Top 5 Fridays! 5 Common Areas Lacking Stability Confused with Mobility | Modern Manual Therapy Blog

Top 5 Fridays! 5 Common Areas Lacking Stability Confused with Mobility

One of the tenets of the SFMA is looking for issues with motor control/stability, if a joint loses mobility after repeated manual techniques, it is very possible there is an underlying MC issue.

These are the clinical presentation I see most often presenting as "tight" but have significantly greater ROM when tested passively, often in an unloaded position.

1) Cervical Spine

Cervical rotation and flexion WB and AROM - DN!

Cervical Flexion and Rotation PROM and NWB
This is such a common SFMA finding, DN in WB AROM, or DP with absolutely no loss of range, so no issues in the tissues! Like many of these patients, they have the motion, they just do not know how to access it.


  • scapula stability exercises
  • postural correction to decrease tone in upper quarter
  • breathing correction to decrease tone in upper quarter
  • repeated cervical retraction
  • IASTM to cervical and upper trap patterns
2) Shoulder MRE

Someone may be limited DP/FP/DN in this common shoulder pattern, then check them passively and they have full motion. Before going to passive NWB in 90 degrees of shoulder abduction, place your hand on the inferior border of their scapula, give them some PNF cuing on to activate the scapula stabilizers, then have them repeat the test. Often they'll go farther and the pain/tightness also changes.

  • IASTM to upper traps to reduce tone
  • postural correction
  • kettlebell overhead carries to facilitate scapula stabilizers
3) "Hamstring Tightness"

Everyone thinks they have tight hamstrings, but many times this is again a motor control issue rather than issues in the tissues. Someone at my Chicago Course said she couldn't touch her toes from a standing position since she was a kid. I cued her on an abdominal blowout (opposite of drawing in), had her hold the belly out as she exhaled and bent forward and her "tight" hamstrings magically lengthened before our very eyes.


  • IASTM to hip flexors, light psoas release with diaphragmatic breathing
  • ASLR with core activation

4) Hip Extension - previous post on this here!

This is a reason why I learned the hard way to have someone else examine you. I had been stretching my right hip flexors for years, literally. Self psoas release, hold relax, having others do IASTM on my ITB, ANYTHING to improve my "super" limited hip extension on the right.

We were teaching interns SFMA breakouts when my business partner watched me epic fail MSE, then in prone, my active hip extension was DP, but in PROM was FN... I couldn't believe it!


  • diaphragmatic breathing with MSE patterns as appropriate
  • psoas release with breathing
  • 90-90 balloon breathing

5) Deep Squat

My hips are so tight! My knees hurt! I can't do this! 

Many times the hips anteriorly impinge if the patient starts with excessive anterior tilt, thus they have no choice but to move the hips posteriorly, pitch the trunk forward and come to end range hip flexion way too early.

There are too many problems and thus solutions to help this movement pattern, but a quick one is if all else is FN (thoracic, shoulder mobility, knee, ankle, tibial IR) and it's purely motor control, cue a posterior tilt in the beginning to open up the hips anteriorly. Many individuals who bring the hips posteriorly initially will be able to go down more vertically and go much farther into the pattern. Give them a weight for added grounding/proprioception and see what happens!


  1. Thanks for posting this! Great information! I would like to understanding the exhale with belly out for the hamstring tightness. Can you explain, or direct me to reading material. Also I would like to understand what is happening with the 90-90 balloon breathing. Is her R arm overhead to address the R psoas? Can you explain further or direct me to more information of this topic. Thank you, Susan

  2. You can start with Movement by Gray Cook, the ebook is only $9.99 and it's a steal at that price! The right arm overhead is to address PRI's common finding of assymmetry called a right brachial chain pattern, it helps the common finding of right anterior superior ribs not being able to expand