By Dr. Lisa Goodman, DC, CCSP
There are two kinds of mobility in your body: soft tissue & joint. Most of us are very familiar with soft tissue mobility (or lack of!). Soft tissue mobility is often referred to as flexibility. I don’t know how many times someone has come into my office stating that they can’t touch their toes because they don’t have flexible hamstrings - but it happens about every day. One of my favorite party tricks as a chiropractor is adjusting that same patient’s pelvis (typically Sacroiliac Joints) and watching them actually touch their toes for the first time. This patient who has most likely foam rolled and stretched their hamstrings daily for 3 years and who has taken up yoga for the last year to improve flexibility - has never touched their toes.
So why, does one chiropractic adjustment facilitate the touching of the toes so easily? Answer: Joint mobility. Joint mobility is possibly the best kept chiropractic secret ever. Most of us think of chiropractors for pain, headaches or injuries. And rightly so. We’re pretty good at that stuff. But the thing we chiropractors have known for a long time, is that smooth movement of the spine and extremity joints is the key to overall mobility. This blog is Part 1 because I’m going to explain soft tissue mobility in Part 2. It is really important to appreciate joint mobility first.
How joints lose mobility (ie. a joint fixation). Have you ever jammed your finger or knuckle playing football or basketball? Most of the time our instinct is to “pull” or “yank” on the finger to release the pressure in the joint. This is a super simple explanation of a joint fixation. The sensation you get with a jammed knuckle is usually described as pressure, stiffness, pain but most people will agree it is hard to move or bend all the way when it is jammed. As soon as you pull it out or unjam it, you can move it fully. There may still be some pain and swelling around the joint, but generally the mobility will return quickly. I love this example when explaining joint fixations, chiropractic adjustments and subsequent mobility.
What is a joint fixation really? Keeping this super simple (trust me, there is a much more anatomically correct explanation) joint anatomy is a lot like a suction cup to a mirror. Both sides of a joint are smooth and with enough joint fluid between the bones, they glide easily, much like a suction cup and liquid on a mirror. Now imagine the suction cup being pressed firmly against the mirror and displacing all of the fluid away. Can you see how hard it would be to move the stuck suction cup? You’d have to really pry it off to get it loose. This is the same with a joint fixation. Take any joint in the body, if the two joint surfaces get jammed too close together they become stuck. We call this a joint fixation. And no amount of stretching or foam rolling can release a moderate to severe joint fixation. And unfortunately, the only joint fixations effectively released on our own are fingers and toes. More on that later...
It’s possible that without reading any further, you are already thinking about joints where this may apply in your own body. But it’s OK if you aren’t! Most of the time joint fixations in our body do not feel so significantly jammed, this is because our nerves sense things differently everywhere. Particularly if you have joint that has been jammed for years, often times the nerves may just not feel it anymore and your body may start to compensate for the lack of mobility in this area.
What does this have to do with Crossfit? Since this explanation is part of my two month crossfit challenge, I’ve got to tie this together. It helps that Crossfit is a great example of how improving joint mobility will immediately impact body mechanics. When I started Crossfit I was told (and noticed easily) that the overhead squat is the move that will immediately show mobility failures in the body. I was also told that the overhead squat is really hard. Both are true it turns out.
So let’s break down a squat... (This part is technical, but if you Crossfit or workout or want better flexibility, please read through it’ll be worth it.) From the ground up...the most significant joint fixation I have found in my Crossfit athletes is in the ankle. Ankles are supposed to be mobile and should be able to flex at least 90 degrees towards your body. Little self-check here: if your ankles are more flexible in the “in and out” position than they are in the “forward and back” position (meaning you tend to roll or sprain them) you may have a huge ankle mobility problem. So truly a quick and easy way to improve squat mobility is to improve ankle mobility. Far and away, the best way to do this is through chiropractic manipulation. Beyond that, there are great ways to maintain and train mobility with bands, roller and balls, but the joint has to get moving first (and for best results several times!) See part 2 blog for more on bands, rollers and balls...Also a very cool part about ankle adjustments is that athletes are absolutely shocked by the immediacy of the results here.
