Does Having Good Mobility Prevent Injury?
Show Me The Data
The Truth: Multiple studies have shown inconclusive and often insignificant results of stretching programs' effectiveness in reducing the incidence of injury.
…no scientifically based prescription for stretching exercises exists and no conclusive statements can be made about the relationship of stretching and athletic injuries. Stretching recommendations are clouded by misconceptions and conflicting research reports.Witvrouw E, Mahieu N, Danneels L, McNair P. Stretching and injury prevention: an obscure relationship. Sports Med. 2004;34(7):443-9.
Who is being studied?
Most of the studies have been performed on field sport athletes. As we know, football, basketball and baseball have different mobility demands than Olympic Weightlifting.
What is being measured?
The effect of a particular stretching or mobility protocol is most often measured in degrees of Range of Motion (ROM) using a goniometer.
The studies are looking at the the raw amount of freedom in a joint, not the ability to control the position, create tension or organize a complex movement.
What isn’t being measured?
The goal of scientific studies is to isolate variables so meaningful conclusions can be drawn. This is why qualities, like ROM, get divorced from other critically-important aspects of movement.
(1) Mobility vs. Flexibility
ROM can also be described as flexibility: the freedom of a joint.
This is very different from mobility, which is about the ability to organize and control a joint through a range of motion.
(2) Active vs. Passive Range of Motion
Simply stretching a joint will likely increase the ability to get into a new range with the assistance of gravity or another external force.
However, the ability to create active tension and move your joint actively into the range is a much more athletic and transferrable quality.
(3) Strength in End Range
Tools like PAILS & RAILS, as well as End Range Isometrics are potent tools because they improve an athlete’s ability to drive high amounts of tension in the ranges where they are mechanically disadvantaged.
Understanding the Role of Mobility in Injury
So a multitude of studies can’t guarantee a stretching regimen will reduce your odds of injury, but surely there is some sort of positive correlation or connection between mobility and injury prevention…right?
But you need to understand is that simply executing a series of stretches is far different from generating meaningful improvements in mobility, motor control, end range strength, and fatigue-resistant quality movement in sporting contexts.
Furthermore, athletes who randomly stretch whatever muscle groups they please, often neglect how the rest of their body is organized in space during that stretch.
In fact, blindly stretching for many athletes can do as much harm as good because (1) not all athletes need to stretch to drive change and (2) not all joints are meant to be mobile.
(1) Not All Athletes Need to Stretch to Drive Change
If a hypermobile athlete is given a stretching protocol, the likelihood of injury will increase. A hypermobile athlete already struggles to maintain active control over the joint because it is not “propped up” by tension from passive structures (ligaments, joint capsule, etc.)
The last thing I want an overly-bendy female ex-gymnast to do is banded distraction-based stretches for her shoulders. Her rotator cuff already has to work super hard to keep the glenohumeral head from thrashing around in the socket and causing trauma during her Chest-to-Bars, so stretching lat, pec and/or capsule will likely make the athlete more likely for injury.
Dramatically more range of motion than is needed for Sport movements is not a good thing; it’s more real estate that needs to be actively controlled.
(2) Not All Joints Are Meant to be Mobile
There’s a reason why the acetabulum (socket) of your hips is deeper than the glenoid fossa (socket) of the shoulder. The hips are designed to be less mobile and more stable than the shoulder.
Furthermore, there is a reason why the hips and shoulders and far more mobile than the knees and elbows.
Again, more ROM requires more active control; Shoulders are injured more often than hips.
And here’s the thing: Not all joints are meant to be mobile.
In general, the body tends to alternate stable and mobile joints…
It’s when this pattern is out of whack that you are much more likely to be injured.
Let’s consider Remmi.
She is a recreational CrossFit athlete with a desk job and who has limited shoulder flexion and t-spine extension due to her hands being on a keyboard a good portion of her day.
When she puts her arms overhead in movements like Push Jerks, she lacks the range of motion needed in those joints to get into a good position.
Basically, her joints that are supposed to be mobile are not. Since she lacks range in one body segment / joint, she is forced to make it up elsewhere.
In other words, she uses a compensatory movement pattern to still get the work done. So Remmi goes into lumbar extension and an anterior pelvic tilt combined with excessive wrist extension to make the position work.
She still got the work done, but the alignment of her axial skeleton was pulled out of whack.
This is something I've talked about extensively before.
Being in lumbar extension when loaded overhead makes it nearly impossible for her to brace effectively, and puts significant pressure on her lumbar spine while it’s in a compromised posture.
An anterior pelvic tilt makes a transfer of power from her legs into the barbell significantly more challenging, while simultaneously making the ability to breathe -particularly expire- much more difficult.
She completed the work, but a window for injury was opened up because the right kind of mobility wasn’t available in the right body segments.
You see, a conversation about injury prevention and mobility can’t be had without considering tension, movement organization and motor patterns.
So no, mindless stretching probably won’t make you any less prone to injury.
So you may be asking… What is needed for reducing injury risk and improving movement quality?
A Holistic Approach to Movement
If you want to reduce the likelihood of injury and improve your movement quality you need a comprehensive plan that takes the whole athlete into account.
You need to work with a professional who can help determine what joints and within what specific ranges of motion you need to target, all while promoting stability, strength and control in other joints and body segments.
This is the key to bulletproofing your body.
Mobilize that which needs to be mobile.
Strengthen that which needs to be strong.
But there is one more layer: move well. It sounds simple yet is anything but easy.
Moving well is a never-ending quest that every athlete must find themselves on.
Don’t just work to move faster and lift heavier; work to make your movement smoother, crisper and more precise.
The Truth: In My Words
Improving flexibility for an athlete who is lacking range of motion in the joints needed to maintain axial alignment will reduce the likelihood of injury if that athlete can actively control their new range and if that athlete uses it as a window of opportunity to move better.
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