Orthopedic joint mobilization and manipulation : an evidence-based approach

272 Pages·2019·30.691 MB·English

by  Janice Kaye Loudon, Michael P. Reiman, B. J. Lehecka, Robert C. Manske

ORTHOPEDIC JOINT MOBILIZATION
AND MANIPULATION
AN EVIDENCE-BASED APPROACH
Robert C. Manske, PT, DPT, MEd, SCS, ATC, CSCS
Wichita State University
B.J. Lehecka, DPT
Wichita State University
Michael P. Reiman, PT, DPT, MEd, OCS, SCS, ATC,
FAAOMPT, CSCS
Duke University Medical Center
Janice K. Loudon, PT, PhD, SCS, ATC, CSCS
Rockhurst University
Library of Congress Cataloging-in-Publication Data
Names: Manske, Robert C., author. | Lehecka, B. J., 1982- author. | Reiman,
Michael P., 1965- author. | Loudon, Janice K. (Janice Kaye), 1959- author.
Title: Orthopedic joint mobilization and manipulation : an evidence-based
approach / Robert C. Manske, B.J. Lehecka, Michael P. Reiman, Janice K.
Loudon.
Description: Champaign, IL : Human Kinetics, [2019] | Includes
bibliographical references and index.
Identifiers: LCCN 2017023781 (print) | LCCN 2017023190 (ebook) | ISBN
9781492544968 (e-book) | ISBN 9781492544951 (print)
Subjects: | MESH: Manipulation, Orthopedic--methods | Joints--physiology |
Manipulation, Spinal--methods | Range of Motion, Articular--physiology |
Evidence-Based Medicine
Classification: LCC RD731 (print) | LCC RD731 (ebook) | NLM WB 535 | DDC
617.4/7--dc23
LC record available at https://lccn.loc.gov/2017023781
ISBN: 978-1-4925-4495-1 (print)
Copyright © 2019 by Robert C. Manske, B.J. Lehecka, Michael P. Reiman, Janice K. Loudon
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E6967
CONTENTS
Treatment Finder v
Preface ix
Acknowledgments xi
PART I Introduction
CHAPTER 1 Basic Science Behind Joint Mobilization and Manipulation . . . 3
History and Legislation 3
Mobilization and Manipulation 4
Joint Congruency and Position 5
Joint Movements 5
Convex and Concave Rules 5
Effects of Mobilization and Manipulation 6
Evidence for Joint Mobilization 8
Summary 8
CHAPTER 2 General Application Guidelines . . . . . . . . . . . . . . . . . 9
General Examination 9
End-Feels 10
Capsular Patterns 10
Clinical Application of Joint Thrusts and Nonthrusts 11
Safety and Risk of Injury 11
Contraindications and Precautions for Thrust and Nonthrust Techniques 11
Summary 12
PART II Mobilization and Manipulation of the Craniomandibular
Complex and Spine
CHAPTER 3 Temporomandibular Joint . . . . . . . . . . . . . . . . . . . 15
Anatomy 15
Joint Kinematics 16
Treatment Techniques 19
CHAPTER 4 Cervical Spine. . . . . . . . . . . . . . . . . . . . . . . . . . 23
Anatomy 23
Joint Kinematics 24
Treatment Techniques 29
CHAPTER 5 Thoracic Spine . . . . . . . . . . . . . . . . . . . . . . . . . 45
Anatomy 45
Joint Kinematics 46
Treatment Techniques 48
CHAPTER 6 Lumbar Spine and Pelvis . . . . . . . . . . . . . . . . . . . . 57
Anatomy 57
Joint Kinematics 59
Treatment Techniques 64
iii
Contents
PART III Mobilization and Manipulation of the Upper Extremity
CHAPTER 7 Shoulder Joint . . . . . . . . . . . . . . . . . . . . . . . . . 83
Anatomy 83
Joint Kinematics 86
Treatment Techniques 92
CHAPTER 8 Elbow Joint . . . . . . . . . . . . . . . . . . . . . . . . . . .109
Anatomy 109
Joint Kinematics 113
Treatment Techniques 117
CHAPTER 9 Wrist and Hand . . . . . . . . . . . . . . . . . . . . . . . . .125
Anatomy 125
Joint Kinematics 129
Treatment Techniques 133
PART IV Mobilization and Manipulation of the Lower Extremity
CHAPTER 10 Hip Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
Anatomy 159
