OVER my last few articles you have seen different styles and ideas on describing how the human body works. By utilizing different ideas of how the body works and being able to look at the body in different perspectives we are able to then come up with some better treatments.
I will always profess, “There is not one BEST way to treat the human body.” More ideas = More tools. Sometimes you need a map that shows roads and sometimes you need a map that shows topography. Because depending on your vehicle there are different ways of getting to your location. The same thing happens with the human body. There are different ways of getting to better results.
Lately I’ve given you all a few ideas that we use in our clinic.
Ideas on how the brain responds to pain and “threat”
Another idea, One I feel is one of the most effective ways of utilizing how the body works together is “the joint by joint approach”. This article is a brief and easy-to-understand explanation of this idea.
Joint by joint or what is often call “Joint stacking” is an update from what I think people have in mind when they say an area is “compensating.” I use this newer term because it’s become quite evident that I can say an area is “compensating” and patients just accept it. Like I magically explain all their ails with this word. But just saying “compensations” doesn’t help at all – it doesn’t change anything.
By understanding this “joint by joint” approach, especially my understanding..it changes the way I treat patients.
This is why I create these articles. New information, new findings, new research dictates new treatments and protocols with the modern thinking doctors and therapists.
Probably more importantly to you …This new information, or perhaps the way I package and explain this new info might help you with a stubborn problem. Lord knows I write over and over again “You’re doing it wrong, You’re doing it the old way.”
If I’m going to say that you are wrong, I better be able to back it up. I better be able to give you something you CAN use!
If you keep getting hurt with your standard workout routine, this one may be for you. In this article I’ll get into how the joint stacking approach may explain why exercises, especially pilates, crossfit and yoga seem to have so many repetitive injuries with their clients. Becasue by no means are these workout systems flawed. It just might be the wrong vehicle for the map you’re using right now.
It will definitely explain why MORE chiropractic adjustments, MORE PT visits and MORE muscle work is not the answer.
The answer isn’t, “if it hurts when you do this…don’t do it.” but instead, “why would that hurt? – Let’s look at this problem differently and fix it. “
Understanding leads to better treatments. So let’s go through my take on the joint by joint approach to your body.
The body is built with a lot of different areas. Summarizing, these areas are either basically mobile areas or stable areas. We’re not built to be a 1960’s robot, all stiff and unbending. We’re also not built to be like my plastic skeleton in my clinic that just is wobbly and unstable and would fall like a sack of potatoes if I tried to stand it on the ground.
This is how I teach my grade school kids when I do career day.
Stable mobile stable mobile.
Your ankle is very mobile it has 20+ bones, 50 muscles, bendy fascia – it’s built to move. The knee is more stable, it has subtle movements but for the most part just wants to bend one way like a hinge. Continuing up, the hip is very mobile. A ball and socket with massive glute muscles attached to generate power. Your Low back should be stable, basically allowing you to hinge forward but even more so, to resist bending forward too much. Middle back should be mobile.
The Upper body works the same the same… every other joint – Thumbs are mobile, hand stable, wrist mobile, elbow stable, shoulder mobile.
It’s the way the body is built.
Pretty obvious to visualize when it’s explained like this yes?
So how does that help me? As a doctor?
Here’s how. If a stable joint isn’t stable, the brain gets alerts that the area may be threatened. Continued threats and the brain does what it does, protects the body…often by stealing mobility from the joints above and below.
Anyone that has ever watched me in a live lecture has heard me talk about how low back pain nearly always correlates with poor hip motion. My patients have. Every single one of them for the last 15 years or so. It’s all I talk about.
You come into my clinic with a hot low back and I preach at you and show you beyond doubt your hip mobility is garbage. I get all excited and worked up and basically put on a one man show you didn’t ask for!
But recently I got a little epiphany on this idea. Because I got a little more in depth to what the joint by joint approach means in real life – I had it explained better at a seminar a few weeks ago. Yep..I was missing a key element!
What if your low back has an issue that is threatening your body to the point that the brain is robbing mobility from your hip? Not your hip causing low back stuff but the other way around – the low back causing the hip issue.
It’s a two way street. Both issues are there, every time! I’ve tested this over and over for years and I can assure you, it is 100% there – these two go together.
Now you guys that know me…know me – I preach that you have to fix the issue, not just treat the pain.
I rant until I’m blue in the face about hip mobility, foot mobility. Chiropractors rule mobility baby – we can and do move everywhere!!!
But what about the stable part? What’s up with that? Well it turns out it’s equally important and depending on what body part your issues occur, maybe even more important than the mobility aspect.
This idea has made me a better clinician, doctor, chiropractor and body detective. Better clues=better treatments.
So how does that help you?
Because I can now give you more. Not more as in piled on exercises that make you think you are doing something…that’s a waste of time. The more I’m talking about is in fact, less work. More pinpoint, accurate corrective type stuff not wasted time.
Do less, but do the right stuff and get more…Way more!
I think this idea is why I’m often introduced as the “guy that hates stretching.” I DON’T hate stretching, I just hate inappropriate exercises given as a HOPE. Let’s do stuff better, Let’s do stuff correctly.
Often – this is the case with stable joints. Stable means stable. Adding more mobility, more flexibility to an area that wants to be stable is just plain wrong. So wrong, It’s often a big part of the problem!
So how this helps you is if I understand better, now you understand better… you get to have the better ideas, the cutting edge techniques.
