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The Joint By Joint Approach

The joint by joint approach, as described by Cook (2010), is a way to conceptualize the body as a stack of joints that alternate between needing mobility and stability, that have specific predictable types of dysfunction. Joint pain is usually accompanied by either dysfunction in the above or below joints mobility or stability. This is due to changes in mobility force a stable joint to move, as a compensation, which leads to altered transfer of forces and pain. Two joint areas that could benefit from added mobility are the ankle and the thoracic spine.

The ankle joint or talocrural articulation is located between the distal ends of the tibia and the fibula and the superior part of the talus, and is classified as a hinge type synovial joint (Moore, Dalley, & Agur, 2014). The tibula and fibula meet at a bracket shaped socket called a mortise. The talus fits snugly in the mortise, forming the joint articulation. Basically, the ankle is where the lower leg meets the foot. The ankle can dorsiflex or plantarflex. Dorsiflexion is raising the foot upwards and is performed by muscles in the anterior compartment of the leg (tibialis anterior, extensor hallucis longus and extensor digitorum longus). Plantar flexion is moving the foot downwards and is performed by the muscles in the posterior compartment (gastrocnemius, soleus, plantaris and posterior tibialis) (Moore et al., 2014).