Joint Kinematics 161
Treatment Techniques 165
CHAPTER 11 Knee Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Anatomy 173
Joint Kinematics 177
Treatment Techniques 182
CHAPTER 12 Ankle Joint . . . . . . . . . . . . . . . . . . . . . . . . . . .193
Anatomy 193
Joint Kinematics 194
Treatment Techniques 198
CHAPTER 13 Foot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207
Anatomy 207
Joint Kinematics 209
Treatment Techniques 213
Appendix: Self-Mobilizations 231
References 247
Index 253
About the Authors 259
iv
Hip Joint
TREATMENT FINDER
Temporomandibular Joint Thoracic Spine
Inferior (Caudal) Glide . . . . . . . . . . . . . . . . . . . .19 Central Posterior-Anterior Nonthrust . . . . . . . . 48
Anterior (Ventral) Glide . . . . . . . . . . . . . . . . . . .19 Unilateral Posterior-Anterior Nonthrust . . . . . . 48
Medial Glide . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Upper Thoracic Thrust . . . . . . . . . . . . . . . . . . . 49
Lateral Glide . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Mid-Thoracic Bilateral Thrust . . . . . . . . . . . . . . 49
Medial/Lateral Glide (Extra-Oral) . . . . . . . . . . . 21 Mid-Thoracic Unilateral Thrust . . . . . . . . . . . . . 50
Mid-Thoracic Prone Rotator Thrust . . . . . . . . . 50
Thoracic Rotation Glide . . . . . . . . . . . . . . . . . . .51
Cervical Spine
Thoracic Flexion Glide . . . . . . . . . . . . . . . . . . . .51
General Cervical Spine Thoracic Extension Glide . . . . . . . . . . . . . . . . . 52
Seated Distraction . . . . . . . . . . . . . . . . . . . . . . 29 Costotransverse Nonthrust . . . . . . . . . . . . . . . 52
Supine Distraction . . . . . . . . . . . . . . . . . . . . . . 29 Seated First Rib Nonthrust Glide . . . . . . . . . . . 53
Upper Cervical Distraction . . . . . . . . . . . . . . . . 30 Supine First Rib Nonthrust Glide . . . . . . . . . . . 53
Upper Rib Nonthrust . . . . . . . . . . . . . . . . . . . . 54
Occipitoatlantal (C0-1) Joint
Lower Rib Nonthrust . . . . . . . . . . . . . . . . . . . . 54
Unilateral Occipitoatlantal (C0-1) Distraction . . .31
Occipitoatlantal (C0-1) Flexion . . . . . . . . . . . . . 32
Lumbar Spine and Pelvis
Prone Occipitoatlantal (C0-1) Posterior to
Anterior Glide . . . . . . . . . . . . . . . . . . . . . . 33
Lumbar Spine
Atlantoaxial (C1-2) Joint
Hook-Lying Nonthrust Distraction . . . . . . . . . . 64
Supine Atlantoaxial (C1-2) Rotation . . . . . . . . . 34
Sitting Nonthrust Distraction . . . . . . . . . . . . . . 64
Seated Atlantoaxial (C1-2) Rotation . . . . . . . . . 34
Side-Lying Nonthrust Distraction . . . . . . . . . . 65
Prone Atlantoaxial (C1-2) Posterior to Anterior
Glide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Quadruped Flexion Glide . . . . . . . . . . . . . . . . 65
Side-Lying Flexion Glide . . . . . . . . . . . . . . . . . 66
C2-3 Joint
Side-Lying Extension Glide . . . . . . . . . . . . . . . 66
Prone C2-3 Posterior to Anterior Glide . . . . . . 36
Posterior-Anterior Nonthrust . . . . . . . . . . . . . . .67
Typical Cervical Spine (C3-7) Joint
Cranial Glide Distraction . . . . . . . . . . . . . . . . . .67
Cervical Flexion . . . . . . . . . . . . . . . . . . . . . . . . 37
Cranial Glide Approximation . . . . . . . . . . . . . . 68
Cervical Extension With Deltopectoral
Prone Gapping Glide . . . . . . . . . . . . . . . . . . . . 68
Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Side-Lying Gapping Glide . . . . . . . . . . . . . . . . .69
Cervical Extension . . . . . . . . . . . . . . . . . . . . . . 38
