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How Spinal and Peripheral Joint Mobilisation Helps My Patients?

Updated: Jan 8

Blog post by David Lintonbon DO & Emily Ho

Joint mobilisation is a manual medicine technique applied by the practitioner to improve joint mobility and relieve pain. It involves the passive movements of a joint to restore or enhance its range of movement, along with relaxing shortened muscles that cross the joint.



Types of Joint Mobilisation

Of the 2 main types of joint mobilisation, we are looking at the theories of Geoffrey Maitland, an Australian physiotherapist and Freddy Kaltenborn, a Norwegian physical educator and later as a physiotherapist subsequently studied orthopaedic medicine in London. Followed by Chiropractic in Germany and Osteopathy in the UK.


Brief History of Joint Mobilisation

Both practitioners developed their techniques during the 1940s and 50s which have essentially evolved from osteopathic articulation (1890 or earlier), whereby joints are put through ranges of motion in a graded fashion with the goal of enhancing the quality and quantity of motion. These were taught in most osteopathic colleges, especially the British School of Osteopathy by Alan Stoddard DO, this is where Kaltenborn (who studied under Alan Stoddard), learnt the application of joint articulation, later to become Kaltenborn mobilisation.


These procedures are extensions of the diagnostic process of evaluating joint movement. If a restriction of motion is encountered in one direction, the practitioner delivers a series of gentle rhythmic movements in the direction of motion restriction. This greatly increases the joint range of movement along with stimulating the flow of blood to the joint and surrounding tissues. When appropriately applied to conditions like osteoarthritis they can help ease pain and improve joint function.

Adapted Kaltenborn vs Maitland Mobilisation Grading Scale
Infograph of Mobilisation Grading Scale

Dr AT Still demonstrating osteopathic articulation shoulder techniques


Benefits of Joint Mobilisation

There are many benefits to the patient, when joint mobilisation is carried out, it improves joint mechanics, range of movement and reduces pain. From this improved function the recipient notes better walking, standing, spinal flexibility and shoulder-arm usage. Although effects may be temporary, they should be accompanied by mobility exercises.


Video of Shoulder Mobilisation


Contraindication

Joint mobilisation can be an effective technique for patient with stiff and painful joints. However, it is not the correct approach for everyone, especially patients with:


  • Osteoporosis

  • Connective tissue disorders where the joints move too much ie Ehlers Danlos

  • Fractures and bone cysts

  • Tumors within a joint

  • Fused joints

  • Infection within a joint

  • Severe inflammatory arthritis ie Rheumatoid Arthritis

  • Prolapsed intervertebral discs

  • Patients on blood thinners

  • Neuropathy ie Charcot Marie Diabetic


Stoddard, A. (1980) Manual of Osteopathic Technique, Rev (Ed), HarperCollins, London.


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