PERIPHERAL JOINT MOBILIZATION JOINT PLAY

• Describes the motions that occur between the joint

DEFINITION
surfaces and also the distensibility or “give” in the
• Used to modulate pain joint impairments that limit
joint capsule, which allows the bones to the move.
range of motion (ROM) by specifically the altered
• The resting position are terms that describe the
mechanics of the joint.
position of the joint where the greatest mobility is
• Joint mobilization stretching techniques differ from
possible. Where the least amount of tension is
other forms of passive of self-stretching that they
placed on the joint capsule and supporting
specifically address restricted capsular tissues by
ligaments. This position is typically used for testing
replicating normal joint mechanics while
used for testing joint play and for applyinh the
minimizing abnormal compressive stresses on the
initial mobilization treatment.
articular cartilage in the joint.

BASIC CONCEPTS OF ARTHROKINEMATICS

PRINCIPLES
TYPES OF MOTIONS
• Thrust manipulation/HVT refers to high-velocity,
short-amplitude techniques. • The movement of the bony lever is called wing and
the thrust is performed at the end of t;he is classically described as flexion, extension,
pathological limit of the joint and is intended after abduction, adduction, and rotation
positional relationships, snap adhesions, or • Motion of the bone surfaces in the joint is a
stimulate joint receptors. variable combination of rolling and sliding , or
• Self-mobilization refers to self-stretching spinning
techniques that specifically use joint traction or
glides the direct the stretch force to the joint ]INDICATIONS AN LIMITATIONS
capsule. • Pain, muscle guarding, and spasm
• Mobilization with movement (MWM) is the • Reversatile joint hypomobility
concurrent applications of sustained accessory • Positional faults/sublaxations
mobilization applied by a therapist and an • Progressive limitations
physiological movement to end-range applied by • Functional immobility
the patient.
• Physisolojgical movements are movements the
patient can do voluntarily. CONTRAINDICATIONS
• Accessory movements are movements in the joint • Hypermobility
surrounding tissues that are necessary or normal
• Joint effusion
ROM but that cannot be actively performed by the
• Inflammation
patient.

PROCEDURES FOR APPLYING PASSIVE JOINT

COMPONENTS MOTIONS
TECHNIQUE
• These are motions that accompany active motion
• Quality of pain
buta are not under lvoluntary control
• Capsule restriction
• Sublaxation or Dislocation
NON-THRUST OSCILLATION TECHNIQUES the dosage or duration until the pain is under
control.
• The patient’s joint and ROM should be reassessed
after treatment and again before the next
treatment. Alternations in treatment are dictated
by the joint response.

PATIENT RESPONSE
• Stretching maneuvers usually cause soreness.
Perform the maneuvers on alternate days to allow
the soreness to decrease and tissue healing to
occur between stretching sessions. The patient
should perform ROM into any newly gained range
during this time.
• If there is increased pain lasting longer than 24
hours after stretching. The dosage (amplitude) or
duration of treatment was too vigorous. Decrease