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...
Therapeutic exercise = “medicine” for many chronic illnesses Therapeutic exercise is a key component in the conservative treatment of hip osteoarthritis. A paper published in the Scandinavian Journal of Medicine & Science in Sports provides the up-to-date evidence-based basis for prescribing therapeutic exercise for hip osteoarthritis and more than twenty other chronic diseases. Exercise as medicine “ evidence for prescribing exercise as therapy in 26 different chronic diseases was written by B.K. Pederson and B. Saltin and published in September 2015. In the section focused on osteoarthritis, the authors observe Patients with osteoarthritis have a low physical activity level (Semanik et al., 2012), low muscle strength, and impaired muscle function (Roos et al., 2011; Segal and Glass, 2011) and go on...
