Mobility: Understanding Normal Scores, Assessment, and Improvement

What is a Normal Mobility Score?

There isn't one universal "normal mobility score" as mobility is a complex, multi-joint, and individualized quality; instead, it's assessed through various functional screens and range of motion tests, with "normal" often defined by functional capacity, absence of pain, and comparison to age- and activity-matched cohorts.

Understanding Mobility: Beyond a Single Score

The concept of a singular "normal mobility score" can be misleading because mobility is a multifaceted physical attribute, not a single measurable entity like body weight or height. While certain assessment tools provide numerical scores, these are typically screening tools designed to identify movement dysfunctions or injury risks, rather than definitive measures of overall "normalcy."

Mobility refers to the ability of a joint, or series of joints, to move through an unrestricted, pain-free range of motion. It's distinct from flexibility (which primarily refers to the extensibility of soft tissues) because mobility encompasses not only the passive range of motion but also the active control and stability required to move through that range effectively. Optimal mobility is crucial for athletic performance, injury prevention, and performing daily activities with ease.

Components of Mobility

To truly understand mobility, we must consider its key components:

• Range of Motion (ROM): This is the extent to which a joint can move. It can be assessed passively (someone moves your limb) or actively (you move your limb using your own muscles). Adequate ROM is foundational.
• Stability: The ability of surrounding muscles and connective tissues to control movement within a joint's available range. Too much mobility without stability can lead to hypermobility and joint instability.
• Motor Control: The neuromuscular system's ability to coordinate muscles to produce smooth, efficient, and controlled movements. Poor motor control can limit effective range of motion even if the passive ROM is adequate.
• Tissue Extensibility: The capacity of muscles, tendons, ligaments, and fascia to lengthen and allow movement. Restrictions in these tissues often limit ROM.

Common Mobility Assessment Tools

Since there's no single "mobility score," professionals utilize a variety of assessment tools to evaluate different aspects of mobility:

• Functional Movement Screen (FMS): This is a widely used screening tool consisting of seven fundamental movement patterns (e.g., deep squat, hurdle step, in-line lunge). Each movement is scored from 0 to 3 based on specific criteria, resulting in a composite score (maximum 21). An FMS score below a certain threshold (often cited as 14, though research on this benchmark varies) may indicate an increased risk of injury or highlight significant movement asymmetries and limitations. It's important to note that the FMS identifies dysfunctional movement patterns, not specific joint ROM deficits.
• Selective Functional Movement Assessment (SFMA): Often used by physical therapists, the SFMA is a more detailed diagnostic tool for individuals experiencing pain. It systematically breaks down movement patterns to identify the source of pain and dysfunction.
• Goniometry: This involves using a goniometer (a protractor-like device) to precisely measure the angles of specific joints (e.g., knee flexion, shoulder abduction). This provides quantitative data for individual joint ROM.
• Clinical Observation and Specific Tests: Experienced professionals often use a combination of observational assessments (e.g., overhead squat assessment, gait analysis) and specific tests (e.g., hip internal/external rotation, ankle dorsiflexion test) to evaluate functional mobility and identify limitations.
• Sport-Specific Screens: Athletes in particular sports may undergo specialized assessments tailored to the demands of their activity (e.g., T-test for agility, Y-balance test for balance and stability).

What Constitutes "Normal" Mobility?

Given the diverse assessment methods, defining "normal" mobility is context-dependent:

• Functional Adequacy: The most practical definition of "normal" mobility is the ability to perform daily activities, occupational tasks, and desired physical activities (e.g., running, lifting, playing sports) without pain, undue compensatory movements, or significant limitation.
• Individual Variability: There is a wide spectrum of "normal." Genetics, body type, previous injuries, activity level, and gender all play a role. A gymnast's "normal" ROM will vastly differ from that of a powerlifter, yet both can be considered "normal" for their respective activities.
• Age: Generally, active and passive range of motion tends to decrease with age due to changes in connective tissue, although regular physical activity can mitigate this decline significantly.
• Absence of Pain: A key indicator of healthy mobility is the ability to move through your available range of motion without experiencing pain. Pain during movement often signals an underlying issue.
• Symmetry: While perfect symmetry is rare, significant left-to-right differences in mobility or movement patterns (often identified by tools like FMS) can indicate dysfunction or increased injury risk.
• Benchmarks vs. Absolutes: Scores from screening tools like the FMS are benchmarks to identify potential issues, not a definition of "normal" in an absolute sense. For instance, an FMS score of 14 or higher is often considered a target for reducing injury risk in active populations, but it doesn't mean a score below 14 makes you "abnormal" in all contexts.

