Therapy Thursday: To mobilize or stabilize, that is the question..
Mobility and stability have been buzzwords the last several years (decades maybe? I’m only 30 and these words have been buzzwords since I entered the profession 8 or so years ago). Many coaches, trainers, or therapists talk about these terms on a daily basis with nearly every patient or client that they see. I know I talk about them a lot.
Let’s first talk about what they mean.
Stability: The ability to maintain control of joint movement or position.
Mobility: The ability to move or be moved freely and easily.
That is from a quick google search and isn’t fitness or therapy specific but looking at the definition it resonates a lot with what we all believe that mobility means. If we don’t have good ankle, hip, or thoracic spine mobility we won’t be able to squat well. If we have poor shoulder mobility, overhead press may be terribly difficult.
There are two forms of mobility that I assess when I look at someone. Joint and tissue mobility. Joint mobility is generally how well your actual joint moves where as tissue could be muscle, fascia, neural related, among other possibilities.
If someone is restricted in joint and tissue mobility, it doesn’t matter how many stability exercises you give someone they aren’t going to make much of a difference. If you don’t do something to address the mobility deficits, they movement patterns just aren’t going to change.
However, just because something looks like a mobility problem does not mean that it is actually a mobility problem.
If you look back to last week’s post, Austin wasn’t able to touch his toes in the first video. Many athletes/trainers might say that he has tight hamstrings.
Look at the second video, Austin now has a full 80-90 degrees of straight leg raise actively.
Next I’m going to look at Austin roll from his back to his front. No video here, but trust me when I say that he cannot roll. Now if Austin has good thoracic mobility (which his isn’t great), he likely has a pure “core” stability deficit and training this deficit would likely restore his ability to touch his toes. In 5 minutes of stability drills, he is going to be able to touch his toes.
We could do joint and soft tissue work all day long and he would likely not come a whole lot closer to touching his toes today.
That brings me to the title of this post: To mobilize or stabilize? Trying to stabilize a mobility problem is like playing pin the tail on the donkey in the wrong room or throwing darts at random.