Joint mobilisation is a “hands on” physiotherapy technique commonly used in a clinical setting to improve the range of movement of a joint in order to lessen stiffness and pain. The technique involves small movements performed by the physiotherapist in an oscillating manner on the joints,
Before commencing joint mobilisation, the physiotherapist will determine if it is a necessary treatment by assessing the joint range of movement both actively (the patient performs the movement) and passively (the physiotherapist feels for stiffness and pain by moving the joint). Any joint which presents with pain or stiffness can be treated with mobilisation except in rare instances such as where there is malignancy, bone infection, spinal cord compression or unhealed fracture.
There are different grades of mobilisation used to treat various conditions. Where there is significant local pain and inflammation, gentle mobilisation is used (Grade 1 or 2) to help with pain relief and reduce inflammation by promoting movement. In conditions where there is not much pain but rather the main problem is joint stiffness, then a more vigorous mobilising technique (Grade 3 or 4) can be used to help restore full range of movement.
There are many types of joint mobilising techniques that are commonly used by physiotherapists and they tend to be named after the physiotherapists who first promoted their use. Most commonly, physiotherapists today use Maitland technique which uses small rhythmic oscillating movements (frequently on the intervertebral joints of the spine), McKenzie technique which utilises the patient’s active range of movement in combination with physiotherapist passive movements and Mulligan technique which moves the joint in a perpendicular or parallel glide in contrast to the patient’s movement.
Extensive research has been performed regarding all of these techniques and their effect in treating joint pain and stiffness is proven as highly valid, which is why joint mobilisation remains one of the most common modalities used by physiotherapists.
Joint mobilisation works by:
- Improving blood supply to the joints by assisting in the blood pumping effect of the venous system which reduces pain, reduces inflammation and promotes better movement.
-Altering the activity of the nervous system to cause less pain sensation in the affected area.
- Stretching the joint structures to achieve greater flexibility and range of motion.
Common conditions that will benefit from joint mobilisation are:
- Adhesive capsulitis (frozen shoulder)
- Tennis elbow or Golfer’s elbow
- Neck and back pain and stiffness
- Post fracture or surgery
- Sports injuries
- Joint replacement
- Joint sprains
And there are just to name a few! Ask your physiotherapist how they can use joint mobilisation to help you overcome joint pain and stiffness.
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