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.
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 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)
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.
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 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:
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P.P.S. Who here uses the joint by joint approach and how are you incorporating it into your training?
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Knee Pain: Understanding the Foot and Hip’s role in Knee Pain – Part 1