At times, patients might develop movement problems secondary to an acute injury while at other times they develop joint mobility problems over time which is more of a chronic nature and is due to increased stress on a particular area, which might eventually result in an injury. Manual physical therapy in the form of joint mobilization and manipulation has been shown to be effective in providing long-lasting relief of pain and movement dysfunction. Furthermore, it improves the mobility of a joint allowing for movement re-education and/or compensatory movement patterns. The physical therapist provides joint mobilization by gliding or tractioning (separating) the joint using a variety of specialized techniques. In some cases, the decreased mobility in a non-painful area may be causing the problem in another area. For example, a patient presents with shoulder pain. It appears that the joint is being strained at the end of range for overhead movement. The therapist determines that this is the result of decreased spinal extension and performs joint mobilizations to the thoracic spine restoring normal extension. This then results in an increase of functional overhead range of motion and decreases the amount that the shoulder has to move thereby reducing the stress and allowing it to heal (Kulig et al. 2004, Cleland et al. 2007, Brosseau et al. 2008a).
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