Limited flexibility is a common feature of musculoskeletal pain and dysfunction. Restoring flexibility and normal joint range is essential for reducing pain and optimising athletic performance.
Limited flexibility and reduced joint range of motion is a common feature of many chronic musculoskeletal pain conditions. An important question for the therapist to ask is, ‘Why is the joint range of motion impaired and what are the primary causal factors contributing to this?’ Rarely is there just one single causal factor at play. Instead, there are almost always numerous causes.
Our bodies are wonderfully intelligent machines, brilliant at compensating for the various soft tissue injuries and traumas that we accumulate throughout the course of life. When the body runs out of ways to compensate and adapt, musculoskeletal pain is the result. Some common causes of reduced flexibility and joint range of motion include:
- Visceral – A restriction of the internal organs or their surrounding fascia and ligaments.
- Neural – A tension or restriction of the nerves.
- Muscular – Hypertonic muscles or tension in their associated fascia.
- Fascial – Tension or adhesions in the fascial web running throughout the body.
- Vascular – A restriction or tension in the arteries or veins.
The health of the internal organs is essential for life. According to visceral pioneer Jean-Pierre Barral, “For an organ to be in good health, it must be able to move”. When an organ loses this ability, either through trauma, infection, invasive surgeries, or emotional distress, then the body will reflexively tighten the surrounding muscles to guard and protect the organ. In these instances, treating or stretching the tight muscles is counterproductive, since it is only treating the symptom, not the cause. For lasting, effective relief, manual visceral manipulation techniques are the solution. For more information on visceral manipulation, click here.
The nervous system is an interconnected highway running throughout the body. Whenever a joint is moved, the nerves passing through that joint need an ability to slide and glide with the surrounding tissues. When this sliding and gliding is compromised, musculoskeletal pain and dysfunction is the result. The body’s main priority is the health of the nerve. The body does not care about muscular tension. Consequently, the body will sacrifice the surrounding muscle tissue to protect the nerve. When neural restriction is present, this must be addressed directly, otherwise muscular pain and dysfunction will quickly return.
The neural restriction is not always located at the site of pain symptoms. Precise assessment is necessary to determine which area of neural tissue requires treatment. Gentle neural manipulation is then used to restore neural function. However, progress and symptom reduction will be gradual. Neural tissue takes approximately 6-8 weeks to rehydrate.
Muscular tension and restriction are significant factors in impaired flexibility and joint range of motion. However, there are many causes of muscular tension aside from the muscles themselves. Direct muscular causes include lack of use, overuse, strength and/or flexibility imbalance, compensatory movement patterns, and adaptive shortening to protect other soft tissue structures. When there is a direct muscular causal driver at play, a combination of muscular massage, stretches, strength exercises and movement pattern integration are essential therapies for lasting resolution.
The simplest way to conceptualise the body’s facial, or connective tissue system, is to think of it as an interconnected web. Fascia runs through our muscle fibres, houses them in a stockinged sheath, forms our ligaments and tendons, envelops and supports the internal organs and nerves. This interconnected relationship is highly complex and sophisticated. Consequently, the location of a significant fascial restriction is rarely where the pain symptoms occur. Careful assessment is required before treatment is undertaken. Treating the fascial web is akin to a tangled ball of yarn; pull on the correct string and it unravels; pull on the wrong string and it tightens, making pain and dysfunction worse.
Much like the nerves, the arteries and veins need to be able to slide and glide with the surrounding tissues, especially during joint movement. When this relationship is compromised, blood flow is impeded, and the uptake of oxygen and nutrients is impaired. Muscular, neural, and joint health soon suffer as a consequence, and reduced flexibility and range of movement soon follow. Gentle vascular manipulation techniques are a highly effective method of treating this condition and restoring normal function.
