Joint Mobilization

Basic Definitions Osteokinematics Arthrokinematics Related Terms Component Motions

Athrokinematics involved in Motion Roll New points on one surface come in contact with new points on the opposite surface Always occur in same direction as bone movement When roll occurs alone:

Athrokinematics involved in Motion Roll Glide (Sliding) One specific point comes in contact with new points on opposing surface Direction depends on surface of joint Combined roll and glide movements

Athrokinematics involved in Motion Roll Glide (Sliding) Spin Compression Distraction or Traction

Convex Concave Rules MUST KNOW Convex Stationary + concave moving = gliding in same direction as angular motion Concave stationary = convex moving = gliding in opposite direction of angular motion

Concave-convex rule

What is the difference between passive stretching and joint mobilization stretching? Passive Angular Stretching Use a lever Joint Mobilization Safer more selective because:

Techniques in Joint Mobilization Joint Position Closed packed position Loose packed position

Closed-packed Position Open-packed Position Joint Closed-packed Position Open-packed Position Glenohumeral 90o ABD & Full ER combo 55o flexion w/ 20-30o HABD Elbow Humeroulnar Humeroradial Raduioulnar Full Extension 90o flex w/ mid-pronation Full pronation or supination 70o Flex w/ 10o supination Full ext w/ full supination 70o flex w/ 35o supination Distal Radiocarpal Joint Full extension & radial deviation or full flex Neutral position MCP joints 2-5 1 Full flexion Full opposition 20o flexion IP joints Hip Full IR, Ext & ABD 55o flex w20-30o HABD Knee (tibiofemoral) Full Ext & ER 20-25o flexion Ankle Mortise Full DF 10o PF Subtalor Full EV or INV Midrange PF & DF Forefoot 1 MTP = 20o DF 2-5 MTP = 20o PF IP’s = 20o PF

Techniques in Joint Mobilization Joint Position Treatment Plane

Techniques in Joint Mobilization Joint Position Treatment Plane Treatment Force

Techniques in Joint Mobilization Joint Position Treatment Plane Treatment Force Grades Oscillation Techniques I and II = pain reduction III and Iv = stretching

Techniques in Joint Mobilization Joint Position Treatment Plane Treatment Force Grades Oscillation Techniques Sustained Traction Movements Grade I Grade II Grade III

Indications Neurophysiologic Effects Mechanical Effects Nutritional Effects

Contraindications Hypermobility Joint Effusion Inflammation Fractures Arthritis Congenital Bone Deformities Manipulations