Definition
Musculoskeletal Physiotherapy is the term used to describe the field of physiotherapy, which relates to disorders of the musculoskeletal system. The term musculoskeletal refers to muscles, bones, joints, nerves, tendons, ligaments, cartilage, and spinal discs. Musculoskeletal Physiotherapy utilises the basic sciences of anatomy, physiology and biomechanics as background theory in the assessment and management of patients. Approaches to management in the field of musculoskeletal physiotherapy involve not only ‘manipulation’, but also manual assessment and treatment techniques, specific therapeutic exercise, electrotherapy and advice on posture and movement disorders. – Physiopedia
Manual Therapy – Mobilising
Mobilising spinal segments can be used to treat pain, maintain ROM and improve ROM. These are determined by the grade of mobilisation (force applied) and if it is an oscillatory motion or a sustained hold. It can be an PPAIVM or a PPIVM.
Mobilising spinal segments can be used to decrease pain, improve ROM and of course both.
The 1-5 grades of mobilisation relate to the force applied.
1 = Low amplitude beginning of range (pain)
2 = Med amplitude, most of joint ROM (pain)
3 = Med amplitude, full joint ROM (pain and ROM maintenance)
4 = Low amplitude AT end ROM (mobilisation)
5 = High velocity, low amplitude, at end range (manipulation)
This is a big topic, and these are some basic components. Read up on how oscillatory or sustained motions can produce different results…
Contraindications to Mobilization:
- bone disease
- malignancy
- pregnancy
- vertebral artery insufficiency
- active ankylosing spondylitis
- rheumatoid arthritid
- spondylolisthesis
- gross foraminal encroachment
- acute nerve root irritation or compression
- instability of the spine
- recent whiplash
- undiagnosed pain
- psychological pain where signs do not match symptoms
- steroid use affects ligament laxity
Spine related:
Have a look at these data pictures to gain insight into the discrepancy there is between detailed imaging pathologies and pain:
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JC Physiotherapy 