel may slide off the buttock to the side.
Knee extension is tested by raising the extended leg (flexed at the hip) but with the other leg fixed to the couch, and the angle between the raised hip and the plane of the couch is measured if resistance is felt when lifting the leg. The person being tested himself feels this resistance as tension in the popliteal fossa and on the back of the thigh, but not as acute pain in the limb and sacrum. To bring the pelvis into a neutral position, the leg on the other side is slightly bent. Grade A –
flexion at the hip joint does not reach 80°;
degree B –
in the range of 80-120°;
grade B –
more than 120°, which should be considered as significant hypermobility.
•
Ankle joint.
During the study, the test person is asked to squat (deep squat), without lifting his heels from the floor.
If at the same time he raises his heels, then it means that the triceps muscle of the leg, including the soleus, is in a state of increased tone - grade A.
If the task is completed - grade
B.
To exclude hereditarily predisposed excessive joint mobility - generalized joint hypermobility syndrome, Carter's criteria are used and Wilkinson as modified by Beighton (1989; Fig. 7).
These tests are completed on each side and only 1 point is awarded for each task (maximum 9 points). If the result is 6 or more points, a conclusion about the presence of generalized joint hypermobility syndrome is acceptable.
In some pathological conditions, there may be excess mobility in other joints.
Training.
To improve flexibility, passive, active-passive and active exercises are used to increase mobility (mobilization) in the joints.
All these exercises are used in both static and dynamic modes.
Rice. 7.
Signs of generalized hypermobility (according to Doherty M., Doherty J., 1993):
a
– extension of the little finger to an angle of 90°;
b
– bringing the thumb across the side and back until it touches the forearm;
c
– hyperextension of the elbow joint more than 10°;
d
– hyperextension of the knee joint more than 10°;
e
– bending the torso until the palms touch the floor
Active movements include:
– simple movements (for example, bending, turning, straightening);
– springy movements (for example, springy bending and straightening);
- swing movements.
The degree of impact of these exercises roughly corresponds to the order in which they are listed. They should be included in the same sequence in sets of exercises for warming up or developing flexibility.
Passive static exercises (when the posture is maintained due to external forces) are somewhat less effective than dynamic ones.
In the dynamic mode, exercises can be performed with relatively smooth swing movements with a maximum increase in the amplitude of movements. In the static mode, as you perform a series of exercises, exercises such as “self-grabbing”, fixed bends, “half-splits”, “splits” and others are used with maximum stretching of certain muscle groups.
The main methodological recommendations when performing exercises to develop flexibility are as follows:
– exercises should be performed after a thorough warm-up;
– number of repetitions in each series – 30–40;
– duration of static poses – from several to tens of seconds.
When planning and conducting classes related to the development of flexibility, it is necessary to comply with a number of important methodological requirements. It is necessary to develop mobility in those joints that play the greatest role in vital activities. It must be borne in mind that stretching exercises have the greatest effect if they are performed daily or even 2 times a day. When you stop performing flexibility exercises, its level gradually decreases and after 2-3 months returns to the original level. Therefore, a break in classes can be no more than 1–2 weeks. When developing flexibility, the following ratios of various stretching exercises are advisable: 40% active, 40% passive and 20% static. But there is such a pattern: the younger the age, the larger the proportion should be active exercises and the smaller – static.
When developing flexibility, it is not always necessary to strive for the maximum, and even more so for a forced increase in indicators, since its excessive development leads to irreversible deformation of the ligamentous-articular apparatus, which negatively affects motor abilities. It is considered advisable to develop flexibility to the extent allowed by the normal structure of the joints, the elasticity of the ligaments and muscles. The extensibility of muscle fibers can increase under the influence of physical exercise. At the same time, their ability to return to their original position should not be affected. Therefore, it is necessary to combine special exercises to develop flexibility with strength exercises. Flexibility and strength have an inverse relationship - muscle hypertrophy as a result of unilateral strength exercises can lead to limited mobility in the joints and a decrease in range of motion. Therefore, it is necessary to rationally combine exercises to develop flexibility and strength training.
Of course, in people with hypermobility, all types of gymnastics that train mobility in the joints should be avoided, and, conversely, in people with hypomobility, emphasis should be placed on its development in physical exercises.
Speed
, or more precisely, speed abilities, is understood as a person’s capabilities that provide him with the performance of motor actions in the minimum period of time for given conditions. In other words, speed is a complex of human functional properties that directly determine the speed characteristics of movements, as well as the time of motor reaction.
