One of my favorite things to talk about is MoStreBility because it has so much to do with what we do as physical therapists, coaches, trainers, and professionals throughout the medical community. Before we get too far, let’s first take apart the pieces of MoStreBility, which are motion, strength, and stability.
Motion – The ability of a joint to experience full motion, actively, both with and without load, in a functional plane (a-planar). We want our athletes and patients, healthy or injured, to obtain full, active, functional range of motion. Be careful when talking about motion, it is NOT synonymous with “flexibility.” Stay tuned for the pitfalls of flexibility in a future blog.
Strength – Strength is what gets us in and out of the end range of motion. It’s what produces the power for us to do work at our highest level of performance. It is what gives our joints stability allowing them to function efficiently and avoid breakdown. One huge component of strength that many people, including medical and performance experts, forget about is that: strength (more specifically neuromuscular facilitation) is what allows normal joint motion. When people say, “I need to get my motion back,” they forget that motion is directly dependent on strength.
Stability – This is the ability to move from one position to another, under a load, without a loss of strength or reduction in performance. A stable joint will neither move too much (hypermobile) or too little (hypomobile). We want joints to go through full range of motion, with normal tension (supplied by muscle) so unnecessary tension, compression and shear are not being transferred to tissue such as a ligament, cartilage, or bone.
So, motion + strength + stability is MoStreBility. And if you have MoStreBility, your chances of being injured are little, your chances of recovering from an injury are much greater, and your performance level increases. Without MoStreBility, you may have motion, but you don’t have the strength or the stability to make that motion safe. Let’s look at an example of a runner who’s healthy, but has some hip pain.
After performing a functional screen, we conclude that a patient doesn’t have enough internal hip rotation. If we’re just looking for motion, we can simply stretch the hip rotators by using external pressure to force joint motion. We could also find the “tight” muscles that are limiting motion and massage or foam roll them. Both of these scenarios will get us motion. But what did we sacrifice to get that motion? We sacrificed strength, and we sacrificed stability. The patient then runs a 5-10K with great range of motion, poor strength, and poor stability. What’s going to happen? Decreased performance, increased risk of injury, and joint breakdown.
After the run, they will most likely say something like, “I felt good for a while, but now my hip is really tight and hurts even more.” If we don’t know any better, we give them another massage, send them home with a handout of 5 pre-run stretches, and sell them a foam roller. Eventually they stop running, continue to run with pain, or find someone who understands MoStreBility.