FREE MOBILITY EBOOK

REHAB-U
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Free Mobility
eBook
Mobility has been a hot topic in the fitness industry for many years now. Search online
and you will find all kinds of mobility specialists, systems and tools. After all, everyone
wants to get more mobile and as therapists and personal trainers, our role is to help
people move better.

Yet, many things are still being done with the intention of improving mobility that aren’t
actually creating lasting changes in the way our clients move.

Much of this is likely due to all the confusion around mobility and how to improve it. In the
fitness industry, there is a nasty habit of living in absolutes. A method or intervention is
ultimately bad or ultimately good. For example, stretching (particularly static stretching)
has gotten a bad rep over the years. We literally went from using it as a go-to for
joint health and injury prevention to touting it as useless or even worse, as capable of
increasing the risk of injury.

In reality, it is likely the outcomes of stretching tissues wrongly or approaching mobility

from a limited point of view that creates much of the confusion around the terms.

This eBook is intended to:

• Redefine mobility and how we improve it
• Help you create learning-driven changes in movement capacity
• Provide you with a full body mobility program that is unique in its kind
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Meet
Mai-Linh
Mai-Linh Dovan is a Certified Athletic Therapist and leading
industry expert in functional rehabilitation. She holds a
Bachelor’s degree in Athletic Therapy and a Master’s degree in
Exercise Science from Concordia University, where she worked
in collaboration with the Department of Psychology and the
Centre for Research in Human Development. With over 20
years of experience in clinical rehabilitation and strength and
conditioning, she has developed a comprehensive and unique
functional training approach with integrated rehabilitation.

She uses this approach with a diversity of athletes and

clients from bodybuilders, powerlifters, CrossFit athletes, as
well as athletes from various sports. She is the Head Therapist
of the Académie Baseball Canada where she oversees the
rehabilitation and reconditioning of Québec’s baseball elite.
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Redefining
Mobility
Interestingly enough, if you do a “similar
words” search for mobility you will find
flexibility, and vice versa. I would hope
that this would start to cue you that
they are intricately linked, even though
our industry has given flexibility, and
anything remotely attached to it like static
stretching, a bad rep.

Mobility is a combination of range of

motion, motor control and strength.

To improve mobility, you have to be able

to move efficiently. Limitations in range
of motion that stem from poor soft-tissue
quality need to be addressed if we hope
to move more efficiently. Flexibility, then, is
a component of mobility, because lack of
flexibility can limit range of motion.

There are many factors and reasons

for reduced joint range of motion, one
of which is muscle tightness. Muscle
“tightness” results from an increase
in tension from active or passive
mechanisms. Passively, muscles can
become shortened through postural
adaptation or scarring; actively, muscles
can become shorter due to spasm or
contraction. Both of these are responsive
to mechanical forces, like various forms of
stretching, foam rolling and other
soft-tissue mobilization techniques.
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Should people stretch then?

The bottom line is, what is it we are trying to accomplish? Whether we are trying to acutely
increase range of motion or lower the excitability of a facilitated muscle, applying a stretch
or other soft-tissue method makes sense if you have a specific task in mind that will
benefit from the response.

This is something I discuss at length in my blog article Is Stretching Good or Bad? If you’re
more of a listener than a reader, there is also a video in the article and on our YouTube
channel.

All that said, remember that there is also an active component to mobility. Regaining
muscle function, active range, control and strength requires active participation that
passive modalities do not provide. What the passive modalities do provide is the potential
range of motion. But it doesn’t stop there!

In order to translate the effect of passive tissue mobilization to mobility we need to apply
intentional force into the newfound range

Simply put, we need to work within that range to create that fine balance between range
of motion and motor control in order to have a lasting effect on mobility. This is Why Foam
Rolling Alone Doesn’t Improve Mobility.

Want to learn to build effective mobility programs for your clients?

LEARN MORE

The mobility-
stability continuum
If mobility is a combination of range of motion, motor control
and strength, what about stability?

From a purely anatomical (structural) standpoint, we tend to view mobility and stability as
opposite ends of the same spectrum: some joints have a structure that affords more mobility,
such as the shoulder, while some have a structure that affords more stability, such as the
knee. Mobile joints have a bony geometry that is conducive to more movement but less
structural stability, and vice versa.
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However, from a functional point of view, the opposite of mobility is not stability, because
mobility can be demonstrated in stable states. In addition, hypomobility can also result in
instability demonstrated by a decreased capacity to generate force.

Individual joints, as well as the entire kinetic chain, require a combination of mobility and
stability that is balanced and extends as far as possible across the range between rigidity
and laxity (the extremes), as depicted in the figure below, which I discuss in this video:

Watch the Mobility-Stability Continuum video and don’t forget to

subscribe to our YouTube channel!

Both hypermobility and hypomobility can result in instability. Hypomobility often manifests
as an inability to produce a desired movement, whereas hypermobility often manifests
as an inability to control a desired movement or an inability to resist an undesired
movement.

For example, a hypomobile shoulder can result in an inability to lock out the arm in an
overhead position. With a hypermobile shoulder, one may have difficulty stabilizing the
end range of the lockout or prevent excessive movement at the end range.
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Mobilize to
allow movement
In my practice, I use the word “mobilization” rather than “mobility”. To IMMOBILIZE is to make
immobile, to prevent use or reduce movement. As such, to MOBILIZE is the exact opposite:
to make mobile, to allow use or increase movement. Mobilization refers to the action of
making something more capable of movement. The objective of mobilization should be to
address the various factors that can affect movement capacity or quality in order to make
the individual more capable of movement.

