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Joint Mobilization

I often say that joint mobilization is one of the most powerful physical treatment tools that a MT can employ. Yet when I go around the country teaching it at workshops, I get some people who absolutely love it and can't wait to use it Monday morning, and others who are scared by it. Other than Erik Dalton, a fellow name Mike Dixon out of BC, Canada, and myself, I do not know of many CE providers who regularly teach this technique. I often like to draw an analogy between joint mobilization and pin and stretching...
Anyway, I have just published an article on joint mobilization of the lower back in the issue of the mtj that is out now. Please take a look at it. Or if you do not get the mtj, then following is a link to the pdf of the article on my website; it is the top article. There are also two other joint mobilization articles on the articles page of the website as well. One on joint mobilization of the thoracic region and the other on joint mobilization of the neck.
Discussion please...

http://learnmuscles.com/articles.html

Replies to This Discussion

Permalink Reply by Joseph E. Muscolino on December 31, 2009 at 9:08am

Hi Bob (and everyone),

It really helps to see a figure for this (i.e., either see Neumann's or my Kinesiology text), but I will try to describe a scenario as an example. Take flexion of the humerus at the glenohumeral joint. The head of the humerus is convex moving on the concave glenoid fossa. With flexion, the shaft of the humerus moves anteriorly and the head of the humerus rolls forward... and without the backward slide, it would roll anteriorly out of the glenoid fossa. I hope this is visually clear.
Regarding laxity or tautness of associated soft tissues (joint capsule, ligament, muscle), I do not know if there is a usual pattern of increased or decreased roll versus slide. I would think that it would depend upon which aspect of the soft tissue is involved (i.e., its line of direction would determine the increased or decreased motion.
Perhaps someone out there knows if there is a typical pattern of joint dysfunction regarding roll versus slide...?

Robert Downes said:

Hi Joe,

What direction is the Roll of the articular surface in relationship to the direction that the bone is moving (taking the case of one bone moving on a stationary bone)?

Does the direction of the Glide depend upon whether the bone end is convex or concave?

When you have a loss restraint (laxity or tear to the ligamentous, capsular and/or muscular structures) do you tend to get more Roll or more Glide versus the normal Roll/Glide ratio? What about if you have excessive restraint (e.g. a tight muscle and/or tight casule)?

Permalink Reply by Erik Dalton, Ph.D. on December 31, 2009 at 1:12pm

Hey Joe, nice blog and a wonderful contribution of ideas from some of my favorite bloggers. Robert contacted me on Facebook a couple days ago asking if I'd mind if he used some references from my "Short Right Leg" article. I asked him to hold off until I had a chance to chime in. It prompted me to check out this very timely and important blog. Hope to jump in when I get a break. Congratulations for introducing this little-appreciated topic among many massage therapists.

Permalink Reply by Joseph E. Muscolino on December 31, 2009 at 5:30pm

Hey Eric,

Thanks for the compliments.
Yes, aside from you, me, and Mike Dixon out of Canada, it seems that nobody teaches joint mobilization, which can be such a powerful technique for the world of massage therapy.
Please do chime in as soon as you have the time.

Folks, I will be away for about a week without much access to a computer, so please keep discussing these wonderful and interesting topics!

Happy New Year everyone!

Joe

Erik Dalton, PhD said:

Hey Joe, nice blog and a wonderful contribution of ideas from some of my favorite bloggers. Robert contacted me on Facebook a couple days ago asking if I'd mind if he used some references from my "Short Right Leg" article. I asked him to hold off until I had a chance to chime in. It prompted me to check out this very timely and important blog. Hope to jump in when I get a break. Congratulations for introducing this little-appreciated topic among many massage therapists.

Permalink Reply by Robert Downes on January 3, 2010 at 1:57pm

The direction of Roll is always in the same direction that the bone is moving and the contact point between the bones moves in the same dirction as the Roll. The direction of glide however depends on whether that bone is convex or concave.

Usually, if you have a loss of restraint then you get too much Roll. If you have too much restraint then you usually get too much Glide.

Permalink Reply by Joseph E. Muscolino on January 17, 2010 at 5:53pm

Hi all. I have been out of town and am just getting started again. It will probably be until next week that I can be more active again.

Bob, nicely put regarding the roll versus the glide! What is your source for the type of motion that tends to occur with too much and too little restraint?

Robert Downes said:

The direction of Roll is always in the same direction that the bone is moving and the contact point between the bones moves in the same dirction as the Roll. The direction of glide however depends on whether that bone is convex or concave.

Usually, if you have a loss of restraint then you get too much Roll. If you have too much restraint then you usually get too much Glide.

Permalink Reply by Robert Downes on January 21, 2010 at 8:48am

Hi Joe,

We learned about Roll and Glide at the Gray Institute from Dr. Dave Tiberio. One of the things we do with FMR is to try to facilitate a normal Roll/Glide ratio.

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