Mobility Training and Flexibility: Definitions, Joints and Evidence

Words that get used loosely

"Mobility" and "flexibility" are used in different ways by trainers, therapists and researchers. We did not find one agreed scientific definition that separates them, so treat any single definition, including the working one below, with caution.

The US National Library of Medicine's vocabulary defines range of motion as "the distance and direction to which a bone joint can be extended," and notes it depends on the joints, muscles and connective tissues involved. [1] It defines muscle stretching exercises as exercises aiming to increase muscle-tendon flexibility, improve range of motion or musculoskeletal function, and prevent injuries. [2]

A common working idea in fitness writing is that flexibility is how far a joint can be moved by something else, and mobility is how well you can move it yourself. Research papers do not use this split consistently, and we are not giving it as a standard.

Evidence by question

Evidence labels used here: established, promising but limited, insufficient evidence, Proper evidence not found.

1. Can range of motion be increased?

   Established

   Yes. Stretching and resistance training both improved it in healthy adults. [3][4]

2. Does greater range of motion mean fewer injuries?

   Insufficient evidence

   A review of 7 observational studies in adolescent dancers and athletes linked ROM changes during growth spurts with injury, but this does not show cause. [5]

3. Do thoracic (upper back) mobility exercises help neck pain?

   Promising but limited

   In one 26-person trial, adding either thoracic mobility exercises or thoracic manipulation to other neck treatment improved pain and disability by similar amounts. [6]

4. Do chest mobility exercises help people with COPD?

   Promising but limited

   One 60-person trial found improvement over stretching in lung function and walking distance. [7]

5. Do hip-mobility programs have a standard evidence base?

   Proper evidence not found

   Proper evidence not found. We searched PubMed titles for hip mobility and range of motion exercise and found no usable trial or review.

What affects how much you gain

• Starting point. People with poorer baseline flexibility gained more from static stretching, and hamstring gains were larger than spine gains after one session. [8]
• Training type. Resistance training with external loads improved range of motion about as much as stretching, while body-weight-only resistance training did not significantly. [4]
• Foam rolling. Similar range-of-motion gains to static stretching over the long term in one meta-analysis; it did not change measured tissue stiffness acutely, though certainty was low. [9][10]

Reading the two trials with care

Both trials above compared two active treatments, so they cannot show how either compares with doing nothing. In the neck-pain trial, both groups also received other treatments and the groups were small (13 each). [6] The COPD trial reported its group differences after seven sessions, which is short. [7] Neither is a basis for a program.

Hips, thoracic spine and "mobility routines"

Online mobility routines for hips and the upper back are common. We found no systematic review we could read that tests a named routine against a comparison for general health. Proper evidence not found. This page therefore gives no exercise protocol. If you want guided options, a physiotherapist can assess your joints and set a program.

More flexibility is not always better

The NHS describes joint hypermobility as very flexible joints, sometimes with sprains, strains, dislocations and pain. Its main treatment is improving muscle strength and fitness so joints are better protected, and it advises not to overextend joints "just because you can." [11] If you have those symptoms, see movement for people with hypermobility and talk to a clinician.

Related guides

• Stretching: what research shows covers stretching types and injury.
• Yoga for flexibility goals and expectations
• Adapted yoga and movement
• Tai chi