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Self-administered joint mobilizations for the ankle, knee, and hip. Addressing feet flatten, feet turn out, knee bow in, knee bow out, excessive forward lean, asymmetrical weight shift, and anterior pelvic tilt. Joint mobilizations and traction techniques for lower extremity and lumbopelvic hip complex dysfunction.

Joint Mobilizations: Lower Body (Self-administered)

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I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

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Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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Human Movement Specialist

Certified Personal Trainer

Integrated Manual Therapist

This course describes self-administered joint mobilization techniques for the lower extremity (also referred to as joint mobility techniques, joint mobilisations, joint mobs, joint mob, or mobz). The techniques included in this course are intended for the hip joint (acetabulofemoral joint), knee joint (tibiofemoral joint), and ankle joint (talocrural joint).

Joint mobilization techniques are recommended for joints assessed as abnormally stiff and should not be considered solely as treatment for addressing chronic pain. The intent is to increase joint mobility and regain optimal lower extremity motion. Unlike manual therapy, self-administered techniques have the advantage of inclusion in therapeutic exercise programs, corrective exercise programs, home exercise programs, and continued self-management routines. In addition to improving mobility and arthrokinematics motion, research has demonstrated that addressing joint stiffness may have an immediate effect on assessed muscle weakness, improving muscle activity, and muscle strength during functional activity.

The joint mobilization techniques in this course may be particularly beneficial for improving the quality of motion of those individuals exhibiting signs of lower extremity dysfunction, lumbopelvic hip complex dysfunction, knees bow in (knee valgus), knees bow out (knee varus), feet flatten (functional pes planus), as well as treatment for low back pain, hip pain, knee pain, and ankle pain. Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) should consider adding these exercises to their repertoire to improve the outcomes of their integrated exercise programs and therapeutic (rehabilitation) interventions.

For additional self-administered joint mobilization techniques check out:

Joint Mobilizations: Upper Body (Self-administered)

For manual therapy versions of the techniques in this course check out:

Course Description: Self-administered Joint Mobilizations for the Lower Body

Self-Administered Joint Mobilization Protocol: Hip Joint

Study Guide: Joint Mobilizations: Lower Body (Self-adminstered)

Introduction

For an introduction to self-administered joint mobilizations including definitions of specific terminology, what a "joint mobilization" is, intent and goal, guidelines, predictable patterns, and best use search for the Introduction to Self-administered Joint Mobilization article on the website.

Self-administered Hip Mobilization: Lateral Distraction

Self-administered Hip Mobilization: Anterior to Posterior with Flexion

Research Corner

Self-administered techniques are always encouraged in the pursuit of optimizing outcomes and patient independence; however, studies on self-administered mobilizations are rare.

A pilot RCT by Walsh et al. compared self-administered and manual hip mobilization techniques, demonstrating that hip internal rotation restriction could be effectively addressed with manual hip mobilization with movement (MWM). The self-administered hip mobilizations did not result in significant improvements in hip internal rotation ROM; however, a trend toward improvement was noted, and this study was an under-powered pilot study. A larger study should be conducted, and perhaps include a combination group that could identify whether the use of self-administered techniques in a home exercise program could augment the results attained using a manual mobilization (1).

A prospective case series by Takasaki et al. investigated the treatment of knee osteoarthritis with a combination of manual knee MWM and self-administered knee MWM, demonstrating immediate and short-term improvements in pain, ROM, and function (2). Although this study does not allow for a comparison of manual mobilization to self-administered mobilization, or an analysis of the efficacy of self-administered mobilization alone, the study does demonstrate that the combination of manual and self-administered mobilization is likely effective.

Jadhav et al. compared self-administered McKenzie knee exercises to manual knee MWM in conjunction with conventional physiotherapy for the treatment of knee osteoarthritis, demonstrating that both techniques were effective for improving pain, timed up-and-go, ROM and manual muscle testing. The self-administered McKenzie exercises did result in slightly better scores on manual muscle testing (3).

An RCT by Cruz-Diaz et al. compared self-management of chronic ankle instability (CAI) with a combination of ankle self-mobilization and CrossFit, CrossFit alone, or no intervention, demonstrating that the combination group had the largest improvements in dorsiflexion ROM, dynamic postural control, and self-reported instability (4). This study suggests that the addition of self-administered ankle mobilization may have a positive effect on ROM and function when added to a warm-up prior to resistance training.

Based on the available research, it may be safe to assume that self-administered mobilization techniques are effective but less effective than manual techniques. Perhaps, the most promising use of self-administered mobilizations is as an adjunct intervention to aid in improving outcomes. Although there are few studies on self-administered techniques, the manual joint mobilizations techniques that these techniques mimic are some of the most well-supported interventions in physical rehabilitation (based on the number and academic rigor of available studies). For a comprehensive review of the research on manual mobilization of the joints covered in this course, please visit the following courses.

