JOINT MOBILIZATION
Before commencing joint mobilization, the physical therapist will determine if it is a necessary treatment by assessing the joint range of movement both actively (the patient performs the movement) and passively (the physical therapist feels for stiffness and pain by moving the joint). Any joint which presents with pain or stiffness can be treated with mobilization except in rare instances such as where there is malignancy, bone infection, spinal cord compression or unhealed fracture. There are different grades of mobilization used to treat various conditions. Where there is significant local pain and inflammation, gentle mobilization is used (Grade 1 or 2) to help with pain relief and reduce inflammation by promoting movement. In conditions where there is not much pain but rather the main problem is joint stiffness, then a more vigorous mobilizing technique (Grade 3 or 4) can be used to help restore full range of movement.Extensive research has been performed regarding all of these techniques and their effect in treating joint pain and stiffness is proven as highly valid, which is why joint mobilization remains one of the most common modalities used by physical therapists.