Blog #10: The Joint-by-Joint Concept
Thanks for tuning in to another blog post from Session 41 LLC, a Naples, Florida-based personal training company designed to prevent injury and get you feeling and moving better. Blog #10 is all about the Joint-by-Joint Concept that was pioneered and termed by renowned physical therapist Gray Cook and is a revolutionary approach in the way we think about the human body and movement.
Photo authored by Anastasia Shuraeva
What is the Joint-By-Joint Concept?
The human body needs a balance of mobility and stability to function optimally. Mobility is how well you can move a joint through its full range of motion, and stability is how well you can resist motion. The Joint-by-Joint Concept is a way that we can understand how each joint of the body interacts with one another to form ideal and efficient movement patterns. By treating each joint as a checkpoint, we can unpack how a person moves and which joint(s) are problematic.
This concept was popularized in the early 2000s by physical therapist Gray Cook and strength & conditioning coach Mike Boyle. At the time, it was a revolutionary approach to the fitness and physical therapy industries because it changed how we viewed injuries, movement faults, and biomechanics. Instead of looking at things with tunnel vision, it told us to look at the big picture: because, in reality, everything affects everything else. Each joint is affected by what’s above and below it. If a person is struggling with lower back pain, for example, the root cause of the problem may not always be solely at the low back; it may actually originate in a far-away location like their feet, and that is the whole idea behind this concept. What if there was a way we could optimize movement by evaluating the mechanics of each joint so that the whole system functions better?
Let’s talk about it.
The Framework:
The Joint-by-Joint Concept has a number of checkpoints starting from the ground up. Each joint is characterized as either a “mobility” or a “stability” joint.
Foot: Stability
Ankle: Mobility
Knee: Stability
Hips: Mobility (and Stability)
Lumbar Spine: Stability
Thoracic Spine: Mobility
Cervical Spine: Stability
Scapula: Stability
Shoulder: Mobility (and Stability)
Elbow: Stability
Wrist: Mobility
Did you notice a pattern? There is an alternating sequence of stable and then mobile joints as we work our way up the body (with the exception of the cervical-to-scapula sequence, since the shoulder interrupts the pattern and makes reordering impractical). That’s because the firm position of the joint below stabilizes the joint above and allows it to move freely: kind of like a pivot point. As a small note, I would even assert that, although it wasn’t highlighted originally, the hips and shoulders have both functions: mobility AND stability.
When a joint loses function, it creates a movement error. Over time, these errors lead to pain and injury . Movement errors, over time, lead to pain and injury because other joints will be forced to take on more loading if other areas are not doing their job. This makes sense: if one joint is dysfunctional, others must pick up the slack to get the job done. Your risk of injury or chronic pain depends on how much mobility or stability is missing, and at which joints. The farther off you are, the more likely you will suffer from some chronic pain or injury, and vice versa.
The Overhead Squat:
The best way to see this concept visually is in an overhead squat, which you can see at the top of this blog post. An overhead squat is simply an exercise, more specifically a variation of a squat. Just like you have a back squat, or a front squat, you can do an overhead squat. The reason this exercise is so relevant is because it demands quite a bit of mobility. So another good use for it is a screening you tool. Let’s see how the Joint-by-Joint concept really works.
Take a look at each checkpoint starting at the feet and working your way up. Each joint establishes the position of the joint above it, and, if there were any limitation in a joint, it would throw off all the joints above it. The overhead squat is one of the most challenging exercises because it is simply a hard position to get into and control. But, if you can do an overhead squat with good technique and under load, then you are a biomechanically sound individual. But that is easier said than done and typically requires many years of dedication.
An overhead squat requires extreme mobility and stability throughout the entire body. Common faults are collapsation of the knees, hyper-extension of the lower back, and forward shoulders. Here is each checkpoint of the Joint-by-Joint Concept as it pertains to the overhead squat:
The Foot (stability) needs to maintain its arch, with weight distributed between the heel, ball of the foot, and underneath the pinky toe. If the foot arch collapses, the knee will cave inwards.
