MOBILIZATION
Patel Dharti J.
3rd Year,BPT
Definition
• They are passive,skilled manual
therapy technique applied to joints
and related soft tissue at varying
speed and amplitude using
physiological and accessory motions
for therapeutic purpose.
Types of motion
1. Roll
2. Slide/translation
3. Spin
Roll
• The surface is Incongruent.
• New point of one surface
come in contact with new
point of another surface.
• Direction of rolling is same
in convex and concave
surface.
Slide / Translation
• The surface must be congruent.
• The same point of one surface
come in contact with new point
of another surface.
• Direction of sliding depends
on whether surface is convex
or concave.
CONVEX-CONCAVE RULE
• When moving
surface is convex,
then sliding occurs
in opposite
directions.
• when moving
surface is
concave , Then
sliding occurs
in Same
directions.
Spin
• There is rotation of segment about
stationary mechanical axis.
• for example,
1. Shoulder flexion / extension
2. Radiohumeral joint - pronation /
supination
INDICATION
1. Pain, Muscle Guarding, and Spasm
2. Reversible joint Hypomobility
3. Positional Fault / Subluxations
4. Progressive Limitation
5. Functional Immobility
CONTRAINDICATIONS
1. Hypermobility
2. Joint Effusion
3. Inflammation
Precautions
1. Malignancy
2. Bone Disease
3. Unhealed Fracture
4. Excessive Pain
5. Hypermobility in associated joints
6. Total joint replacement
7. weakened connective tissue
8. Elderly individual
Procedure for applying passive joint
techniques
1. Examination and Evulations
1. Documentation
2. Grades and Dosage of movement
3. Positioning and Stabilization
4. Directions and target of treatment
5. Initiation and progression of treatment
6. Patient response
7. Total program
Grades of
mobilization
1.Non-Thrust Oscillation Technique
2.Non-Thrust Sustained Joint-play
Technique
1.NON-THRUST Oscillation
Technique
• MAITLAND GRADING
GRADE 1. Small Amplitude, Rhythmic
Oscillations
Performed at the beginning of the
range.
GRADE 2. large Amplitude, Rhythmic
Oscillations
GRADE 3. Large Amplitude, Rhythmic
Oscillations, Performed up to available motion
and are stressed into tissue resistance.
GRADE 4. Small Amplitude, Rhythmic
Oscillation, Performed at the limit of available
motion and stressed into tissue resistance.
• Indication
GRADE 1 AND 2. pain relief
GRADE 3 AND 4. stretching Maneuver
Non - Thrust Sustained
Joint-play Technique
• KALTENBORN GRADING
GRADE 1. (LOOSEN)
Small amplitude Distraction
No stress over the Capsule.
GRADE 2. (TIGHTEN )
Enough Distraction
To tighten tissue around the
GRADE 3. (STRETCH)
Large Amplitude Distraction
To Stretch the joint capsule.
INDICATION
GRADE 1 and 2. Pain Relief
GRADE 3. Stretch the joint
And to increase joi
Direction of Force
• TREATMENT PLANE - Middle of
Concave articular surface.
• DISTRACTION - Perpendicular
to treatment plane.
• GLIDING - Parallel to treatment
plane.
ELBOW AND FOREARM
MOBILIZATION
1. Humeroulnar Articulation
Humeroradial Articulation
Proximal Radioulnar joint
Distal Radioulnar joint
Humeroulnar Articulation
• Convex trochlea articulate with
Concave olecranon fossa.
• RESTING POSITION - Elbow flexed
70
Forearm
Supinated 10
• TREATMENT PLANE - olecranon
fossa
• STABILIZATION - Fixate humerus
Humeroulnar Distraction
• Indication - increase flexion or extensi
Humeroulnar Distal glide
• Indication - To increase
Flexion.
• Humeroulnar radial glide
• Indication - To increase varas
• Humeroulnar ulnar glide
• Indication - To increase valgus
Humeroradial Articulation
• Convex capitulam articulate
with Concave radial head.
• RESTING POSITION - Elbow is
extended
Forearm is
Supinated.
• TREATMENT PLANE - radial head
• STABILIZATION - fixate the
Humeroradial Distraction
• Indication - To increase
mobility joint
Humeroradial Dorsal/Volar
glides
• Indication -
• Dorsal glide to
increase Extension.
• Volar glide to
increase Flexion.
Humeroradial Compression
• Increase - To reduced a pulled elbow
Proximal Radioular Joint
• The convex rim of the radial head
articulation with the Concave
radial notch on the ulna.
• RESTING POSITION - Elbow is
flexed 70
Forearm
Supinated 35
• TREATMENT PLANE - radial notch
of ulna
Proximal Radioulnar
Dorsal/volar glides
• Indication -
• Dorsal glide
to increase
Pronation.
• Volar glide
to increase
Supination.
Distal Radioulnar joint
• The Concave ulnar
notch of the radius
articulates with the
Convex head of the
ulna.
• RESTING POSITION -
Forearm Supinated
10
• TREATMENT PLANE -
radius articulating
suface
• STABILIZATION -
Distal Radioulnar
Dorsal/Volar Glides
• Indication -
• Dorsal glide to
increase
supination.
• Volar glide to
increase
pronation.