There are elementary and complex forms of manifestation of speed abilities. Elementary forms include reaction speed, speed of a single movement, frequency (tempo) of movements.
All motor reactions performed by a person are divided into two groups: simple and complex. The response with a predetermined movement to a predetermined signal (visual, auditory, tactile) is called a “simple reaction.” Examples of this type of reaction are the beginning of a motor action (start) in response to the shot of the starting pistol in athletics or swimming, the cessation of an attacking or defensive action in martial arts or during a sports game when the referee whistles, etc. The speed of a simple reaction is determined as follows: called the latent (hidden) period of the reaction - the time period from the moment the signal appears until the moment the movement begins. The latent time of a simple reaction in adults, as a rule, does not exceed 0.3 s.
In outdoor games, there is another specific manifestation of speed qualities - the speed of braking, when, due to a change in the situation, it is necessary to instantly stop and start moving in a different direction.
Most complex motor reactions, characterized by a constant and sudden change in the situation of action, are reactions of “choice” (when, from several possible actions, it is necessary to instantly select one that is adequate to the given situation). In a number of sports, such reactions are simultaneously reactions to a moving object (ball, puck, etc.).
The time interval spent performing a single movement (for example, a punch in boxing) also characterizes speed abilities. The frequency, or tempo, of movements is the number of movements per unit of time (for example, the number of running steps in 10 seconds).
In various types of motor activity, elementary forms of manifestation of speed abilities appear in various combinations and combinations with other physical qualities and technical actions. In this case, there is a complex manifestation of speed abilities. These include: the speed of performing integral motor actions, the ability to reach maximum speed as quickly as possible, the ability to maintain it for a long time, etc. The speed of complex complex motor reactions is closely related to dexterity and coordination ability.
For the practice of physical education, the greatest importance is the speed at which a person performs integral motor actions in running, swimming, skiing, cycling, rowing, etc., and not the elementary forms of its manifestation. However, this speed only indirectly characterizes a person’s speed, since it is determined not only by the level of development of speed, but also by other factors, in particular the technique of mastering the action, coordination abilities, motivation, volitional qualities, etc. The ability to reach the maximum speed as quickly as possible is determined by the phase starting acceleration or starting speed. On average, this time is 5–6 s. The ability to maintain the achieved maximum speed for as long as possible is called speed endurance.
and determined by distance speed.
The manifestation of forms of speed and speed of movements depends on many factors. From a physiological point of view, the speed of the reaction depends on the speed of the following five phases:
1) the occurrence of excitation in the receptor (visual, auditory, tactile, etc.) involved in the perception of the signal;
2) transmission of excitation to the central nervous system;
3) transfer of signal information along nerve pathways, its analysis and formation of an efferent signal;
4) conducting an efferent signal from the central nervous system to the muscle;
5) excitation of the muscle and the appearance of an activity mechanism in it.
The maximum frequency of movements depends on the speed of transition of motor nerve centers from a state of excitation to a state of inhibition and back, i.e., it depends on the lability of nervous processes.
Genetic studies (twin method, comparison of speed capabilities of parents and children, long-term observations of changes in speed indicators in the same children) indicate that motor abilities significantly depend on genotype factors. According to scientific research, the speed of a simple reaction is approximately 60–88% determined by heredity. The speed of a single movement and the frequency of movements have a moderately strong genetic influence, and the speed manifested in integral motor acts, running, depends approximately equally on the genotype and environment (40–60%).
The most favorable period for the development of speed abilities in both boys and girls is considered to be the age from 7 to 11 years. The growth of various indicators of speed continues at a somewhat slower pace from 11 to 14–15 years. By this age, the results actually stabilize in terms of the speed of a simple reaction and the maximum frequency of movements. Targeted influences or participation in various sports have a positive effect on the development of speed abilities: those who specifically train have an advantage of 5–20% or more, and the increase in results can last up to 25 years.
Gender differences in the level of development of speed abilities are small until the age of 12–13 years. Later, boys begin to outperform girls, especially in terms of speed of complex motor actions (running, swimming, etc.).
Testing.
Tests for measuring speed abilities are divided into four main groups:
– assessment of the speed of simple and complex reactions;
– assessment of the speed of single movements;
– assessment of the maximum frequency of movements in different joints;
– assessment of speed manifested in holistic motor actions, most often in short-distance running.
