Joint Mobilization Techniques PDF

Therapeutic Effects of joint mobilization Mechanical 1-increase extensibility of soft tissue and joint capsule (by disrupting cross linking 2- increase ROM  Therapeutic Effects of joint mobilization 1. Nutrional effect 2. 1-distraction and small glide increase synovial fluid movements...

Therapeutic Effects of joint mobilization Mechanical 1-increase extensibility of soft tissue and joint capsule (by disrupting cross linking 2- increase ROM  Therapeutic Effects of joint mobilization 1. Nutrional effect 2. 1-distraction and small glide increase synovial fluid movements 3. 1- movement increase cellular metabolism and protein synthesis 4. 2-increase nutrients to cartilage  Causes of joint restrictions 1- spasm or shortening of surrounding tissue 2-shrinkage or adhesions of joint capsule 3- decreased extensibility of articular and periarticular tissues 4-entrapment of fat pads or mensicoids.  Lack of joint motions leads to Structure and function of region changed Cartilage atrophy Muscle around stiff joint lose their ability to contract and relax sufficiently and become tight Region dysfunction surrounding stiff joint  Arc stretch versus joint glide stretch Passive range of motion exercises [arc] when bony lever is used to stretch tight capsule and muscle, may cause increase pain and joint trauma as use bony lever magnifies force Joint mobilization stretching [glide ] is used to stretch tight capsule is more safer and selective as force applied close to joint surface and appropriate for joint pathology  Grades of mobilization Grades of oscillation techniques (5 grades ) Grade 1:small amplitude rhythmic oscillation at the start of range Grade 2: large ________________________within range not reach limit Grade 3: large _______________________up to limit of available motion Grade 4 :very small ____________________ at limit of available motion Grade 5 : joint manipulation. Small,high velocity thrust technique is performed to snap adhesion at limit of available motion Grades of oscillatory mobilization  Uses of oscillatory Grade 1and 2 for pain and muscle spasm relief Grade 3and 4 for increasing joint play and Rom  Sustained translatory joint play technique Grade 1(loosen ):small amplitude joint distraction where no stress is placed on capsule. It equal cohesive force ,muscle tension.15- 25% of available joint play range. Used relief pain Grade 2(tighten or tack up slack ) : enough distraction of joint surface to stretch the tissue around joint. Used in initial treatment to determine joint play and stretch soft tissue surrounding joint capsule Grade 3:large or enough amplitude distraction to place stretch on capsule and periarticular structures. Used to stretch capsule and increase joint play Sustained grades of mobilization  Uses of sustained technique Grade 1: relief pain Grade 2: initial treatment to determine how joint is sensitive Grade 3:stretch joint structures and increase joint play  Mobilization techniques selection High tissue reactivity :pain before resistance Oscillation no stretch sustained Moderate tissue reactivity : pain with resistance : oscillation ,sustained, oscillation low tissue reactivity : resistance before pain : stretch and thrust  Indication 1- joint pain and muscle spasm 2-reversanle joint hypmobility (joint stiffness) 3-joint malaligment or positional fault 3-treating capsular pattern  Contraindication 1-metastasis (tumour ) 2- acute inflammation Rheumatoid disease 3- recent or unhealed fractures 4-excessive undiagnosed pain 5- pyogenic arthritis 6- joint sepsis 6- bacterial infection (infective arthritis) 7- hypermobility 8-acute Inflammatory arthritis 10-osteoprosis 11-neurological signs /vascular disease