Joint PMCS
Joint care, also known as joint Preventive Maintenance Checks and Services (PMCS), is a crucial step in managing joint pain and inflammation. It is essential for patients to actively engage in exercises and take charge of their care to effectively manage their pain and restore movement. While physical therapy services play a significant role, they are not enough on their own and require the patient's active participation. To gain a more comprehensive understanding of these concepts and principles, it is recommended to refer to chapter 17 of ATP 7-22.02, which provides a detailed review of these concepts (for your convenience, use this link). The information presented below is meant to serve as a quick reference for the user. Patient empowerment and active involvement are key in joint care to ensure the best possible outcomes and long-term joint health.
Joint PMCS should serve as a self-check and fix for musculoskeletal issues. These provide early identification of MSK issues so that the service member can take care of issues before they become chronic or severe. I would strongly recommend that you integrate these into your daily practice (before PRT and to augment a daily exercise routine) as you take control of your physical and mental well-being.
Regarding patient safety, I would not recommend performing these exercises following trauma or if you feel that these exercises are unsafe or otherwise painful. If you attempt to do these exercises and they are painful, stop, and seek medical attention.
PMCS Exercises
Spine
Begin your routine with spine exercises. The spine is often a source of referral and we must first determine if your pain originates from the spine.
Neck
Repeat restricted movement, as shown in the exercises below, approximately 15-20 reps, and assess your pain level. If it has reduced, perform another 2-3 sets of about 15 reps. I would suggest performing this series of repeated movements 3-4x/day.
If pain worsens, perform movement in the opposite direction. If pain is unable to be reduced, please seek medical attention.
Protraction
Retraction
Rotation (right and left)
Mid-Back
Rotation
Extension
Low-Back
Prone Extension
Standing Extension
Attempt to push your head as far forward as you can. Limit rotation or side flexion.
Draw your chin straight back (envision making a "double chin"). Use your fingers to push straight back.
Rotate to either side, focusing on reducing any restrictions.
While seated with an upright posture, rotate to either side as shown.
Reach up and back as far as you can, then return to starting position.
Place hands on top of hips, and lean back as far as you can tolerate and push hips forward.
From this position, push yourself up with your hips in contact with the ground. Again, go as far as you can tolerate.
Lower Extremity
Extension
Flexion
Hip
With the knee of your sore leg in contact with the ground as shown, lean forward and accept weight into your other leg.
Pull the knee of your sore leg towards your chest.
Knee
Extension
Flexion
With your sore leg forward, attempt to "straighten" your leg. A cue to help would be to "drive your knee back".
Attempt to bend your knee as far as you can. An alternative way to perform this is to perform the hip extension exercise above but with your sore leg forward.
Ankle
Plantarflexion
Dorsiflexion
Perform as depicted in the picture. Keep the "tops" of your feet in contact with the ground.
With your sore leg forward, lean as far forward as you can. **Attempt to keep your heel in contact with the ground for optimal results.
Upper Extremity
Shoulder
Extension
Internal Rotation
Depicted with a partner, the intent is to descend as far as you can tolerate.
Two variations are provided here. Regarding the use of the strap, the sore arm is the one that is grasping the strap behind the back. Your other hand should be pulling the arm "up and over".
Elbow
Extension
Flexion
With hand in position shown, attempt to straigthen your arm and drive elbow forward.
Bend your elbow as much as you can and add over-pressure with your other arm.
Wrist
Extension
Flexion
