Joint mobilisations 2

Question 1

how do we know clinically that joint mobilisations are indicated for treatment?

Answer 1

• patient showing a decreased range of motion in general
• pain in joint
• hip or knee osteoarthritis - ie pathology of joint

Question 2

what are the 3 types of force that are exerted on human joints and muscles etc?

Answer 2

• tensile force
• compressive force
• shear force

Question 3

what is a tensile force?

Answer 3

a force that tends to pull an object apart

Question 4

what is a compressive force?

Answer 4

a force that presses inward on an object and causes it to become compacted

Question 5

what is a shear force?

Answer 5

unaligned forces acting on one part of the body in a specific direction and another part of the body in an opposite direction

Question 6

what is very important to maintain connective tissue health and bone health?

Answer 6

loading is necessary

Question 7

what happens as a result of reduced loading of connective tissue?

Answer 7

• tissues rapidly reduce strength
• mechanical and tensile strength decreases in ligaments within weeks
• loss of mass, volume and strength in bone and cartilage

Question 8

how can immobilisation affect bone? (immobilisation - bedrest)

Answer 8

• there can be regional osteoporosis - ie bone resorption or breakdown

Question 9

how can immobilisation affect cartilage?

Answer 9

• there can be a decreased activity in choncrocytes
• increase in water content - which will decrease its capacity to bear load
• decrease in thickness

Question 10

what are the effects of immobilisation on muscle?

Answer 10

• atrophy - decrease in size of muscle
• 20-30% decrease in cross sectional area of muscle after 8 weeks
• greatest loss in first weeks as there is a loss of proteins and change in metabolism

Question 11

if a muscle becomes weakened, or atrophy happens.. what can other muscles do as a result?

Answer 11

• other muscles compensate and take over or movement is changed
• eg weak gluteus maximus causes hamstring muscles to work harder

Question 12

what is the effect of immobilisation on ligaments?

Answer 12

• weakening of ligament and dissorganisation of collagen arrangement

Question 13

how does immobilisation effect the menisci? (c shaped pad of cartilage in knee)

Answer 13

there is an increased water content - which leads to a decreased ability to withstand or bear load

Question 14

how does immobilisation effect tendons?

Answer 14

• protein degradation - decrease in collagen content

Question 15

what main part of the joint does osteoarthritis effect?

Answer 15

the cartilage starts to break down

Question 16

what part of the joint does rheumatoid arthritis affect?

Answer 16

the synovium - becomes inflammed

Question 17

what is joint effusion?

Answer 17

• joint effusion is increased intra-articular fluid (ie synovial fluid) inside the joint
• can be caused by injury, arthritis etc

Question 18

what is an overuse injury?

Answer 18

• an injury caused by repeated micro-trauma rather than a single specific event
• smaller force with an insufficient recovery time

Question 19

can continous passive movement ( CPM machine) help prevent muscle atrophy?

Answer 19

no - as the person is not actively contracting or moving themselves

Question 20

what are 2 examples of clinical strategies that aim to lessen the impact of immobilisation on muscles , joints etc?

Answer 20

• Continous passive movement devices
• dynamic splinting - devices that provide a low load and prolonged stretch to joints that have a reduced range of motion after surgery etc

Question 21

what are indications of joint mobilisations?

Answer 21

• joint dysfunction
• joint pathology

Question 22

what are the potential outcomes of treating a patient with a joint dysfunction or pathology through mobilisations?

Answer 22

1. joint dysfunction - imrpove mobility, pain relief and to improve functional ability
2. joint pathology - pain relief, improve joint mobility eg after flare RA flare up