Effects of Joint Mobilizations and Manipulations

Physical rehabilitation professionals, including physical therapists, osteopaths, and chiropractors, have been refining joint mobilizations and joint manipulations for 100s of years. There are even depictions of joint mobilization treatment that are 1000s of years old. Joint mobilization strategies have been published for chronic pain of the low back, hand pain, extremity joint issues, and various sports injuries. Some practitioners have noted the effect of joint mobilizations and joint manipulations on muscle activity and have integrated these techniques into routines for muscle weakness, muscle strains, and recurring pain relief for active trigger points.

The neurophysiological and mechanical effects of mobilizations and manipulations are actually quite complex. However, the simplest and most effective recommendation for their use is the intent to reduce joint stiffness for specific joints that have been assessed as exhibiting a reduction in joint play (arthrokinematic motion). Despite outcome studies demonstrating the efficacy of this approach to using these techniques, it would be presumptive to imply that there is a single, or a simple reason, that these techniques are effective. Some studies even imply mechanisms that are similar to deep tissue massage, massage guns, and other muscle tissue and connective tissue techniques, that are related to nerve endings involved in neuromuscular reflexes like autogenic inhibition (relaxation response), and altered cortisol concentrations (stress hormone), and central nervous system mediated pain relief which may be particularly effective for the treatment of chronic pain.

We hope this course helps to build a foundation of knowledge regarding the effects of joint intended technique from a very large body of research and rich clinical history. Further, this course is pre-approved for credits toward the Integrated Manual Therapist (IMT) Certification, and pre-approved for continuing education credits for sports medicine professionals and health care providers (physical therapists, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.).

Brookbush Institute's Position Statement

Mobilizations and manipulations result in kinematic, neurophysiological, and muscular changes that have been correlated with the improvement of various subjective and objective patient outcomes, both short-term and long-term. Further, these changes have been demonstrated in randomized placebo/nocebo-controlled trials, implying the effects are not attributable to placebo or patient perceptions/expectations.

What this Course Covers

• Myth Busting
  • The Effects Are Not Placebo
• Kinematics
  • Joint Motion During Mobilization and Manipulation
  • Factors affecting force during mobilization and manipulations.
  • Factors Affecting Joint Stiffness
  • Effect on Structures
• Nervous System
  • H-reflex, M-wave, and V-wave Response
  • Central Nervous System (CNS) Mediated Changes
  • Sympatho-excitatory Effects
  • Analgesia
• Muscle Activity
  • Spine
  • Extremities
  • Additional Considerations

Related Courses

• Joint Mobilization and Manipulation: Introduction
• Joint Stiffness Assessment by Palpation
• Joint Mobilizations and Manipulations: Risk of Adverse Events
• Joint Mobilizations and Manipulations: Evidenced-based Teaching and Learning