Joint Mobilizations PDF

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Joint Mobilization Basics

Joint Roll-Gliding
Healthy joint motion is a combination of rolling and gliding. The direction of the rolling component is always the
same as the direction of bone movement. The direction of the gliding component is dependent on the convexconcave rule.
Convex Concave Rule
*We are focusing on the moving segment*
-If the moving segment is concave, joint gliding is in the same direction as bone movement-If the moving segment is convex, joint gliding is in the opposite direction as bone movement-

In a hypomobile joint this roll-gliding relationship is disrupted. Typically, the joint is rolling without the
necessary associated gliding component. The goal of joint mobilization is to restore the gliding component.
Joint mobilizations are typically performed in the resting position of the joint. However, there are circumstances
where you may want to bring the joint to the point of restriction, and mobilize there.
Treatment Plane
An imaginary line that is always parallel with the concave joint surface. You always test joint play or mobilize a joint
by moving the bone segment parallel with the treatment plane. In the case of traction, you pull perpendicular to
the treatment plane.

Grading Mobilizations (Kaltenborn)


Grade I Pain relief. Performed in resting position. Typically involves only light traction.
Grade II Pain relief/relaxation. Performed in resting position. Again putting traction on the joint and taking up
slack.
Grade III Stretch mobilization. May be performed in resting position or at the point of restriction within the range
of motion.
Grade IV Manipulation.
Grading Mobilizations (Maitland)
Grade I Low amplitude oscillations for pain relief. Takes place at the beginning of the ROM.
Grade II High amplitude oscillations for pain relief. Takes place within available ROM.
Grade III High amplitude oscillations to treat stiffness. Reaches the end of available ROM.
Grade IV Low amplitude oscillations to treat stiffness. At the end of available ROM.
Grade V High velocity low amplitude thrust. At the end of ROM, but within anatomical range.

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