Janda's Upper/Lower Cross Syndrome & the Joint-by-joint model
What is the joint-by-joint model?
The Joint-by-joint (JBJ) model provides an overview of each major joint system of the body.
It is true that every joint needs both mobility and stability, there are some joints that require more stability and some joints that require more mobility.
If you have a look at the body you’ll see that joints tend to alternate between mobile and stable requirements.
Where this rule changes a little is in the Scapulas, it needs both mobility and stability. Stability to adhere to the ribcage (why serratus anterior work is important) but also mobile so it can move in all directions when we need it, and it needs to work with the Glenohumeral joint (GH) in rhythm. Funnily enough it’s called Scapulohumeral rhythm. This interaction is important for optimal function of the shoulder.
As a full body perspective the JBJ model gives us a target to shoot for or even something to look out for while watching clients warm up. Or at the very least, it helps us take some mental notes while clients are training.
When it comes to assessing clients, we can see how they are functioning and where they can improve, and we train that difference.
It’s really easy to get injured if you force a stable joint to become mobile.
For example, if the ankle and hips aren’t mobile, the knee ends up doing the job of either the ankle or hip. If the hips don’t act like a hip or are “tight” or cannot extend (hip extension) properly then it forces the movement onto the lumbar spine.
When a mobile joint is restricted it affects the areas above and below. If those joints are affected then the joints next in line are affected, basically like a domino effect and the JBJ model inverts.
Which now leads me onto Janda’s Upper and Lower Cross Syndrome.
Vladamir Janda was a Czech neurologist, physical therapist and teacher who passed away at the age of 74 in 2002.
He had a philosophy which was not about intervention or manual therapy but about understanding muscle imbalances and how they interact with the nervous system.
Because Janda’s approach is functional rather than structural, from this point of view pain can be seen as a software issue, rather than a hardware issue.
Upper Crossed Syndrome (UCS)
Focusing on the upper body posture, Janda provides an overview of how high threshold breathing patterns, sometimes poor programming or previous injury can promote a “weak” upper back, tight internal rotators of the shoulder and a kyphotic posture.
- Loss of thorasic mobility (extension and rotation) drives a kyphotic posture and inhibition of low-to-mid trapezius and deep cervical neck flexors, while upper traps and pectorals become short and tight.
Lower Cross Syndrome (LCS)
Similarly, for the lower body, hyper lordosis, tight hips and poor core stability and function can be facilitated by these same poor breathing patterns and weaknesses.
- Poor lumbo-pelvic control, inefficient breathing mechanics and core instability facilitates hip immobility, inhibition of the gluteals, internal obliques, and external obliques, while the hip flexors and spinal erectors become hypertonic and shortened.
There are strategies to restore posture and function, but to understand where the person/athlete presents, we need to start with an assessment to help create a plan in the initial phase of the program.
The goal is to create some kind of neural drive to the tissues that need strengthening and release the “tight” tissues that are restricting movement.
This work doesn’t happen overnight. Creating change in the soft-tissues and improving sequencing of muscular recruitment patterns and function takes time and consistency.