Prone Sidebending Glide . . . . . . . . . . . . . . . . . .69
Unilateral Down and Back . . . . . . . . . . . . . . . . 38
Side-Lying Sidebending Glide (“Breaking the
Unilateral Down and Back Grade V
Bread”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
(Downslope Thrust) . . . . . . . . . . . . . . . . . . 39
Lumbar Gapping Thrust . . . . . . . . . . . . . . . . . . .70
Unilateral Up and Forward . . . . . . . . . . . . . . . . 39
Lumbar Down-and-Back Thrust . . . . . . . . . . . . .71
Unilateral Up and Forward Grade V
(Upslope Thrust) . . . . . . . . . . . . . . . . . . . . 40 Pelvis
Central Posterior to Anterior Glides . . . . . . . . 40 Posterior Innominate Rotation . . . . . . . . . . . . . 72
Unilateral Posterior to Anterior . . . . . . . . . . . . .41 Anterior Innominate Rotation . . . . . . . . . . . . . . 72
v
Treatment Finder
Prone Outflare Glide . . . . . . . . . . . . . . . . . . . . 73 Ventral Glide . . . . . . . . . . . . . . . . . . . . . . . . . .102
Supine Outflare Glide . . . . . . . . . . . . . . . . . . . 73 Scapulothoracic Joint
Inflare Glide . . . . . . . . . . . . . . . . . . . . . . . . . . . .74 Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . .103
Inferior Innominate Glide . . . . . . . . . . . . . . . . . .74 Cranial Glide . . . . . . . . . . . . . . . . . . . . . . . . . .103
Superior Innominate Glide . . . . . . . . . . . . . . . . .75 Caudal Glide . . . . . . . . . . . . . . . . . . . . . . . . . 104
Inferior Pubic Glide . . . . . . . . . . . . . . . . . . . . . .75 Lateral Glide . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Superior Pubic Glide . . . . . . . . . . . . . . . . . . . . .76 Medial Glide . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Bilateral Sacral Sidebending Glide . . . . . . . . . .76 Lateral Rotation . . . . . . . . . . . . . . . . . . . . . . . 105
Unilateral Sacral Sidebending Glide . . . . . . . . 77 Medial Rotation . . . . . . . . . . . . . . . . . . . . . . . 106
Sacral Rotation for a Posteriorly Sheared
Sacrum . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Elbow Joint
Sacral Rotation for an Anteriorly Sheared
Sacrum . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
Joint Mobilization for the Elbow
Supine Sacroiliac Thrust . . . . . . . . . . . . . . . . . . .78
Distraction, Loose Packed Position . . . . . . . . .117
Side-Lying Sacroiliac Thrust . . . . . . . . . . . . . . . 79
Medial Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .117
Lateral Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .118
Shoulder Joint
Medial Gap . . . . . . . . . . . . . . . . . . . . . . . . . . . .118
Lateral Gap . . . . . . . . . . . . . . . . . . . . . . . . . . . .119
Glenohumeral Joint
Humeroradial Joint
Distraction, Loose Packed Position . . . . . . . . . 92
Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . .120
Lateral Distraction, in Flexion . . . . . . . . . . . . . 92
Compression . . . . . . . . . . . . . . . . . . . . . . . . . .120
Inferior Glide, Loose Packed, Supine . . . . . . . . 93
Radial Dorsal Glide . . . . . . . . . . . . . . . . . . . . . .121
Inferior Glide, Loose Packed, Sitting . . . . . . . . 93
Radial Ventral Glide . . . . . . . . . . . . . . . . . . . . .121
Inferior Glide, End ROM, Sitting . . . . . . . . . . . 94
Proximal Radioulnar Joint
Anterior Glide, Loose Packed Position,
Supine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Dorsal Glide of the Radial Head . . . . . . . . . . .122
Anterior Glide, Loose Packed Position, Ventral Glide of the Radial Head . . . . . . . . . . .122
