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JointMobilization

Kinesiology 157Therapeutic Exercise

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Definitions

Mobilization

Physiologic Movements/Mobilization

Accessory/Joint Play Movement

Manipulation

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Osteokinematics:movement of

the bone

Arthrokinematics:movement of

the joint surface

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Joint Surfaces

SellarOvoid

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A

Roll

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AB

Roll

2

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AB

C

Roll

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D

AB

C

Roll

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A

Glide

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A

B

Glide

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A

B

CGlide

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A

B

C

DGlide

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A

Spin

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A

Spin

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A

Spin

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A

Spin

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Knee:Glide... Roll…Spin

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Knee:Glide... Roll

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Knee:Glide... Roll

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Knee:Glide... Roll

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Knee:Glide... Roll…Spin

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Knee:Roll /Glide

Knee:Roll /No Glide

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concave

convex

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concaveconcave

convex

convexconvex

Convex on Concavejoints

Concave on Convexjoints

concave

Name all Name all

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Convex Concave Rule

A convex on a concave joint surface glides the opposite direction that the bone swings.

Example: When the humerus swings up into abduction, the head of the humerus glides downward.

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Glenohumeral:Roll / Glide

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Glenohumeral:Roll /Glide

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Glenohumeral:Roll / Glide

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Glenohumeral:Roll /Glide

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Glenohumeral:Roll / Glide

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Glenohumeral:Roll / No Glide

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Glenohumeral:Roll / No Glide

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Glenohumeral:Roll / No Glide

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Glenohumeral:Roll / No Glide

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A concave on a convex joint surface glides the same direction that the bone swings.

Example: When the tibia swings posteriorly in knee flexion, the tibial joint surface glides posteriorly.

Convex Concave Rule

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Knee:Posterior GlidePosterior Swing

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Knee:Posterior GlidePosterior Swing

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Knee:Posterior GlidePosterior Swing

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Knee:Posterior GlidePosterior Swing

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Ankle:Plantar Flexion

What do you expect?

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Ankle:Plantar Flexion

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Ankle:Plantar Flexion

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Ankle:Plantar Flexion

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Ankle:Plantar Flexion

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MTP:Flexion

What do you expect?

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MTP:Flexion

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MTP:Flexion

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MTP:Flexion

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MTP:Flexion

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CLINICAL IMPLICATIONS

Goal: Restore Normal Joint Play to Increase Pain-Free Joint ROM

Follow Convex Concave Rule

Treatment often combines Physiological Mobilization and Accessory Mobilization to restore a particular Movement

Example: Increase Knee Extension

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Increase Glenohumeral Flexion:

Increase Knee Extension:

Problem Solving #1, Page 67

Problem Solving #3, Page 68

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JointDistraction

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Hip:Distraction

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Hip:Distraction

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Joint Traction: Longitudinal pull along the shaft of the long bone

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Hip:Traction

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Hip:Traction

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Spine Traction:Longitudinal pull along the line of the spinal column

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Spine TractionVertebral Bodies Separate

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Spine TractionVertebral Bodies Separate

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Spine TractionFacets Glide Apart Foramen Open

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Spine TractionFacets Glide Apart Foramen Open

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Which direction is: Traction? Distraction?

Which direction is: Traction? Distraction?

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Effects of Joint Mobilization

Synovial Fluid

Stretching

Improve tissue tensile strength

Decrease Pain (Neurophysiological) Mechanical Receptor: Gate Mechanism

Increase Relaxation (Neurophysiological)

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Contraindications/Precautions

See ROM/Stretching

Hypermobility

Inflammation and Joint Effusion

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Pain Resistance Relationship

I

N

T

E

N

S

I

T

Y

BeginROM

EndROM

R1

R2

P1

P2

RANGE OF MOTION

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Grades of Vigor

I

II

III

IV

Begin Available

Range

End Available

Range

III-IV-