The Minimum Effective Dose for Joint Health

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Wouldn't it be satisfying to know that you don't have to be an avid exerciser to have healthy joints? We're talking about a basic level of health. 

There are not a lot of services out there advocating for basic joint health & wellness via safe and effective mobility and motor control training. Motor control is the current term used to describe how the brain and nerves control our muscles and joints. 

Too often we see people try to get healthier by exercising and moving more, but are side tracked by joint pain or orthopedic problems. 

It's really sad but exercise has become a risk factor!

We agree that many people lack strength and a basic level of fitness because of inactivity. But many more people, whether inactive or active, lack basic levels mobility and motor control (body weight control) that aren’t even routinely considered before letting people jump into exercise.

This is "Why We Need Prevention in Orthopedics" and why we honor our Core Principle 2: Move Well. Move Often"

The message is not that all of your muscles and joints have to move perfectly before you start being active and exercising. The message here is that we should help show you and teach you where your mobility and motor control limitations might be using evidence based objective screening and assessments like The Functional Movement Screen & The Selective Functional Movement Assessment. With that information we can help guide you in making informed and wise decisions about your physical activities and exercise choices. 

This information helps to give you the 3 ingredients of your minimum effective dose for joint health. 


So what are the 3 ingredients for the minimum effective dose for joint health?

1.Learn where your current mobility and motor control limitations are then learn how to safely and effectively address them.

2. Use your insight from #1 to make wiser exercise choices. 

3. As recommended by the American Heart Association, perform at LEAST 30 min of low to moderate steady state aerobic activity 5 days per week. This is 2.5 hours per week however you want to divide it up. Learn more about low - moderate aerobic activity by ready What is Active Recovery?

Wait! but what about strength training?

Remember we're just talking about the MINIMUM effective dose. If you learn more about the systems we use, you'll see how basic mobility and motor control drills can very effectively develop fundamental levels of body weight competency and strength. This is relative strength - body weight control - not absolute strength - "how much weight can you lift, bro?" 

This is again why we strongly believe in Core Principle 2: "Move Well. Move Often".

Even if you have no interest in “exercising” and just want to be a little more active, wouldn't it be cool to know which areas of your body you should focus on as you start to incorporate short walks into your daily routine? 

You don't have to be intimidated and think that you have to clean out all your cabinets, join a gym, and sign up with a personal trainer 3 days a week. If you want to do that eventually that's great! But lets start small with simple behavior changes using a "minimum effective dose" mindset first, so these changes last for a life time. Remember the goal is movement longevity and sustainability.


part 2: Evidence based Knowledge + Evidence based experience

We have intuitively known this for many years, but now we have evidence that has correlated tightness in joints and muscles to orthopedic symptoms like “nonspecific low back pain”.

In other words having a significant left & right difference in hip mobility places you in the high risk category for low back &/or knee pain. Just like we know that high blood pressure and high cholesterol puts you in the high risk category for cardiovascular disease.


Another example: we know that tightness in your upper back places you in the high risk category for shoulder, neck, and low back pain.

We have also shown that physical activity level is more correlated to flexibility than age. In other words the research suggests that old age is less likely the cause of tightness, but rather a lack of movement, even in the presence of osteo-arthritis (OA). Some exceptions include autoimmune diseases like Rheumatoid arthritis or Psoriatic arthritis where our own immune system attacks health joint surfaces. 

We have measured plenty of older people with OA yet they move a lot better than expected. Their X-rays look intimidating, yet they are pain free and their movement is graceful and fluid. Of course there are also plenty of people in pain that have OA, we're not denying that. The studies are simply saying that the presence of OA is not well correlated to pain when studying large groups of people. Joint pain has been more correlated to poor active joint control than what the joint looks in a static picture (Xray). This challenges the common thought of OA being the primary cause of pain. 

When we ask the individuals who are pain free yet also have OA how this could be, we learn that they have made movement and physical activity a priority in their lives in addition to having a balanced movement diet.

What does a balanced movement diet mean?

I asked one of my older clients that moves really well for their age, "What have you been doing to move this well at 65?"

Their response: "Ever since my 40's, I strength train 2x/week, I’ll work on my mobility everyday after my daily walk. I’ll hike, swim or ride my bike if I don’t feel like doing the other stuff. That's it.”

There you have it - basic strength, mobility, cardiovascular training done on a consistent basis beats inconsistent advanced strength, mobility, cardio training any day.


What I’ve learned over the last several years from my clients that are well is that if you want to learn how to live longer, healthier, and pain free don’t study disease & disability - study health & wellness.

Study the patterns of behavior of those who are much older than you who are moving way better than you and their peers.

Remember, the 3 key ingredients for establishing our minimum effective dose can help us achieve movement wellness & joint health. This is the case whether you're sedentary or competing in the CrossFit games.

Obviously, everyone's minimum effective dose is different depending on their goals and their bodies. The point is we don't all have to be neurotic exercisers to stay healthy, feel great, and even loose some weight.  

If you enjoyed this read you might also be interested in reading Why Does Our Body Tighten Up? and Why Does Controlled Mobility Matter?

Ramez Antoun