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joints, range of motion and exercise


joints, range of motion and exercise
It’s a sad fact that us modern humans now live a very sedentary lifestyle. Combine this with bad diets and we are slowly changing into overweight, slow and lazy humans. This modern lifestyle also leads us into many health issues once we start exercising.

One of the issues are injuries from incorrect exercise performance. When an injury occurs to a joint there is an increased chance of it reoccurring, especially as we get older, which can lead to long term issues such as osteoporosis, arthritis, inflammation and dislocations. Therefore preventing these injuries is much better than having to deal with it after it has happened.

Before I carry on, it is important to point out that this article is written to help those working out in main stream types of exercise, combined with our modern lifestyle where we spend most of our lives in a seated or lying down position. Performing your exercise correctly with proper technique is much more important for joint health in this instance due to going from living a life of immobility to suddenly working out.

The joints of our bodies have a normal range of motion. Our body has several joints comprising of the one’s that have next to no movement, those with limited movement and those with higher movement. There are many forms of joints all with different names, but for the purpose of this article I’m simply going to concentrate on the joints affected by most main stream exercise.

Most of the joints of our bodies have various combinations of capsule, cartilage, connective tissue, ligaments and tendons holding together and cushioning the bones of the joints. Care of these joints is important for our mobility later in life.

Neck (cervical spine)

Your neck has a normal range of motion as follows:

  • Flexion (look down) – between 40-60 degrees
  • Extension (look up) – between 45-70 degrees
  • Lateral flexion (lateral bend by nodding side to side) – between 35-45 degrees
  • Lateral rotation (looking left or right) – between 60-80 degrees

Note, that at no stage have I mentioned circular rotation. While the neck can certainly do this, the problem is that your neck has many muscles and ligaments that help protect the range of motion of your head. This is important, as you have many nerves running down your spine from your brain. The natural movement of your head is a linear one and not a circular one. Doing circular motions can lead to impingement and joint damage.

When lifting weights, it is almost always better to keep your head in a neutral (straight position).

Spine (Thoracic and Lumbar)

Your spine has a normal range of motion as follows:

  • Flexion (bend forward) – up to 80 degrees
  • Extension (bend backward) – up to 30 degrees
  • Lateral flexion (bend side to side) – up to 30 degrees
  • Lateral rotation (twisting shoulders left/right) – up to 20 degrees

Your spine has 24 vertebrae running from your neck to your Sacrum (the Sacrum is a bone with 5 vertebrae of its own fused together). The Thoracic part has 12 vertebrae and the Lumbar part has 5 vertebrae. These vertebrae have discs as cushions between them. The spine also has muscles, ligaments and tendons around it that work together with your skeletal muscles to aid movement and stabilise and protect the joints. The spine isn’t straight and has a number of natural curves.

Most problems that occur are due to bad posture (sitting or standing), poor back muscles, tight hamstrings, inflexible hips, weak core strength, incorrect alignment when lifting, lifting too much weight, sudden impact/movement, awkward twisting and over use.

With regards lifting weights, always look to keep your back in as neutral position (chest pointed out and forward) as much as possible and always look to use proper form and technique to protect your spine. Some exercises aren’t the best for your back, they include most exercises that place a load on your spine, squats, dead lifts, overhead presses, etc and even seated overhead pressing movements, where you round your back, create flexion or extension and don’t use proper technique.

Elbow joint

Your elbow has a normal range of motion as follows:

  • Flexion (bend up) – up to 150 degrees
  • Extension (bend down) – up to 180 degrees

The elbow joint is essentially a hinge joint that connects the humerus (upper arm bone) to the ulna and radius (lower arm bones) and forms three joints at the elbow. Although the elbow joint itself only allows for flexion and extension the combination of the other joints also allow the hand to be turned over and for a certain amount of pivoting.

Elbow issues can be quite debilitating due to the fact that we use our arms and hands all the time, making completing daily tasks a problem and even worse, hindering recovery and prolonging the healing process. Most injuries from exercise comes from tendinitis (tennis elbow) or bursitis, where the tendons or bursa can become inflamed. This is often caused by over-use of the joint and often appears over a period of time. Another problem can occur from the compression of nerves in the joints, including nerves that run down the neck, shoulder and arm.

