When you look at the human skeleton, you will notice that the bones all stack up on each other like links of a chain. Each bone is connected to the next by a joint like a well designed machine. How these joints interact with one another via the muscular system dictates our function. A somewhat new concept (introduced by therapist Gray Cook) is that the joints of the body alternate between mobility and stability.

Mobility: the ability to move or be moved freely and easily.

Stability: the state of being not likely to change or fail.

A stable joint is surrounded by 2 mobile joints. For example, the stable knee joint is surrounded by the mobile ankle and hip joints. When the stable joints of the body are actually working correctly, and therefore stable, and the mobile joints are mobile, the body functions well. When a joint stops functioning correctly it usually causes compensation in another joint in the chain. An example of this is a sprained ankle. The ankle sprain causes swelling and pain. Then the ankle is usually immobilized to prevent movement and the ankle gets stiff. Now if the ankle stiffness isn’t properly addressed the knee has to compensate by making up for the lost ankle mobility. Since the knee prefers to be a stable joint it will start to show signs of wear and tear and therefore become painful.

Each joint area in the body can be categorized as needing more mobility or stability:

Starting at the bottom, the toes needs mobility, the mid-foot needs stability, the ankle needs mobility, the knee needs stability and so the process goes up the chain.

From a treatment standpoint, this is why your BTF doctor likes to use chiropractic adjusting for your joints that need mobility (toes, ankles, hip, thoracic spine, upper cervical spine, shoulder, wrist and fingers) and likes to use stability exercises and strength training around the joints that need stability (mid-foot, knee, lumbar spine, lower cervical spine, scapula, elbow and hand).

Most good therapists and trainers have given up on the old body part strength training method. When I hear a client say that it is chest and bicep day I cringe! Training should be focused on making the joint areas that need mobility move more efficiently (example Prayer Quarter Rotation for thoracic spine mobility) and strengthening joint areas in a neutral position that need stability exercises (example Push Crunch for rectus abdominis facilitation). The focus on training movement not muscles is an important concept that we use at BTF to improve client function.

Injuries relate closely to proper joint function, or more appropriately, to joint dysfunction. Problems at one joint usually show up as pain in the joint above or below. An obvious example of this is the lower back. It’s clear we need trunk/core stability exercises, and it’s also obvious many people suffer from back pain. The interesting part lies in the theory behind low back pain and the new theory of the potential cause: lack of hip mobility.

Loss of function in the joint below–in the case of the lumbar spine, the hip, seems to affect the joint or joints above. In other words, if the hips can’t move, the lumbar spine will compensate. The problem is the hips are designed for mobility and the lumbar spine for stability. When the intended mobile joint becomes immobile, the stable joint is forced to move as compensation, becoming less stable and subsequently painful.

The Process is Simple:

Lose ankle mobility –> knee pain

Lose hip mobility –> low back pain

Lose thoracic mobility –> neck and/or shoulder pain

At Back to Function, our doctors are trained to recognize these compensatory joint relationships. This starts with taking a thorough history of your current injury and any previous injuries. We use the BTF functional screen to evaluate stability and mobility at each of the joints of your body. With this knowledge, we are able to design a treatment plan that best serves your needs.

So what does your body need, mobility or stability?