August 15, 2016
When patients come to a physical therapist for their various conditions, it is up to us to figure out which structure(s) are causing the symptoms, and more importantly, why. As a physical therapist, our expertise focuses on how the different structures in the body interact to produce movements within our joints. When there is a fault in the system, abnormal movement patterns will occur, which often lead to symptoms like pain, weakness, stiffness, etc. Once we discover which structure(s) are responsible for causing the symptoms, we need to figure out why. As it relates to joints, I am often trying to determine if the joint needs mobility, stability or both.
Mobility refers to the joint’s ability to move through a given range of motion. A healthy shoulder is a great example of a joint that has a large range of motion, with good mobility. The mobility allows us to use our arm/hand in many directions. Stability refers to the ability to restrict movement. The knee is a good example of a joint that has restricted movement in various planes, which creates a more stable platform for weight bearing activities. We can improve mobility through specific stretches, and manual therapy techniques performed by a physical therapist. Stability is improved through teaching muscles around the joints to contract when needed, and by improving strength via exercise. Listed below is a breakdown of some of our major joints and their needs as it relates to mobility or stability.
Joints that need mobility: Joints that need stability:
Shoulder (glenohumeral) Cervical spine
Wrist Scapula (scapulothoracic)
Thoracic spine Lumbar spine
Hip (femoroacetabular) Knee
Ankle (Talocrural/subtalar) Foot
These lists are basic guidelines for the joints. However, when dysfunction is present, you may need to add mobility to a joint that typically needs stability or vice-versa. There are often times when you need to improve both mobility and stability of a joint. If we use the knee as an example, there are instances when the knee joint has reduced mobility and range of motion because of injury. If we do not restore the normal mobility and range of motion within the knee, it is more likely to cause symptoms and is more susceptible to injury. Also, the injury that lead to the knee mobility issues, likely caused weakness of the surrounding musculature. So as we restore normal mobility, we need to restore normal muscle activation to improve stability as well. This holds true for each joint in our body, and is why it is so important as a therapist to discover the ‘why’ eluded to earlier.
When you truly figure out why symptoms are being produced, you can create a targeted program for your patients that will improve symptoms quickly. This is the essence of individualized care, and what we strive to do at Portland Physical Therapy. Each patient is like a puzzle that can be solved through evaluation, examination and the proper prescription of exercises. If you or someone you know is suffering from pain, call our office at 207-828-4455 for more information.