Spinal & Joint Mobilization

Spinal and joint mobilization are manual therapy techniques that involve applying gentle forces to the joints of the spine and other body regions to improve their mobility, reduce pain, and restore function. They are performed by trained physical therapists.

What is spinal and joint mobilization?

Spinal and joint mobilization are based on the principle that joints need to move freely and smoothly to function properly and prevent injury. Sometimes, due to various factors such as trauma, inflammation, posture, or muscle tension, joints can become stiff, restricted, or misaligned. This can cause pain, inflammation, muscle spasm, and reduced range of motion.

Spinal and joint mobilization aim to restore the normal movement of the joints by applying gentle forces in the direction of the restriction. These forces can be oscillating (back and forth) or sustained (held for a period of time), depending on the type and severity of the problem. The amount of force used is also tailored to the patient's comfort level and tolerance.

Spinal and joint mobilization are different from spinal manipulation, which involves a high-velocity, low-amplitude (HVLA) thrust that produces an audible "pop" or "crack". Spinal manipulation is more forceful and may not be suitable for some patients with certain conditions or preferences. Spinal mobilization is gentler and can be controlled by the patient.

What are the benefits of spinal and joint mobilization?

Spinal and joint mobilization have been shown to provide various benefits for patients with musculoskeletal conditions, such as:

Reducing pain by decreasing the sensitivity of the joint tissue and activating pain-inhibitory pathways in the nervous system
Improving range of motion by increasing the flexibility of the joint capsule, ligaments, and muscles
Enhancing joint function by restoring normal biomechanics and alignment
Reducing inflammation by improving blood flow and lymphatic drainage
Relaxing muscles by decreasing spasm and tension
Improving posture by correcting joint imbalances
Preventing further injury by maintaining joint health

Some of the common conditions that may benefit from spinal and joint mobilization include:

Low back pain
Neck pain
Shoulder pain or impingement
Hip osteoarthritis
Knee osteoarthritis
Ankle sprains or instability
Plantar fasciitis
Tennis elbow

What are the risks of spinal and joint mobilization?

Spinal and joint mobilization are generally safe and well-tolerated by most patients. However, as with any manual therapy technique, there are some potential risks and complications that may occur, such as:

Temporary soreness or stiffness after the treatment
Aggravation of existing symptoms or underlying conditions
Injury to the nerves, blood vessels, or soft tissues around the joint
Adverse reactions such as dizziness, nausea, headache, or fainting

To minimize these risks, your physical therapist will conduct a thorough assessment of your medical history, physical examination, and diagnosis to determine if spinal and joint mobilization are appropriate for you. They will also explain the procedure, benefits, risks, alternatives, and expected outcomes to you before starting the treatment.

You should also inform your physical therapist if you have any of the following conditions or situations that may contraindicate spinal and joint mobilization:

Severe osteoporosis or bone fragility
Spinal instability or fracture
Spinal infection or tumor
Inflammatory arthritis or gout
Bleeding disorders or anticoagulant medication use
Pregnancy
Recent surgery or trauma

How is spinal and joint mobilization performed?

Spinal and joint mobilization can be performed in any setting by your physical therapist. The treatment may last from 15 to 30 minutes depending on your condition and goals. You may be asked to wear comfortable clothing that allows access to the affected area.

Your physical therapist will first assess your joint mobility, pain level, range of motion, muscle tone, posture, and function. They will then select the appropriate technique and grade of force to apply to your joint. They will explain what they are going to do and ask for your consent before starting the treatment.

The treatment may involve one or more of the following steps:

Your physical therapist will position you in a comfortable and stable posture, such as lying on your back, side, or stomach, or sitting on a chair or table.
Your physical therapist will use their hands or a device to stabilize one segment of the joint while applying a gentle force to the other segment in the direction of the restriction. The force may be oscillating or sustained, depending on the technique and grade used.
Your physical therapist will monitor your response and feedback throughout the treatment. They will adjust the force, direction, speed, and duration of the mobilization as needed to achieve the desired effect.
Your physical therapist will repeat the mobilization several times until they reach the end point of the joint movement or until you feel a reduction in pain or an improvement in mobility.
Your physical therapist will re-assess your joint mobility, pain level, range of motion, muscle tone, posture, and function after the treatment. They will also provide you with instructions on exercises, stretches, self-care techniques, and lifestyle modifications to maintain your results.

What are the types of spinal and joint mobilization?

There are different types and grades of spinal and joint mobilization that can be used depending on the patient's condition, goals, and preferences. Some of the common types of spinal and joint mobilization are:

Activator method: This technique uses a hand-held, spring-loaded device that delivers a low-force impulse to the joint. It is often used for patients who prefer a gentle approach or have contraindications to spinal manipulation.
Maitland technique: This technique involves applying oscillating forces of varying intensity and frequency to the joint. It is based on a clinical reasoning framework that guides the selection and progression of the treatment.
Mulligan technique: This technique involves applying a sustained accessory force to the joint while the patient performs a pain-free active movement. It is based on the concept of positional faults or minor misalignments of the joint that cause pain and dysfunction.
McKenzie method: This technique involves using repeated movements or sustained postures to centralize or reduce pain that radiates from the spine to the limbs. It is based on the concept of directional preference or specific movements that improve symptoms.
Kaltenborn technique: This technique involves applying accessory forces to the joint in a specific direction and plane. It is based on the concept of arthrokinematics or the movement of joint surfaces relative to each other.

How can you prepare for spinal and joint mobilization?

Before undergoing spinal and joint mobilization, you should:

Inform your physical therapist about any medical conditions, medications, allergies, or previous injuries that may affect your treatment
Wear comfortable clothing that allows access to the affected area
Avoid eating a heavy meal or drinking alcohol before your appointment
Arrive on time and follow the instructions of your physical therapist

What can you expect after spinal and joint mobilization?

After receiving spinal and joint mobilization, you may experience:

Temporary soreness or stiffness in the treated area that usually resolves within 24 hours
Improved mobility, pain relief, and function in the treated area
Increased awareness of your posture and movement patterns
Advice on exercises, stretches, self-care techniques, and lifestyle modifications to maintain your results

You should follow the recommendations of your physical therapist regarding your home exercise program, activity modification, pain management, and follow-up appointments. You should also report any adverse reactions or worsening symptoms to your physical therapist as soon as possible.