Stability vs. Mobility
Our orthopedic health is largely dependent on finding a proper balance between stability and mobility. Because this balance is so critical to how our joints junction and to the quality of our movement, it also determines our vulnerability to injury. Below is a list of the terms we continue to reference throughout this series:
Big Picture Posture- Long straight spine, neutral shoulders and hips, and feet pointed forward.
Neutral Horizon- Eyes and ears level.
Wobble- The effects of having a structural imbalance and the compensations that result.
Common Postural Collapse- Head forward, rotation to the pelvis, internal rotation to the shoulders and external rotation to the hips.
Our major joints alternate between stable and mobile. The metatarsal line of our foot (think where the toes attach to the foot) is stable. The ankles are mobile, and are considered loose adaptors. The knee is a stable joint. It functions best as a true hinge. The hip is a mobile joint that offers movement through multiple planes. The low back is stable, mid-back is mobile and where the neck and shoulders meet is stable. The occiput and first cervical vertebrae at the top of the neck are once again mobile.
It is this mobility at the top of the neck that in so many ways affects the structural integrity of the rest of the body. Because we will always try to accomplish a Neutral Horizon, any structural imbalance in the body must be corrected through change of position of the head and neck. When you take a joint that is mobile in nature and subject that joint to the stress of making an ongoing postural correction, mobility will be lost. In our practice we see so many patients with neck pain and loss of cervical mobility. Seldom is the solution found in the neck. The great majority of the time we will identify another area that started the Wobble. If the pelvis and lower lumbar spine are stable in nature, any excessive mobility will compromise the integrity of the spinal alignment and cause a change to Big Picture Posture.
In order to maintain proper balance and insure structural integrity, our patients are coached to orient towards a nice upright posture. We recommend strengthening exercises to add tone to weak over stretched muscles and lengthening exercises to address short and contracted muscles. Most people on their own will chronically over-stretch already weak overstretched muscles and completely ignore the muscles that are truly tight and contracted. Everyone can relate to the knot (focal adhesion) that forms at the top of your shoulder. Most people will try and stretch this knot by pulling the arm across the body and tucking the chin towards the chest. Where this feels good for a moment, it is making the problem worse. The tops of the shoulders or the upper trapezius muscle and the levator scapulae muscle underneath are chronically over-worked. The Common Postural Collapse is that most people have a head forward posture. This means that the muscles previously mentioned are constantly responsible for supporting the weight of the head falling forward. Rather than stretching these muscles further, greater relief comes from sitting up straight.
When it comes to other joints like the knee, change to mobility of the hip or ankle are often the cause of dysfunction. If the mobility of the hip is compromised and it becomes stiff, the angle of the knee will become greater than what is good for the joint. As mentioned the knee is a stable joint that likes to function as a hinge. Once subjected to rotation, pain and degeneration will occur. Rather than focusing all attention on correcting the knee, restoring proper mobility to the hip and ankle are often effective solutions. This is especially true when proper lengthening is done to the short contracted muscles that are pulling the knee out of true, and strengthening is done to the weak overstretched muscles allowing the joint to fail.
Each joint has a set of conditions that give rise to greatest structural integrity. Maintaining proper muscle length and tone is critical to sustaining orthopedic wellness. Paying attention to maintaining good upright posture is the single most effective solution for reducing abnormal stress on our joints. When we find ourselves in pain or have lost proper function of the major joints, be sure to seek solutions that look at the entire body, not only that focus on the affected joint alone.
Douglas Bertram, L.Ac., MTCM