Is the Joint by Joint Approach Accurate for Shoulder Pain?

I’m a big fan of the joint by joint approach as a basic understanding of how the joints in the body interact for movement.  As a refresher the joint by joint approach was popularized by Gray Cook and later Mike Boyle.  It basically identifies our body as a system of joints that either require more stability or more mobility for optimal function.  I’ve written quite a bit about it in the past, if you’re interested click HERE. Using the shoulder as an example:

  • Thoracic Spine – Requires Mobility
  • Scapula – Requires Stability
  • Shoulder – Requires Mobility

Now, there’s a lot of good information that can be gleaned from this approach.  For the most part I agree with the joint by joint approach.  However, when it comes to rehabilitation of the athletes I see some of these basics principles fall apart.  Here are a few examples:

  • If the glenohumeral joint is inherently unstable from an anatomical perspective, why does it require mobility?
  • If athletes are acquiring labral tears within the shoulder joint from a lack of control, why does the shoulder need more mobility?
  • If we place so much emphasis on the rotator cuff to control the shoulder joint, why isn’t stability the major requirement for the shoulder?

I can think of a few examples off the top of my head where endurance and strength are a major requirement for the thoracic spine when training (Think coming out of the hole in a clean).  It also gets a bit wishy washy when we start talking about which muscles need a mobility intervention vs. a strength intervention.

In this month’s Insiders Webinar I went through the shoulder throughly and talked the specific needs of the shoulder and local joints as it pertains to our population.  What does the shoulder need in order to perform olympic lifts, power lifts and basic gymnastics movements.  What do we need to rehabilitate, get back to our activities and stay healthy?

For current Insiders Members click HERE to log-in and access the webinar.

To learn more about the FPF Insiders Mentoring Programming and become a member (Just $7.99 a month), click HERE.

Shoulder Madness,

Daniel Pope, DPT, OCS, CSCS

 

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