Range of Motion and Tissue Stiffness in Young and Older People

Aging decreases joint flexibility and joint range of motion (ROM), which may impair balance and functional ability in the older person leading to an increased risk of falls and reduced quality of life.

ROM can be grouped into passive and active ROM. Passive ROM is used to represent joint flexibility and is considered to be restricted by tension applied to tissues surrounding a joint (biomechanics) as well as by the perception of such tension (sensory theory).

The muscle of older people is more compliant than that of their younger counterparts. Considering that muscle atrophies with age, the effect of muscle stiffness on passive ROM might become weaker for older people compared with young. Myofascial structures have also been suggested to play a role in limiting passive ROM.

A study from Japan investigated differences in the associations between passive ankle dorsiflexion ROM and stiffness of the triceps surae, sciatic nerve, and deep fascia located in the posterior leg between young and older people.

Twenty young and twenty older males were recruited and were placed in a prone position with their hip and knee fully extended. Stiffness was measured using shear wave speeds of the muscles.

Results showed that the medial and lateral gastrocnemius’s shear wave speeds measured at 15° dorsiflexion correlated negatively with passive ROM in young but not in older participants.

The shear wave speed of the sciatic nerve measured at 15° dorsiflexion correlated negatively with passive ROM only in older participants. No association was observed between passive ROM and shear wave speed of the deep fascia in the posterior leg. For data measured at maximal dorsiflexion angle (as an index of stretch tolerance), shear wave speeds of the triceps surae and passive joint torque correlated positively with passive ROM in both groups.

This means that in younger individuals, the stiffness of the local calf tissues is the main factor, while in the elderly, the stiffness of the long bundle of nerve fibers is the primary factor affecting joint mobility.

Stretch tolerance influences passive ROM for both groups. This implies that the relative contribution of myofascial tissues to joint flexibility becomes stronger than that of muscles with age.

Dr Robert Schleip commented that if this study’s conclusions are to be confirmed, this would argue for promoting the mobility of older individuals with other stretches (and instruments?) than is appropriate for younger individuals. For example, mere calf stretching would be more appropriate in younger individuals, as broadly applying myofascial self-treatment with a foam roller. On the other hand, in older individuals, long-chain stretches across multiple joints would be a better choice.

Likewise, manual grips targeting small areas and device techniques that specifically focus on the septa and the neurovascular bundles running within them would be more useful here. At least if an increase in passive joint mobility is desired.