In the world of Functional Manual Therapy (FMT) we refer to efficiency rather than normal. Normal is difficult to define when referring to the human body because we are all slightly different anatomically. When referring to efficiency of joints we consider how the bones move on each other in three dimensions. In FMT we refer to the roll and glide of one bone on another. In the knee the top of the tibia moves back on the end of the femur like a drawer when the knee is bending. [...]
When the knee is straightening, the opposite occurs. FMT takes this understood convention a little further and we assess how the tibia moves side to side and in diagonals as it bends and straightens as well. Doing so allows us to obtain maximum joint motion efficiency and mobility. This motion only occurs if the thick joint capsule that attaches the two bones allows. A clinical example may help to illustrate this a little more clearly. If we are treating someone whose knee does not bend efficiently, we apply an assisting force with our hands or myriad other devices including towels or straps and have the patient/ client contract the appropriate muscle to perform the same action. This is what is known as a functional mobilization. Functional mobilizations use external force (therapist) and internal (patient effort) to move bones efficiently and with far less pain than “traditional” joint mobilizations. When we take the three-dimensional motion of a joint into consideration and apply it to joint mobilizations and couple it with retraining of the neuromuscular system to move the bones appropriately, we restore the efficiency of motion or stability.
Author: Mike And Tiffany
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