Joint Mobilization Technique in Physiotherapy

Introduction

Joints may quickly come into possession of dysfunction after injury, trauma, or overuse. At times, joints get locked up or stiffened. In other instances, an alignment or uncontrolled aspect makes the joint move in an undetermined unnatural direction resulting in pain and disability. So, all these concerns are presented as pain and immobilization when a person encounters them. Therefore, one requires physical-allied treatment to unlock the joint and enhance the potential function.

What Is the Joint Mobilization Technique?

The joint mobilization technique is a form of manual therapy, a physical treatment for musculoskeletal disability and pain. Here, in joint mobilization, the approach addresses the joint’s function, range of motion (the linear distance that an object in motion travels when attached to another), and pain. The physiotherapist implements specific passive movements at varying degrees of size and speed. The movements are targeted at the joints, muscles, nerves, and surrounding tissue to restore ideal joint function.

How Does It Work?

After the appropriate evaluation of a person’s posture, gait, coordination, pain, discomfort, and range of motion, physiotherapy professionals will design a tailored plan based on individual concerns. The therapy relies on several sessions where the person is made to be in a comfortable, warm position granting free joint movements. Next, the therapist, with hands, gradually locates the affiliated joint and commences with applying movements ascending at levels of grades.

What Are the Types of Joint Mobilization?

The therapeutic movements a physiotherapist applies are not the usual ones but manual motion or traction that completes the whole plane of joint motion, moving from one segment to alternate aspects. The joint mobilizations are of the following types.

• Oscillatory Joint Mobilization: The oscillatory type is about the gentle pressure applied on all points covering the whole range of motion of the joint. Here, the physiotherapist applies slow-speeded pressure, which eventually varies with the amplitude (size) of the movement. As a result, he will grade the scores for pain according to the points moved.

• Sustained Joint Mobilization: In this type of mobilization, force is applied to employ pulling or traction-type movement. The movement is clenched for a specific span. This sustained joint mobilization diminishes the compression of the joint with persistent practice. In addition, it helps stretch the protective and surrounding tissue.

• Manipulation: This is being applied in cases of joint tightness and unsound joint mobility. Pressing or thrusting type of movement is applied over here but with high-speed and low amplitude.

Grades of Joint Mobilization:

With the general classification of joint mobilization, an Australian physiotherapist Geoffrey Maitland classified joint mobilization into the five grades of motion. Each grade is about the range of motion applied at the joint site, which eventually activates the joint sectors. The five grades are described below:

• Grade 1: Slow-speeded small amplitude forward and backward movements are applied at the beginning arc of joint motion.

• Grade 2: Slow-speeded but large amplitude forward and backward movements are applied here. The application is within the middle aspect of the joint’s arc.

• Grade 3: Slow-speeded large amplitude back and forward movement is applied to start from the middle to the end.

• Grade 4: Slow-speed small amplitude movement is applied to the end phase of the arc of the joint.

• Grade 5: Here, a single manipulation is applied to the end point of the joint’s range—manipulation in the sense of thrusting movement.

What Are the Conditions That Benefit With Joint Mobilization Technique?

The irritation, inflammation, pain, or misalignment of the joint is due to various causes like stress, injury, posture, recurrent activities, and wear-and-tear. Therefore, a joint problem is not just a joint concern but an underlying cause of various conditions. The physiotherapist will recommend the technique if it’s appropriate for the person. The joint mobilization technique is commonly and effectively employed in the following states and conditions.

• Lower back pain.

• Neck pain.

• Knee osteoarthritis.

• Other wear and tear arthritis.

• Arthritis of elbow, hip, knee, shoulder, and spine.

• Facet joint locking and other spinal misalignments.

• Adhesive capsulitis (frozen shoulder).

• Medial epicondylitis (golfer’s elbow).

• Lateral epicondylitis (tennis elbow).

• Wrist fractures.

• Ankle sprains.

Precautions:

Joint mobilization is a safe technique practiced in secure settings, though. Like reporting any medical condition, it always excels in conveying the underlying health issues before proceeding with the intervention. Nevertheless, caution should be taken into consideration if the person is in the following states to circumvent the potential risk of adverse responses.

• Congenital disability.

• Cardiovascular illnesses.

• Fracture.

• Tumor.

• Osteoporosis.

• Joint hypermobility.

• Joint ankylosis.

• Rheumatoid arthritis.

• Pregnancy.

• Malignancy.

• Paget’s disease.

• Nerve root compression.

• Spinal cord concerns.

What Are the Benefits of the Joint Mobilization Technique?

Trained, certified, experienced physiotherapy professionals implement the joint mobilization technique. The technique's primary benefit is restoring function and motion, even alleviating pain. Subsequently, the joint mobilization of injured, swollen, painful, or dislocated joints possesses the succeeding benefits.

• Reduces pain and discomfort concerning the joint over time.

• Improvement in range of motion.

• Enhancement of the function in the specified joint area.

• It diminishes joint stiffness.

• Improvement of joint mobility and, thus, functionality.

• It diminishes muscle spasms and muscle tension.

• Restores optimal motion.

• Therefore, it improves the quality of life overall.

Complications Associated with Joint Mobilization:

Complications are not expected as the approach is well-handled by physiotherapy professionals. Nevertheless, these notable complications should be tended to.

• Tendon or muscle injuries.

• Nerve damage.

• Dislocation of the joint.

• Fracture.

Conclusion

The role of physiotherapy is to help regain muscle function, strength, and movements following an injury. By giving physiotherapy, physiotherapists help one regain independence and get back into the previous activities. During the therapy, the physiotherapist uses a type of hands-on technique to treat and this technique is called joint mobilization. This treatment has significant benefits, such as decreasing pain, increasing range of motion, and enhancing function. It is a simple approach where the therapist stabilizes one segment of the joint and gives manual pressure or traction kind to the proximal section. The clinical findings so far have shown that the joint mobilization technique has been so effective in treating various conditions including chronic musculoskeletal disorders.