Week 4 - Joint mobs

Question 1

Describe the concave, convex rule

Answer 1

When a convex surface moves on a stable concave surface, the sliding of the convex articulating surface occurs in the opposite direction to the motion of the bony level
When a concave surface is moving on a stable convex surface, sliding occurs in the same direction as the motion of the bony lever

Question 2

What are the indications for joint mobilisations?

Answer 2

Restoration of movement to a joint
Pain
Spasm
Joint soft tissue tightness

Question 3

Describe central pain control

Answer 3

Descending inhibition
Dorsal PAG - NA blocks substance P at spinal cord level
Ventral PAG - opioid mechanisms, 5HT

Question 4

What are the arthrogenic effects of joint mobilisation?

Answer 4

Restore osteo/ arthro-kinematic movements
Restoration of accessory glide
Capsular stretch
Soft tissue receptors
Increase in joint ROM
Influencing deep/ superficial joint muscles
Dispersal of inflammatory ‘soup’

Question 5

What is the SIN factor?

Answer 5

Severity - intensity of symptoms, e.g. pain scale, constant vs. intermittent, level of meds recquired
Irritability - the ease with which symptoms are increased or produced
Nature - tissue mechanisms, pain mechanisms, PS factors, ‘genics’

Question 6

Contraindications for joint mobilisations

Answer 6

Infection 
Tumour
Acute inflammatory
Fractures/ dislocations
RA - acute flare up

Question 7

Precautions for joint mobilisations

Answer 7

Joint instability
Hypermobility
Sero-negative athropathies
High SIN
IDDM