The idea that exercise benefits your health is a medically and scientifically proven, and perhaps more importantly, socially accepted concept. We can now call it a fact. Research conclusively shows that regular physical activity promotes multiple improved health metrics such as lowered LDL and increased HDL cholesterol levels; decreased triglyceride levels; healthy blood pressure, brain health, improved bone density, increased insulin sensitivity and more. Exercise is also positively correlated with longevity. We know exercise is important if we are to stay healthy, maintain a high quality of life, and live longer.
When it comes to exercising, there are basically three groups of people who engage in it:
1. The elite, professional athletes whose livelihood depends on their physical abilities and talents. These people have the benefit of professional trainers and unlimited facilities and equipment to get their bodies in shape. Not something the rest of us can say.
2. The fitness fanatics who hit the gym 3-7 times a week; sometimes more than once a day; keep abreast of the latest exercise techniques and have a better grasp on the science of fitness—basically those who make fitness a central part of their life.
3. The everyday Joes and Janes who take aerobics classes; jog, use a treadmill or Stairmaster and/ or lift weights, as best they know how.
Which group do you fit in?
There are two, textbook categories of exercise: resistance and endurance. In resistance exercise, you apply resistance to your muscles via traditional weights; other heavy objects (medicine balls, tires, sandbags); friction, rubber tubing, and even your own body weight (planks, squats, TRX). In resistance exercise, the primary goal is to strengthen your muscles by stimulating your body to produce more actin and myosin myofibrils, the specialized protein structures that do the actual contraction. The more myofibrils your muscle cells (muscle fibers) have, the bigger your muscle; the bigger your muscle, the greater its potential for generating power.
In endurance exercise, the goal is to improve a muscle’s ability to function for a longer duration before fatiguing. These exercises are more commonly called aerobic or cardio exercises since a big part of improving muscular endurance is to strengthen the heart and lungs. Distance running and wind sprint running; Stairmaster™, cycling and aerobics classes are examples of endurance exercises.
It’s not entirely clear what precisely happens when muscles increase endurance from these exercises, but we do know that placing a sustained, increased demand on the heart, which is the essence of cardio exercises strengthens the heart, a muscle itself, enabling it to pump a larger volume of blood with each contraction (called stroke volume) to skeletal muscles to meet their oxygen and glucose (fuel) demands. Endurance exercises also increase the number of muscle cell mitochondria, the organelles where ATP, the “energy currency” of cells, is manufactured. Generally, more mitochondria means more ATP production. By the way, if you find yourself out of breath after engaging in a level of physical activity comparable to walking up one flight of stairs, you likely have poor cardiovascular fitness.
A third type of exercise that is gaining popularity is muscle coordination or functional exercises. These exercises focus on doing movements that are commonly required in everyday life, with the goal of strengthening/ improving the synergy and coordination between the muscle groups that create that movement. Examples include walking up a flight of stairs; lifting and carrying luggage; lifting something from the floor to a higher level; lifting and carrying something heavy on your shoulder; pulling and pushing something heavy; jumping; sitting down and getting up, crawling on the floor, and so on. Movement patterns such as these involve several synergistic muscle groups such as leg, buttock and back muscle groups that contract in a precise sequence and amplitude determined by your brain. A primary goal of functional exercises, therefore, is to improve the neurological component of muscle group contraction so that your body responds more efficiently to its environment. To get a sense of how functional exercises work, check out the website Functional Patterns.
This brings us to the fourth exercise that most people forget. Resistance exercises strengthen the muscles; cardio exercises improve muscles’ endurance; and functional exercises improve the coordination of muscle groups involved in common movements, so what is missing? The one exercise that people forget, and should incorporate into their workouts are joint exercises.
In joint exercises, the goal is to mobilize and strengthen all the components of the joints—joint articulations, tendons, capsules, ligaments and deep muscles. This requires moving the joint through all its ranges of motion, with and without resistance. The resistance used in joint exercises is not as strong (use lighter weights) as that used in resistance exercises done to increase muscle mass, because gaining muscle mass is not the goal of joint exercises. Whenever connective tissue (ligaments, tendons, bone) and muscle are stressed, the body senses it and makes adaptations: it increases their mass and produces more supportive collagen fibers. This is called Davis’ Law, which describes how soft tissue remodels along the axis of force. The benefit is healthier, sturdier joints that resist degeneration better, and improved strength/ power generation.
Joints are a biomechanical wonder that are an essential component of your locomotor system—the parts of your body designed to generate movement. They enable your skeleton and muscles to do work; i.e. generate power. Recall from basic science the simple machines: pulleys, inclines, and levers with fulcrums. As a machine, your musculoskeletal system incorporates all three; especially levers and pulleys.
