The Best Kept Secret in Injury Prevention: Joint By Joint Approach for Crossfit – Part 1

The human body is complex.  Assessment, corrective exercise and injury prevention is also tricky.  If we’re new to the game, how can we begin to figure out our deficits...

The human body is complex.  Assessment, corrective exercise and injury prevention is also tricky.  If we’re new to the game, how can we begin to figure out our deficits and address them?  If we’re seasoned, is there some type of system we can use to analyze our athletes and clients?

Enter the joint by joint approach first described by Gray Cook and later popularized by Mike Boyle.  The joint by joint approach is actually not a secret at all.  I first learned of it when Mike Boyle released this article back in 2007.  Since then it has become widely popular in the strength and conditioning and personal training realm and has been revamped and fine tuned over time by Gray.

For whatever reason, it doesn’t seem like this approach has made its way over to the crossfit world.  This is a shame because the joint by joint approach serves as a wonderful basic template to figure out how we can start using corrective exercises to increase performance and decrease risk of injury.  Elements of this approach are also used in rehabilitation as well.

The basic gist of this approach is that the joints in our body are either designed for stability or mobility and improving the joint’s performance will rely on treating it according to these principles.

Some joints are inherently mobile and will benefit by being trained for more stability.  Other joints are more stable (or stiff) and will benefit more from mobility and flexibility exercises.

For our convenience the joints in our body tend to fluctuate from joints needing stability to joints needing mobility.  Let’s start from the bottom.

  1. The Foot: Needs Stability
  2. The Ankle: Need Mobility
  3. The Knee: Needs Stability
  4. The Hips: Need Mobility
  5. The Lumbar and Sacral Spine: Needs Stability
  6. The Thoracic Spine: Needs Mobility
  7. The Upper Cervical Spine: Needs Mobility
  8. The Mid/Lower Cervical Spine: Needs Stability
  9. The Scapula: Needs Stability
  10. The Shoulder Joint (Gleno-humeral joint): Needs Mobility

The Foot:

Our feet are composed of many, many bones and articulations.  The foot is kept stable in position all day long by cushioned shoes and never gets a chance to build it’s own stability through barefoot training.  Because of this it is inherently flexible and would benefit from stability exercise.

The Ankle:

The ankle is inherently stiff and inflexible (especially in dorsiflexion).  This is also compounded from individuals who have a long history of chronic ankle sprains. (Inversion and supination becomes excessive while dorsiflexion becomes limited)

The Knee:

Our knees generally have full range of motion but they are prone to injury if the joints above and below (ankle and hips) lack flexibility.  If that’s the case the knee will compensate in something like the deep squat.  Someone who lacks ankle or hip flexibility and squats deep will generally end up with genu valgus (knee in).  Because of this the knees will benefit from stability training, motor planning and addressing flexibility at the hips and ankles.

The Hips:

Our hip consists of a deep ball and socket joint, thick ligamentous supports and a labrum.  On top of that sit many large thick muscles.  Couple that with a career that requires us to sit 8 hours a day and you’ve got a recipe for tight hips.

The Lumbar and Sacral Spine

We know that excessive flexion and rotation under load is the main mechanism of injury for disc herniations of the spine.  Excessive extension at the spine is the mechanism of injury for spondylolysthesis injuries and excessive rotation and extension can cause facet joint damage.  We’ve heard time and time again of the importance of a neutral spine.  Therefore it makes sense that the lower back would benefit from stability training.

The Thoracic Spine

The thoracic spine sits right above the lumbar spine and is an attachment point for our ribs.  Because of this the thoracic spine has a tendency to be stiff.  Poor posture also adds to the problem.

The Cervical Spine

The cervical spine can be divided into two sections.  Our uppermost cervical vertebrae (C1 and C2) are responsible for about half of the motion of our neck.  This area typically needs mobility and has a tendency to become stiff.  This stiffness often comes from poor posture as well (We’re seeing a trend here huh?)

Weakness and dysfunction of the deep cervical flexor muscles is implicated in those with neck pain and strengthening these muscles has shown great effect in rehabbing these patients.  Therefore this region could benefit from more stability.