Prone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Distal Radioulnar Joint
Anterior Capsule/Soft Tissue Physiological
Dorsal Glide of the Radius . . . . . . . . . . . . . . . .123
Mobilization . . . . . . . . . . . . . . . . . . . . . . . . 95
Ventral Glide of the Radius . . . . . . . . . . . . . . .123
Anterior Glide With Combination of External
Shoulder Rotation and Shoulder
Abduction . . . . . . . . . . . . . . . . . . . . . . . . . 96 Wrist and Hand
Posterior (Dorsal) Glide, in Adduction . . . . . . . 96
Distal Radioulnar Joint
Posterior Glide, in Loose Packed Position . . . . 97
Ventral (Palmar) Glide . . . . . . . . . . . . . . . . . . . .133
Posterior Glide, in Flexion . . . . . . . . . . . . . . . . 97
Dorsal Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .133
Posterior Capsule/Soft Tissue Physiological
Mobilization . . . . . . . . . . . . . . . . . . . . . . . . 98 Radiocarpal and Ulnocarpal Joint
Sternoclavicular Joint Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . .134
Dorsal Glide . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Dorsal Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .134
Ventral Glide . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Ventral Glide . . . . . . . . . . . . . . . . . . . . . . . . . .135
Cranial Glide . . . . . . . . . . . . . . . . . . . . . . . . . 100 Radial Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .135
Caudal Glide . . . . . . . . . . . . . . . . . . . . . . . . . 100 Ulnar Glide . . . . . . . . . . . . . . . . . . . . . . . . . . . .136
Acromioclavicular Joint Mobilizations for Scaphoid, Lunate, and
Triquetrum for Restricted Extension . . . . .137
Dorsal Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .101
Mobilizations for Scaphoid, Lunate, and
Dorsal Glide—Method 2 . . . . . . . . . . . . . . . . .101
Triquetrum for Restricted Flexion . . . . . . .138
vi
Treatment Finder
Midcarpal Joint Posterior Glide in Hook-Lying . . . . . . . . . . . . .169
Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . .139 Direct Lateral Glide . . . . . . . . . . . . . . . . . . . . .170
Dorsal Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .139 Lateral Glide Internal Rotation Motion . . . . . .170
Ventral Glide . . . . . . . . . . . . . . . . . . . . . . . . . .140 Indirect Technique: Posterior-Lateral Glide . . .171
Radial Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .140
Knee Joint
Ulnar Glide . . . . . . . . . . . . . . . . . . . . . . . . . . . .141
Midcarpal Extension Mobilization . . . . . . . . . .142
Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . .182
Midcarpal Flexion Mobilization . . . . . . . . . . . .143
Dorsal Glide of Tibia on Femur . . . . . . . . . . . .182
Intercarpal Mobilization . . . . . . . . . . . . . . . . . .144
Ventral Glide of Tibia on Femur 1 . . . . . . . . . .183
Carpometacarpal Joints (CMC)
Ventral Glide of Tibia on Femur 2 . . . . . . . . . .183
CMC Distraction . . . . . . . . . . . . . . . . . . . . . . . .145
Ventral Glide of Tibia on Femur 3 . . . . . . . . . .184
CMC Dorsal Glide . . . . . . . . . . . . . . . . . . . . . .145
Medial Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .184
CMC Ventral Glide . . . . . . . . . . . . . . . . . . . . . .146
Lateral Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .185
Intermetacarpal Joints
Medial Gap . . . . . . . . . . . . . . . . . . . . . . . . . . . .185
Intermetacarpal Dorsal Glide . . . . . . . . . . . . . .147
