Blog #12: Who Loses Range of Motion and Why?
Thanks for tuning in to another blog post from Session 41 LLC, a Naples, Florida-based personal training company designed to prevent injury and get you feeling and moving better. Blog #12 discusses who may be at increased risk of having mobility challenges and how you can change that.
Who is at Risk of Losing ROM and why?
There are a number of populations that are more inclined to experiencing lost range of motion (ROM) than others.
Senior Individuals -
Reduced ROM is normal and a natural part of aging. As we age, fundamental changes occur to our muscle tissue, connective tissue, bones, cartilage, and more.
One such factor are changes to our extracellular matrix (ECM), which is a complex network of proteins like collagen and other connective tissue makeups surrounding our muscle fibers and soft tissues. It has been observed in elderly mice that “densely packed and extensively cross-linked collagen” are a leading mechanism to age-related passive stiffness (Wood et al., 2014).
So, what does this mean in english? This means that, in the context of aging, it is not so much mechanical stiffness in muscle fibers themselves that limit ROM but rather stiffness and disorganization in connective tissues like ECM that is hypothesized to reduce muscle extensibility.
Additionally, senior individuals experience changes to cartilage and other age-related wear and tear conditions like arthritis and joint degeneration that can significantly impair ROM and function.
Sedentary Populations -
Chronic unloading of tissues also tends to cause decreases in ROM because of a dual effect of muscle atrophy and the fact that certain tissues are held in a chronically shortened position. Muscles are mechanically adaptive, which means they adapt to the specific positions, demands, and loads that they are placed under. If the body is not challenged with loading, we tend to lose that adaptation. The saying “use it or lose it” is actually quite true.
Additionally, sitting places certain tissues in a shortened position and others in a lengthened position. This leads to a number of adaptive changes. In a study evaluating a chronically shortened bicep muscle in stroke patients, it was established that, similar to other animal-based studies, skeletal muscle adapts to chronic, shortened positions by reducing serial sarcomeres as well as muscle tissue from chronic disuse and positioning (Adkins et al., 2021).
Those Exposed to Overuse & Repetitive Motions -
So we said under-loading tissues can lead to lost ROM, but overloading tissues can also have the same outcome of limited ROM. This would be known as “overuse”, which means that the physical demands on the body are beyond its current capacity or ability to recover, leading to tissue changes or injuries that reduce ROM.
Chronic overuse instances that lead to lost ROM typically have the following characteristics:
Repetitive loading through a partial range and under-utilization of other ranges
Consistent loading beyond the tissue’s capacity or ability to recover
Tendon degradation from excessive loading
Disorganization in ECM and other connective tissues
What’s happening here is that the body is not given the chance to recover properly. Instead of fully repairing micro-tears in muscle and connective tissue, the body resorts to a very haphazardly and inflammation-induced way of healing that impairs strength, ROM, and overall function within the tissue.
A central reason this happens is because the body will lay down excessive amounts of collagen that leads to disorganizing changes in the ECM and limits tissue extensibility, known as fibrosis. These fibrotic changes have been seen in rat animal studies, where higher levels of collagen were observed in groups performing a repetitive task than their control group counterparts (Hilliard et al. 2020).
What Can We Do About It?
Regularly performing strength training and performing mobility exercises like static or dynamic stretching has been proven to increase range of motion. While both strength training and dedicated flexibility training have been shown to produce similar results, it is often best to perform a combination of both to maximize results and health benefits.
According to a study in the Journal of Strength and Conditioning Research testing the effects of strength training combined with flexibility training over the course of 16 weeks, found that just 3 sessions per week were enough to significantly improve ROM, improving a simple sit-and-reach test by up to 11 cm (Simão et al., 2011).
For individuals performing repetitive motions and dealing with overuse-related injuries, load management, in addition to strength and mobility training, should be considered. There is no solution to overtraining except for proper planning, nutrition, and recovery.
Strength and mobility training should be a regular part of everyone’s active lifestyle, not just to improve function and resilience, but also to improve range of motion and movement quality.
About the Author:
My name is Ethan Gendron, and I am a Certified Personal Trainer and founder of Session 41 LLC, a Naples Florida based fitness company. I am certified through W.I.T.S., an NCCA accredited institution. I have years of experience working with clients of all ages and backgrounds, ranging from seniors to children. My firsthand experience in training and competing in triathlons has given me insight into the practical application of biomechanics, mobility, and strength training for performance enhancement. I have a background in injury prevention, although not by choice, and am passionate about helping others avoid chronic pain. No matter your current fitness-level, I believe everyone should think of themselves as an athlete and, therefore, train like one.
Disclaimer:
The information contained in this blog for informational purposes only. Use information discussed here at your own risk. One should always consult a qualified Healthcare Professional before beginning any exercise program. Content published by Session 41 LLC should never be used as a substitute for proper clinical attention.
References:
A.N. Adkins, J.P.A. Dewald, L.P. Garmirian, C.M. Nelson, & W.M. Murray, Serial sarcomere number is substantially decreased within the paretic biceps brachii in individuals with chronic hemiparetic stroke, Proc. Natl. Acad. Sci. U.S.A. 118 (26) e2008597118, https://doi.org/10.1073/pnas.2008597118 (2021).
Hilliard, B. A., Amin, M., Popoff, S. N., & Barbe, M. F. (2021). Force dependent effects of chronic overuse on fibrosis-related genes and proteins in skeletal muscles. Connective Tissue Research, 62(1), 133–149. https://doi.org/10.1080/03008207.2020.1828379
Lauren K. Wood, Erdan Kayupov, Jonathan P. Gumucio, Christopher L. Mendias, Dennis R. Claflin, and Susan V. Brooks Journal of Applied Physiology2014117:4,363-36910.1152/japplphysiol.00256.2014
Simão R, Lemos A, Salles B, Leite T, Oliveira É, Rhea M, Reis VM. The influence of strength, flexibility, and simultaneous training on flexibility and strength gains. J Strength Cond Res. 2011 May;25(5):1333-8. doi: 10.1519/JSC.0b013e3181da85bf. PMID: 21386731.
