Joint mobilization is a hands-on treatment that is frequently performed by physical therapists (healthcare professionals specializing in rehabilitation for movement disorders) and chiropractors (alternative-health professionals treating disorders of the musculoskeletal system, including bones, muscles, and soft tissue).
This manual technique involves applying targeted forces on a painful, stiff, or otherwise compromised joint in order to improve its overall function. While not appropriate in all situations, joint mobilizations may help improve your range of motion, reduce your pain, and minimize your stiffness.
This article will detail how this treatment works, what it is used for, and the risks associated with it.
Uses
When performing a joint mobilization on a body region, the practitioner typically stabilizes one segment of a joint while applying a force to the adjoining body region. This force is usually applied in the direction of the tightness and can be more gentle and oscillating or more forceful and sudden, depending on the type of technique being performed.
Theoretically, joint mobilizations could be used to address stiffness or pain in almost any of the body’s joints. That said, there are a number of body regions that have been shown to respond more favorably to this type of treatment. Among the most common diagnoses that benefit from joint mobilizations are:
- Shoulder pain or impingement
- Acute or chronic back pain
- Plantar fasciitis (inflammation of the thick band of tissue running along the base of the foot and causing heel pain)
- Hip osteoarthritis
- Lateral epicondylalgia (tennis elbow)
- Ankle sprains or instability
- Knee osteoarthritis
How It Works
While joint mobilizations have been shown to improve pain and overall function when appropriately performed, their exact mechanism of action is not completely understood.
It is thought that this treatment enhances the ability of the body to respond to pain stimuli by making the tissue in the targeted area less sensitive to pressure. Because the joint is less “excitable” post-mobilization, overall pain levels usually diminish.
This "desensitizing" of the joint tissue may also help the surrounding muscles function more normally and better support the joint itself. It can help certain joints move better, which puts less strain on muscles and decreases pain.
Joint Mobilization Exercises
After undergoing joint mobilizations in the clinic, your practitioner will have you perform exercises that help continue your progress at home. These techniques typically involve gentle movements or stretches in the restricted direction and may be completed multiple times each day.
Benefits
While the potential mechanisms of action are still somewhat theoretical, the benefits provided by joint mobilization are more concrete.
This treatment has been found to have a positive impact on the pain levels associated with many of the musculoskeletal conditions described above. Mobilizations have also been associated with temporary increases in joint range of motion and improved overall balance reactions.
It is worth noting, however, that these benefits are usually relatively short-lived. Because of this, your physical therapist or chiropractor will typically use joint mobilizations in tandem with other treatments, like strengthening or stretching, in order to optimize your overall outcome.
Caution
Individuals with the below issues should not undergo joint mobilization without consulting their healthcare provider:
- Acute fractures (broken bones)
- Herniated disks (problem with the cushions between bones in the spine)
- Decreased bone density (volume of bones)
- Sensory issues
- Hypermobility disorders (extremely flexible joints that cause pain)
- Taking blood thinners
Risks
Joint mobilizations are generally considered to be safe for most individuals. This technique does involve the application of force or pressure (sometimes with a high velocity) to an area of the body, however. Because of this, there are some risks involved.
People with the following conditions should exercise caution before undergoing this treatment:
- Uncontrolled diabetes or atherosclerosis (buildup of fatty deposits on the walls of the arteries)
- People taking anticoagulant (blood thinner) medication
- Vertebralbasilar disease (poor blood flow to the brain stem)
- Hypermobility disorders or congenital joint laxity (condition causing hypermobility from the time of birth)
- Local blood vessel aneurysm (bulge in blood vessel)
- Osteoporosis (brittle bones) or impaired bone density
- Acute spinal disk herniation (condition in the spine causing severe pain that limits function)
- Acute or unhealed fractures
If you have questions about whether joint mobilizations are appropriate in your situation, be sure to speak to your physician before undergoing any new treatments. In many cases, the risk of the mobilization may be diminished by performing lower intensity, more gentle versions of the technique.
Summary
Joint mobilization is a hands-on technique used by physical therapists and chiropractors. It involves the application of pressure over a stiff or painful joint. This treatment can improve your range of motion and function while reducing your pain. It is thought to do this by decreasing the
sensitivity or excitability of the tissue in the targeted joint.
A Word From Verywell
Living with a stiff, painful joint can make everyday activities seem insurmountable and can significantly limit your ability to function. Fortunately, joint mobilizations may be able to help.
When incorporated into a therapy regimen that includes other valuable treatments like strengthening or stretching, this technique can help you get back to the things you love.
If you are dealing with any of the conditions listed above or just have questions about joint mobilizations, be sure to consult with your medical provider.
Frequently Asked Questions
What are the grades of joint mobilization?
Joint mobilizations are graded based on the speed at which they are performed and the movement associated with them:
- Grade 1 mobilizations are small, slow oscillations at the beginning of a joint’s range of motion.
- Grade 2 are large-amplitude, slow forces within the joint’s entire available range.
- Grade 3 movements are large in amplitude, slow, and focused on the middle to end range of a joint’s movement.
- Grade 4 mobilizations are slow, small amplitude movements at the end of a joint’s range.
- Grade 5 mobilizations involve a single high-velocity, small-amplitude thrust at the end of the range.
How long does joint mobilization take to see results??
The pain relief and range of motion improvements from a joint mobilization are often seen immediately after the technique is performed.
Who can benefit from joint mobilization?
Most people with stiff or painful joints may benefit from joint mobilization. That said, individuals with sensation issues, hypermobility disorders, fractures or impaired bone density, or similar conditions should use caution. It is always a good idea to speak to your healthcare provider if you have questions or concerns about undergoing this treatment.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Physical Medicine and Rehabilitation. Manual treatments.
Heiser R, O’Brien V, Schwartz D. The use of joint mobilization to improve clinical outcomes in hand therapy: A systematic review of the literature. Journal of Hand Therapy.2013;26(4):297-311. doi:10.1016/j.jht.2013.07.004
Weerasekara I, Osmotherly P, Snodgrass S,Marquez J, de Zoete R, Rivett DA. Clinical benefits of joint mobilization on ankle sprains: a systematic review and meta-analysis. Archives of Physical Medicine rehabilitation. 2018;99(7):1395-1412.e5. doi:10.1016/j.apmr.2017.07.019
Courtney CA, Steffen AD,Fernández-de-las-Pñas C, Kim J, Chmell SJ. Joint mobilization enhances mechanisms of conditioned pain modulation in individuals with osteoarthritis of the knee. J Orthop SportsPhys Ther. 2016;46(3):168-176. doi:10.2519/jospt.2016.6259
Lascurain-Aguirrebeña I, Newham D, Critchley DJ. Mechanism of action of spinal mobilizations: a systematic review. SPINE. 2016;41(2):159-172. doi:10.1097/BRS.0000000000001151
By Tim Petrie, DPT, OCS
Petrie is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade.
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