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Key
Benefits of Spinal and Joints Mobilization
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Mobilization is the passive movement of a joint through its'
physiological ranges of motion. Repetitive passive joint oscillations
at the limit of the joint's available range can have mechanical
effects on joint mobility
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Neurological effects of passive mobilization includes restoration
of nerve and joint function, and reduction in pain via stimulation
of large-fiber joint afferents and associated release of endorphins
- Spinal
and Joint Mobilization
Restricted
joint range of motion can be diagnosed by evaluating "joint
play" (Maigne R., 1997). In the spine joint play is assessed
by applying springing pressure over the spinous processes. Normal
joints allow the spine to deflect in the direction of pressure
with little or no associated pain. The application of pressure
to abnormal joints allows little deflection and causes pain.
As reported in a double blind study, manual diagnosis for zygapophysial
joint pain syndrome can be as accurate as radiologically controlled
diagnostic blocks (Jull G., Bogduk N., et.al., 1988). Joint
restriction could be due to spasm or shortening of surrounding
muscles, shrinking of the joint capsule or entrapment of fat
pads or meniscoides (inner membrane of the joint capsule) between
articular surfaces.
The entire musculoskeletal system behaves as a functionally
linked kinetic chain. A localized tissue injury can produce
functional biomechanical adaptations at locations some distance
from the primary site of injury (Tollison D., et. al; 1994).
This prompts evaluation and treatment of the whole spine, especially
"transition" zones where the spinal curve changes
from lordotic to kyphotic, or from kyphotic to lordotic (Maigne
R., 1997). Pain, muscle
spasm, and joint restriction needing treatment may occur at
a site distant from the original injury.
Treatment of the spinal motion segments (two vertebrae,
one disc, two zygapophysial joints with associated muscles and
ligaments) involves mobilization. Mobilization is the passive
movement of a joint through its' physiological ranges of motion.
Repetitive passive joint oscillations at the limit of the joint's
available range can have mechanical effects on joint mobility,
due to moving the joint tissue into the area of plastic deformation
of the stress-strain curve (Paris S., 1979). Neurological effects
of passive mobilization includes restoration of axonal transport,
and reduction in pain via stimulation of large-fiber joint afferents
and associated release of endorphins (Korr I.M., 1985). Self-mobilization
exercises and postisometric relaxation techniques help maintain
the effects of these office procedures.
