Lecture 3: Peripheral Joint Mobilization Flashcards
When do we use joint mobilization?
- modulate pain
- treat joint impairments limiting ROM (replicate normal joint mechanics while minimizing compressive stresses on cartilage)
What is definition of a mobilization/ manipulation?
skilled, passive manual therapy techniques applied to joints and related soft tissues at varying speeds and amplitudes
What is osteokinematic motion?
the motion you see as bones move in space (moved by muscles)
DF, PF, flex/ ext
What is arthrokinematic motion?
accessory motion between adjacent joint surfaces, occurs with A/PROM the motion you feel
Ex: roll, glide, spin
What is joint play?
passive movement
can not be achieved if there is an active muscle contraction
What is a component movement?
involuntary obligatory joint motion, occurs with active motion
scap upward rotation with shoulder flexion
What is example of a roll?
new points on one surface come in contact with other new points
ER of shoulder- humeral head rolls posteriorly
What is an example of glide/slide?
one point of one surface contacts new points on another surface
tibia slides posteriorly during OC knee flexion
What is concave convex rule?
concave moving on convex:
osteo and arthro move in same direction
What if convex is moving on concave?
osteo and arthro motion in opposite directions
ex: humeral head on glenoid
What is obligate translation?
restricted capsular mobility will cause translation away from tightness
ex: tight posterior GH capsule results in anterior translation of humerus
What is a treatment plane?
perpendicular to the axis, parallel to joint surface
What is traction?
seperation of joint surfaces perpendicular to treatment plane
What is gliding?
joint surfaces displaced parallel to treatment plane
What are the only 3 grades for traction?
1-3
What is grade 1 traction?
good for early pain b/c you are unweighting joint but not putting load on tissues
What is grade 2 traction?
taking up tension in tissue but not enough to cause any type of change
What is grade 3 traction?
capsule and ligaments are stretched causing actual change in mobility
What are important handling techniques during joint play?
soft hands, hands close to joint line
palpate joint line first
pt must be relaxed
What is important to note for quality of motion?
where is the onset of resistance or muscle guarding
appropriate end feel?
movement provoking pain?
What are the indications for a joint mobilization?
- if patient has pain, ms guarding or spasm
- reversible hypo mobility (vigorous techniques)
- positional fault or sublxation
goal is to achieve full unrestricted pain free ROM
Why are mobilizations good for pain/ spasm?
gentle techniques stimulate mechanoreceptors to inhibit transmission of nociceptive stimuli (neurophysiological)
also promotes proprioceptive and kinesthetic awareness
What are mechanical effects of grade 3-4 mobilizations?
increases blood supply and nutrients to area
stretch or elongate hypomobile structures
break adhesions
What are absolute contraindications for mobilization?
malignancy in area, infectious arthritis , metabolic bone dz, fusion, OM, fracture, ligament rupture
What are precautions for mobilizations?
excessive pain/ swelling, arthroplasty, pregnancy, hyper mobility, RA, VA insufficiency
What are grades 1-2 for mobilization?
1- small amplitude at beginning of range
2- large amplitude within available range
best for pain won’t produce mechanical effects
What are grades 3-4 for mobilization?
3- large amplitude that reaches end range
4- small amplitude movement at very end range
these will increase ROM
What is a grade 5 mobilization?
can also be referred to as manipulation depending on state
high velocity thrust that will help increase ROM
If patient has low pain in end range what is an appropriate action?
you can most likely skip grade 1 and 2 but see what patient can tolerate
