…..case study from an excellent PT and golf specialist………
58 yo female golfer with R THA and L Hip OA presents….typically……..mobility issues at ankle, hips, and thoracic spine, poor core control.
After 1 tx……significantly improve all mobility. Obviously not really a true “mobility” issue. Nothing of note……but here is the kicker.
Seated torso rotation more than doubled (15 to 35 degrees). Did not work on any mobility above hip level and [no] soft tissue work other than talocrural and hip mobs, strain counterstrain into Hip Flexion, PNF hold relax.
….I think Tx influence on central neuromuscular tone may have more than just a regional patterned influence, it may actually “quiet” the whole system, allowing for return of….normal patterns…… I suspect we do not see this……..due to the significant fascial changes that…..accompany joint mobility issues in the middle aged athlete.
I think this is almost to be expected.
Mobility and Stability in terms of the Joint by Joint are principle-based terms and really best used in relative descriptions. They are explanatory much more than instructive. They can explain instruction, but not always put expectations into those 2 buckets in a restorative situation.
The best way to start to rule out mobility is simply look at the thread of loaded and unloaded movement. This is the basis of SFMA Breakouts.
But an apparent mobility loss isn’t always a locked up joint requiring weeks of remodeling.
The brain’s control is always one of stability, and if you feed the brain the right input, the brain should put the puzzle pieces into the right place. The puzzle may work by decreasing the protective neural tone to particular muscles. Tom Myers’ fascial Lines can predict the route(s) of the puzzle.
I think when we can break up apparent mobility loss into joint system stiffness, positional fault, pain, or combination, it can make these results more realistic and often.
Joint system stiffness that is fibrotic won’t be responsive. You can only know by scanning the tissue. But stiffness from neurological tone is ripe for magic.
This person’s results was probably a combination of both being neurologically sensitive AND excellent skills finding the right keyhole. The more good stuff, the right stuff you know, the better your odds at pulling a rabbit of the hat.
When you have neuromuscular methods down, this happens a lot more than you might expect.
Did you step in poop? Do you believe you make your own luck by being good at what you do?
Indeed when there is a local restriction, DNS doesn’t always work, at least if you’re not Pavel Kolar.
In fact, Pavel would say stability before mobility, but I have not yet grasped how you can always manipulate the brain all the time to adjust peripheral and local dysfunction.