Joint Mobilisation is a term used to describe a collection of manual therapy techniques that are concerned with passive maneuvering of the surfaces of a particular joint in the body. Joint mobilisation techniques have been developed for all of the major joints of the body. As a general rule, there are two main categories of joint mobilisation techniques.
- Those that produce passive accessory motion in a joint
- Those that produce passive physiological motion in a joint
Accessory mobilisation techniques involve the passive maneuvering of joint surfaces in the direction of the joint’s “accessory glide” capacity. The accessory motion at a given joint is dictated by the joint’s arthokinematics. Physiological mobilisation techniques involve the passive maneuvering of a joint through it’s physiological planes of motion, without any particular attention or force directed to the accessory glides of the joint in question. Traditionally, among the manual therapy professions, the prevailing view has been that symptoms such as joint pain or stiffness can be reduced or resolved by mobilisation techniques that restore either (or both) a joint’s accessory and physiological motion. The purported mechanism of action by which these mobilisation techniques bring about these reductions in symptoms has been challenged by research emerging over past couple of decades. Traditionally the thinking was that the passive maneuvering of a joint led to a degree of stretching of joints tissues that “freed up” the joint and allowed it to move more easily, with less adverse tension on joint structures, thus resulting in decreased pain.
In the light of more recent research related to the neurophysiology of pain, it seems more sensible to include in our explanatory narrative the notion that when joint mobilisation techniques help to reduce or resolve a patient’s symptoms, there has been a “letting go” of protective motor programming by the patient’s central nervous system. In other words, the mobilisation intervention helped to trigger a shift from a “protective” state to a “relaxed state”, such that joint motion occurs more easily and joint tissues, muscles and nerve pathways are more easily perfused by fresh blood flow- setting the scene for a reduction in pain being experienced in the joint.
Joint mobilisation is a safe form of manual therapy that can be of tremendous use to anyone who is dealing with ongoing pain or other symptoms. It is probably most useful for clinical scenarios in which a patient has suffered a joint sprain, muscle strain or simply a nagging aching or stiffness. Essentially, in any scenario where your central nervous system has decided to “protect” a particular joint, by driving a defensive motor program, joint mobilisation techniques are likely to help. If there happens to also be some pathology within the joint in question, such as arthritic, or structural wear and tear changes, joint mobilisation techniques may only provide limited benefit. For other clinical presentations, such as some chronic pain or inflammatory conditions a particular focus on passive joint maneuvering is unlikely to be directly useful. There is always the possibility however, that overlaying some of these chronic conditions is a degree of joint immobility that is amenable to joint mobilisation.
In our clinic, the decision to utilise joint mobilisation as a treatment intervention is guided by our assessment of your symptoms and the undoubtedly unique story that led to their emergence. If you’re interested in learning more about how we might be able to assist you with your symptoms or rehabilitation, feel free to speak with us on 0296659667