As such, the objective of Mobilization should be to address any of the following elements
that are susceptible to limit movement capacity:

• address soft tissue limitations and/or joint restrictions

• down regulate facilitated muscles
• improve joint dissociation capacity
• improve proprioception
• address autonomic state
Mobilization can be aimed at improving any of the different components of mobility: range
of motion, motor control and strength, depending on the individual needs of the client.

What about hypermobility?

Knowing what we know about mobility and stability, we can appreciate that
even the hypermobile client can benefit from a well thought out intervention including
appropriate mobility work.

To see what kind of intervention is effective for the hypermobile client, head to my blog
article: “Managing Functional Instability in the Hypermobile Athlete”.

Want to learn to build effective mobility programs for your clients?

LEARN MORE
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You can direct mobilization to be more passive or more active, depending on the client
you are working with:

PASSIVE MOBILIZATION ACTIVE

SMR (foam roller, lacrosse Active-assisted ROM Active ROM

ball, Tiger tail, etc)
Self-mobilization PNF stretches Flows
Long duration passive Loaded stretching
stretching

Definitions:
SMR (self-myofascial release): soft-tissue mobilization using a foam roller, lacrosse ball,
tiger tail, tool or other implement

Self-mobilization: joint mobilization techniques performed with assistance and/or

movement such as, for example, thoracic spine extension performed with the elbows on a
bench

Long duration passive stretch: static stretch held for over 1 minute

Active-assisted range of motion: moving actively through full range of motion with
additional passive motion at end range using a band or other form of assistance

PNF stretch: hold-relax or contract relax stretch

Active range of motion: moving actively through full range of motion

Flows: combination of active range of motion exercises and or other movements in a

continuous circuit

Loaded stretching: contracting a muscle while it is in a stretched position

As you can see, there are many different tools that you can use. The key is to become
better at identifying the right tool for the right client, because not every client will benefit
from the same tool. That is the difference between your tools and you practice.

Don’t confuse your tools with your practice

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Breathing
and Mobility
Breathing is probably the simplest and perhaps most under-used form of mobilization.
Among other benefits, it can bring you into a parasympathetic state which helps to
alleviate muscle tension, reduce rigidity and facilitate movement. As such, it is a great way
to mobilize the nervous system, as explained in this must-watch YouTube video.

With every breath we take comes a natural mobilization of the spine, moving into
extension on inhalation and flexion on exhalation. I discuss the link between breathing and
thoracic mobility in this blog article: Read article Breathing and Thoracic Mobility

Breathing is also a fundamental competence for core stability. An effective breathing

pattern is the necessary foundation on which to build the core and then, movement.
Current literature suggests that diaphragmatic activity can help stabilize the core, unlocking
more mobility for the extremities.

If breathing is shallow or inefficient, the secondary breathing muscles become hypertonic:

scalenes, pec minor, sternocleidomastoid and levator scap. Hypertonicity of these muscles
can impact function of the scapula and shoulder girdle leading to mobility deficits. Mouth
breathing also leads to a decrease in the amplitude of diaphragm movement which
results in a decrease in thoracic expansion and increased tone in the secondary breathing
muscles. This excessive tone and elevation of the thorax further inhibits the diaphragm
and perpetuates the cycle of inefficiency. Sub-optimal breathing can also impact the hip
complex, as the body will look for stability from the psoas, hamstrings and pelvic floor.

Learning to breathe and implementing para-sympathetic breathing can alleviate muscle

tension and help unlock mobility.
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The
Program
This full body mobility program is unique in its kind. The goal is to improve mobility by
targeting various passive and active components that can affect movement potential of
the shoulder and hip complex.

The program includes soft-tissue and joint mobilization exercises, but also various active
exercises meant to apply intentional force within range of motion.

The mobilization strategies utilized in the program extend far beyond passive stretching
and soft tissue release, focusing on the active components of mobility. The benefits touch
not only on performance, but also on injury prevention and robustness.

EXERCISE SETS REPS NOTES

BREATH MOBILIZATION

Nasal breathing - 5-sec inhale,

A. Crocodile breathing 1 3 mins
5-sec exhale

SOFT-TISSUE MOBILIZATION

Stretch - contract x 6s - release and

A. Lats PNF stretch 3 6 sec
stretch - Repeat 3 times

Foam roll quads +

B. 1 2 mins Foam roll for a total of 2 mins
Foam roll hamstrings
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EXERCISE SETS REPS NOTES

SHOULDER COMPLEX

A. Seated chin tuck 2 10 Hold tuck position 2 seconds

Prisoner T-spine
B. 2 8/side Inhale on rotation
rotation

Tall sitting shoulder

C. 2 8
dislocates

Complete total 2 mins in as few sets

D. Wall walk-out hold 1 2 mins
as possible

HIP COMPLEX

Active-assisted straight
A. 2 8/side Hold stretch 2 seconds
leg raise

Low
B. 2 10
cat-camel

Active thread
C. 2 8/side Hold end range 2 seconds
the needle

Globet squat loaded Light weight – Total 3 mins isometric

D. 1 3 mins
stretch hold bottom
 Online Mobility Course
Your clients are going to move based on the resources they possess. If you want them
to move differently, you need to give them access to more resources. Want to learn the
strategy to build effective mobility programs for your clients?

The Mobility Fundamentals for Prehab and Performance Online Course provides you
with the know-how to build an individualized targeted intervention aimed at making
learning-driven changes in movement behavior.

This online course provides you with unlimited lifetime access to over 4 hours of video
content allowing you to learn at your own pace and in the comfort of your home. The
course also includes access to a 200+ video exercise library, two 12-week purpose-
oriented mobility programs and access to a private Facebook Community for questions
and extra support.

Want to learn to build effective mobility programs for your clients?

LEARN MORE

Disclaimer: The information contained in this document is presented to improve movement, not treat medical conditions.
This information is not a substitute for medical advice or treatment of specific medical conditions.