Thoughts on the Mobility-Stability Continuum, feat. Dr Quinn Henoch

My day job as a strength coach means I cross paths with many bodies of varying anatomies, structures and movement potentials. An overarching concept I like to frame my work under is called “The Mobility-Stability Continuum.” Regardless of who coined the term, it’s a useful model to use when assessing new clients and athletes, to see where they’re at with the status of their bodies, before we begin programming and planning for future performance goals.

One way I like to use the model is in a very simplistic, categorisation fashion. At the end of my assessment process, before I begin working with an athlete for the first time, I can usually tell what end of the continuum they’re sat on. This is useful because if I get an athlete, for example, who is stiff but strong (hypomobile), I know that it’s likely we’re going to need to work on mobility interventions to bring up any joint function that is perhaps under-achieving or holding them back from performance. And on the other end, if an athlete comes to me and is crumpling under load, lacks stiffness and is hypermobile, I have an idea of what mobility and stability work needs to be done.

Again, this is an over-simplified categorisation of how I like to use the continuum in a split-second manner. It actually goes much further than just surface-level, post-assessment categorisation judgements, so we’re going to need to dive deeper to really give you an understanding of how this continuum works. But before we utilise the help from Dr Quinn Henoch, let’s set some definitions for clarity purposes.

Continuum
Noun
A continuous sequence in which the adjacent elements are not perceptibly different from each other, although the extremes are quite distinct.

Mobility
Noun
Movement potential.
Example; A joint has the potential to move through its full range.

Mobility Interventions
Noun
Specific exercises that focus on correcting flexibility, soft tissue, extensibility or joint mechanic impairments.

Stability

Noun
Your ability to control your movement potential.

Conscious Stability

Noun
Conscious thought applied towards contracting a muscle to stabilise a joint.
(A form of active stability.)

Reflexive Stability

Noun
Subconscious, automatic control of movement potential via instinctive muscle contractions.
(A form of active stability. One of sport performance’s main focuses.)

Static Stability

Noun
Resisting movement around a joint by utilising conscious or unconscious muscle contraction.
(A form of active stability.)

Passive Stability

Noun
Control of movement potential via structures that don’t contract.
(Think of hanging on your ligaments.)

The Mobility-Stability Continuum is an important overarching theme of the assessment process. The assessment is to show what needs correcting. From there, the warm up process for the client is programmed intelligently, so that specific interventions are used properly and effectively, meaning the warm up does not last forty-five minutes and is ultimately useless. Instead, a solid ten minutes of preparation is the result, so the athlete is ready to carry out their training session safely and effectively.

What we’re aiming for as coaches is to get the athlete’s body to use active and passive stability in sync with each other. Most people depend on passive stability, but in reality you need a balance of both.

Mobility-stability Continuum Guidelines

Let’s see what guidelines Dr Quinn Henoch has when it comes to using this continuum, especially within the mobility realm.

1. MOBILITY BEFORE STABLITY
You can’t stabilise a pattern if you can’t move through it! If an athlete can’t get their arms overhead comfortably, my focus as a coach should not be on trying to stabilise the shoulder joint. It should be on mobilising it, first. Once that has been achieved, we can work on conscious stabilisation of the joint, leading towards reflexive stability down the line.

2. CORRECTIVES SHOULD BE PRECEDED BY SOME KIND OF SCREEN OR ASSESSMENT
An assessment doesn’t have to be carried out by a physio, FMS practitioner, etc.
But if you don’t assess your athletes, you’re just guessing. You should be looking at joint function, training history, muscle testing, load testing where necessary, and inquiring about lifestyle factors, injury history, recoverability and stress tolerance.
Screen and Assess, don’t guess.