Factors Influencing Mobility

Numerous factors can impact an individual's mobility:

• Anatomical Structure: The shape of your bones, the type of joints you have (e.g., ball-and-socket vs. hinge), and the laxity of your ligaments can determine your inherent range of motion.
• Soft Tissue Health: The length, extensibility, and health of muscles, tendons, fascia, and joint capsules significantly influence mobility. Tightness, scar tissue, or adhesions can restrict movement.
• Neurological Factors: The nervous system's ability to control muscle activation and relaxation plays a critical role. Issues like muscle spasticity or impaired motor control can limit functional mobility.
• Pain and Inflammation: When pain is present, the body often restricts movement as a protective mechanism. Inflammation within a joint can also physically limit its range.
• Lifestyle and Activity Levels: Sedentary lifestyles, prolonged static postures (e.g., sitting for long periods), and repetitive movements can lead to specific mobility restrictions. Conversely, regular, varied movement helps maintain it.
• Injury History: Previous injuries, surgeries, or chronic conditions (e.g., arthritis) can lead to scar tissue formation, altered biomechanics, and persistent mobility limitations.

The Importance of Optimal Mobility

Cultivating and maintaining optimal mobility is paramount for overall health and physical performance:

• Injury Prevention: Adequate mobility ensures that joints can move through their intended ranges without placing undue stress on ligaments, tendons, or joint surfaces, thereby reducing the risk of strains, sprains, and overuse injuries.
• Enhanced Performance: Good mobility allows for more efficient and powerful movement patterns. For athletes, this translates to better force production, improved technique, and enhanced agility. For everyday individuals, it means easier movement.
• Reduced Pain and Discomfort: Many common aches and pains (e.g., low back pain, neck stiffness) are linked to mobility restrictions and compensatory movement patterns. Improving mobility can alleviate these issues.
• Improved Posture: Adequate mobility in key areas like the hips, thoracic spine, and shoulders supports better postural alignment, reducing strain on the musculoskeletal system.
• Greater Independence and Quality of Life: As we age, maintaining mobility is crucial for performing daily tasks, staying active, and preserving independence.

Improving and Maintaining Mobility

Mobility is not static; it can be improved and maintained through consistent effort:

• Regular Movement: Incorporate diverse movements into your daily routine. Avoid prolonged static postures.
• Targeted Stretching:
  • Dynamic Stretching: Movements that take your joints through their full range of motion (e.g., arm circles, leg swings) are excellent for warming up.
  • Static Stretching: Holding stretches for 20-30 seconds can improve tissue extensibility, best done after a workout or when muscles are warm.
  • Proprioceptive Neuromuscular Facilitation (PNF): Advanced stretching techniques involving muscle contraction and relaxation to achieve greater range.
• Strength Training Through Full Range of Motion: Lifting weights through a joint's complete available range helps to build strength and control at end ranges, improving active mobility.
• Soft Tissue Work: Foam rolling, using massage balls, or getting professional massage can help release tight muscles and fascia, improving tissue extensibility.
• Neuromuscular Control Exercises: Incorporate exercises that challenge balance, stability, and coordination to improve your body's ability to control movement within its available range.
• Listen to Your Body: Pay attention to sensations. Never push into pain.

When to Seek Professional Guidance

While self-assessment and general mobility work are beneficial, it's advisable to consult a professional if you experience:

• Persistent pain during movement or at rest.
• Significant limitations in your range of motion that impact daily activities or athletic performance.
• Noticeable asymmetries in movement or mobility between your left and right sides.
• Sudden loss of mobility following an injury.
• You are unsure how to safely address your mobility limitations.

A physical therapist, chiropractor, or a highly qualified exercise professional specializing in movement analysis can provide a thorough assessment, accurately identify the root cause of any mobility limitations, and develop a personalized intervention plan.