The Ankle (Mobility) needs to be able to dorsiflex (knee translation over the toe) to accommodate the deep squat position.
The Knee (stable) needs to track in line with the toes to be most efficient. Since it’s a hinge joint, it works best in line with the direction of force and not when it’s being pulled off track, which is a common cause for knee pain.
The Hips (mobile) need to allow for the deep squat position by having optimal hip flexion and external rotation range of motion. If there is an obstruction here, the lower back will likely bear it or the knees will collapse.
The Lumbar Spine (stable) needs to remain rigid, especially under load, so that force can be transferred from the legs into vertical displacement of the weight overhead.
The Thoracic Spine needs to be mobile to allow for extension of the middle back to hold the weight overhead. A person with a very “hunch-back” posture would have a difficult time centering the weight above them.
The Cervical Spine needs to be stable to hold the head up and over the shoulders without being too far forward.
The Scapula needs to be rigid so that the arms have a stable foundation to work from.
The Shoulder needs to be flexible to allow for that extreme overhead position and to prevent the lower back from hyperextending.
The Elbow needs to be stable for the same reason as the knee joint: it is a hinge joint and works best in the direction of force.
Finally, the Wrist needs to be flexible enough to hold the barbell comfortably in the palm.
If anyone of these checkpoints does not function optimally and symmetrically, then there will be a proportional movement breakdown.
Why Does Your Overhead Squat Matter?
While you may not be doing overhead squats in your daily routine, your movements represent different aspects of it. If you bend down to pick something up, you just did a squat that involved all mid-to-lower joints of your body. If you reach for something on a shelf, you just did a movement that requires overhead shoulder mobility. When you do these movements poorly and many times over time, micro-trauma accumulates. After decades of poor movement patterns, you can find yourself smack dab in an injury that just “came out of nowhere” or in a posture that just “happened”. But it really happened over millions of different movements and positions you had over the course of your life. Injuries aren’t always acute, meaning happen abruptly. Oftentimes injuries develop after sustained micro-trauma over years, and, if they didn’t, many times that same micro-trauma laid the groundwork for a sudden, acute injury to occur. If you are a manual laborer or an endurance athlete, then you perform these movements at very high volumes, which means a movement fault repeated enough can add up to something substantial.
The overhead squat takes away your ability to hide your compensations. If you can do an overhead squat well, you can do anything well. And by that logic, if we can improve your overhead squat, then we can improve the quality of every single movement you will perform in your entire life. Pretty important right?
What Can You Do About It?
The first thing you can do is screen yourself. Take a video of yourself from a few different angles and see what you find. Start from the ground up and follow this check list:
Feet: Do your feet turn out? Or do you lose the foot arch?
Ankles: Are you able to push you knees past your toes, or do you get a pinch at the front that stops you? Or does your upper body lean very far forward, this is often due to missing ankle range of motion.
Knees: Do the knees collapse inward? The most likely reasons are unstable feet, stiff hips, or even unstable hips.
Hips: Do your hips go back into a hinge motion? Are you able to lower yourself to where your thigh is parallel to the floor? Are you shifting into a side or staying evenly distributed?
Lower: Does your lower back arch excessively? Or does it round out?
Thoracic spine: Is your middle back stuck in a rounded position, or is it able to extend so you can hold your arms overhead?
Shoulders: Do your shoulder dump forward and elevate?
These are just the major checkpoints, but you get the idea. If you identified a problematic joint, dig a little deeper. Is it ankle stiffness that’s holding you back, or is it a lack of knee stability? Or is it a stiff thoracic spine that prevents you from holding that overhead position?
If you’d like to learn more about your overhead squat or get a free screening, contact us, and we’ll help steer you in the right direction. But the aim of this blog post is simply to bring awareness to the various joints of the human body and what that means for our movement quality.
To shedding light on how you can use the Joint-by-Joint Concept,
Ethan
