Musculoskeletal

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:

  1. bone disease
  2. malignancy
  3. pregnancy
  4. vertebral artery insufficiency
  5. active ankylosing spondylitis
  6. rheumatoid arthritid
  7. spondylolisthesis
  8. gross foraminal encroachment
  9. acute nerve root irritation or compression
  10. instability of the spine
  11. recent whiplash
  12. undiagnosed pain
  13. psychological pain where signs do not match symptoms
  14. 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:

10468679_10152724635666500_2229326346046519430_n 10449539_10152724635621500_5567085683454547744_n 11074482_10152724635571500_8186025538882839746_nOsteoarthritis-460x331

Choose a section to learn more:

Cervical Spine

Shoulder

Elbow

Wrist & Hand

Sacroiliac Joint

Hip

Knee

Foot & Ankle

 

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