Joint Mobilization: Hip Joint and Knee Joint

Joint Mobilization: Ankle Joint and Tibiofibular Joint

Dr. Brent Brookbush demonstrating a self-administered hip mobilization

Self-administered Joint Mobilization Protocol

When to use self-administered joint mobilization:

Use when assessment highlights an apparent mobility restriction that is not alleviated by muscular system interventions (foam rolling, release techniques, and/or stretching).

If mobilization causes pain stop immediately.

If mobilization does not result in immediate improvement as confirmed by reassessment, a couple more attempts may be made, but if still ineffective abandon the technique.

Carefully position the band on the appropriate bone close to the restricted joint.

Ensure force is applied in the desired direction.

Apply enough tension to ensure arthrokinematic motion is achieved and tension is maintained throughout the entire range of the oscillation

Rate of roughly 1 – 2 oscillations per second

" Joint mobilizations do not generally result in the relatively intense feelings of tension, stretch or pressure commonly associated with release and lengthening techniques. With the exception of the pressure exerted against the skin by the band, it is not uncommon for the patient/client to feel nothing in the joint being mobilized. When a mild sensation is felt, it is most often described as a "light stretch", an "opening" or "movement within the joint". The most important indication that the technique has been successful, is improvement during reassessment.

Hip Mobilizations

Hip Internal Rotation in Prone < 40 - 50°

Hip External Rotation in Prone < 40 - 50°

Hip 90/90° Internal Rotation < 40 - 50°

Hip 90/90° External Rotation < 40 - 50°

 Any positive sign that includes the hip joint could be an indirect sign of hip joint arthrokinematic dyskinesis.

Tensor Fascia Latae and Gluteus Minimus Self-administered Release

Vastus Lateralis Self-administered Release

Posterior view of the pelvis with ligaments of the sacroiliac and hip joint

Knee Mobilization

 Any positive sign that includes the knee joint could be an indirect sign of knee joint arthrokinematic dyskinesis. The same is true of the ankle.

Biceps Femoris Static Self-administered Release

Gastrocnemius and Soleus Static Manual Release

Self-administered Knee Mobilization: Posterior to Anterior with Extension

The ankle joint with connective tissues, bones, and muscles labeled

Self-administered Ankle Mobilization: Anterior to Posterior Mobilization with Dorsiflexion

Knee and Ankle Mobilization

Walsh, R., & Kinsella, S. (2016). The effects of caudal mobilisation with movement (MWM) and caudal self-mobilisation with movement (SMWM) in relation to restricted internal rotation in the hip: A randomised control pilot study. Manual therapy, 22, 9-15.

Takasaki, H., Hall, T., & Jull, G. (2013). Immediate and short-term effects of Mulligan's mobilization with movement on knee pain and disability associated with knee osteoarthritis–A prospective case series. Physiotherapy theory and practice, 29(2), 87-95.

Jadhav, V. S., & Anap, D. B. (2019). Effectiveness of Mulligan Mobilization Versus Mckenzie Exercises in Knee Osteoarthritis: A Single Blind Randomized Controlled Trial. Physiother Rehabil, 4(177), 2.

Cruz-Díaz, D., Hita-Contreras, F., Martínez-Amat, A., Aibar-Almazán, A., & Kim, K. M. (2020). Ankle-Joint Self-Mobilization and CrossFit Training in Patients With Chronic Ankle Instability: A Randomized Controlled Trial. Journal of Athletic Training.

Darnell, K., Harland, J., Casner, A., Kimball, T., & Tuong, D. (2017). A comparison between hip internal rotation mobilization to posterior glide and their effects on hip internal rotation.

Bibliography

Questions, comments, and criticisms are welcome and encouraged.

Joint Mobilizations: Lower Body (Self-administered)

Related Courses:

Course Description: Self-administered Joint Mobilizations for the Lower Body

Study Guide: Joint Mobilizations: Lower Body (Self-adminstered)

Introduction

Research Corner

Self-administered Joint Mobilization Protocol

Hip Mobilizations
2 Sub Sections

Knee and Ankle Mobilization
2 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Joint Mobilizations: Lower Body (Self-administered)

Related Courses:

Course Description: Self-administered Joint Mobilizations for the Lower Body

Study Guide: Joint Mobilizations: Lower Body (Self-adminstered)

Introduction

Research Corner

Self-administered Joint Mobilization Protocol

Hip Mobilizations2 Sub Sections

Knee and Ankle Mobilization2 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Hip Mobilizations
2 Sub Sections

Knee and Ankle Mobilization
2 Sub Sections