Joint Mobilization (Week 2) Flashcards
What is the difference between passive-angular stretching and joint-glide stretching?
Passive-angular stretching uses the bone as a lever to stretch the capsule, which may cause pain or damage the joint because it magnifies the force through the joint, causes joint surface compression, and does not replicate normal joint mechanics.
Why can passive-angular stretching be harmful?
It may cause pain or damage the joint because:
• The use of a lever magnifies the force going through the joint.
• The force causes joint surface compression in the direction of the rolling bone.
• Roll without slide does not replicate normal joint mechanics.
What are the two common sources of joint ‘cracking’ sounds?
Tendons or scar tissue moving over a bony prominence (e.g., snapping hip syndrome).
Cavitation/tribonucleation.
What is the mechanism behind joint ‘cracking’?
The mechanism is not fully understood, but current evidence suggests that:
• When joint surfaces are pulled apart, they resist movement until they reach a critical point where they separate rapidly (tribonucleation).
• This separation creates a vapor cavity (cavitation), resulting in a ‘crack.’
What should documentation of joint mobilization include?
Patient files should reflect the application and include:
• Patient position (if specific).
• Joint mobilized.
• Grade applied.
• Type (oscillatory or sustained).
• Direction of mobilization.
• Parameters (duration, rest, total time).
Example: gr 3, osc. post glide, R GH jt, 3x1 min w/ 10 sec rest.
What key points should be covered in communication with the patient during mobilization?
• Briefly explain the mobilization in simple, layperson terms.
• Inform the patient it should not cause pain, and they must let you know if it does, so you can stop/modify.
• Ask if they have any questions.
• Confirm if it’s okay to proceed.
What is self-mobilization?
Self-mobilization, or ‘auto-mobilization,’ involves traction, distraction, or glides applied by the patient as part of home care. It’s important that patients have the ability to do it properly and the self-restraint not to hurt themselves.
Describe the palpation exercise for knee mobilization.
• Patient Position: Seated with leg hanging over the end of the table.
• Therapist Position: Seated, facing the patient’s leg, palpating the anterior joint space of the knee with one hand.
• Mobilization: Distract the leg by pulling down towards the floor with the other hand.
• Questions to Consider: Can you feel the ‘spring’ of the tissue? Can you feel when you have reached the end of the ‘spring’?
What is the loose-pack and close-pack position for Metatarsophalangeal (MTP) joints?
• Loose-Pack Position: Slight (10°) extension.
• Close-Pack Position: Full extension (ideally >90°).
What is the loose-pack and close-pack position for Interphalangeal (IP) joints?
• Loose-Pack Position: Slight flexion.
• Close-Pack Position: Full extension.
What is the patient position for MTP and IP mobilizations?
The patient can be in any position.
Describe the therapist position for mobilizing MTP and IP joints.
• Stabilizing Hand: Grasps the head of the proximal bone.
• Mobilizing Hand: Grasps the base of the distal bone.
What are the mobilization techniques for MTP and IP joints?
• Distract the distal bone.
• Mobilize the distal bone in a plantar or dorsal direction.
What are the uses of distraction, dorsal glide, and plantar glide for MTP and IP joints?
• Distraction: To improve general MTP/IP mobility.
• Dorsal Glide: To improve MTP/IP extension.
• Plantar Glide: To improve MTP/IP flexion.
What is the reference point for the foot in Distal Intermetatarsal joint mobilizations?
The reference point is the 2nd metatarsal.
