Joint Mobilization and Manipulation Health Article

Definition

Joint mobilization is a treatment technique used to manage musculoskeletal dysfunction. Most manipulative and mobilization techniques are performed by physical therapists, and fall under the category of manual therapy.

In most cases, at the end of a long bone there is a joint or articulation. The long bone is attached or joined to another bone by a joint. For example, the femur is attached to the tibia at the knee joint. The knee joint is made up of the surface of the tibia, femur, ligaments, and capsule. Thus, the knee joint is stable and yet mobile. When an individual is sitting in a chair and freely kicks his leg out (knee extension), the tibia moves, while the femur is stationary. However, at the surface of the articulating bones (tibia and femur), there is other movement. This movement is known as slide or glide; some have termed it "joint play." When an individual kicks his leg out, the lower leg or tibia is not only moving forward, but also gliding across the end of the femur. Mobilization is the treatment technique that involves the clinician applying a force to mimic the gliding that occurs between bones. It is a passive movement, the goal of which is to produce a slide or glide. Mobilizations are usually completed at slow speed, sometimes with oscillations, and even with a "hold" or stretch. Manipulations are more aggressive, high velocity techniques, or thrusts. They occur very fast, and at the end of available joint play.

Purpose

Mobilizations are used to restore joint play that has been lost due to injury or disease. In order for an individual to kick his leg out, there must be sufficient joint play, or freedom for the tibia to move on the femur. Thus, mobilizations are used when range of motion or mobility is lacking. Furthermore, gentle oscillations within the available joint play range is a technique used to decrease pain. Manipulations are quick movements that occur beyond the available joint play range. The purpose of manipulations, or joint thrusts, is to increase the available range if it is not full. Secondly, manipulations are done to break adhesions that disrupt joint movement.