Peripheral Joint
Mobilization
CONTENTS Basic Concepts of Joint Motion
Indications & Limitations of PJM
Contraindications & Precautions
Grading & Dosage of Movement
Basic
Concepts of
Joint Motion
Definition
Peripheral Joint Mobilization
◦ Peripheral Joint Manipulation
◦ Manual therapy techniques used to modulate
pain and treat joint impairments that limit range
of motion by specifically addressing the altered
mechanics of the joint.
Basic Concepts of Joint Motion
Definition
High-Velocity Thrust
◦ High-velocity, short-amplitude techniques
◦ Performed at the end of the pathological limit
(available ROM w/restrictions) of the joint
◦ Alter positional relationships, snap adhesions, or
stimulate joint receptors.
Basic Concepts of Joint Motion
Arthrokinematics
◦ Movement of joint’s articulating surfaces.
Basic Concepts of Joint Motion
Arthrokinematics
ROLL
◦ New points on one surface meet
new points on the opposing surface.
◦ Rolling is always in the same
direction as the swinging bone
motion whether the surface is
convex or concave.
Basic Concepts of Joint Motion
Arthrokinematics
SLIDE
◦ The same point on one surface
comes into contact with the new
points on the opposing surface.
◦ Pure sliding does not occur in joints
because the surfaces are not
completely congruent.
Basic Concepts of Joint Motion
Basic Concepts of Joint Motion
Arthrokinematics
SPIN
◦ The same point on the moving
surface creates an arc of a circle as
the bone spins.
◦ Spinning rarely occurs alone in joints
but in combination with rolling and
sliding.
Basic Concepts of Joint Motion
Arthrokinematics
Other accessory motions that affect the joint:
1. Compression – normally occurs on joints subjected
to weight-bearing actions.
2. Traction – longitudinal pull (A).
3. Distraction – separation of joint’s articulating
surfaces (B).
Basic Concepts of Joint Motion
Arthrokinematics
Effects of Joint Motion
◦ Stimulate biological activity in the joint.
◦ Maintenance of articular and periarticular tissues’
extensibility and tensile strength & prevents
adhesion.
◦ Provides awareness of position & motion.
Basic Concepts of Joint Motion
Indications
& Limitations
Indications
Pain, Muscle Guarding, Spasm
Reversible Joint Hypomobility
Positional Faults/Subluxations
Progressive Limitations
Functional Immobility
Indications & Limitations
Limitations
Joint techniques cannot change
the disease process of disorders
Patients must be properly
examined before application of
PJM.
Indications & Limitations
Contraindications
and Precautions
Contraindications
Hypermobility
Joint Effusion
Inflammation
Contraindications and Precautions
Precautions
Malignancy
Detectable Bone Dse
Unhealed Fx
Excessive Pain
Total Joint Replacement
Contraindications and Precautions
Grading &
Dosage of
Movement
Grading & Dosage
Oscillation Techniques
◦ I – SARO, beginning of ROM
◦ II – LARO, w/in the ROM
◦ III – LARO, upto the limit of available
ROM; Stressed into tse resistance
◦ IV – SARO, at the limit of available ROM;
Stressed into tse resistance
Grading & Dosage of Movement
Grading & Dosage
Sustained Joint Play Techniques
◦ I – Loosen, small amplitude distraction,
no stress placed on the capsule.
◦ II – Tighten, taking up the slack
◦ III – Stretch, large amplitude distraction,
joint capsule is stretched.
Grading & Dosage of Movement
Oscillation and
Distraction Techniques
Grading & Dosage of Movement
Grading & Dosage of Movement
Peripheral Joint
Mobilization
REFERENCE(S):
K I S N ER , C . , & C O L B Y , L . A . (N . D . ) . C HA P T E R 5 : P E R I PH E R A L J OI N T
M O BI LI ZA TI O N/ M A NI P UL A TI O N . I N TH E R A PE U TI C E X ER CI S E:
F O U N DA TI O N S A N D T E C HN I QU E S . F A D A VI S C O M P A N Y.
