Note: The following article is heavily influenced by my training from Functional Movement Systems (FMS). For more information, I recommend the SFMA Levels I and II courses.
When many people go to their doctor for knee pain, their doctor may run through a battery of tests to assess the state of the knee joint. X-rays, MRIs, and various orthopedic diagnostics may be employed in hopes of finding the source of the problem.
How often, however, are doctors also examining the ankle and hip mobility of their knee-pain patients? In many cases, pain in areas such as the knee or low back are often influenced by a lack of mobility at nearby joints, and range of motion assessment could be a key diagnostic for uncovering the source of pain.
The Joint-By-Joint Approach
According to the “Joint-By-Joint” Approach, the human body is essentially a stack of sable segments sitting on top of mobile joints. Some joints tend to require more mobility, while other joints tend to require more stability, and in general, the stability/mobility demands of each joint tend to alternate as seen below:
When we are lacking range of motion at one of the mobile joints, the body has no choice but to compensate and create extra motion at one of the stable joints.
For example, somebody lacking hip flexion may compensate by creating excessive flexion at the lumbar spine. Somebody lacking shoulder motion may compensate by creating excessive scapular elevation or anterior tilt. Somebody lacking ankle dorsiflexion may overly pronate and collapse the knee into valgus during gait.
Over time, this can put unfavorably high amounts of stress and load on the compensating joints and lead to injury or pain.
- Lack of hip range of motion is a risk factor for low back pain (1-16)
- Lack of hip range of motion is a risk factor for knee pain (17-19)
- Lack of ankle dorsiflexion can increase likelihood of knee valgus and is a risk factor for knee pain (20-26)
- Lack of shoulder range of motion is a risk factor for elbow pain (27-28)
For these reasons, it is not hard to see why maintaining proper joint mobility is essential for injury prevention. When mobility is lacking, joint compensations occur, and over time these compensations can be a major contributor to pain or injury.
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