Some exercises place a lot of stress on the elbow joint and include most pressing movements, especially the bench press and some triceps exercise like the skull-crusher or triceps extension. Use of proper technique, appropriate weight and using a neutral grip with wrists straight will all help avoid these injuries. If you do suffer from any elbow injury, avoid exercises that feel uncomfortable to do, especially ones where your arms are extended and straight, such as side lateral and front raises and possibly some might have issues with doing pull ups with inner elbow pain, so avoid them also if you feel pain.

Knee joint

Your knee has a normal range of motion as follows:

  • Flexion (bending of leg) – up to 140 degrees
  • Extension (straightening of leg)

The Knee joint connects the bone of the upper leg with the patella bone of the knee and two bones of the lower leg. There are two pieces of cartilage, numerous bursa, tendons and a number of ligaments in what is a major mobility joint of the human body. The knee joint is a hinged joint, although it does also have the ability to have some internal and external rotation in its movement.

The normal range of motion for flexion is around 0-140 degrees, although some people have knee joints that allows for even a minus ROM when most people’s legs when straight are closer to 0 degrees. People who can straighten their legs beyond 0 degrees need to take extra care when using weights and not go too close to locking out, as I have seen damage to knees and even broken legs occur with exercises like the leg press for example. Those with a limited range of motion may develop a limp and will also place more stress on their knee cap. Problems occur for most people who do not have a ROM of at least 120 degrees.

There are a lot of potential issues with the knee joint, many created by over use and age. However for this article I’ll just be mentioning the ones effected by exercise performance. Sports injuries often occur due to over rotation of the knee joint, especially if your foot is planted and not allowed to rotate in the same direction. Another issue can come from tendinitis of the patellar that leads to crunching sounds from the knee cap and often associated with runners. Compression from load can cause muscular and bursitis pain. Using good form and technique when performing leg exercises will help strengthen weak knees, however do them wrong and you could do the complete opposite. For all leg exercises don’t allow your knees to go beyond your toes such as with squatting or lunges. If you have issues with your knees avoid leg extensions (unless going very light), lunges, deep squats and long hold stretching. For those looking to strengthen weak knees, try partial squats or wall squats, use light weights and don’t put too much load on your joints with or without weights. Warm-up properly, don’t lock out as it puts too much pressure on the knee joint. Keep your heel down when squatting or doing pressing movements with the legs. No matter what leg exercise you do, avoid bowing your legs in or out and keep them in a straight plane.

Ankle joint

Your ankle has a normal range of motion as follows:

  • Dorsiflexion (foot points up) – up to 30 degrees
  • Plantarflexion (foot points down) – up to 40 degrees

Your ankle joint is a connection between your two lower leg bones and the bone of the foot. The ankle joint is essentially a hinge joint, however  the joint has some flexibility that allows it to also tilt and rotate a little. There is a complex array of ligaments that keep the ankle stable.

Many issues with your ankles occur from sudden impact or awkward rolls or twists. These injuries tend to damage ligaments or tendons, causing sprains and strains or even fractures to the bones from impact.

Use appropriate footwear and run on a stable flat surface as much as possible. If you think you have weak ankles, try doing some balancing exercises, which will help not just strengthen your ligaments and surrounding muscles, but also help it learn stability control of the joint. I suggest a wobble board. Alternatively go for a walk (not run) on uneven surfaces to build up strength and stability of the ankle joint, but start off and build up slowly.

Shoulder  joint

Your shoulder has a normal range of motion as follows:

  • Vertical flexion (lift arms forward in front of body and up above head) – up to 170 degrees, although some may be able to go as far as 180 degrees
  • Extension (move arms straight back behind you) – about 45 degrees, although some may be able to go as far as 60 degrees
  • Abduction – (move arms out to your sides laterally and above head) – up to 150 degrees, maybe as much as 180 degrees for some
  • Adduction – move arms back from abduction and across body
  • Internal rotation (medial rotation with arms bent 90 degrees) (allows shoulders to rotate inwards) – up to 80 degrees
  • External Rotation (lateral rotation with arms bent 90 degrees) (allows shoulder to rotate outwards or upwards with upper arm 90 degrees to the body) – up to 90 degrees

The shoulder joint is a ball joint (one bone is rounded at the end, while the other bone is cup shaped) and it has the widest range of motion of any joint in the human body. It is also involved in just about all upper body movement, as such it is susceptible to overuse and injury. Its joint is connected via many muscles, tendons, ligaments not just with its ball joint, but by the shoulder girdle that includes the scapula, humerus and clavicle.

