The joint by joint approach is a way I, and many others, look at the body in regards to treatment and training. It was first described by Gray Cook and Mike Boyle as a way of simplifying the body by regions and what it needs.
This approach states that each joint either needs mobility or stability. It all starts at the foundation.
- Foot- Stability
- Ankle- Mobility
- Knee- Stability
- Hip- Mobility
- Low Back- Stability
- Thoracic- Mobility
- Scapulothoracic- Stability
- Shoulder- Mobility
- Lower and mid cervical- Stability
- Upper cervical- mobility
If any joint complex above is lacking in what it needs; there will be compensations above and below. I like explaining this using the ankle as an example in terms of the squat. The ankle is a common area that loses mobility mainly in dorsiflexion. As you descend into a squat the knee translates over the toes and in a perfect situation between the 1st and 2nd ray. However, a common problem I see is as the knee translates forward the ankle runs out of mobility causing the knee to cave inward in a valgus stress. This compensation causes some loss of stability and faulty mechanics at the knee. The body also compensates at the foot with the arch collapsing and turning outward when out of ankle mobility.
Test this out yourself. Have your foot approximately 4 inches away from the wall or a fist and a thumb as seen in the video below. Pretend like there is a laser on your knee and the laser dot doesn’t move from the starting position as you attempt to touch your knee to the wall without your heel coming off the ground. To fail this test is not touching the knee to the wall, medial arch collapses, knee goes to the inside or the outside of foot. If any of this happens the ankle does not have enough mobility.
Another example that is a common problem that I always see in the office is restricted thoracic spine. Thoracic mobility has implications for the shoulder and low back as well as elsewhere. Just as a mobility problem in the ankle caused compensations above and below, the thoracic spine has implications above and below. I see this most with overhead shoulder movement, if we don’t have enough T-spine mobility to go completely overhead we will compensate by extending in the lumbar spine to fake full overhead mobility.
A quick test for thoracic mobility is the lumbar locked rotation test. Start with sitting back onto the heels and have forearms on the ground in front. Take one hand and put it behind the back and rotate that way. Passing this test would be 50 degrees of rotation each way. A failure would be shifting to one side to gain more rotation, excessive effort in one or both ways, not getting to the required 50 degrees and significant asymmetry.
It is important to keep this joint by joint approach in mind in treatment as well as in the gym with training. Remember to mobilize the joints that need to have mobility and stabilize the areas that need stability. If you do this you will be less likely to compensate and have faulty movement patterns, which can lead to pain and injury.
These are just a few test that check mobility. Stay tuned to see how we can increase mobility in these joints.
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