Lateral Gap . . . . . . . . . . . . . . . . . . . . . . . . . . . .186
Intermetacarpal Ventral Glide . . . . . . . . . . . . .147
Patellofemoral Joint (PFJ)
Metacarpophalangeal (MCP) Joints
PFJ Cranial Glide . . . . . . . . . . . . . . . . . . . . . . .187
MCP Distraction . . . . . . . . . . . . . . . . . . . . . . . .148
PFJ Caudal Glide . . . . . . . . . . . . . . . . . . . . . . .187
MCP Dorsal Glide . . . . . . . . . . . . . . . . . . . . . . .148
PFJ Medial Glide . . . . . . . . . . . . . . . . . . . . . . .188
MCP Ventral Glide . . . . . . . . . . . . . . . . . . . . . .149
PFJ Lateral Glide . . . . . . . . . . . . . . . . . . . . . . .188
MCP Radial Glide . . . . . . . . . . . . . . . . . . . . . . .149
PFJ Medial Tilt . . . . . . . . . . . . . . . . . . . . . . . . .189
MCP Ulnar Glide . . . . . . . . . . . . . . . . . . . . . . . .150
PFJ Lateral Tilt . . . . . . . . . . . . . . . . . . . . . . . . .189
Interphalangeal (IP) Joints
Proximal Tibiofibular Joint Posterior Glide . . .190
IP Distraction . . . . . . . . . . . . . . . . . . . . . . . . . .151
Proximal Tibiofibular Joint Anterior Glide . . . .190
IP Dorsal Glide . . . . . . . . . . . . . . . . . . . . . . . . .151
IP Ventral Glide . . . . . . . . . . . . . . . . . . . . . . . .152
Ankle Joint
Trapeziometacarpal (TMC) Joint
TMC Distraction . . . . . . . . . . . . . . . . . . . . . . . .153 Distal Tibiofibular Joint
TMC Dorsal Glide . . . . . . . . . . . . . . . . . . . . . . .153 Anterior Glide . . . . . . . . . . . . . . . . . . . . . . . . . .198
TMC Ventral Glide . . . . . . . . . . . . . . . . . . . . . .154 Posterior Glide . . . . . . . . . . . . . . . . . . . . . . . . .198
TMC Radial Glide . . . . . . . . . . . . . . . . . . . . . . .154 Weight-Bearing Anterior Glide of the Fibula . .199
TMC Ulnar Glide . . . . . . . . . . . . . . . . . . . . . . . .155 Superior Glide of Fibula . . . . . . . . . . . . . . . . . .199
Inferior Glide of Fibula . . . . . . . . . . . . . . . . . . 200
Hip Joint
Talocrural Joint
Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Indirect (Longitudinal) Distraction . . . . . . . . . .165
Distraction Thrust . . . . . . . . . . . . . . . . . . . . . . 201
Indirect (Longitudinal) Distraction via Knee
Posterior Talar Glide . . . . . . . . . . . . . . . . . . . . 202
Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . .166
Posterior Talar Glide: Weight-Bearing
Lateral Distraction . . . . . . . . . . . . . . . . . . . . . .166
Mobilization With Movement . . . . . . . . . 202
Inferior Glide . . . . . . . . . . . . . . . . . . . . . . . . . .167
Posterior Talar Glide: Mobilization With
Anterior Glide in Prone . . . . . . . . . . . . . . . . . .167
Movement . . . . . . . . . . . . . . . . . . . . . . . . 203
Anterior Glide in Modified Prone . . . . . . . . . . .168
Anterior Talar Glide . . . . . . . . . . . . . . . . . . . . 203
Anterior Glide in Prone FABER Position . . . . . .168
Indirect Anterior Talar Glide . . . . . . . . . . . . . . 204
Posterior Glide in Resting Position . . . . . . . . . .169
vii
Treatment Finder
Foot Cervical Spine
C2-C7 Rotation (Opening Contralateral
Subtalar Joint Facet) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . .213 C2-C7 Rotation (Closing Ipsilateral Facet) . . . 233
Lateral Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .213 Thoracic Spine
Medial Glide . . . . . . . . . . . . . . . . . . . . . . . . . . .214 First Rib Inferior Glide . . . . . . . . . . . . . . . . . . 234
Calcaneal Rocking . . . . . . . . . . . . . . . . . . . . . .214 Thoracic Extension With a Towel . . . . . . . . . . 234