As the shoulder joint relies upon the rotator cuff muscles, shoulder girdle and ligaments to allow this large range of movement available, issues can arise where the joint becomes over stretched and unstable as the further you push the joint the more it squeezes and compresses various areas of the joint, creating issues of bone on bone, ligament snagging, bursitis, adhesion, impingement, rotator cuff injuries, joint separation, frozen shoulder and many degenerative disorders and even muscle tears. So what gives it its flexibility also has to help cope with its stabilisation and having too much flexibility will have strength issues and being too tight will have mobility issues. So you can see it’s a joint with a bit of a catch 22 situation.

To reduce or stop many of these issues, try to avoid putting the shoulder in an awkward overhead position or being rotated into an awkward position. Much of the problems can occur due to weak rotator cuff muscles, which are there to help stabilise the shoulders and when stability is lost and then load applied to the joint, problems can arise.

Train your rear deltoids as often and hard as your chest muscle to create a balance in strength and strengthen your rotator cuff muscles. Concentrate on your posture, avoid letting your elbows go back when pressing and press with a more neutral elbows forward position. Avoid wide grip pull-ups, bench presses to the upper chest/neck and also avoid dips and upright rows. Use of a neutral grip in most lifts will help keep the shoulder in a better stable position. Don’t forget to also warm-up before lifting weights or playing sports.

Hip joint

Your hip has a normal range of motion as follows:

  • Flexion (lifting leg to the front of you) – up to 140 degrees (dependant on whether you have your leg extended)
  • Extension (moving your straight leg back behind you) – up to 20 degrees
  • Internal Rotation (medial rotation – with leg bent at the knee 90 degrees, rotate hip to bring foot outwards) – up to 40 degrees,
  • External Rotation (lateral rotation – rotate hip to bring foot inwards) – 30 degree hip extension or 50 degrees extended
  • Abduction move (leg out to the sides) – up to 50 degrees
  • adduction (from neutral to the opposite side) – up to 30 degrees

Your hip joints are made up of a ball and socket and connects your lower limbs to the pelvic girdle via ligaments, a capsule, fluid, cartilages, tendons and muscles. It has a moderate range of movement to maintain stability and be able to allow it to take a reasonable amount of weight and still give you enough flexibility and articulation to maintain balance, walk, run, jump, sit and stand up.

Like the shoulders there are many issues that can arise from your hips. Many are age related from degeneration and overuse and friction, while some are caused by bad exercise form, bad posture and being in the seated position for too long. Your posture is often governed by your pelvis angle.

Balance is key when working your legs and keeping a stable joint position to maintain hip joint alignment. For tight muscles around the hip, use a foam roller or massage ball, don’t do static stretches. Remember your looking for a strong stable hip, not a loose over flexible hip that can lead to injuries when using weights. When squatting keep the weight over your heels and have a neutral back. Include non linear exercises, i.e. side lunge jumps, single leg dead-lifts, band circuits and leg swings to work on the stabiliser muscles.

Wrist joint

Your hip has a normal range of motion as follows:

  • Flexion (bend down) – between 70-90 degrees
  • extension (bend up) – between 65-85 degrees
  • Radial deviation (tilt to thumb side) – between 25-40 degrees
  • Ulna deviation (tilt to little finger side) – between 15-25 degrees
  • Supination – turn palm up
  • Pronation – turn palm down

Your wrist is essentially a gliding joint and consists of many bones that glide individually, with the bones of your hand connecting to the bones of the lower forearm. However there is enough flexibility to allow the wrist to tilt and also do circular rotations.

Due to the flexibility of your wrist joint, they are prone to frequent injury. It is important that almost all tasks involved in pressing or pulling be performed with the wrist as straight as possible in its neutral position to avoid placing stress on it. Also avoid doing exercises like wrist curls off the end of a bench, as this can place too much stress on your ligaments. Other issues are related to overuse giving rise to repetitive strain injuries.

Summary

Physical health should be looked upon as a long term plan. Many people workout in such a way to push their bodies to extremes or use the wrong exercise technique to try to make progress as quick as possible. However sensible training can help you make great progress without damaging your body.

Minor injuries to your joints can put you back in your training and major Injuries can either stop you training for a long time or even create a permanent issue that will affect you in later life and therefore your exercise choice and technique should be given some thought to avoid this.

For those who would like to know more about natural movement exercise that replicates what our ancestors used to do with their bodies, I will be shortly writing an article on that subject. (stay tuned). In the mean-time it may be worth looking into animal flow exercises for those looking for a way to increase their general strength, core strength, joint strength, agility, stability, flexibility and body awareness.