Joint-by-Joint approach
Joint-by-joint approach.
In my last post I introduced foam rolling in a very basic, surface level way. This post, I’m going to dig a little deeper into the importance of using foam rolling, as well as other recovery techniques, to avoid or recovery from injury.
Gray Cook coined the phrase and accompanying theory “joint-by-joint” approach. In the most basic of terms, the joint-by-joint approach has us look above and below the pain site (where it hurts) for the pain source (where the pain is coming from). I use this methodology everyday when working with clients.
A simple example is an athlete experiences knee pain when squatting. It may seem like there is something wrong with their knee, which is possible. However, it is extremely likely (especially in an otherwise healthy athlete) that the pain is coming from a muscle or joint above or below the knee.
If any part of your quadriceps, calf, or hamstring is “tight” it could pull your patella (knee cap) out of alignment, thus causing friction when stepping up, lunging, or squatting. The result is pain.
Going deeper into this theory, Cook explains that joints alternate between needing more stability (control) or needing more mobility (less stiffness). Starting with the ankle (should be mobile), then the knee (should be stable), hip (mobile), lumbar spine (stable), thoracic spine (mobile), and ending with the glenohumeral joint (shoulder; stable) he gives an outline for treatment of pain.
If an athlete is experiencing knee pain, it might be from a tight hip (flexor, extensor, rotator) rather than a tight quadriceps, calf, or hamstring. This is a clear example of how the pain site and the pain source are different. If you only focus on the pain site (where it hurts) it’s easy to miss the pain source. If this is the case, an athlete will be in pain much longer than is necessary.
I have several mobility exercises on my YouTube channel, and these are what I use to address pain with clients. I use these “mobs” with all of my clients (even when they aren't experiencing pain) to help keep them pain-free.
By pairing soft tissue therapy (lacrosse ball & foam rolling) with ankle, hip, and t-spine mobs, you can stay pain-free. When pain occurs, focusing in on the areas above and below the pain site with specific mobility and stability exercises, you can eradicate pain.
**Note: cases are not always this simple, and sometimes medical intervention is necessary.**
Questions? Comment below.