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ABSOLUTE contraindications to joint mobs (6)
Malignancy (cancer) of targeted region
Recent or unhealed fx
Red flag symptoms
Unstable upper C spine
Bony block confirmed w imaging (fusion or ankylosis)
Cervical arterial dysfunction
Describe cervical arterial dysfunction. Symptoms generally look like what condition?
Disturbance of function of cervical arteries
Symptoms look like stroke symptoms
Relative contraindications to joint mobs (4)
Acute inflammation, radiculopathy, infection, TB
Osteoporosis
Pregnancy
BC use and blood clotting disorders
If pain is reported prior to clinician feeling tissue resistance...
STOP: Don't mobilize into resistance
Red light
Use grade I or II
If pain is reported at the same time clinician feels tissue resistance...
Proceed with caution: Reassess after using grade I or II
Yellow light
If pain is reported after tissue resistance OR only w end range overpressure...
GO: Use grades III and IV
Green light
If patient has pain, describe the speed, frequency, and reps of mobs to use
Speed: Slow
Frequency: Smooth rhythmic (1Hz)
Reps: Few
If patient has restriction or stiffness, describe the speed of mobs to use
Faster speed (2-3 Hz)
Describe the rhythm to be used with ALL grades of joint mobs
Should be performed in smooth rhythmical manner w/o sudden change in direction or speed
Timeline for oscillatory techniques (how long to use them per rep, how many reps)
30 sec treatments
Repeat bouts of 30 sec for 1-2 min per technique
Timeline for sustained techniques (how long should I hold?)
5-10 sec per rep, increasing to 30 sec or longer as tolerated
May eventually hold up to 2-3 min
Convex on concave joint motions
Roll and glide in OPPOSITE directions
Concave on convex joint motions
Roll and glide in SAME direction
List out steps of performing joint mob (4)
1. Stabilize joint and surface
2. Distract and glide
3. Test ROM before and after procedure
4. Assess response
Direction of humerus roll and glide during shoulder abduction
Rolls superiorly
Glides inferiorly
Direction of humerus roll and glide during shoulder ER
Rolls posteriorly
Glides anteriorly
Humerus movement during shoulder flexion and extension
Humerus spins on glenoid fossa
Frontal plane movements of SC joint
Elevation and depression
Transverse plane movements of SC joint
Retraction and protraction
Longitudinal movements of SC joint
Axial rotation
Clavicle roll and glide during SC elevation
Rolls superiorly
Glides inferiorly
Clavicle roll and glide during SC depression
Rolls inferiorly
Glides superiorly
Clavicle roll and glide during SC retraction
Rolls posteriorly
Glides posteriorly
Clavicle roll and glide during SC protraction
Rolls anteriorly
Glides anteriorly