When assessing the manifestations of speed, the following are distinguished:
– latent time of motor reaction;
– speed of single movement;
– frequency of movement.
One of the widely used tests for assessing speed is the “jumping ability” test, or Abalakov test. To perform it, the subject stands sideways to the wall, legs together, raises his right hand up and marks the level (height) of contact with chalk (Fig. 8, a
).
Then he sits down and, straightening his knees as quickly as possible, tries to jump up, using a raised hand to mark the height (level) of contact with chalk (Fig. 8, b, c
). The difference between the first and second marks will reflect “jumping ability”, or motor quality - speed, since the Abalakov test reflects the innate ratio of fast and slow muscle fibers in the muscles of the lower extremities. High test results indicate that the muscles are dominated by strong fast fibers, adapted for short-term strength and speed-strength work. Low test results indicate the opposite - the predominance of slow aerobic fibers, adapted to long-term endurance work.
Rice. 8.
Jumping ability test (according to V.A. Abalakov, 1970)
The test results shown in table. 2, can be used to assess the age-related decline in speed-strength motor qualities (speed and strength, the main anti-gravity muscles of the lower extremities).
Table 2.
Age standards for the V.A. sample Abalakova
Simple reaction time can be determined by catching various gymnastic sticks. The subject must catch a falling stick in the shortest time (determined by the shortest distance).
This test is performed in a standing position (Fig. 9). The strongest hand with straightened fingers (palm edge down) is extended forward. The assistant places a 40-centimeter ruler parallel to the palm of the subject at a distance of 1–2 cm. The zero mark of the ruler is at the level of the lower edge of the palm. After the command “Attention!” The assistant must release the ruler within 5 s. The examinee is faced with the task of clenching his fingers into a fist as quickly as possible and stopping the falling ruler. The distance is measured in centimeters from the bottom edge of the ruler. 3 attempts are made, the best result is counted: 13 cm for men and 15 – for women is considered good.
Rice. 9.
Determination of speed of movements (according to Dushanin S.A., 1986)
Speed can also be determined by wrist tempometry. If a woman performs 45 or more taps in 10 seconds, and a man performs 55 or more taps, then they are considered to have good speed capabilities.
The maximum frequency of movements is also assessed when running in place. It is possible to estimate the time for performing a complex exercise - 6 repetitions: basic stance, crouching, lying down, crouching.
Training.
As a means of training speed, exercises of an exclusively active nature are used, which can be performed at maximum speed. They must satisfy at least three requirements:
– the technique of performing exercises should not interfere with maximum speed (therefore, many gymnastic exercises, walking, etc. are of little use);
– must be well mastered so that the main efforts are directed not at the method, but at the speed of performing the exercises;
– the duration should be such that by the end of the exercise the speed does not decrease due to fatigue.
Speed exercises refer to work of maximum power, the duration of which does not exceed 20–22 s even for qualified athletes (for poorly trained people this time is even less).
However, speed abilities, unlike other physical qualities, are less amenable to development and are predominantly innate in nature. An example of this is the very slow growth of results in a sprint.
Due to the fact that work with maximum intensity occurs under anaerobic conditions, rest intervals between exercises should be sufficient to repay the oxygen debt (from 4-6 to 8-12 minutes). In the post-work period, recovery processes proceed unevenly: immediately after work, recovery occurs very quickly, and then slows down. We can assume that in the initial third of the recovery period of a number of functions, 70% of the total restoration takes place, in the second third - 25%, in the third - only 5%. Therefore, for example, if recovery after a 100 m run takes 12 minutes, then after 8 minutes your performance will be restored to 95%, which makes it possible to start the next attempt with virtually no reduction in speed.
Treatment of limited joint mobility
If you regularly feel stiffness in your joints for no apparent reason, do not self-medicate: you can accelerate the development of the disease. For some diseases, increasing physical activity will help, while for others it is better not to put stress on the joints.
Make an appointment with an orthopedic traumatologist. The doctor will clarify the symptoms, perform palpation and assess the degree of limitation of mobility. After which he will refer you for examination to clarify the diagnosis. The examination may include ultrasound, MRI, and laboratory tests.
In the early stages of diseases, complex conservative treatment is prescribed, which includes medications, physiotherapy, and therapeutic exercises. In advanced cases, injections of medications are made into the joint cavity. In later stages, partial or complete joint replacement is performed.
