1. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 13 Swedish Massage Techniques

2. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Topic 13–6: Joint Movements Joint Movements: What’s in a Name? –Gymnastics: therapeutic movements to improve joint flexibility. –Range-of-motion (ROM): joint flexibility techniques.

3. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Topic 13–6: Joint Movements Review of Joint Structure and Function –Joint (articulation): place two or more bones meet. –Classified way they are formed (structure); by type and degree of movement they allow (function). –Structurally: fibrous, cartilaginous, synovial. –Functionally: immovable (synarthrosis;, slightly movable (amphiarthrosis); freely movable (diarthrosis).

4. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Topic 13–6: Joint Movements Review of Joint Structure and Function –Joint movement techniques focus predominantly on synovial joints. –Ligaments (connective tissue) attach one bone to another. –Tendons (attach muscle to bone) to provide support. –Movement “opens” or “closes” joint.

5. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Topic 13–6: Joint Movements Review of Joint Structure and Function –Gliding joints –Hinge joints –Pivot joints –Condyloid joints –Saddle joint –Ball-and-socket joints

6. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Topic 13–6: Joint Movements Range of Motion, Limits to Movement, and End Feel –ROM: amount of movement possible at joint depending on its structure and condition. –If joint’s ROM normal, joint can move freely and without pain in all of its actions. –If joint’s ROM restricted, joint cannot move freely or without pain in some or all of its actions.

7. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Topic 13–6: Joint Movements Range of Motion, Limits to Movement, and End Feel –Anatomical restrictions: caused by structures that make up joint itself. –Physiological restrictions: limit movement of joint before anatomical restriction reached. –Hard-end feel: bone runs into bone. –Soft-end feel: soft tissue in way of movement. –Firm-end feel: muscles, tendons, ligaments, joint capsule reach limit to lengthen without injury.

8. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Topic 13–6: Joint Movements Range of Motion, Limits to Movement, and End Feel –Pathological restrictions: limit and decrease joint’s ROM because of pain or structural dysfunction. –Joint fixation: diminished movement within joint capsule space. Cautions When Working with Joints –See Table 13-1: Conditions, Contraindications, and Cautions for Joint Movement Techniques.

9. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Topic 13–6: Joint Movements Benefits of Joint Movements –Encourages movement of lymph. –Stimulates production of synovial fluid to lubricate and nourish joint. –Increases local circulation. –Stretches muscles and fascia. –Helps reeducate body about movement potential. –Maintains or increases flexibility.

10. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Topic 13–6: Joint Movements Types of Joint Movement Methods –See Technique 23: Active Joint Movements Paired With Massage. –See Technique 24: Active-Assisted Joint Movements. –See Technique 25: Active-Resisted Joint Movements. –See Technique 26: Passive Joint Movement Techniques. –See Technique 27: Passive Stretches.