3. YOU ARE NOT CREATING STRUCTURAL CHANGE WITH MOBILITY INTERVENTIONS
Our bodies, fortunately, are just not that fragile. Just imagine if we were actually like a piece of clay. Everytime you stood up from a chair, your butt would be moulded into the shape of it!
What a mobility intervention does do, is send a message to the nervous system. It’s a nervous system thing, not a structural thing. If you were to put an athlete under anaesthetic, it’s highly likely their mobility restrictions would disappear during the time they’re unconscious.
This is an important principle when it comes to dosing and frequency. If a thirty second roll on a foam roller worked, you don’t need to do another four and a half minutes of rolling. The thirty seconds did the job. Once you’ve done the intervention, you’ve got to go and use the area you’ve just mobilised otherwise the effect on the nervous system is going to go away. What actually creates structural change is taking a consistent, intelligent approach to loading, over time. Using the right intervention, then working on position after, over and over again, day after day. Your tissues adapt to loaded movements. They don’t necessarily adapt to passive modalities.

4. BE EFFICIENT WITH YOUR TIME
Ten minute warm up and movement preps are fine. Interventions shouldn’t take half the session. Preparation means there’s still a main course to come. The main course is where the most adaptations are going to be gained, providing you’re not loading a dysfunction and encouraging that pathology to continue. Again, if a short duration intervention sent the right message to the nervous system, you don’t need to keep performing the intervention for more reps.

5. POSITION MATTERS
Position is ninety percent of the game. The ribcage dictates shoulder mobility, as the scapula and ribcage are intrinsically linked. Your pelvis dictates your hip mobility, as your hip is attached to your pelvis. If these areas are in poor positions you won’t be able to access the movement potential of them. Get the athlete into the right position first, then look at their potential.

6. USE IT OR LOSE IT
This axiom is super useful. In general, any perishable skill that is not used, is lost. If we take this idea and zoom into the context of an athlete’s training session; once the mobility intervention has done its job (telling the nervous system to calm down and knock down some of the tone) if you don’t then go and use that temporary effect on the nervous system in the context of a movement pattern, it’s likely the movement potential in that area will return to the way it was. So once you’ve triggered the nervous system signal, it’s time to get on with it and put that signal into play.

7. MINDFULNESS AND AWARENESS
An athlete can’t think when they’re under a heavy barbell – so get them to think during their corrective intervention instead. It shouldn’t take a genius to figure out that during a corrective intervention, loads and consequences of failure are drastically reduced.

8. ANATOMY WILL DICTATE SOME THINGS
Not everyone is meant to squat with their toes facing forwards. Limb lengths and structural bone positions will mean that an athlete’s set up will likely be unique to them. Don’t force a ‘toes facing forwards’ approach to squatting if that does not suit their anatomy.

9. YOUR MOBILITY CORRECTIVE SHOULD ENHANCE AND NOT HINDER
If your corrective is recreating the exact symptoms you are trying to take away, that is bad. Symptoms should be temporarily relieved, not amplified.

When to use Mobility Interventions?

As mentioned above, if the assessment process shows that flexibility, soft tissue, extensibility or joint mechanics are impaired, then correctives are needed. Interventions can be performed any time; before training, in between sets or after training. Research doesn’t show that one time slot is superior to another. Once you find a corrective that works for your athlete, you can input wherever you want.

When to use Stability Interventions?


The goal of stablity training is to reinforce our movement potential. We are reinforcing our mobility. When should you input stability interventions? Again, it doesn’t matter. Before training, in between sets, or after. Stability is about the right muscle firing at the right time, at the right intensity, without the athlete thinking about it. When they have reflexive stability, you can layer on some strength work. When the athlete doesn’t have stability and you’re there layering on strength, all you’re doing is reinforcing dysfunction. Mindfulness and awareness are also important components when performing stability interventions. Although it’s muscular contraction we are after, it’s not about trying to shit yourself with how much tension you’re producing. It’s about maintaining breathing patterns during the given exercise. If the athlete can’t breathe properly in a pattern, they don’t own it yet. And again, position matters. Position is a variable. We can manipulate position to improve proprioception, so before the stability intervention is carried out, be vigilant that the athlete is in the correct position, first.

Dr Quinn Henoch earned his Doctorate of Physical Therapy from Indiana University.
He currently works with athletes of all levels and has competed in weightlifting since 2010.
His forte is bridging the gap between S&C and Physiotherapy/Sports Rehab.
He also started Clinical Athlete, a network of health care providers, students, and coaches who specialize in the management of athletes.

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