Using the Joint-by-Joint Model to Help Yourself
Wednesday May 4, 2016
The old way of looking at the human body and the function of the musculo-skeletal system was simply to check muscle strength and joint range of motion, one level at a time, and then compare those findings to average. This model lacked concern for the relationship between any joint in the body and the joints above and below it, for example, the knee as it relates to the ankle and the hip.
The newer "Joint-by-Joint" approach considers stability and motion together in a more holistic model. Whole body movement patterns are checked to find which joint levels/body parts are painful or dysfunctional. The squat would be an example of a movement pattern that requires multi-level joint motion and stability. The Joint-by-Joint analysis often shows that pain and dysfunction do not occur at the same level, that is, the site of pain and the source of pain may be different.
Take the example again of the ankle, knee and hip - three consecutive joint levels. When we walk, run, or jump we use all these joints at the same time. Of course, all joints need motion, but the most common type of dysfunction (a lack or stability or a lack of mobility) tends to alternate at successive joint levels. So the ankle tends to lack mobility, the knee tends to lack stability, and the hip tends to lack mobility. Therefore a tight ankle or hip joint can cause compensatory excessive knee motion therefore resulting in an unstable and painful knee.
Two areas of chronic tightness (loss of mobility) in many people today are the mid-back (ribcage) and the hips. The unfortunate body part between the ribcage and the hips is the lower back. Lower back pain is one of the most common complaints of modern society. While stability "core" exercises have helped, the need for normal ribcage and hip flexibility is often overlooked. The lower back cannot be stable if it has to compensate for tightness in the ribcage and hips with excessive mobility.
So help yourself by considering what is going on not only at the level of a painful joint, but also the adjacent joints above and below. You'll be more likely to find the root of the problem.