In our company, Probility Physical Therapy, we commonly do hands-on techniques called “joint mobilizations”.  These are used for when a patient has a joint that is not moving correctly due to being “stuck”, hypomobile, or out of position (subluxed).  There are also physical therapists who call these techniques manipulations and there is some ambiguity in this.  A Manipulation can be any therapeutic technique that increases the range of motion of a joint or it can be a very specific kind of mobilization – referred to as a high-velocity, low amplitude thrust (sorry for the technical terms, here).  A “thrust” technique is similar to what many chiropractors call an “adjustment”.  In the end, as far as Physical Therapists are concerned, all of these techniques are just trying to get a joint moving more normally so that a person can move their body without restriction or pain.

Joint mobilizations can be done to any joint in the body.  They can be done in multiple directions and with varying degrees of force or speed.  A mobilization can be done where a therapist takes a joint to its end-range barrier and stretches it at that point or where a therapist takes it to the end range barrier and oscillates it (gentle glides the joint back and forth).  It is important to note that joint mobilizations are DISTINCTLY different from stretching a part of the body.  A therapist who takes a part of the body and just moves it through its range as far as it can go and stretches the muscles around the joint is not mobilizing the joint – and often times this type of technique (aggressive stretching of a dysfunctional joint) simply causes compression of the joint structures and pain.

Our belief is that it is best to mobilize the joint to make sure it moves correctly, release / relax the muscles in the areas and then do stretching and muscle retraining to those same muscles.  This is basically a concept that, when a person has a dysfunction that is creating pain, you need to fix/correct the problem before you should stretch or strengthen the area.  After you correct the underlying issues that are creating the pain, then it is perfect to strengthen the heck out of the muscles to make sure it doesn’t come back!