The Scapula

The shoulder blades are incredibly important in providing stability to the shoulder but they have a tendency to move abnormally and cause problems. Scapular dyskinesis is a large problem in conditions such as subacromial impingement syndrome.   Because of this the shoulder blades often need stability training as well as training to normalize their movement.

The Shoulder Joint (Gleno-humeral joint)

The shoulder joint is a bit more complex.  It is a very shallow ball and socket joint with little boney congruency.  Because of this and its attachment to the scapula the gleno-humeral joint has lots of range of motion.  This would make you believe the shoulder joint would benefit from stability work, and it does.  The gleno-humeral joint gains most of its stability from the rotator cuff musculature and these muscles need to be kept healthy and functional.

However, the other prime movers of the shoulder get short and tight easily such as the pectorals and latissimus.  This can create large limitations during exercise leading to injury and decreased performance.

*Remember that each person must be treated as an individual and not everyone is going to need more mobility or stability.  On top of that there are circumstances where the above guidelines are broken for certain movements.  the joint by joint approach is just a basic template to start understanding the human body and how to make it move more efficiently.

In the next article we’ll discuss three common lifts seen in crossfit and explain how we can apply the above concepts to improve performance and decrease our risk of injury:

  • The Squat
  • The Overhead Press
  • Deadlift/Olympic Pull Variations

Until then,

Dan Pope

P.S. If you enjoyed this article please sign up for the newsletter on the top right hand side of the page to receive the latest articles as they’re spawned from my brain.

P.P.S.  Who here uses the joint by joint approach and how are you incorporating it into your training?

Categories
anklefootInjury PreventionKneeLower BackScreening and AssessmentShoulderUncategorized
22 Comments on this post.
  • Using the Joint by Joint Approach for Performance and Injury Prevention in Crossfit Part 2: The Squat | FITNESS PAIN FREE
    30 October 2012 at 10:26
    Leave a Reply

    […] by joint approach.  If you missed part 1 where we introduce the joint by joint approach you can find it HERE:  Now let’s put it into a meaningful context within a few popular exercises used in […]

  • The Best Kept Secret in Injury Prevention: Joint By Joint Approach for Crossfit – Part 3 – The Overhead Press | FITNESS PAIN FREE
    1 November 2012 at 10:26
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    […] now that we have a little background about the joint by joint approach (Part 1 HERE) and we have an idea of how we can apply it to the squat (Part 2 HERE), let’s see how it […]

  • Why Your Deadlift Technique Sucks – Using the Joint By Joint Approach – Part 4 | FITNESS PAIN FREE
    12 November 2012 at 10:26
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    […] two things are part of the joint by joint approach we’ve been discussing.  If you missed it: Part 1, Part 2, Part […]

  • 10 Idiot Proof Principles to Crossfit Performance and Injury Prevention | FITNESS PAIN FREE
    24 November 2012 at 10:26
    Leave a Reply

    […] Read up on the joint-by-joint approach to corrective exercise to get started.  Here’s an example of how to fix a crappy squat with this approach.  Just remember, corrective exercise is exactly that, something used to correct a problem.  Finding specific issues and treating those is far more effective then taking a shotgun approach to corrective exercise. […]

  • Why Do My Hips Hurt When I Squat? Femoral Acetabular Impingement: Part 2 | FITNESS PAIN FREE
    5 March 2013 at 10:26
    Leave a Reply

    […] given that our body is a system of joints, if you’ve got a limitation in any one of these areas it’s going to affect what goes on […]

  • Shoulder Stability | Peak Wellness and Chiropractic
    2 May 2013 at 10:26
    Leave a Reply

    […] Source: Fitnesspainfree.com […]

  • toy storage
    18 June 2013 at 10:26
    Leave a Reply

    Hey! Quick question that’s entirely off topic. Do you know how to make your site mobile friendly? My site looks weird when viewing from my iphone4. I’m trying to find a theme or plugin that might be able to resolve this problem.
    If you have any suggestions, please share. With thanks!

    • djpope
      19 June 2013 at 10:26
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      I use WPtouch, has worked well for me!

