Joint Mobilization

Question 1

Purposes of joint mobilization

Answer 1

• Remodel connective tissue to improve extensibility and reduce stiffness
• Reduce pain and encourage relaxation
• Bathe the joint in synovial fluid and nourish joint structures

Question 2

Indications for joint mobilization

Answer 2

• Stiff joints
• To decrease pain
• To prevent joint capsule tightening

Question 3

Contraindications for joint mobilization

Answer 3

• Joint replacements
• Fractures that aren’t healed
• Acute inflammatory or septic arthritis
• Bone disease
• Bacterial infection
• Malignancy
• Unstable joint

Question 4

Convex on concave rule

Answer 4

• Joint surface moves in the opposite direction the bone shaft is moving (i.e. head of humerus on glenoid fossa)
• “Convex on concave: run the opposite way”

Question 5

Concave on convex rule

Answer 5

• Joint surface moves in the same direction the bone shaft is moving (i.e. middle phalanx on proximal phalanx)
• “Concave on convex: like a wrench moves a hex”

Question 6

Mobilization techniques

Answer 6

• Oscillations: to stimulate mechanoreceptors and inhibit nociceptors
• Roll/tilt (more advanced)
• Glide (same motion as slide but performed passively)
• Spin/rotation
• Distraction

Question 7

Traction grading

Answer 7

• Grade I (loosen): neutralizes pressure in joint without actual surface separation, produces pain relief by reducing compressive forces
• Grade II (tighten or take up slack): separates articulating surfaces, taking up slack or eliminating play within joint capsule; used initially to determine joint sensitivity
• Grade III (stretch): involves stretching of soft tissue surrounding joint, increases mobility in hypomobile joint