As a clinical myotherapist who sees clients regularly seeking help for injuries and chronic pain, which are often related to sports or gym injuries, if there is one thing that I never stop telling my clients, it is: Before you start lifting weights, look into your mobility capacity. In this blog, I will run through the concept of Mobility Joint, Stability Joint and Strengthening. This is the order in which anyone who is interested in their well-being and sport performance should approach their physical activity. Therefore, Mobility is the degree to which a joint can move before being restricted by surrounding tissues. Not all the joints taught are considered mobility joints. Indeed, some are considered stable joints. The Mobility and Motility Joints Theory As it is clear now, the body is made of two types of joints when we look at their functionality and not conformity. Starting from the big toe joint and moving up the body to the upper cervical joints, we can count one by one a mobility joint alternating with a stability joint. So this would be like this: Big toes – Mobile Metatarsal – Stable Ankle – Mobile Knee – Stable Hip – Mobile Lumbar -Stable Thoracic – Mobile Lower Cervical (C3-C7) – Stable Upper Cervical (C1-C2) – Mobile Shoulder (AC joint) – Mobile Elbow – Stable Wrist – Mobile Hand Tarsal – Stable Fingers – Mobile Basic Differences Between Mobile and Stable Joints Mobile joints move in more planes than stable ones Stable joints are designed to prioritise support Mobile joints are more prone to dislocation, given their more exposed structure, and this is more likely when muscles surrounding those joints are weak The body’s optimal movement is a balance between mobile and stable joint individual capacities. What to Train First? If we are planning to start a fitness journey, for whatever reason, the first thing I always suggest to my clients is to check and evaluate their mobility. This can be done with a few simple tests, and improved (to a maximum extent, which is different for each individual) with mobility exercises. Indeed, someone may present with a restricted capacity at their mobile joints, as their natural consistency of ligaments is really stiff. This is what we call someone hypomobile. On the other hand, the opposite presentation would be hypermobility. Two individuals who present with those basic capacities of movement would need to start with a different approach to training, and possibly, even along the way, two different ways to warm up, before they start to lift heavy. Beighton Score – Let’s Look Into Your Mobility Capacity When I want to assess a client’s capacity for mobility, or overall hypomobility, I use the Beighton Score, where each joint that we test can refer to 1 point if it responds with hypermobility (maximum 9 points): Passive dorsiflexion of the middle or index finger >90° 1 point each side (2 points total) Passive thumb apposition to the forearm Thumb can touch the forearm 1 point each side (2 points total) Elbow hyperextension >10° 1 point each side (2 points total) Knee hyperextension >10° 1 point each side (2 points total) Forward flexion of the trunk with knees straight Palms flat on the floor (1 point) Interpretation: 0–3 points: Generally considered within normal mobility range 4–5 points: Increased joint laxity (depends on age, sex, and population) ≥6 points: Generalised joint hypermobility (commonly used threshold in adults) What to be aware of: One thing to be aware of when using this test is that the Beighton Score measures laxity, not necessarily functional mobility. Someone can score high but still have poor movement control or stability in other specific joints (for example, lack of thoracic rotation). Therefore, as a clinical myotherapist, I do combine this test with: Active ROM assessment Strength testing Joint control/stability tests Functional movement screening (squat, lunge, overhead movement) How To Improve Your Mobility? In order to improve mobility, we need to focus on mobility exercises. Often these types of exercises are simple and possible to do in any environment. A basic example would be opening the book for thoracic rotation or a cat and cow for spine flexion and extension. Other mobility exercises include the ankle passive dorsiflexion on an inclined plane. The aim of these exercises is not to cause inflammation and tissue growth, but to stimulate your joints to get to a greater range of motion. That said, in an adult, it is not always possible to reach optimal mobility because of some bone prominences or previous injury. So we do our best to get to where we can, and we work with that. Mobility exercises can be practised daily, and for those who are hypomobile, it would probably become a mandatory warm-up routine, pre-heavy lifting. If Mobility Is Not The Issue, The Next Step Is Stability Training If mobility is not a limitation, then we can start looking into training your stability joints. Training the stability joint is not a direct training of the joint per se, but it is the strengthening of the muscle that cuts across that joint. So let’s use the knee as an example. The knee joint is considered a stable joint; indeed, it is capable of mainly 2 direction movement: flexion and extension (from a flexed pose). There is some rotation, but it’s really limited. Now, in order to train its stability, we want to put effort on the quads muscles, on the hamstrings, and on the calf muscles. In this last case, specifically the gastrocnemius. Indeed, all those muscles or muscle groups originate and insert on the opposite side of the knee position when looking at its longitudinal line. Indeed, they all originate proximal to the knee and insert distally to the knee. This ensures the knee is wrapped within those muscle fibres, and its ligaments, ACL, PCL, MCL, LCL, are supported in their job, especially if lax or even missing. An effective and easy way to train those muscles is: Quad curl for quadriceps […]
