Taking A Look At The Joint By Joint Approach

I was first introduced to the joint by joint approach by strength and conditioning coach Mike Boyle and then further with FMS creator and physiotherapist Gray Cook.

The joint by joint approach helps us to take a look at the human body region by region and each of these regions is either categorised as primarily a mobility or stability joint.  Whilst all joints require both mobility and stability, the idea is based on their primary function and how this interacts with the rest of the body.

Starting from the bottom up, Mike Boyle has outlined the following joint by joint system.

Ankle = Mobility (sagittal)

Knee = Stability

Hip = Mobility (multi plane)

Lumbar spine = Stability

Thoracic spine = Mobility

Scapular = Stability

Gleno-humeral = Mobility

When it comes to using this system within a strength and conditioning model or within an injury treatment and prevention model, we should ultimately be looking to assess and prescribe appropriate exercises or drill that are focused towards ensuring these primary functions exist, are maintained and/or are further developed.  I will often also borrow from the ideas of physio Gary Gray of the Gray Institute who has coined the term “Mostability”.  This is a combination of mobility and stability that all joints have.   Take the ankle for example.  If the ankles roll is primarily to provide mobility, then we should be looking to maintain mobility within this joint and therefore any exercise prescribed should be working towards maintaining this, but also ensuring that we are developing further control through the range of motion.

From an injury treatment model, often someone might present for an injury to the clinic reporting pain in one area of the body, yet has other movement dysfunctions going on within the body that perhaps are feeding into this particular issue.  A great example could be pain around the patellar.  Often a client will present the clinic reporting anterior knee pain that perhaps is related to an activity that has gradually developed over time due to a range of factors (these including overuse, poor movement patterns, external environmental factors).  Whilst the individuals site of pain is the knee, should we as osteopaths, physiotherapist, chiropractors, myotherapists etc only just treat the knee, the likelihood of this injury returning is high if there are musculoskeletal issues occurring elsewhere in the body. This is where it is important for us to take our clients through a screen and assess the whole body (both in isolation and through whole movement) to identify other potential causes.  The client with the sore knee that has a stiff ankle or stiffness through the hip which should both be primarily mobility drivers may well be the cause of the knee pain due to the need for the body to steal mobility or load tissues elsewhere in the body i.e. the knee.   By having a model or models to view and look at when dealing with the body is great because it helps us to create a system in which we can fully assess ones movement and function to determine some strategies to address our goals, be it for strength and conditioning, athletic performance, injury prevention and or treatment of an injury.

At Principle Four Osteopathy we pride ourselves on taking a whole body, whole function approach to dealing with ones musculoskeletal complaints and or strength and conditioning goals.  To find out more about Principle Four Osteopathy, please go to www.principlefourosteopathy.com.  Appointments can be booked online via our website or by calling 03 9670 9290.  We have clinics located in the heart of the Melbourne City CBD and Docklands area.