Joints (Synovial), Joint Capsules and Ligaments
Several named modes of therapy involve joints. Manipulation, joint mobilization, alignment, remodeling of collagen and even exercise are the main ones. Any muscle lengthening procedure will involve joints as well. This section will demonstrate one way of accessing and treating them. Ligaments and joint capsules that span the joint and the bone on either side are all actually part of that joint. As an early embryo all the above structures including the joint space were one enlage that is, a common mold of mesenchymal cells. Therefore, one part of the joint alone can’t be affected without involving others. The bone will be discussed in another video. Only a few examples are shown here.
Remember, nerves are in these structures, especially after injury.
Many of the problems exist where the ligaments and joint capsules join the bone (enthesis). Only the soft tissue aspect of the entheses will be covered here.
With all these techniques, the position has to be held long enough in order to have fluid movement.
Just a reminder, after injury previous avascular and aneural tissue change. We humans often injure joints and these changes are therefore quite common. The intervertebral disc is a good example. Again, take the joint to end range and hold for a few seconds. Give the excess fluid time to egress. We always monitor the patient’s response during these techniques. End range loading is really no different than performing orthopaedic and neurological tests.