Joint by Joint Approach – Explained

What is Joint by Joint Approach?

Here you can read easily which body parts should be mobile/stabile according to joint by joint approach.

The joint by joint approach is a unique way to analyze the functional needs of our joints. The author of this method is physical therapist Gray Cook. The joint by joint method is used as a means to search for the ‘weakest link’ in a functional sense and serves as an analysis of functional movements. A poor result on this test indicates untapped functional potential, as well as increased chances of injury.

It covers two factors responsible for proper joint function: mobility and stability. 

Some joints in our body are prone to instability, while others tend to be stiff and inflexible. 

With reduced joint functionality, there are higher chances of having pain in the affected part of the body (joint above or below). 

Let’s see the basic functional needs of a joint by joint theory:

• Ankle – mobility
• Knee – stability
• Hip – mobility and stability
• Lumbar spine – stability
• Thoracic spine – mobility
• Scapula – stability
• Glenohumeral – mobility

Any deviation from functional needs will negatively impact surrounding joints. The chance of pain increases drastically, while the functionality of the joints in the environment decreases.

Following the rule that the body is a stack of joints that play a certain role in our body, Gray explains their connection and difficulties. See the connection between the joints in the lower body. 

The most common movement restriction in the ankle joint is dorsiflexion (pulling feet towards the body). Ankle immobility will result in increased pressure on the joint above. Instead of being stable, the knee gets unstable. 

Hips get affected also. They get stiff and lose mobility as well. 

The joint by joint approach is a great tool to detect ‘weak points’ in our body and focus on improving them: 

1. Improving ankle mobility reduces pain and tension in the knee joint. 
2. Improving knee stability eases the pressure off the hip joints. 
3. Better mobility in the hips reduces the pain of the low back spine.

It’s a simple and efficient concept, but exceptions exist. The hip joint should be stable and mobile at the same time.

A weak hip that allows knee adduction and internal rotation of the thigh bone (femur) equals knee pain.  

On the other hand, weak flexion and extension in the hip would change functionality in the lower back segment. Gluteal muscles become inactive while low back extensors overtake hip extension movement. 

Hamstring strains, gluteal amnesia or low-back tension can occur after a changed extension pattern in the hips. 

‘Stacking’ joint is a term that describes alignment in joints during the movement with or without load. Proper function in all body parts is required for optimal performance and injury prevention.

How to detect mobility or stability issues in joints?

Test passive and active range of motion. If passive ROM is good, but active ROM is limited, then it’s a stability problem.  

Constant limitation in ROM indicates mobility problems. Decreased mobility may be due to a lack of mobility in the muscles or the joints themselves. If the muscles are limited, then muscle massages with muscle mobility training are recommended. However, if the joints are limited, then joint mobilizations and passive stretching are recommended.

Exercise Program

Exploring the joint’s functionality is the first part. The next thing to do is to find the right exercise program for getting more mobility and stability. 

Follow the two simple rules with your training:

• Mobility before stability
• Strength exercises after stability 

Mobility exercises – consist of active range of motion exercises. Goal is to increase range of motion and create a powerful foundation before adding any strength exercises with weights. There are a few other ways to increase range of motion and you might that article useful.

Stability exercises – consist of static and dynamic stability exercises. Static exercises are known as isometric because they occur without any movement. Dynamic stability exercises describe controlled motion under the load from any direction.

Common mistake happens when people add strength to dysfunction. If you follow mobility and stability progression, you will avoid this mistake and potential joint or muscle injuries. 

Remember: Never add strength to dysfunction.

In order to exercise strength, it is necessary to have mobile and stable joints, as well as excellent shape in basic exercises.

Conclusion

The joint by joint approach by Gray Cook is a phenomenal method because of its efficiency and simplicity. It’s useful both for improving sports performance or as a prevention against joint and muscle pain. 

It’s not perfect because every body is unique and has their individual needs, but joint by joint theory is worth implementing as a part of training and assessment if you are a personal trainer or physical therapist. 

If you have experience with this method, share it with us in the comments so that as many people as possible are informed about the joint by joint method.

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