Functional stability re-training: principles and strategies for managing mechanical dysfunction - Masterclass

Sep 30, 2026

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Functional stability depends on integrated local and global muscle function. Mechanical stability dysfunction appears as segmental (articular) and multi-segmental (myofascial) problems, often combining restricted normal motion with compensatory give. Diagnosis is guided by the site and direction of give linked to symptomatic pathology. Management strategies focus on specific mobilization of articular and connective tissue restrictions, restoring myofascial extensibility, and retraining stability via local recruitment for segmental control and global control for multisegmental load direction.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Muscle function

Stability dysfunction

Manual Therapy (2001) 6(1), 3±14 \# 2001 Harcourt Publishers Ltd doi:10 . 1054/math.2000.0389, available online at [http://www.idealibrary.com on](http://www.idealibrary.com on) | Masterclass
Functional stability re-training: principles and strategies for managing mechanical dysfunction
M. J. Comerford, S. L. Mottram
Kinetic Control, Mede House, Salisbury Street, Southampton SO15 2TZ, UK | | --- | | SUMMARY. Functional stability is dependent on integrated local and global muscle function. Mechanical stability dysfunction presents as segmental (articular) and multi-segmental (myofascial) dysfunction. These dysfunctions present as combinations of restriction of normal motion and associated compensations (give) to maintain function. Stability dysfunction is diagnosed by the site and direction of give or compensation that relates to symptomatic pathology. Strategies to manage mechanical stabililty dysfunction require speci®c mobilization of articular and connective tissue restrictions, regaining myofascial extensibility, retraining global stability muscle control of myofascial compensations and local stability muscle recruitment to control segmental motion. Stability re-training targets both the local and global stability systems. Activation of the local stability system to increase muscle sti􀂀ness along with functional low-load integration in the neutral joint position controls segmental or articular give. Global muscle retraining is required to correct multisegmental or myofascial dysfunction in terms of controlling the site and direction of load that relates to provocation. The strategy here is to train low-load recruitment to control and limit motion at the site of pathology and then actively move the adjacent restriction, regain through range control of motion with the global stability muscles and regain su􀂁cient extensibility in the global mobility muscles to allow normal function. Individual strategies for integrating local and global recruitment retraining back into normal function are suggested. \# 2001 Harcourt Publishers Ltd. | INTRODUCTION Over the last 20 years a greater understanding of movement and function has emerged. This has occurred from inter-linking anatomy, biomechanics, neuro-physiology, motor control, pathology, pain mechanisms, and behavioural in¯uences. The simplistic model of thinking that if something does not move well enough, it is tight and needs stretching or it is weak and needs strengthening no longer holds the answer to mechanical dysfunction. Movement dysfunction can present as a local and/ or global problem (Bergmark 1989), though both frequently occur concurrently. Poor movement habits, poor postural alignment (Janda 1978; Sahrmann Received 20 November 2000 Revised 15 December 2000 Accepted 18 December 2000 M. J. Comerford, B. Phty, MCSP, MAPA, S.L. Mottram, MSc, MSCP MMACP, Kinetic Control, Mede House, Salisbury Street, Southampton SO15 2TZ. Correspondence to: MJC. Tel: 44 (0) 8451 300808; E-mail: comerford@kineticcontrol.com 1992, 2000), and abnormal neuro-dynamic sensitization (Elvey 1995) can contribute to the development of imbalance between the global stability and mobility muscles. This imbalance presents in terms of alterations in the functional length and recruitment of these muscles and results in abnormal force contribution by the muscles around a motion segment. This places direction speci®c mechanical stress and strain on various structures which, if overloaded beyond tissue tolerance results in pain and related pathology. From the evidence to date, it appears the local stability system dysfunction only develops after the onset of pain and pathology (Richardson et al. 1999; Comerford & Mottram 2001) . This presents as dysfunction of the recruitment and motor control of the deep segmental stability system resulting in poor control of the neutral joint position. Although pain and dysfunction are related, the pain may resolve but the dysfunction may

FAQs

What determines functional stability in this masterclass?

Functional stability relies on integrated local and global muscle function, coordinating both control of segmental motion and global stability and mobility demands.

How does mechanical stability dysfunction present clinically?

It presents as segmental (articular) and multi-segmental (myofascial) dysfunction, combining restricted normal motion with compensatory give to maintain function.

How should stability dysfunction be diagnosed and managed?

Diagnosis targets the site and direction of give or compensation related to symptomatic pathology. Management retrains local and global stability systems using mobilization of restrictions, restoring extensibility, and low-load recruitment to control motion at the pathology site while moving and integrating adjacent restrictions through range control.

Sep 30, 2026

Uploaded by Dipper