If you’ve suffered an injury in the previous two years, chances are someone has told you to do some sort of mobility work (foam rolling, lacrosse ball, stretching, etc…). Low back pain? Roll on it. Knee pain? Roll on it. Headaches? Uh, I guess roll on it. It seems like mobility work is the answer for every sports injury. This blog post will discuss why mobility work doesn’t fix everything and what you should be doing to prevent sports injuries.
Mobility work definitely has its place in performance for both quality of movement and from a pain management aspect. However, mobility is only one piece of the puzzle when it comes to movement. Strength, endurance, and motor control are also components of movement that may contribute to faulty movements and injury. Of course adequate mobility in your joints can help prevent an injury, but the amount of mobility needed will depend on the activity (for example, jogging doesn’t require a lot of mobility but a snatch will).
Tissue Capacity < Load = Injury
A simplified way of looking at injuries is when the tissue is not able to adapt to the stresses placed upon it. For example, let’s take a look at Achilles tendinopathy in runners. The Achilles tendon has a specific amount of force that it can absorb which will vary from person to person. If more force is placed on the tendon than it can absorb then pain may occur to prevent or as a result of damage to the tendon.
It’s important to understand that pain and injury are not synonymous. If the system works as it is supposed to, pain will occur before there is tissue damage to protect the tissues. However, you can have a tissue injury without pain (ie. cancer) and you can also have pain without a tissue injury (ie. chronic low back pain). This is why it is important to have pain evaluated because running through pain could lead to longer term issues.
Preventing sports injuries is a complicated topic because there are so many factors that are associated with injuries. The focus on preventing injuries should be on increasing the tissue capacity. The higher the tissue capacity, the higher total load the tissue can accommodate with a risk of injury.
The most effective way to increase tissue capacity is through controlled loading. By loading the tissues, you are stimulating the tissue to adapt to the stresses placed upon it. The key is to create a progressive program where the load does not exceed the tissue capacity. As a general rule, it is advised to not increase the program more than 10 percent per week (this includes weight, duration, frequency, etc).
If you are doing rehab, pain can be an acceptable part of the program. This is because you need to stimulate the tissues enough to cause an adaptation. Too little load or too much load can both be problematic. It’s always to your advantage to have a professional create a rehab program for you if you are dealing with pain.
An example of a loading program for the person with Achilles tendinopathy could start off with isometric heel lifts (lifting the heels off the ground and holding) then progress to concentric-eccentric heel lifts (slowly lifting standing on toes then lowering the heel). The program could then progress to using weights or increasing the speed depending on what the goal of the runner is (sprints, long distance, etc).
Can mobility work increase tissue capacity? Not really. The length-tension relationship of muscles states that muscles will generate more tension at a specific length, which is typically at about mid-range (imagine carrying a bag of groceries with your elbow flexed different amounts). Optimizing this length-tension relationship is important but for most activities, people can get into the “optimal” length-tension zone. For example, think about how much hip extension or ankle dorsiflexion are actually needed during running… not much.
Mobility work is an important part of sports performance, but it is only one piece of the puzzle. The goal of an injury prevention program should be aimed to increase tissue capacity, which means that a progressive loading program is needed.