Joint Mobilization | How does it help in increasing the range of motion?

Are you unable to move your joints after a long period of immobilization, overuse, or trauma?  If yes, then to restore the normal movement of these affected joints you require early treatment.  One such treatment technique used is Joint mobilization. This technique is used by physiotherapists to passively move the joint to increase the range of motion and decrease pain. The treatment enhances movements like gliding, rolling, spinning, etc that take place between the bones after injury.  These are small, involuntary movements that assist the joints to perform to their optimum. In this blog, we will discuss joint mobilization and its benefits.

 

Joint Mobilization

This technique, also known as manual therapy, is performed by well-trained physiotherapists.  Joint mobilization is the application of graded forces to move a joint in the desired direction. The person is placed in a comfortable and relaxed position to allow the free movement of the joint.  Hands are used to localize the joint which is to be mobilized, mobilization is applied at a slow speed, with or without oscillations or a stretch, by using the hands in the appropriate direction. Grades of joint mobilization range from Grades 1 – 5.  Grades 1 – 4 are used to apply partial movement glides to the end range and Grade 5 is the same as manipulation. The treatment is progressed with the application of high-speed mobilizations helping in reducing pain and in restoring joint play.

 

Classification of movements:

• Medial to Lateral
• Anterior to Posterior (AP)
• Oscillations
• Translation
• Distraction

 

Grades:

Grade 1: Small-amplitude movement at the beginning range of joint movement.

Grade 2: Large amplitude movement at the mid-range of joint movement.

Grade 3: Large amplitude movement at the end range of joint movement.

Grade 4: Small amplitude movement at the end of the range of joint movement.

Grade 5: Manipulation of high velocity and low amplitude to the anatomical endpoint of a joint.

 

What Happens When a joint has limited motion?

Due to limited joint mobility, the nutrition of cartilage starts to decrease within the joint, and other joints begin to compensate for the joint stiffness and thus move excessively. This overuse of the adjacent joints causes their deterioration due to overuse. Muscles surrounding the stiff joint become tight and lose their ability to contract and relax sufficiently, thus causing overall dysfunction of the joint.

 

Benefits:

• Decreases pain,
• Decreases joint tightness,
• Improves joint mobility
• Decreases muscle spasms
• Decreases muscle tension,
• Induce reflex muscle relaxation,
• Increases functionality.

 

Indications for Joint Mobilization

The physiotherapist examines the anatomy, arthrokinematics, and the pathology of the neuromusculoskeletal system to recognize when the techniques are indicated. The pathomechanics of the condition is understood first to determine whether joint mobilization is appropriate for the specific musculoskeletal condition.

 Precautions

Joint mobilization is a successful treatment technique used to treat many cases of joint dysfunction, but certain precautions are necessary like in case of:

• Joint hypermobility
• Osteoporosis
• Joint effusion
• Severe scoliosis
• Fracture
• joint ankylosis
• Spondylolisthesis
• Rheumatoid arthritis
• Tuberculosis
• Paget's disease
• Malignancy
• Pregnancy

 Complications of joint mobilization like tendon or muscle injury, nerve damage, dislocation, and fracture should be taken care of.  Therefore, these techniques should be performed by a well-trained physiotherapist to avoid any unnecessary injuries.

This article was first published at CB Physiotherapy