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Functional Mobilization - Indications, Contraindications, and Benefits

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Functional mobilization is a type of approach in physiotherapy to improve the function of the affected areas. Read this article to learn more.

Written by

Dr. Kayathri P.

Medically reviewed by

Vikram S. Bharadwaj

Published At March 15, 2023
Reviewed AtApril 24, 2023

What Is Functional Mobilization?

Functional mobilization aims to restore function by identifying and eliminating the neuromuscular, mechanical, and motor causes leading to dysfunction or disorganization. Functional mobilization combines active and passive resisted motions with directional pressure to help restore functional mobility. It is also useful in soft tissue mobilization and joint mobilization through exercise training.

How Is Functional Mobilization Done?

A thorough physical examination is done initially to evaluate any abnormalities found in the body. While examining, all factors are taken into consideration, such as pain level, range of motion, coordination, strength, and posture. Functional mobilization helps restore function in many conditions that can be painful and disabling. Joint and soft tissue mobilization are done to restore functional and structural deformities.

What Are the Indications?

The indications are as follows:

  • Ankle Sprains: Sprains occurring in the ankle can be due to sudden, painful twists and turns of the leg.

  • Whiplash Injury: It is a type of neck injury that results due to sudden movements of the head backward and then forward. It usually results from road traffic accidents.

  • Sciatica: Sciatica is a painful condition that is characterized by pain along the path of the sciatic nerve that runs from the legs to the back.

  • Nerve Impingement Syndromes: Nerve impingement refers to the compression of a nerve due to irritation or pressure for a long time.

  • Rotator Cuff Tear and Sprains: These occur due to chronic repetitive use of the hand and wrist, resulting in a tear or sprain of the tendons and ligaments of the hand.

  • Adhesive Capsulitis: It is also called frozen shoulder and is characterized by pain and stiffness in the shoulder joint occurring due to prolonged immobilization of the shoulder joint.

  • Arthritis: It is a disorder in which there is swelling and pain in almost all the joints due to inflammation.

  • Medial (Golfer’s Elbow) And Lateral (Tennis Elbow) Epicondylitis: These conditions are caused due to repetitive overuse of the fingers and hand, resulting in inflammation and pain of the tendons of the hand.

  • Spinal Misalignments: There are various spinal abnormalities that cause misalignment of the spine, which produces pain, and lead to an improper posture.

  • Facet Joint Locking: It is a type of joint location occurring in the lower part of the spine and causes extreme pain.

What Are the Techniques?

Functional mobilization for the lower extremities:

1) Hip Joint: Functional mobilization is done in the hip joint to restore the generalized mobility of the hip joint and to improve the range of motion. The direction of mobilization is applied anteriorly, inferiorly, and laterally.

  • Inferior Glide: The inferior mobilization is also called distraction. It is done by asking the patient to lie down on a bed or table, and a belt is wrapped around the patient and the therapist's legs. The belt is placed as low as comfortable for both the therapist and the patient. Taking the slack of the belt in a lunging way and the therapist applies a light distraction force. This position is held for a few minutes, and the patient is asked to push toward the therapist for a few seconds and then relax. While relaxing, the therapist takes up the slack and moves the patient more in flexion. This type of movement is done to improve mobility.

  • Lateral Glide: It is done by asking the patient to lie down near the edge of a bed or table, and a belt is wrapped around the patient and the therapist's legs. The belt is placed as low as comfortable for both the therapist and the patient. Taking the slack of the belt in a lunging way and the therapist applies a light distraction force. This position is held for a few minutes, and the patient is asked to push the knee toward the therapist for a few seconds and then relax. While relaxing, the therapist takes up the slack and moves the patient more in flexion. This type of movement is also done to improve mobility.

  • Anterior Glide: It is done by asking the patient to lie down near the side of a bed or table. One hand of the therapist is placed over the posterior greater trochanter (present near the upper buttock), and the other hand is placed near the distal femur (area above the knee joint) while bending the patient's leg to a 90 degrees angle. Now the therapist gently raises the distal femur while keeping an anterior force on the posterior aspect of the greater trochanter. The patient is asked to pull the knee towards the table for a few seconds and then relax. While relaxing, the therapist takes up the slack, and the exercise is repeated. This type of movement is done to aid in extension and external rotation.

2) Sacroiliac Joint: Posterior rotation is done to aid in flexion of the hip and general sacroiliac mobility. The patient is asked to lie down sideways on a table, and both hands are wrapped underneath the femur of the other leg to prevent lumbar spine hyperextension. The therapist stands behind the patient by placing one hand on PSIS (posterior superior iliac spine), part of the hip bone, and cradles the patient's leg with the other hand wrapped around the distal femur. A force is applied by the therapist in a posterior tilting direction and also simultaneously pulling the femur towards the therapist. Now the patient is asked to flex the hip while the therapist resists motion. Finally, the patient is asked to relax and take up the slack.

3) Sacrum: Sacrum is a triangular-shaped bone present between the hip bones and spine. Sacral nutation or anterior tilting is done to aid in the extension of the spine and general sacroiliac mobility. The patient is asked to lie downwards with the face facing the bed, and the knee is bent at a right angle. The heel of one hand of the therapist is placed over the superior poles of the sacrum, and the other hand wraps around the bilateral distal tibia (near the ankle) of the patient. Now the therapist applies a gentle force to the superior poles of the sacrum while resisting the bilateral extension of the patient. The patient is held for a few minutes in this position and asks them to relax while taking up the slack and repeating the same steps.

What Are the Benefits?

The benefits of functional benefits are:

  • It has been used for the treatment of spine dysfunction and has proven effective.

  • Manual therapy combined with exercise helped improve shoulder impingement syndrome.

  • In adhesive capsulitis, functional mobilization combined with exercise therapy is the only effective treatment protocol. It has also helped improve mobility.

  • Patients with limited joint mobility and neuropathy have largely benefitted from joint mobilization techniques.

  • Immediate functional mobilization after a patellar dislocation has helped prevent the side effects of long-term immobilization.

What Are the Contraindications?

The contraindications include:

  • Presence of malignancies in the treatment area.

  • Patients with infective arthritis.

  • Patients with metabolic bone disease.

  • In conditions like fusion or ankylosis.

  • Neoplastic disease.

  • Areas of fracture or ligament rupture.

  • Patients with osteomyelitis.

  • Pregnant women.

  • When there is hypermobility in the treatment area.

Conclusion

In the case of musculoskeletal and soft tissue injuries, functional mobilization is done, which will restore full strength and range of motion. The patient will feel a sense of independence at the end of the treatment. The overall health and wellness of the patient are also restored as the disability is eradicated completely through functional mobilization. Functional mobilization done immediately after surgery helps in the early rehabilitation of the operated areas.

Source Article IclonSourcesSource Article Arrow
Vikram S. Bharadwaj
Vikram S. Bharadwaj

Physiotherapy

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