Midtarsal Joints Mid-Thoracic Extension With a Chair . . . . . . . 235
Navicular Dorsal (Anterior) Glide . . . . . . . . . . .215 Thoracic Foam Rolling . . . . . . . . . . . . . . . . . . 235
Navicular Dorsolateral Glide . . . . . . . . . . . . . .215 Lumbar Spine
Navicular Plantar (Posterior) Glide . . . . . . . . . .216 Lumbar Extension . . . . . . . . . . . . . . . . . . . . . 236
Navicular Plantarmedial Glide . . . . . . . . . . . . .216 Shoulder
Cuboid Dorsal (Anterior) Glide . . . . . . . . . . . .217 Glenohumeral Posterior Glide . . . . . . . . . . . . .237
Cuboid Dorsolateral Glide . . . . . . . . . . . . . . . .217 Wrist and Hand
Cuboid Plantar (Posterior) Glide . . . . . . . . . . .218 Wrist and Hand Distraction . . . . . . . . . . . . . . 238
Cuboid Plantarmedial Glide . . . . . . . . . . . . . . .218 Anterior Glide at the Radiocarpal Joint . . . . . 238
Cuboid Manipulation . . . . . . . . . . . . . . . . . . . .219 MCP or Phalangeal Distractions . . . . . . . . . . . 239
Tarsometatarsal Joints MCP or Phalangeal Glide . . . . . . . . . . . . . . . . 239
Dorsal (Anterior) Glide . . . . . . . . . . . . . . . . . . 220 Hip
Plantar (Posterior) Glide . . . . . . . . . . . . . . . . . 220 Lateral Glide for Hip Flexion in Kneeling . . . . 240
Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . 221 Lateral Glide for Hip Flexion in a Squat
Position . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Metatarsophalangeal Joint
Hip Distraction in Quadruped . . . . . . . . . . . . .241
Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
Hip Distraction in Standing With Hip
Dorsal (Anterior) Glide . . . . . . . . . . . . . . . . . . 222
Flexion . . . . . . . . . . . . . . . . . . . . . . . . . . . .241
Plantar (Posterior) Glide . . . . . . . . . . . . . . . . . 223
Knee
Medial Glide . . . . . . . . . . . . . . . . . . . . . . . . . . 223
Long-Sitting Medial and Lateral Patellar
Lateral Glide . . . . . . . . . . . . . . . . . . . . . . . . . . 224
Glides . . . . . . . . . . . . . . . . . . . . . . . . . . . . .242
Sesamoid Mobilization . . . . . . . . . . . . . . . . . . 224
Long-Sitting Superior and Inferior Patellar
Intermetatarsal Mobilization . . . . . . . . . . . . . 225 Glides . . . . . . . . . . . . . . . . . . . . . . . . . . . . .242
Interphalangeal Joint Medial and Lateral Patellar Tilt . . . . . . . . . . . 243
Distraction . . . . . . . . . . . . . . . . . . . . . . . . . . . 226 Weight-Bearing Rotation of the Tibia . . . . . . 243
Dorsal (Anterior) Glide . . . . . . . . . . . . . . . . . . 226 Ankle and Foot
Plantar (Posterior) Glide . . . . . . . . . . . . . . . . . 227 Talocrural Joint Distraction . . . . . . . . . . . . . . 244
Posterior Talar Glide . . . . . . . . . . . . . . . . . . . . 244
Self-Mobilizations
Lateral Calcaneal Glide . . . . . . . . . . . . . . . . . .245
Great Toe Metatarsophalangeal (MTP)
Temporomandibular Joint Distraction . . . . . . . . . . . . . . . . . . . . . . . . .245
Mouth Opening (Bilateral TMJ Protrusion) . . 232
Mandible Lateral Excursion (Lateral Jaw
Movement) . . . . . . . . . . . . . . . . . . . . . . . . 232
viii
Hip Joint
PREFACE
The purpose of this book is to provide educators, designed to give readers improved visualization of
clinicians, and students of pre-professional phys- the techniques’ intentions and to guide hand place-
ical therapy and osteopathic medical programs a ment and procedures. Relevant clinical tips exist
