• Rob

What is Manual Therapy, Part 3

Welcome to the third of four blog posts of What is Manual Therapy series. This blog post is going to look at techniques that are used more on joints in the body. With techniques below, it does not matter if the joint is in the spine, in your arm or foot. As long as the practitioner has the appropriate knowledge of the anatomy in the area these techniques can be modified to any area of the body. Enjoy!


Mobilization


Mobilizations are techniques that are performed on a joint, in the body. These techniques are done by holding one of the bones, in place, and moving the other bone. This technique uses slow, oscillating movements to get the joint moving. Mobilizations are done by the physiotherapist but are actually controlled by the client. If the client finds the technique uncomfortable, all they have to do to stop the technique is to tense up the area of the body. The physiotherapist cannot perform a mobilization on an area of the body under muscle tension.


Taken from: https://southcoastphysiotherapy.ca/physiotherapy-treatments/manual-therapy/


This technique should be performed in a sequential fashion, something like this. The part of the body is assessed and a particular joint is stiff in a certain direction. It is explained by the physiotherapist to the client what is found, what treatment technique would be beneficial, in this case we are talking about mobilizations, what they should expect to feel, the goal of the treatment and anything risky about the treatment. This is called getting consent, possibly informed consent, from your client. This may seem unimportant but it is actually very important, maybe a blog post down the line. From there treatment can begin. There are five grades of mobilizations, with Grade V being a manipulation, see Part 4. Grades I and II are generally used when the client states that there is more pain limiting the movement then by the stiffness in the joint, itself. Grades III and IV are generally used when the client is limited more by stiffness than pain.


Taken from: https://veteriankey.com/joint-mobilization/



How many/often are mobilizations performed to help a client? In general, it really depends on a person-by-person account, mobilizations are performed for 20-30 seconds, 2-5 times per joint in the direction of restriction. Sometimes they are performed longer or shorter or possibly more times or simply once.


Taken from: https://www.pinterest.ca/pin/815925657464600704/


After a mobilization is completed, the client should be asked to try and move that joint through the new range of motion, ROM, that the joint now has, under their control. This gets the muscles firing, joint receptors working, and joint surfaces lubricated in the newly available ROM. Most of the times, people can gain a lot of ROM from mobilizations. Sometimes after a physiotherapy session, the client may find that the joint gets stuck in the same position it was previously and it can be frustrating for the client. This reoccurring stiffness could be caused by numerous factors, which may be sleeping position, doing too much with in the new ROM and straining the muscles or causing little bits of inflammation or swelling to go into the joints and stiffen them up. Sometimes, this only happens once or twice with a client. Some people, if they have had a stiff neck for a number of months, need more treatments, than someone that comes in right after they notice their neck pain.


After a mobilization is completed, the client should be asked to try and move that joint through the new range of motion, ROM, that the joint now has, under their control. This gets the muscles firing, joint receptors working, and joint surfaces lubricated in the newly available ROM. Most of the times, people can gain a lot of ROM from mobilizations. Sometimes after a physiotherapy session, the client may find that the joint gets stuck in the same position it was previously and it can be frustrating for the client. This reoccurring stiffness could be caused by numerous factors, which may be sleeping position, doing too much with in the new ROM and straining the muscles or causing little bits of inflammatiion or swelling to go into the joints and stiffen them up. Sometimes, this only happens once or twice with a client. Some people, if they have had a stiff neck for a number of months, need more treatments, than someone that comes in right after they notice their neck pain.


All of the physiotherapists at New Leaf Physiotherapy have the ability to perform joint mobilizations on our clients, if the physiotherapist deems it to be appropriate. Please contact us and we would be pleased to discuss this with you.


In the next, and final, part of this series we will discuss adjustments (manipulations) to the joints in our body.



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