Say what?!?! When is a mobility issue not a mobility issue? You read that right. A mobility issue is not a mobility issue when it’s a stability issue. There I said it. Soak that statement in and think about it for a few seconds before making any judgments (in either direction).
We know the human body is a wonderful and powerful tool. We also know that the human body is the great compensator. When you cannot move properly, the body will get it from somewhere else. The epitome of robbing Peter to pay Paul. The human body will also sacrifice quality over quantity. I bet you that right now, you have movement dysfunction that you have no clue exists and there is a good chance you don’t have any pain associated with it… Yet… Eventually you will. You can take that to the bank.
When the body reacts with pain signals- basically it’s saying to you, “Hey Idiot, do something. There is a problem somewhere”. The problem is that a lot of practitioners are tricked by the pain and they start to “chase it”, as my good friend Perry Nickelston likes to say. Just because there is pain in one location with a potential tissue lesion, does not mean that is the root cause. We have to look at everything in order to understand 1 think.
Janda was way ahead of his time. He stated that you must understand the motor system as a whole in order to understand individual impairments. Damn that dude was smart.
So back to mobility issues not being mobility issues. Do NOT take this as an absolute. The only absolute is that there are NO absolutes (I can thank one of my students for that line). Mobility issues must be consistent. We know that and we understand that. So having a patient/client fail a toe touch and then assuming they have tight hamstrings is putting the cart before the horse. That’s only one way to look at movement.
1- Check toe touch in standing
2- Check toe touch in long sitting
3- Check active straight leg raise (needs to be greater than 70 degrees)
4- Check passive straight leg raise (needs to be greater that 80 degrees)
If you FAIL all 4 of those, guess what, there is a good likely hood you have a mobility issue or issues limiting you. If you pass even just one of those, it most likely cannot be a mobility issue.
So what could it be? It could be a lot of things but lets use this example. A patient presents with a limited toe touch in standing and then a perfect toe touch in sitting. One of the likely scenarios here is that this person has some fundamental core stability issues such as a lack of pelvic stability or diaphragmatic issues which is causing their hamstrings to contract in standing and stabilize the pelvis, thus causing a compensation. You then have the person long sit- and BOOM they touch their toes. What’s stabilizing the pelvis in this position- the FLOOR. Hamstrings shut down, stop overworking and bingo, the person touches their toes.
Now- how do we go about fixing their toe touch in standing? Stretch their hamstrings? Mobilize their l-spine? Nope. Not going to work. Go to your days of Pediatric development and focus on rolling, crawling, half kneeling balance. Maybe even before that you need to assess their breathing and teach proper diaphragmatic strategies.
One of the most powerful options to fix this issue is segmental rolling. The next blog coming out soon is titled “This is How I roll” and will go in depth into segmental rolling. Think about how we develop and think about what needs to stabilize properly in order to roll from your back to your stomach. I have a few good videos that will accompany that blog which will demonstrate this.
The point is- develop proper fundamental core stability and you will clear up a lot of “mobility” issues. Just remember this: Mobility issues will be consistent. If it’s inconsistent, you need to look at what stability problems are present.