Traction is separating the joint surfaces by pulling them apart. It is considered a form of passive joint mobilization. Traction can be applied manually, by your physical therapist, or mechanically, by a machine. It is most commonly performed in the neck (cervical spine) or low back (lumbar spine). Manual Traction is applied either intermittently, with slow oscillatory movements, or as a sustained hold, where a steady force is applied and maintained for an extended period of time.
Grades of Sustained Traction:
- Grade I - Small amplitude movement with little joint separation. Nullifies the normal compression forces on your joints. Grade I traction is very gentle and can relieve pain, and is most commonly performed after an acute injury. For example: can be used to treat the decreased mobility and inflammation of a whiplash injury
- Grade II - Sustained movement performed within the joint range of motion to the restriction. The ligaments and joints capsule are taut. The “slack” is taken up in the joint. Grade II traction can be used to relieve pain and increase mobility. When someone is suffering from a frozen shoulder they are usually in pain and have loss of range of motion in all directions. Mid-grade traction will increase the ROM and provide pain relief.
- Grade III - Sustained movement performed at the end of the joints range of motion through the restriction. Grade III traction is performed to increase mobility which will as a result decrease pain. This is most commonly used in the low back and neck when there is a disc bulge causing nerve root irritation and pain in the extremities.
Spinal Traction
Sustained manual traction has been shown to cause spinal elongation and increase the space between vertebrae. This can be very beneficial if you are have a herniated disc in your neck or back causing pressure on the nerve roots supplying your arms and legs with sensation and muscle innervation. A disc bulge can cause pain, weakness, numbness, or tingling in your back, neck, and extremities. Traction can take pressure off the irritated nerve roots, and over time, can allow the disc to slide back into place.Traction in your Arms and Legs
Traction can also be used in any other joint throughout the body. Whether it’s a sprained ankle, frozen shoulder, or wrist sprain, traction can help relieve pain, reduce swelling, and increase mobility. For example: a low-grade ankle sprain can result in a lot of swelling and decreased mobility in all planes of movement at the ankle. The joint can look like one large balloon of fluid. Gentle low-grade traction at your ankle joint can help relieve pain, reduce swelling, and increase range of motion. A frozen shoulder results in loss of motion throughout all planes, and shoulder traction can help increase that range of motion and joint mobility.Traction improves general joint mobility in all planes of movement. A physical therapist understands normal joint mechanics and can apply traction in the right plane of motion to separate joint surfaces. A skilled physical therapist can apply manual traction with appropriate force to help alleviate your symptoms. Another option is mechanical traction for your neck or lower back, and with a prescription from your doctor, home mechanical traction units may be covered by health insurance. Traction is one of many manual skills a physical therapist may use to treat your everyday aches and pains. If you are living with pain or discomfort in your joints, see your doctor and seek care from a physical therapist.
