joint mobilizations - general info Flashcards
what could be the reason why you have loss of motion at a joint
pain and muscle guarding joint hypomobility joint effusion (swelling) contractures or adhesion in joint capsule or supporting structures combination
what are the objectives of manual therapy
pain modulation
address tissue extensibility
address muscle guarding
peripheral effects (circulation, fluid/waste uptake, improve healing)
improve tolerance for other interventions
what is the role of the joint capsule
seals joint space
provides stability by limiting movements
provides active stability via its proprioceptive nerve endings
during AROM, translation direction is influenced by what?
capsuloligamentous complex
passive restraints restrict movements, but also do what?
reverse articular movements at the end range of motion
what will tight capsular structure cause?
early and excessive accessory motion in the opposite direction of the tightness
what position of the joint is the assessment done in?
resting position/open pack
what are you looking for while assessing joint mobilization?
gross quantity of movement: hypomobile, normal or hypermobile
end feel: firm, hard, empty
provocation: painful, painless
hypomobile
motion stops before what the body is capable of
pain, spasm, adhesions, inflammation
hypermobile
joint continues to move past limit due to laxity of surrounding structures
manual therapy techniques involving movement of articulating surfaces with intention of what?
regaining normal ROM improving joint capsule extensibility regaining normal distribution of forces and stresses on a joint reducing pain lubricating joint surfaces providing nutrition to joint structures
what is the most effective intervention regarding joint mobilizations?
joint mobs + with active exercise following
what are absolute contraindications to joint mobs?
malignancy in area of treatment active inflammation/infection ankylosis fracture practitioner lack of ability neurological deterioration: myotome, dermatome, deep tendon reflexes, pathological reflexes diseases which affect integrity of ligaments: down syndrome, RA arterial insufficiency
what are relative contraindications to joint mobs?
excessive pain or swelling arthroplasty hypermobility metabolic bone disease pregnancy spondylolisthesis
biomechanical proposed mechanism
motion improvement
positional improvement
increase joint capsule extensibility
