Spinal Manual Therapy

Spinal Joint Mobilization

 Spinal Joint Mobilization
 Result of the following observation
1. See and measure decreased active movement
2. Feel the restricted joint play in the associated
joint
3. Pain
4. Postural / biomechanical dysfunction
5. Mobilization – increase active movement,
increase passive joint play and pain
6. Diagnostic accuracy and treatment effectiveness
 Goals
 Pain-relief mobilization - To ease severe pain,
spasm, and paraesthesia, and to help
normalize joint fluid viscosities that interfere
with movement.
 Relaxation mobilization - To relax muscles,
decrease pain and facilitate movement ease.
 Stretch mobilization and manipulation (quick
mobilization) To stretch shortened joint tissues,
increase ROM and correct positional faults
 Mobilization Techniques
 Pain-relief mobilization – I and II SZ – actual
resting position
 Relaxation mobilization – grade I and II –
actual resting position
 Stretch mobilization – III – actual resting
position and at the point of restriction
 Manipulation – quick mobilization – III – thrust
 Pain Relief Mobilization
 Pain relief traction mobilization- grade I-II SZ
 Vibration and oscillations – grade I-III
 Relaxation Mobilization
 Glide
 Traction
 Grade I and II
 Stretch Moblization
 Sustain stretch – 7 seconds – 1 minute or
longer , 30-40 seconds on mobilization belt
large joints – 15 minutes cyclic , time is more
important than amount of force – patient
response
 Preparation for sustain stretch
 Stretch traction mobilization
 Stretch glide mobilization
 Stretch traction
mobilization
 Stretch glide
mobilization
 Manipulation
 Risks, indications and contraindication
 Linear thrust versus rotatory thrust
 Linear thrust – traction / glide
 Linear Thrust initiated from actual resting
position – quick impulse (thrust) to a joint
showing suitable end feel to effect joint
separation, and restore Translatoric glide
 Misconception about manipulation and grade
III stretch moblization
 Avoid high Risk Manual Treatments
 If traction exacerbates symptoms:
1. Adjust joint position
2. Reduce traction force
3. Correct an understanding positional fault
4. Discontinue traction treatment
 Rotation Mobilization
 Avoid
 Can be effective in some cases – lumber fact
joint Arthrosis in elderly , but could be
dangerous
 Quick results, easy to perform
 Always misused by novice practitioners
 Disc problem, artery involvement , nerve
irritation
 Joint Compression
 Avoid joint compression techniques
 Easily aggravate joint condition – swelling
additional injury
 Direct and indirect compression
 Cartilage regeneration
 Normal compression DJD
 Compression – pain
 Active assisted
 Compression – pain –traction
 Joint compression test