What are mobilization techniques?
What are mobilization techniques?
By Dr Daniel Rocha DN LMT CPT CNS
Manipulative and mobilization techniques are a category of manual therapy. Mobilization is a treatment technique involving the application of force to mimic the gliding that occurs between bones. It is a passive movement, used to produce a slide or glide. Mobilizations are completed at slow speed, with oscillations, and a stretch. Manipulations are an aggressive, fast, high-velocity thrust, occurring at the end of available joint play.
Mobilizations are used when range of motion or mobility is lacking, as they restore joint play lost due to injury or disease. Gentle oscillations within the available joint play range is a technique used to decrease pain. The purpose of manipulations, or joint thrusts, is to increase the available range, and to break adhesions that disrupt joint movement. They are quick movements beyond the available joint play range.
Peripheral joint mobilization is the mobilization of the joints of the limbs. There is a grading system for completing mobilizations based on how much joint play is available. The clinician must know what the total range is by examination through passive movement.
”The first common mobilization techniques are sustained joint play movements that have three grades.
Grade 1
The clinician applies passive movement at 15%–25% of the available joint play range.
Grade 2
Bone is passively moved at 50% of the available joint play range.
Grade 3
The passive force causes one bone to move on the other to the end of the available joint play range.” (Ross 2018)
These mobilizations aid in decreasing pain and increasing mobility. Stretching mobilizations are used for pain management and stretching, where the stretch or “hold” is approximately five to seven seconds.
Oscillatory mobilizations have five grades associated with them. Grades 1–2 are used to decrease pain within a joint. Grades 3–4 are used to increase mobility of joint play. Grade 5 mobilization is really a manipulation.
”The following are grades for oscillatory mobilizations:
Grade 1
Slow oscillations within the first 20%–25% of the available joint play range.
Grade 2
Slow oscillations within 45%–55% of the available joint play range, or from the beginning to the middle of available joint play range.
Grade 3
Slow oscillations from the middle of the available joint play range to the end of available joint play range.
Grade 4
Slow oscillations at the end of the available joint play range.
Grade 5
Bone is passively moved to the end-range, and a fast thrust is performed. This is manipulation.” (Ross 2018)
Mobilization reduces pain and restores joint play. Manipulations release adhesions and are done under anesthesia by a medical physician. Patients who undergo mobilization need to be monitored for pain and any inflammation after treatment. Patients having manipulation done to restore joint mobility, such as after a total knee replacement, need to be more closely monitored for pain and inflammation. Most manual therapy is done by physical therapists as the education to conduct forceful or thrust manipulations are becoming part of physical therapy education and post-education.
Kisner, C., & Colby, L. A. (2013). Therapeutic exercise: Foundations and techniques. Philadelphia: F.A. Davis.
Ross, M. D. (2018). Joint Mobilization and Manipulation. In J. L. Longe (Ed.), The Gale Encyclopedia of Nursing and Allied Health (4th ed., Vol. 4, pp. 1979-1981). Farmington Hills, MI: Gale. Retrieved from https://link.gale.com/apps/doc/CX3662600633/HWRC?u=lirn33148&sid=HWRC&xid=360ebeae