comprehensive evidence-based text on the clinical in each chapter to further readers’ understanding
application of joint thrust and nonthrust proce- of techniques.
dures. This book is designed for physical therapists, Part I introduces the basic science behind
osteopathic doctors, educators, and students of joint mobilization and manipulation, including
pre-professional therapy and osteopathic programs indications, general joint kinesiology, and other
charged with treatment of patients with musculo- information. Part II describes specific thrust and
skeletal joint pain and dysfunction. The language nonthrust techniques for the entire spine and
and content of the text is easy to follow for use temporomandibular joint. Part III details tech-
in the classroom, lab, clinical, or professional niques for the upper extremity. Part IV describes
workshop setting. The text provides the reader an techniques for the lower extremity. Finally, the
appreciation for the current evidence and theory appendix presents 26 self-mobilizations. We hope
supporting the clinical application of joint thrust/ the clear, organized, and well-illustrated descrip-
nonthrust for clients experiencing symptoms across tions of these techniques will benefit all readers as
a wide range of musculoskeletal ailments related well as the clients they treat.
to pain, limited joint mobility, and dysfunction.
Joint manipulation and mobilization has been Student Resources
practiced for more than 40 years. This form of
joint manipulation and mobilization is a popular Students will benefit significantly by completing the
form of manipulation used by a large percentage 11 case studies, with questions showing treatments
of physical therapy programs in the United States. for patients suffering from various musculoskeletal
It is one of the easiest techniques to understand conditions, in the accompanying web study guide.
and apply in clinical practice. This book offers In addition to the case studies, there are 60 videos
the reader a straightforward approach based on of treatment techniques. The web study guide is
traditional anatomical structure and function as available at www.HumanKinetics.com/Orthopedic
well as current evidence. JointMobilizationAndManipulation.
The text provides a comprehensive overview of
the literature supporting the use of joint mobiliza- Instructor Resources
tion and manipulation and manual therapy as well
as complementary explanations of the literature, Two ancillaries are available to instructors:
concepts, and theories to bolster the reader’s under-
• Instructor guide: This guide details how to
standing of how thrust and nonthrust techniques
best use the various ancillaries and includes
work to eliminate pain and re-establish normal
a sample syllabus and ideas for lab activities
joint motion and function. Readers are instructed
and class projects.
on how to determine arthrokinematic joint dys-
• Chapter quizzes: Each chapter is supported
function to be treated with joint mobilization/
by a ready-made chapter quiz to assess stu-
manipulation. Additionally, the text provides
dent understanding of the main concepts of
the aspiring manual therapist with easy-to-apply
the chapter.
methods for treatment of common musculoskeletal
conditions. These ancillaries are available at www.Human
Unique to this book is anatomical artwork over- Kinetics.com/OrthopedicJointMobilizationAnd
laid on pictures of the clinical techniques. This is Manipulation.
ix
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