  • Fitness Pain Free Podcast #23: Stability vs Mobility with Dr. Brian Strump | FITNESS PAIN FREE
    26 June 2013 at 10:26
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    […] [35:32] How the joint by joint theory can help you figure out if you need stability or mobility. Learn more HERE: […]

  • Gymnastics Application of The Joint by Joint Approach (Pt 1): Concepts and Skill Examples | The Hybrid Perspective : Linking Gymnastics & Physical Therapy
    28 January 2014 at 10:26
    Leave a Reply
  • My Favorite Mobility and Warm-up Exercises for the Entire Body | FITNESS PAIN FREE
    6 May 2014 at 10:26
    Leave a Reply

    […] entire body and plugged it into one big old video.  The exercises selected are based off on the Joint by Joint concept popularized by Gray Cook .  Check it out and let me know what you […]

  • My Favorite Mobility and Warm-up Exercises for the Entire Body
    6 May 2014 at 10:26
    Leave a Reply

    […] entire body and plugged it into one big old video.  The exercises selected are based off on the Joint by Joint concept popularized by Gray Cook .  Check it out and let me know what you […]

  • Crossfit Eleven55 » My Favorite Mobility and Warm-up Exercises for the Entire Body
    17 June 2014 at 10:26
    Leave a Reply

    […] entire body and plugged it into one big old video.  The exercises selected are based off on the Joint by Joint concept popularized by Gray Cook .  Check it out and let me know what you […]

  • Gymnastics Application of The Joint By Joint Approach – Handstands (Pt 1) – The Hybrid Perspective : Linking Gymnastics & Physical Therapy
    26 August 2014 at 10:26
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    […] The Joint by Joint Approach in Crossfit – Dr. Dan Pope of Fitness Pain Free […]

  • Dynamic Warm-ups in the Physical Therapy Setting | FITNESS PAIN FREE
    8 December 2014 at 10:26
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    […] warm-up like this but I also feel that the benefits are well worth it.  I base my warm-ups on the joint-by-joint approach popularized by Gray Cook and Mike Boyle.  It also fits well with my treatment which usually […]

  • WOD Doc: Ankle Symmetry Vital for Decreasing Hip/Low Back Pain | Prehab Before Rehab
    26 December 2014 at 10:26
    Leave a Reply

    […] poor ankle mobility will RUIN you for any exercise you do (See Dr. Pope’s explanation of the Joint-by-Joint Approach. Lack of ankle movement makes other areas of your body (i.e. your hips and low back) work harder […]

  • WOD Doc: Stability Solution, Part 2: Subscapualris | Prehab Before Rehab
    26 December 2014 at 10:26
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    […] 20: As per the Joint-by-Joint Approach, the shoulder should have MOBILITY. However, in the presence of pain, you may be dealing with a […]

  • WOD Doc: Shoulder Stability Solution, Part 3: Lat Dorsi | Prehab Before Rehab
    26 December 2014 at 10:26
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    […] 21: As per the Joint-by-Joint Approach, the shoulder should have MOBILITY. However, in the presence of pain, you may be dealing with a […]

  • WOD Doc: Stability Solution for Elbow Pain | Prehab Before Rehab
    28 December 2014 at 10:26
    Leave a Reply

    […] respectively. However, unresolved pain is coming from somewhere else. The elbow is (as per the Joint-by-Joint Approach) a stable joint, meaning pain can signify a lack of stability.  Here, Dr. Tim addresses the distal […]

  • WOD Doc: Plantar Fasciitis | Prehab Before Rehab
    4 January 2015 at 10:26
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    […] the Joint-By-Joint Approach dictates that areas that are under tension create distortion patterns on other areas above and […]

  • Ankle Pain, Weak Foundation & Joint By Joint Approach | Prehab Before Rehab
    25 January 2015 at 10:26
    Leave a Reply

    […] best-kept secret of the health care community among chiropractors and physical therapists is the Joint-by-Joint Approach. Sure, you might have foot, knee or hip pain – but that may not be the true area of your […]

  • Why Do My Hips Hurt When I Squat?? : CrossFit SoCo
    3 August 2016 at 10:26
    Leave a Reply

    […] given that our body is a system of joints, if you’ve got a limitation in any one of these areas it’s going to affect what goes on with […]

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