What's the difference between mobilization done by physical therapists and manipulation done by chiropractors?
Mobilization and manipulation are two methods used by physical therapists, osteopathic physicians, and chiropactors. The treatment technique is designed to restore the normal joint position and biomechanics.
Mobilization is a back-and-forth oscillatory movement. The clinician physically moves the joint within the available joint motion. Mobilization can be divided into four grades.
Grade I is a small movement at the beginning of the joint motion. This is done to help reduce painful symptoms. Grade II is a larger amplitude of movement but still done within the joint range of motion.
During Grade III mobilization, the doctor or therapist moves the joint right up to the end of the available motion. In Grade IV, all the slack in the joint is taken up. Then the oscillation occurs at the very end of the available range of motion. This is a way to stretch the joint capsule and the surrounding soft tissues.
Manipulation is a thrust technique. It is done at the end range of joint motion. The patient has no control over the joint motion during a manipulation. Manipulation is also meant to restore full and pain free motion.
The decision to use mobilization versus manipulation is based on several factors. The patient's diagnosis is important. Age and general health are also factors. Older adults with brittle bones from osteoporosis may not be able to tolerate a manipulation but can benefit from mobilization. Each patient is evaluated individually when making this treatment decision.
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