In the case of the low back, this new look changed my day to day protocols for working on clients. I was missing something.
The change? Stability. I was skipping a step. Maybe THE primary step.
Let’s go back to the sore back example.
When the joint by joint approach is the right way of looking at the body – a client with a sore lower back will present with decreased hip mobility and decreased thoracic mobility. As a chiropractor, physio, PT, Massage therapist etc. we tend to Want more mobility. In fact we want more mobility in the lower back. That’s where the pain is why don’t we move that thing more. Even my patients will tell me, “Doc I need more, go harder or give me some stretches so I can get more movement in there..”
But see here’s the problem. The lower back from the lower thoracic to the sacrum area is a part of the body that is craving stability. The area is a stable portion of the body and the joints there are built for stability. The fascia is huge and thick, stabilizing thick.
The trouble is oftentimes the low back area is over mobile. If a stable area of the body has too much Mobility it will tend to steal it from The Joint above and below. Exactly like I explained it a minute ago. In this case a lower back that is over mobile will steal stability from the hip and thoracic spine. That’s why your hip and thoracic spine aren’t working are also sore and why I find this out when I examine and test you. It’s why your low back doesn’t get much better with MORE MORE MORE.
So in this case it could be that the hip isn’t moving the right way and that’s what’s causing the lower back issue or that the lower back is moving too much and is causing stiffness in the hip.
The best thing is,when I, or you, take the time to evaluate correctly and treat both these areas rather than chase pain and we have a better understanding – We get a better treatment.
Consensus: Sometimes, we need to stop trying to get the lower back more mobile.
While taking the seminar that really gave me this eye-opening change one of the presenters talked about the difference between a professional golfer and a very high-level amateur.
So imagine for a second a side-by-side video image. On the left you have a professional golfer and on the right you have a high-level amateur that shoots scratch. Both of these golfers shoot the same score. They both can hit the ball 315 yards off the tee.
Even when their stroke is shown in slow motion individually it looks about the same.
But when these Strokes are shown side by side, in a comparison view, a couple glaring differences are observed.
The pro golfer will rotate through the hips and as he starts to bring the club back his lumbar spine looks almost as if it is made of iron. There’s basically no rotation happening there. It is all happening from the hips and as the club starts to come back more thoracic rotation happens. Almost like his chest and rib cage are opening up so he can take the club back. This generates tremendous power.
The amateur however, despite being able to hit the ball the same distance has very little hip rotation. The majority of his opening up of the body is happening from his lower back. There is a significant twist through his lower back and not very much rotation through his upper thoracic. His Club head still needs to come back to generate power and distance so he’ll tweak a little with the majority of the club rotation happening at the wrists with a cocking of the wrist because he doesn’t have proper thoracic rotation.
The difference is one guy’s a professional because he has the longevity to stay on the course and hot like this for years and can tweak his game by having a fluid stroke over and over again. The other guy’s in the Chiropractic Clinic throughout his life on and off. This is despite shooting the same score and despite hitting the same distance. Injury happens because the body isn’t working like it was made to.
My second hard hitting idea with this is to just watch the end of a marathon. Nobody looks the same. The guy over there looks like a phenom while the guy behind him looks like he came off the set of a Zombie movie. This girl limps across and this girl has a hitch like her hip is a cogwheel. It’s not that we all run differently… Well actually it is. Properly put.. We all “compensate” for our weaknesses and improper motions, That’s what compensation truly is – mobile joints not moving and stable areas over moving. We can carry on, but to what end?
And at the end of the day that’s what I want you to get out of my explanation of this joint by joint approach. Too much of what we learn as we continue to Google our injuries and look up YouTube videos is mis-information and although it makes sense it doesn’t always work in the clinical setting. I just want to give you a different idea of looking at the body to visualize a new map – a modern look at your own body. It definitely made a difference on how I treat my clients who are coming to the office and I think it will make a difference on how you treat yourself.
Maybe that plantar fasciitis issue that you have in the foot isn’t so much a problem where the pain is. Maybe it’s because the big toe which is supposed to be mobile and the ankle which is supposed to be mobile aren’t mobile at all. So the stable area in the foot is having to do its job and the job of the big toe and ankle.
If that’s true than attempting to constantly increase mobility in the foot by mashing and smashing the crap out of a lacrosse ball over and over again is more hope -not really treatment. It’s just more. More of the wrong idea.
Maybe sore knees that Creak and pop when you squat don’t need more stretching, but a true look at the ankle and hip mobility need to be performed. The idea is to give you more tools for your body.
As always guys, just like I said on the first paragraph, I will never try to fit everybody into just one way of seeing the body. Different maps, different tools. If a certain technique or idea that we are trying clinically isn’t working we have to get a different idea. Basically we need a new map or a different detailed map. This helps in our clinical decision-making and treatments.
I hope you like the introduction of The “Joint by Joint” body approach. If you like the simple way I present a complex body Theory, I think you should also look at the last couple articles I wrote which describe different ways of seeing the body then the joint by joint approach. “Body mapping” and the article “different body parts respond differently to injury” would really give you some insight and ideas.
I would also ask that if you do like this info and my way of teaching and you think there are others that would as well, please share this information. By sharing my podcast, leaving a review or writing comments it really makes it much more available to other people out there and helps me move forward with where I want to go with my career. I want to teach. I want to teach ONLINE. I could use a little help.