Joint Capsule mobilization is essential in helping patients with joint restrictions improve their mobility. The more consistently the patient can work on capsular mobilization between visits and after discharge, the sooner they can obtain good results. Here is an example of a Self-Mulligan Mobilization with Movement (SMWM) for improving extension using a SuperBand. Typically, for self-hip mobilizations, most individuals over 140 lbs. of body weight will likely want to use a SuperBand with a 100 lb rating, whereas individuals less than 140 lbs may prefer a SuperBand with a 65 lb rating. It can vary on the size of the individual, skill level and goals for treatment. Start by securing the SuperBand to a heavy table or object using a...
As expected with the progression of hip OA, the hip begins to lose mobility in all directions along with a capsular pattern of restriction. During a FABERs test, the patient typically demonstrates a loss of mobility with the knee not being able to fall out as much, sticking up a lot more than normal. One way to improve hip multiplanar mobility is to perform a mobilization technique in what I call a Modified FABERs. Place the patient prone with a pillow under their waist for unloading lumbar spine and place the involved hip into a relative upside-down FABERs position. Initially, you may have to keep them in less relative external rotation using your hand on the involved foot/ankle as this...
To improve hip capsule mobility as quickly as possible, the patient needs to put small doses of "stress" onto the capsule at home between visits and after discharge. If the patient does not assist the provider by performing some exercises or self-mobilization at home, the manual therapy will likely be less effective in its accumulation of benefit and oftentimes not effective at all. All of us healthcare providers will recognize this adductor stretch position commonly called the butterfly stretch, but what a lot of us don't recognize is the value of this movement for "stressing" the joint capsule in a positive way. I teach this movement/position on the first day of treatment in the clinic for all my patients with...
"My name is Julie and I am a 47-year-old mother of 5 boys. I live in Hawaii and lead a fairly active lifestyle. My world came crumbling down when I began to have pain in my hips after activities such as running and volleyball. I went to an orthopedist and he told me that I was developing hip osteoarthritis. He told me to stop doing activities that irritated my hip and that I would need to get a hip replacement soon. Not the news that anyone wants to hear." "I went to an orthopedist who told me that I was developing hip osteoarthritis...to stop doing activities that irritated my hip...get a hip replacement in the near future." "I decided to...
More Self-Mobilization Options for Patients This is the third part of Dr. Tony Rocklin's focus on mobilization with movement that patients can independently do at home. This discussion is excerpted from Tony's presentation at OPTA 2016. You can watch the first part of this discussion here, the second part here, and other excerpts here. Or listen to the full one-hour presentation here. Dr. Rocklin is one of the leading advocates for the efficacy of conservative treatment for patients with hip osteoarthritis, regardless of whether they are preparing for, waiting for, or not candidates for hip replacement surgery. Physical therapy that combines education, manual therapy, and therapeutic exercise can both relieve the pain and improve joint mobility, enabling the patient to...
