Therapeutic
Exercise I
Chapter 5
Peripheral Joint Mobilization
What is Joint Mobilization?
(manipulation)
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Joint mobilizations are to be done by the
supervising PT and PTA, but PTA’s can
perform only grades I & II
It is a passive traction and or gliding
movement applied to joint surfaces that
maintain or restore the joint play normally
allowed by the capsule, so the normal rollslide joint mechanics can occur as a person
moves. The speed and amplitude which
applied may vary.
Examples of Mobilization!!!!!
Definitions
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Joint Mobilization/Manipulation
Self Mobilization
Mobilization with Movement (MWM)
Physiological Movements (osteokinematic)
Accessory Movements (arthokinematic)
Thrust – high velocity, short amplitude
Manipulation Under Anesthesia (MUA)
Muscle Energy
What Can Alter Joint Mechanics?
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Pain
Muscle guarding
Joint effusion
Contractures/adhesions of the joint capsules or
supporting structures
Malalignment/subluxation of the bony surface
---Types of Motion---
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Swing
Rolling/sliding/spinning
Slide/Translation
Combined Roll-Slide in a joint
Spin
Indications for Joint Mobilization
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Pain, muscle guarding, and spasm
Reversible joint hypomobility
Positional faults/subluxations
Progressive limitations
Functions Immobility
Mobilizations cannot change a disease process/inflammation
process, but it can minimize pain, maintain joint play, and
reduce mechanical limitations
Contraindications
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Hypermobility
Joint Effusion
Inflammation
Grade or Dosage of Movement
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Grade I
Grade II
Grade III
Grade IV
Grade V
Peripheral Joint Mobilization
Techniques
- see handout
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Closed Pack Position
Open Pack Position
Capsular Pattern of Restriction
Example of Grade I and V
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Shoulder (posterior/inferior/anterior glide) Oscillations
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http://www.bing.com/videos/search?q=shoulder+mobilizations&view
=detail&mid=A12A5B8D01186B5562B2A12A5B8D01186B5562B2
&first=0&FORM=LKVR14
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Ankle (talocrural Joint) Thrust
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http://www.bing.com/videos/search?q=grades+of+mobilizations&vie
w=detail&mid=48B740EF882B77EF067048B740EF882B77EF0670
&first=0&FORM=LKVR2
Things To Remember:
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Mobilization assist in minimizing pain,
maintain joint play, and reduce mechanical
limitations
Mobilization is to be done by the PT and
PTA, but PTA’s can ONLY perform grades I
& II
Break for Lab with Lecture on UE Stretching
Techniques in Anatomical Planes of Motion
LAB ON JOINT MOBILIZATION…..To be
reviewed and practiced in week #2
(If time permits may review LE’s)