KyungMo Han, PhD, ATC
California State University
Dominguez Hills

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Understanding of joint mobilization
Planes of the body (& axes)
Arthrokinematics vs. Osteokinematics
Concave-Convex Rules
Treatment plane
Mobilization & Traction techniques
Examples & Thinking Problems

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Manual therapy techniques that are used to modulate pain and treat joint dysfunctions that limit range of motion by specially addressing the altered mechanic of the joint
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Mobilization vs. Manipulation

Z
Y
X

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Sagittal plane
Frontal (coronal) plane
Transverse (horizontal) plane

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Description of movement with reference to the joint
Unobservable articular movements between adjacent joint surfaces
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Osteokinematics: description of movement with reference to the bones (for example, flexion, extension, abduction, etc.)

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3 Accessory Movements
• Roll
• Glide
• Spin

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New points on one surface meet new points on another surface
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Occurs in the same direction as bone movement
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Occurs with gliding but never alone

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Same point on one surface comes into contact with new points on the opposite surface
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The direction of the glide depends on shape of the moving surface

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Rotation around a stationary mechanical axis
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Primarily only takes place in the glenohumeral and radiohumeral joints

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What is the shape of a concave and convex surface?
What shape is the femur and tibia at the knee?
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Convex and concave surface-the roll is always in the direction of the bone movement
• For example: If the bone is moving anteriorly, the roll is anterior and vice versa

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If the convex surface is moving on fixed concave surface, roll and glide occur in the opposite directions
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If the concave surface is moving on fixed convex surface, roll and glide occur in the same direction

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A passive movement performed by the clinicians for intending to increase mobility and/or decrease pain using gliding and traction techniques
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Why do we perform mobilizations?
What structure is being stretched?

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A joint capsule
A joint cavity
A synovial membrane
Synovial fluid
Hyaline cartilage

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Treatment plane lies in the concave articular surface
Treatment plane moves with the concave surface

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Gliding is a movement where the joint surfaces are passively displaced parallel to the treatment plane
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Glides are used to improve a particular movement (i.e. flexion or extension of the knee)
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Glides are performed in the direction of arthrokinematic movement

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Grade I
Grade II
Grade III
Grade IV
Grade V

Grade I - IV
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I : Small amplitude movement at the beginning of the available ROM
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II: Large amplitude movement within the available ROM
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III: Large amplitude movement that reaches the end of ROM
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IV: Small amplitude at the very end ROM

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High velocity thrust of small amplitude a the end of the available
ROM and within its anatomical range
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This is referred to as a manipulation

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The process of pulling one bony surface away from the other
(joint separation)
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A passive bone movement which is at a right angle to the treatment plane
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A general mobilization technique that can improve mobility in all directions

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Grade I: unweighting or barely separating the joint surfaces
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Grade II: slack of the capsule taken up
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Grade III: capsule and ligaments stretched

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Knee extension (femur is fixed)
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Wrist flexion (radius is fixed)
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Ankle dorsiflexion (tibia is fixed)
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Shoulder abduction (scapula is fixed)

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An athlete comes in to the training room, an athletic trainer performs POSTERIOR glides of the FEMUR on the
TIBIA . What osteokinematic movement is the trainer trying to improve?

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An athlete comes in to the training room, an athletic trainer performs ANTERIOR glides of the CARPALS on the
RADIUS . What osteokinematic movement is the trainer trying to improve?