STABILITY OR MOBILITY

 STABILITY OR MOBILITY

In the treatment of abnormal joint and muscle conditions, the general goals of treatment based on whether stability or mobility is the desired result for optimal function. Joint structures they are designed so that, along with greater mobility, there is less stability and, along with greater stability, there is less mobility. It is generally accepted that along with growth from infancy to adulthood, there is a "hardening" of the ligament structures, along with a corresponding decrease in muscle flexibility. This modification allows greater stability and strength for adults than for children.

The individual with "relaxed" ligaments, which are often referred to as the "loose tissue" type, does not have the stability of the foot that a less flexible individual has. A knee that goes into hyperextension, for example, it is not mechanically stable to support weight like one held in normal extension. The lack of stability of the spine in a flexible individual can lead to problems when the job requires prolonged sitting or standing, or the need to lift or carry heavy objects. Muscles fail to function as much for movement as for the support normally provided by the ligaments. When symptoms do occur, they will appear first as fatigue and then as pain. Often a young adult with excellent strength but excessive spinal flexibility will require back support to relieve painful symptoms. In some circumstances, function improves and pain is relieved by limiting range of motion to the point of complete fixation. Conditions such as Marie-Striimpell arthritis of the spine, when fused with good alignment, and postoperative fusions of the spine, hip, foot, or wrist exemplify this principle. From a mechanical point of view, two types of failures are related to alignment and mobility: excessive compression on the joint surfaces of the bone and excessive stress on the bones, ligaments or muscles. Eventually, two types of bone changes can occur: excessive compression produces an erosive effect on the joint surface, while traction can cause increased bone growth at the attachment point. Lack of mobility is closely associated with persistent misalignment as a factor causing excessive compression. When mobility is lost, stiffness occurs and some alignment remains constant. This may be the result of the restriction of movement by the tense muscles or the inability of the weak muscles to move the part through the range of motion. Muscle tension is a constant factor that tends to keep the part out of alignment regardless of body position. Muscle weakness is a less constant factor because changing body position can cause a change in part alignment. With normal joint movement, wear on the joint surfaces tends to be distributed; however, with the limitation of the flow rate, wear will only occur on the mating surfaces representing the range of use. If the part that is limited by muscle tension is protected against any movement that could cause tension, the other parts that need to compensate for the restriction will be stressed instead. Excessive joint mobility puts strain on the ligaments that normally limit range of motion it can cause excessive compression at the edges of the joint surfaces when excessive extension is of long duration.

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