Joint mobilization is also known as

Refers to manual therapy techniques that are used to modulate pain and treat joint impairments that limit ROM by specifically addressing the altered mechanics of the joint

Applied to joints and related soft tissues at varying speeds and amplitude

Small-amplitude force

Large-amplitude force

Is performed at the end of the pathological limit of the joint

Is intended to alter positional relationships, snap adhesions, or stimulate joint receptors

Movements the patient can do voluntarily

Osteokinematics

Used when these motions of the bones are described

Used to describe bone surfaces within joints

Accompany active motion but are not under voluntary control

Motions such as upward rotation of the scapula and rotation of the clavicle, which occur with shoulder flexion

Movements in the joint and surrounding tissues that are necessary for normal ROM but that cannot be actively performed by the patient

Motions that occur between the joint surfaces which allows the bones to move

Necessary for normal joint funtioning through the ROM and can be demonstrated passively, not actively

Arthrokinematics

Refers to self-stretching techniques that specifically use joint traction pr glides that direct the stretch force to the joint capsule

Is a procedure used to restore full ROM by breaking adhesions around a joint while the patient is anesthesized

Is the concurrent application of sustained accessory mobilization applied by a therapist and an active physiological movement to end-range applied by the patient

Use active contraction of deep muscles that attach near the joint and whose line of pull can cause the desired accessory motion

This position is typically used for testing joint play and for applying the initial mobilization treatment

Terms that describe the position of the joint where the greatest mobility is possible

Surfaces are incogruent

New points in one surface meet new point on the opposing surface

Results in angular motion of the bone(swing)

Always in the same direction as the swinging bone motion

If it occurs alone, causes compreasion of swing side and separation on the opposite side

The surfaces must be congruent, wither flat or curved

The same point on one surface comes into contact with the new points on the opposing surface

Sliding is in the __________ direction if the moving joint surface is convex

Sliding is in the ________ direction if the moving surface is concave

For combined roll-sliding, the more congruent

For combined roll-sliding, the more incongruent,

______ component of joint motion is used to restore joint play and reverse joint hypomobility

______ is not used to stretch tight joint capsules because it causes joint compression

PJM uses ______ instead of _______ which promotes passive-angular stretch

There is rotation of a segment about stationary mechanical axis

The same point on the moving surface creates an arc of a circle

Rarely occurs alone in joints

May cause increased pain or joint trauma

Use of lever magnifies the force at the joint

Force causes compression of the joint surfaces in the direction of the rolling bone

The roll without a slide does not replicate normal joint mechanics

Safet and more selective

Force is applied close to the joint surface and controlled

Direction of the force replicates the sliding component of the joint mechanics and does not compress the cartilage

The amplitude of the motion is small yet specific to the restricted structures

Forces are selectively applied to the desired tissue

Longitudinal pull

Separation, or pulling apart

Is the decrease in the joint space between bony partners

Normally occurs in the extremity and spinal joints when weight bearing

Normal intermittent compressive loads may lead to articular cartilage changes and detoriaration. Abnormally high compression loads help move synovial fluid and thus help maintain cartilage health.

Effects of joint motion

Brings nutrients to the avascular articular cartilage of the joint and intraarticular fibrocartilage of the menisci

Indications for use of joint mob

Pain, muscle guarding and spasm: stimulate the mechanoreceptors that may inhibit the transmission of nociceptive stimuli at the spinal cord or brain stem levels

Pain, muscle guarding and spasm: Cause synovial fluid motion

Pain, muscle guarding and spasm: maintain nutrient exchange and this prevent the painful and degeneraying effects of stasis

Can be treated wih gentle joint-play techniques

Can be treated with progressively vigorous joint-play stretching techniques to elongate hypomobile capsular and ligamentous connective tissue

Sustained or oscillatory stretch forces are used to distend the shortened tissue mechanically

MWM techniques attempt to realign the bont partners while to person actively moves the joint through its ROM

Thrust techniques are used to reposition an obvious subluxation, such as pulled elbow or capitate-lunate

Can be treated with joint-play techniques to maintain available motion or retard progressive mechanical restrictions

The dosage of distraction or glide is dictated by the patient’s response to treatment and the state of the disease

Can be treated with nonstretch gliding or distraction techniques to maintain available joint play and prevent the degenerating and restricting effects of immobility

Joints can change the disease process of disorders

The skill of the therapist affects the outcome

Patients with painful hypermobile joints may benefit from gentle joint pkay techniques if kept within the limits if motion

Stretching is not done

Gentle oscillatong or distraction motions may temporarily inhibit the pain response

Swelling

Rapid swelling of a joint usually indicates bleeding in the bone

Hemophilia

Do not stretch a swollen joint with mobilization or passive stretching techniques

Gentle oscillating motions that do not stress or stretch the capsule

Precautions

Contraindications