Stopping minor aches & pains early
The majority of patients I see have simple joint "derangements", which can be thought of as generalized joint inflammation that causes the joint to not move as fluidly as it should. It's best to resolve this inflammation early to ensure you don't begin to move in sub-optimal ways, which can predispose you to a more serious injury.
Luckily, there's a tool you can use to treat your own pain in the majority of situations. It's called "Joint PMCS" & is described in ATP 7-22.02 in chapter 17.
Below is an expanded version of the ATP.
The mobilizations used in joint PMCS can also be used as a daily preventative routine to keep your joints healthy - I like to use the analogy of it being similar to an oil change for your joints.
Please note: I do not recommend performing joint PMCS following a traumatic injury. Also, if any of these movements feel unsafe, stop. Finally, as the ATP instructs, if these exercises do not help then get evaluated by a medical professional.
Instructions
It's important to understand that you are serving as your own clinician when conducting joint PMCS. These movements are not guaranteed to make you feel better - in fact, some may even make your pain worse.
The way we self-assess if one of the movements listed below are helpful for your condition is by using a test/re-test model. To do so, we'll follow this sequence in order:
1) Perform a movement that's painful or limited to establish a baseline. Examples:
➤ Range of motion of a joint - assess for both pain & the amount of motion you can perform
➤ A functional movement such as a squat, pushup, jogging 25 yards, etc.
2) Perform an exercise listed below
➤ Perform 10-15 reps
➤ Only hold each rep for 1 second. Perform each rep slowly.
➤ As you perform the rep, exhale & relax your body as much as possible
3) Repeat the same movement in step one to determine if the pain or limitation in motion has gotten better, stayed the same, or gotten worse
➤ If the exercise helped, perform 50-100 reps of it per day
➤ Spread out your reps into chunks of 10-15 every ~2 hours
Something to note is that pain in an arm/leg can sometimes be referred from the spine. Due to this, if you have pain in your shoulder/elbow/wrist, first perform the neck exercises before attempting the exercise of the involved area. The same goes for pain in the hip/knee/ankle - first perform the low back exercises to ensure the pain isn't being referred.
Each body region will have 2 exercise options.
The Exercises
Neck 1: Retraction
Cue: Push the chin straight back without tilting the head / chin
Neck 2: Retraction into extension
Cue: Perform the first neck movement (retraction), then push the head back into extension
Shoulder 1: Extension
Cue: With the painful arm behind you, grab a stick and make the painful arm move into extension by pushing the stick with your non-painful arm
Shoulder 2: Internal rotation
Cue: Grab the painful arm’s wrist and pull it behind the back and up
Elbow 1: Extension
Cue: With the hand facing backwards on a surface, push with the other hand to cause elbow extension
Elbow 2: Flexion
Cue: Push with the other hand to passively cause elbow flexion
Wrist 1: Extension
Cue: With the other hand, pull the wrist into extension (note: be gentle)
Wrist 2: Flexion
Cue: With the other hand, pull the wrist into flexion (note: be gentle)
Low back 1: Extension
Cue: Lie flat, then push-up while exhaling and relaxing the glutes
Low back 2: Rotation
Cue: If you have pain on the left side of your back, hook your right foot behind your left leg and push down on your right leg to cause max rotation. Attempt to make both shoulders touch the ground.
NOTE: This exercise should be sustained for up to 1 minute and not repeated like the others
Hip 1: Extension
Cue: With the painful leg back, push the hips forward to cause hip extension
Hip 2: Flexion
Cue: Pull the painful leg up into max flexion
Knee 1: Extension
Cue: With the painful leg forward, place your hands above the knee and push backwards to cause knee hyperextension
Knee 2: Flexion
Cue: Place the painful leg on a bench/chair and stand upright. Using your non-painful leg to control your descent, "sit on" your painful leg to cause max knee flexion. Use the non-painful leg to return to standing.
Ankle 1: Dorsiflexion
Cue: Kneel with the knee of the non-painful leg on the ground. Drive the knee of the painful leg forward (keeping your heel on ground) to cause ankle dorsiflexion.
Tip: I recommend holding onto something while you do this to allow you to concentrate on driving your knee as far forward as possible.
Ankle 2: Plantarflexion
Cue: From upright kneeling, sit your bodyweight onto both ankles to cause ankle plantarflexion
Mid back 1: Extension
Cue: With the foam roller near the painful area, bend backwards and exhale to cause extension. Don't roll up and down your back, the motion should be similar to a sit-up.
Tip: A medicine ball can also be used here
Mid back 2: Rotation
Cue: Rotate from neutral to the most painful/limited side and back to neutral
Need help?
If you're confused by the ATP or the above instructions you can consult your medic or email me at brandon.l.launstein.mil@army.mil.
If the above movements do not help your pain or they feel unsafe, please consult myself or your PCM.