Joint Mobilization: is a manual technique used by physical therapists to achieve a therapeutic effect to benefit you, the patient. There are various types of mobilization including: traction, sustained, oscillatory, or high velocity thrust. There are also varying grades or intensities of mobilization. How can this benefit you, when is mobilization used, when should mobilization not be used, and how do these techniques differ from chiropractic care?
How Can Joint Mobilization Help You: Joint mobilization can be used to relieve pain caused by many orthopaedic conditions, increase range of motion (for example frozen shoulder), improve the mechanics of how your joints move to help with posture, reduce swelling after an acute injury (for example an ankle sprain), relieve neural tension (such as pain in your arms or legs from a herniated disc in your neck or back), and to break up adhesions.
Oscillatory Mobilization: Passive movements using a small bouncing effect of two or three per second. These can be large or small movements within a joints range of motion.
Sustained Mobilization: Sustained stretching often with tiny oscillations at the limit of the joints range. This is also known as traction. A joint is stretched to its limit and the stretch is sustained. This is most commonly used in the neck and low back.
Grades of Oscillatory Mobilization:
- Grade I - Small movement performed at the beginning of the joint range primarily used for pain relief.
- Grade II - Large-amplitude movement performed within the joint range but not reaching the limit of the range. Used for pain relief and has some effect on your range of motion.
- Grade III - Large amplitude movement performed up to the limit of the joint range. This is used to increase stretch and range of motion at the joint.
- Grade IV - Small amplitude movement performed at the limit of the joint range
Grade V Manipulation: A grade V joint mobilization is also known as a high velocity thrust. The limit of the joint range is sustained (grade IV) and a quick thrust is administered. This can sometimes, but does not always, result in a cavitation of the joint (“crack” or “pop” sound). This is used over a hypomobile joint (one that does not move well, for example a frozen shoulder) usually in the spine. This differs from chiropractic care in that it targets a specific segment or joint, for example: if your physical therapist finds that you have limited mobility with rotation in your low back he/she can determine which segment/s are limited and perform a high velocity thrust to increase mobility at that segment.
Joint Mobilization is one of many manual techniques that a Physical Therapist may use to treat your injury. It should not be used if you have any malignancy, inflammatory arthritis, on broken bones, on fused joints, if you have osteoporosis, or if you experience vertebrobasilar insufficiency (decreased blood flow to the brain). Your physical therapist will make sure it is safe to perform all manual therapy.