Our bodies are able to move because we have articulation or joints, where one bone meets another. Multiple factors can contribute to reduced joint function including injury, contracted muscles, overuse, and the aging processes. Joint mobilization is a type of passive movement of a skeletal joint. It is usually aimed at a ‘target’ synovial joint with the aim of achieving a therapeutic effect.
There is a grading system for completing joint mobilizations. The grading system is based on how much joint play is available. Thus, the clinician must know what the total range is by examination through passive movement. Furthermore, there are stretching mobilizations used for pain management and stretching. The most common mobilization technique employed by manual therapists is termed oscillatory mobilization. These mobilizations aid in decreasing pain and increasing mobility. There are five grades associated with them. Grades one to two are used to help decrease pain within a joint. Grades three to five are used to increase mobility of joint play.
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 more properly known as joint manipulation and is typically performed by Chiropractors or Osteopaths.
Massage Therapy scope of practice includes joint mobilization. We are licensed to perform grades one through four. A massage therapist never performs grade 5 manipulations; rather the more gentle grades are employed to achieve the same effect in a manner that gives the muscles tendons and ligaments time to adjust to the new range of movement. Joint mobilization is used extensively on virtually all joints of your body and is typically a part of most treatments performed in this clinic. It also very effective in treating:
Frozen shoulder (adhesive capsulitis)
Ankle and wrist issues
Mild Arthritic pain
Reduced range of motion in:
Virtually any joint in the body