The next most problematic joint in our mobility chain is the Sacroiliac Joint (SI Joint) of the pelvis. Yes, I skipped over the knee and hip on purpose. Hips and knees can be a very symptomatic and problematic issues during a squat, but are not generally a major factor in joint mobility (more on hips in part 2). What do SI joints have to do with a squat? So first take a second to find yours, at the base of your lower back you will feel two prominent bumps, these landmarks are basically one either side of your SI joints. They are where the Ilium meets the sacrum (therefore SacroIliac). There should be a significant amount of movement in the SI joints, particularly when the hip is flexed toward the body (knee to chest) or away from the body (butterfly stretch). The SI joint when in fixation will significantly limit squat depth and hip mobility. This can be super problematic if it becomes chronic, because it results in compensation from muscle surrounding the glutes and hips, leading to pain and overuse of the hip flexor, piriformis and IT Band. Yes, we’ll cover that in Part 2. The point here is, for chiropractors it is ridiculously easy to detect an SI Joint fixation and also easy to mobilize it. Again, once we have achieved decent mobility in the SI joint, there are ways to maintain it.
Some of you reading this may have heard of the mobile-stable joint description. As a reminder what we would like to see in all of our athletes is the following:
Ankle - mobile
Knee - stable
Hip/pelvis - mobile
Lumbar Spine - stable
Thoracic Spine - mobile
Neck - stable
Shoulders - mobile
I am definitely biased, but the best professional to have address your joint mobility/stability balance is a sports chiropractor. Our goal is not to mobilize your entire spine/body, but to ensure the correct joints are mobile, with the appropriate ones remain stable. I have pointed out to some athletes at the gym, some obvious mismatches in their mobile/stable balance, but I try really hard not to pick on anyone (unless they ask!). However in some cases it can be that obvious.
Back to mobility, using the overhead squat in our analysis we can easily find mobility problems with the thoracic spine and shoulders. Overhead squat mechanics can improve immediately once problem areas are adjusted. They can continue to improve and more significantly improve with repeated adjustments to these areas (we’re likely talking 5-6 adjustments during 3-4 weeks). Thoracic and shoulder mobility can also be maintained much like the other areas we discussed and will get into more in Part 2.
Believe it or not, it is simple mechanics. Like I said, my favorite in-office chiro party trick, adjusting the SI joints and patient touching their toes moments after. Second favorite, adjusting the thoracic spine and ribs and overhead squat mechanics improve dramatically.
Putting it all together. One of my favorite people to work on is Coach Ethan from Crossfit Wash Park. He is strong, fit and has very few injuries. Prior to seeing me he had received infrequent chiropractic adjustments (mainly due to not having ‘back problems’). As part of my crossfit experiment, I wanted Ethan and his wife Kristina to understand what sports chiropractic can really do for their mobility and performance, thus suggested that they see me weekly for 5-6 weeks. Lucky for me they have been very compliant :) I was easily able to identify joint fixations in Ethan’s ankles and Sacroiliac Joints as well as his thoracic spine and ribs. The most significant changes I have seen since working on him are shoulder mobility improvement and wrist mobility improvement - which we haven’t even discussed in this blog! Truly, if there is a fixation in the body, sports chiropractors can find it and improve it. His case gets more interesting when start talking about soft tissue mobility in Part 2...stay tuned.
Washington Park Chiropractic is the only practice in Denver, Colorado specializing in Sports Chiropractic, Prenatal Chiropractic and Pediatric Chiropractic. Our Wash Park Doctors are expert certified and trained in Sports, Pediatrics and Prenatal Care including massage, acupuncture, Webster Technique, Graston Technique, Laser, K-Laser, Kinesiology Tape, RockTape and Normatec.
Lisa Goodman, DC, CCSP, CACCP is a Certified Chiropractic Sports Physician (CCSP) and Certified Prenatal and Pediatric Chiropractor (CACCP). She is a CrossFit L1 and CrossFit Kids Certified Trainer. Dr. Goodman founded Washington Park Chiropractic in 2006 in Denver, Colorado. Dr. Goodman incorporates sports chiropractic techniques with prenatal and pediatric patients, she teaches mobility and taping classes locally, and is a contributor to POPSUGAR, Urban Life Wash Park and DC Aligned. She is a committee member on the boards of the ACA Pediatrics Council and the ACA Sports Council. Areas of special interest include prenatal care, ankle and wrist injuries, instrument assisted soft tissue techniques, strength training, and pediatric fitness. Stay connected with Dr. Goodman on Instagram @washparkchiro or @lisakgoodman
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