Let’s take your arm for instance. Your upper arm bone, or humerus connects to your lower arm bones, the radius and ulna via a joint we all know as the elbow joint. This is a lever and fulcrum system such as the one illustrated above, with the humerus being the effort arm of the lever and ulna/radius being the resistance arm; the elbow being the fulcrum, and the biceps and triceps muscles being the force generators (effort). The elbow joint is a critical component of this simple machine, as it stabilizes the system while allowing movement. Its main components are the cartilage-lined ends of the long bones; the musculotendinous attachments to the long bones; and a capsule made of dense, connective tissue. When you do joint exercises, you target all these structures.
There are several types of joints in the body, classified by their construction and movability. The type we will focus on are the synovial joints, which is the type that enables the greatest arcs of movement compared to other joint types. Examples of synovial joints are the facet joints of the spinal column; the shoulder, elbow, wrist, and finger joints; and the hip, knee, ankle and toe joints.
To exercise a joint, start by moving it in all directions possible (active motion). If you find a joint is offering restriction in one direction, you can passively move it; i.e. relax the muscles of the joint and use your opposite hand to move it, or ask a partner to move it; gradually pushing into the restriction and breaking through the mechanical barrier (but make sure it is not contraindicated; check with a specialist first). Areas of joint movement restriction are usually caused by scar tissue adhesions where scar tissue from previous injuries adheres to adjacent tendons, inhibiting movement in a particular direction.
After doing active and passive joint movement, apply resistance. There are several options, which depend on the joint you are exercising. For the shoulder joint–the joint in the body that has the most versatility– you can use dumbbells or Theraband™ tubing. If you have pre-existing shoulder problems, it may be better to start off with Theraband tubing. If you have no shoulder joint problems, then start out with 3 – 5 pound dumbbells. You can do these exercises standing up, sitting down, or lying prone or supine (refer to diagram below). Basically, you move the resistance doing shoulder forward flexion, extension, abduction, adduction, and internal and external rotation (see diagram below). Occasionally hold the position at ¼, ½, ¾ and end range for a few seconds, then return to full movement.
Next, transcribe circles with your arm, starting with small ones and increasing in circumference; then reverse directions. I will post a video of these exercises later, so stay tuned.
Similar approaches can be done for the elbow, wrist, finger, knee, ankle and toe joints.
Sometimes a joint “dries up” after years of insufficient movement. This is common in office workers whose job description centers on typing/data entry. In this position, the shoulder joint is relatively static (upper arm angle doesn’t change) and synovial fluid doesn’t adequately circulate around the joint surfaces. Synovial fluid is the equivalent of motor oil for joints, allowing them to move nearly friction-free. When you don’t move your joints enough, synovial fluid levels drop and some friction sets in. This causes your joints to feel achy and stiff. Sometimes you may even hear grinding sounds with shoulder movement when levels are low. Lubricin is another substance in the joint capsule that contributes to smooth joint movement by protecting the cartilage-secreting cells. It, too, can dry up if there is insufficient joint movement.
If your joints feel stiff, apply heat, like an infrared lamp for 20 minutes followed by active and passive stretching in all ranges of motion. Movement will re-stimulate the secretion of synovial fluid and lubricin. Do twice a day for two weeks, then as needed. Infrared heat is a superior heat modality for the shoulder joint due to its ability to penetrate deep into the body. I made a video that shows how to rehab shoulder joint pain using myofascial release and red light therapy, which you can view below if you have shoulder problems:
You really don’t want to go too long with achy, stiff joints because it typically worsens; often resulting in a “frozen” or locked joint that is prone to accelerated degeneration (osteoarthritis) and partial disability (the x-ray image below shows what advanced degeneration of the shoulder joint looks like). This is why joint exercises are so important, especially for those over age forty, the approximate age when the brain’s secretion of human growth hormone (HGH), the “fountain of youth” hormone sharply drops, causing connective tissues throughout the body to lose their resilience. Just know that placing controlled, directional stress to your joints via these joint exercises will trigger your body to build them up, strengthening them.
Bottom line: Incorporate joint exercises into your workout routine. Target the heavy use joints first—your shoulders, hips and knees. Allowing your joints to weaken can lead to loss of support, joint degeneration, chronic pain, partial disability and reduced quality of life so make sure to strengthen those joints using the methods described above.
01/29/2020 UPDATE: Just completed the video that shows some joint strengthening exercises for the Big Three: Shoulder, Hip and Knee joints.
