Joint Mobilizations Flashcards
What did Mennell contribute to joint mobilizations?
Joint adhesions, differential Dx
What did Cyriax contribute to joint mobilizations?
STTT, capsular patterns, thrust techniques
What did Kaltenborn contribute to joint mobilizations?
Loose/close-pack, concave/convex
What did Mulligan contribute to joint mobilizations?
Mobilization with movement
What did Maitland contribute to joint mobilizations?
Grades, oscillatory movements
Who are two other important contributors to joint mobilizations?
Paris and McKenzie
What is the difference between a mobilization and manipulation?
A mobilization has a slower-velocity. The speed/technique is such that it can be controlled/resisted by patient PRN.
A manipulation has a higher velocity. The patient cannot resist/control it.
Why is it important to understand the arthrokinematics and osteokinematics of a joint when doing joint mobilizations?
When a motion is restricted osteokinematically, you need to know which direction to mobilize the joint. This requires knowing the arthrokinematics of the joint.
What is the open-packed (resting) position?
The open packed position is where the joint is the loosest.
What is the close-packed position of a joint?
It is the position where the joint structures are the tightest.
What is the zero position of a joint?
Anatomical position of the joint
What is the goal of joint play?
- Accessory motions
- Used to assess joint pathology
- Used in treatment
- Normal joint play is essential for normal, pain-free ROM
Which direction do you move the articular surface when assessing joint play?
Parallel or perpendicular to treatment plane
What joint position should you perform joint play in?
Start by using the open-packed position.
What surface is the treatment plane based off?
The treatment plane is based off the concave surface.
If you are moving the convex surface, what happens to the treatment plane?
Nothing because the treatment plane is based off the concave surface.
If you are moving the concave surface, what happens to the treatment plane?
The treatment plane will move if you move the concave surface.
What are the three joint play motions?
- Traction (distraction)
- Compression
- Glides
What methods can you use to determine the direction of restricted gliding?
- Direct method (glide test)
- Indirect method
Why would you use the direct method?
- Gives the most accurate info
- Jt gliding is performed in all directions - includes assessment of end-feel
When would you use the indirect method?
- Used when glide tests cannot be performed (severe pain/spasm)
- Based on convex-concave rule
How is hypomobility graded?
0 = no movement 1 = considerably decreased movement 2 = slightly decreased movement
What is a normal grading for joint play?
3 = normal
How is hypermobility graded for joint play?
4 = slightly increased movement 5 = considerably increased movement 6 = complete instability
Normal mobility and no pain =
no lesion
Normal mobility and pain =
mild sprain
Hypomobile and painless =
tight, adhesion, contracture
Hypomobile and pain =
more acute sprain, muscle guarding
Hypermobile and painless =
chronic instability, nerve damage, complete tear/rupture
Hypermobile and pain =
Tear with some attachment still
What are some indications for joint mobilization?
- Assessment and testing of joint function
- Joint dysfunction
- Pain
What are the effects of immobilization?
- Cartilage degeneration
- Decreased mechanical and structural properties of ligaments
- Decreased bone density
- Weakness/atrophy of muscles
