How Joint Mobilizations Are Used in Physical Therapy

When you require physical therapy following an injury, illness, or surgery, your therapist may employ various techniques to help you regain strength and relieve pain. 

Physical Therapy

Your therapist may use a hands-on technique called joint mobilization to treat the area around a joint (where two bones come together, such as at your elbow, knee, hip, or wrist). Here’s an overview of this PT approach and when it might be helpful to you.

Joint mobilization is a manual therapy used to reduce pain, increase range of motion (how far you can move a part of your body), and improve function. 

A therapist typically performs this technique by stabilizing one joint segment and applying manual pressure or traction to the nearby section. The applied force is usually directed in a very tight or hypermobile plane to improve overall joint function.

Several types of mobilizations may be used, depending on the patient’s tolerance and the overall goals of the treatment.

How Joint Mobilizations Are Used in Physical Therapy

Joint mobilizations have a variety of uses in physical therapy. Their primary objectives are to alleviate pain and improve joint mobility. Studies have shown that they are effective in achieving the following outcomes for patients:

  • Relieving pain
  • Enhancing the range of motion
  • Enhancing functionality (e.g., For better walking, standing, arm use, etc.)
  • Taking care of joint tension

The mechanisms underlying the effectiveness of joint mobilizations in producing these effects are unknown, and some effects, such as increased mobility, may be transient.

It is known, however, that this approach can make a significant difference for patients suffering from conditions such as the following:

  • Hip and knee osteoarthritis
  • Wrist fractures
  • Plantar fasciitis
  • Tennis elbow
  • Lateral ankle sprains
  • Back pain
  • Neck pain

Types of mobilizations

Joint mobilizations are broadly classified into the following types:

Oscillatory joint mobilization: This involves applying gentle pressure to the joint that is slow (low-velocity) and varies in size (amplitude). This type of mobilization is used at various points along a joint’s available range of motion and is graded based on how well a patient tolerates it.

Sustained joint mobilizations are a type of pulling or traction movement held steady for an extended period. This mobilization is intended to stretch the surrounding soft tissue and reduce joint compression.

Manipulation: A high-speed, low-amplitude thrusting movement is generally applied in the direction of tightness or impaired joint mobility.

A classification scale may be used to more precisely describe the joint mobilizations performed by your therapist on occasion.

The following grades are used to distinguish between the various techniques:

Grade 1: Slow, small-amplitude back-and-forth movements used at the start of a joint’s arc of motion (regular rotational pattern)

Grade 2: Slow, large-amplitude back-and-forth movements are used in the middle section of a joint’s arc of motion.

Grade 3: Slow, large-amplitude back-and-forth movements are applied from the middle to the end of the arc of motion of a joint.

Grade 4: Slow, small-amplitude back-and-forth movements applied to the end of a joint’s arc of motion.

Grade 5: A single, high-velocity, small-amplitude thrusting motion (also known as a manipulation) applied at the end of a joint’s available movement.

Who should NOT be subjected to joint mobilization?

Joint mobilization can be an effective treatment option for patients suffering from joint pain, stiffness, tension, and discomfort. There are, however, better approaches for everyone.

Some of the conditions that may preclude the use of joint mobilization are as follows:

  • Excessive flexibility in the joint
  • Severe osteoporosis
  • Nerve compression
  • Fracture or tumor on the joint
  • Circulatory problems
  • Joint inflammation
  • Severe infection
  • Disk herniation
  • Fused joints

Final thoughts

Joint mobilization is a type of physical therapy that aims to improve or normalize joint function. It can help reduce pain and increase the range of motion. The amount and type of force applied to the joint vary depending on the injury or musculoskeletal pain being treated.

Joint mobilization is only appropriate for some. It should be avoided by people who have osteoarthritis or other inflammatory common conditions, spinal disc problems, or circulatory issues. Alternative therapies, such as tissue massage and electrical stimulation, may be more beneficial.

It can be a frustrating experience to recover from surgery or to deal with musculoskeletal pain. Fortunately, joint mobilizations are one tool in the physical therapy “treatment toolbox” that may help alleviate your symptoms.

Speak with your healthcare provider to determine if PT and joint mobilization are right for you. Following a thorough examination, your doctor can provide you with treatment options and assist you in weighing the potential costs and benefits.