Mobility, Stability, and Strength
The joint by joint approach is a framework that identifies compensations through the kinetic chain that can contribute to the root cause of an individual’s injury. Dr. Kody Au from Baseline Health & Wellness is a practicing Chiropractor with an immense background in exercise sciences. He kindly came in to share his knowledge and practice in regards to the joint by joint approach.
The joint by joint framework was first defined by Mike Boyle and Gray Cook. These concepts have provided the basis or framework for FMS, SFMA, and many other diagnosis systems that are used today. Within the joint by joint framework, there are 3 facets that will be defined and used in the assessment. These are organized in a hierarchical fashion as shown in the diagram that is used to guide exercise prescription/treatment.
Mobility is defined by the degree of articulation within a joint without restrictions from surrounding structures or tissue. These can be broken into tissue or joint mobility.
- Joint Mobility: intent is to open/expand joint to promote an increase in both passive ROM and active ROM
- Tissue Mobility: intent is to lengthen tissue to improve soft tissue movement availability, where lack of mobility is caused by shortening muscles (via scarring or muscle tightness)
Stability is the ability to engage muscles in a fashion that allows for the maintenance or control of a joint through a movement or position
- Considered the second stage of the joint by joint framework
- Proprioception and balance play an essential role in optimal muscular balance where changes due to injury will affect the capacity and alter movement capacity and perception
Strength is the muscle’s ability to produce force against a resistance
- Considered the last stage of the joint by joint rehab pyramid, but does go further beyond working into power and sport/skill-specific activities
- The joint by joint model suggests that mobility and stability should be addressed to a degree to prevent injury and/or plateau
The joint by joint framework provides a simple model to help address and guide treatment for individuals. An example is that if an individual does not have an adequate base of mobility, then stability training will not be as efficient, where stability training will only be performed within the limited range that is allowed. However, these limitations could also be due in part to stability issues elsewhere in the kinetic chain, which is important to consider if mobility treatment strategies are not effective. Exercise treatment programming should include all the facets mentioned above, where we look to create a base of mobility and stability for individuals and then reinforcing those patterns through strength training. We’d like to thank Dr. Kody Au for presenting and sharing his knowledge with us! We look forward to collaborating with him at Baseline Wellness and if you are an individual who is in need of Chiropractic treatment, definitely check out their clinic at www.baselinewellness.ca or their Instagram page @baseline_wellness.