The joint by joint approach
Summary
The joint by joint approach is a theory presented by Physical Therapist Gray cook that gives us a framework to work from when talking about mobility vs stability and where to focus our attention. Generally speaking, things that tend to be more sloppy and unstable have greater need for stability and motor control to be introduced to the system; and things that tend to be more stiff and stuck have greater need for mobility and flexibility to be introduced to the system.
Joints that should be more mobile:
- Big toes
- Ankles
- Hips
- Thoracic spine
- Shoulders
- Upper cervical spine
- Wrists
Joints that should be more stable:
- Feet
- Knees
- Lumbar spine
- Scapulae (shoulder blades)
- Lower cervical spine
- Elbows

Cause
When you experience a sudden stiffness in your neck, shoulders, lower back, knees or feet, typically there will be a need for mobilization of the joints above and below to help create a better environment for the “stable joint” to live in. This will help to take the pressure off of the joint in question because the above and below joints are not moving as they should and the joints that should be stable are fighting to stay rigid. However, with the lack of movement above and below, the stable joint now becomes unstable causing it to be extremely tight and tender.
Effects
When you experience pain in ankles, hips, upper back, shoulders, neck or wrists, typically there will be a need for greater stability in the areas above and below to help create a stronger, more stable base to move from. This will create a feeling of safety to the brain allowing for more range of motion to be achieved through the perceived safety from that stability.
Treatment
Start to mobilize the mobile joints through banded distractions, floss bands, and stretches. Start to help stabilize the stable joints with corrective exercises, breathing techniques, and other mobilization tools such as pods or tape to help reduce the “threat” that the brain feels and calm down the nervous system to allow for greater stability.
This is going to be a process, so don’t get frustrated! Finding what your body needs is going to be challenging at first and difficult to navigate. Starting with the basic framework of the joint by joint approach, we have been implementing postural alignment exercises to get the appropriate stability that the body is constantly searching for and helping to strengthen your muscles and fascia to make your body more resilient , as well as mobility therapy to show you how to mobilize the appropriate way to improve the overall health and function of your joints. This process will take a few weeks to create long lasting change, but if you stay consistent, you will see amazing results with the postural alignment therapy, mobility therapy as well as your physiotherapy sessions.
Schedule a FREE wellness consultation
Schedule a FREE wellness consultation
Ready to experience how our therapy can help you address the pain and discomfort you may be feeling?
Dive straight into the feedback!Login below and you can start commenting using your own user instantly