This document discusses joint stability and mobility. It defines the different zones of motion for a joint, including the neutral zone, elastic zone, plastic zone, and destructive zone. The neutral zone refers to the initial "free play" of motion around the neutral position before resistance increases. Pathological conditions can increase the size of the neutral zone. The document also defines the barriers to motion, including the physiologic, elastic, and anatomical barriers, and discusses how mobilization techniques can be used within the spaces between barriers to increase range of motion. Breaching the anatomical barrier can result in plastic changes to tissues around the joint.
This document discusses joint stability and mobility. It defines the different zones of motion for a joint, including the neutral zone, elastic zone, plastic zone, and destructive zone. The neutral zone refers to the initial "free play" of motion around the neutral position before resistance increases. Pathological conditions can increase the size of the neutral zone. The document also defines the barriers to motion, including the physiologic, elastic, and anatomical barriers, and discusses how mobilization techniques can be used within the spaces between barriers to increase range of motion. Breaching the anatomical barrier can result in plastic changes to tissues around the joint.
This document discusses joint stability and mobility. It defines the different zones of motion for a joint, including the neutral zone, elastic zone, plastic zone, and destructive zone. The neutral zone refers to the initial "free play" of motion around the neutral position before resistance increases. Pathological conditions can increase the size of the neutral zone. The document also defines the barriers to motion, including the physiologic, elastic, and anatomical barriers, and discusses how mobilization techniques can be used within the spaces between barriers to increase range of motion. Breaching the anatomical barrier can result in plastic changes to tissues around the joint.
F.A.P. • In order to understand joint instability you must understand joint stability. • Where does joint stability primarily come from? • What are its components? • When damaged which structures must take over the role? • What is the difference between instability and laxity? F.A.P. Midline neutral (neutral axis) – A longitudinal line in a long structure where normal axial stresses are zero when the structure is subjected to bending. That is to say there are no “stresses” imposed upon the soft tissue components about the joint. F.A.P. • Zone’s • Neutral Zone (apart of the physiologic zone) • Elastic Zone (apart of the physiologic zone) • Plastic Zone (apart of the pathologic zone) • Destructive Zone (apart of the pathologic zone) F.A.P. • Neutral zone – The initial phase of ROM is called the neutral zone (NZ) and is usually quite small. • An exception to the rule is the atlanto-axial joint (C1-2) where the NZ makes up 75% (30 degrees) of the total ROM for Y axis motion (40-45). Therefore the NZ can be thought as the free-play or “slop” of the motion segment or joint laxity around the neutral position. F.A.P. • NZ continued – Also described as the displacement between the neutral position and the initiation point (beginning) of spinal resistance to physiological motion. Translatory and rotatory neutral zones are expressed in meters and degrees, respectively. The neutral zone can be expressed for each of the six degrees of freedom. (X-Y-Z, + & -, Translational & Rotational) F.A.P. • NZ continued – Starting from the neutral position, there is large deformation due to application of a small load. After this “easy” deformation, again called “free-play” or “joint play”, there is increasing resistance offered by the tissue. Thus, the motion that takes place between the neutral position (mid-line) and the beginning of significant resistance is the NZ. F.A.P. • Pathological neutral – The NZ has been shown to increase with: • Degeneration (joint & disc) • Surgical injury • Repetitive cyclic loads • High-speed trauma • Elastic Zone is at the end of the neutral zone to the end of active and passive joint motion. • This passive sub-system provides restraint to control end of range motion. • Plastic Zone starts at the yield point and leads to plastic deformation. • Destructive zone. Encompasses both the plastic deformation to complete failure (fracture). BARRIERS TO MOTION
• 1st barrier is called physiologic and represents the end of A-
ROM. • 2nd barrier is called elastic and represents the end of P-ROM. • 3rd barrier is called anatomic or anatomical and represents the end of joint motion that causes no permanent damage to the structures that limit or “check” motion and are important to joint stability. FULL (RESTRICTION FREE) JOINT MOTION • Is that motion attained through complete and un-encumbered motion with assistance (passive) up to that joints anatomical barrier. • To get from the elastic barrier to the anatomic barrier requires a force that exceeds the strength of those things (capsular, fluid & surface tension etc.) that normally restrict joint motion creating that elastic barrier. THE SPACES BETWEEN THE BARRIERS. • The space created between the physiologic barrier and the elastic barrier or the space created between the different distances attained with A-ROM & P-ROM is where we perform mobilization. • This is an aspect of joint motion that one can not do to them self or by them self. It requires outside assistance and therefore is passive in nature. • We use this area (work with in this space) to increase ROM when we can not, for some reason, perform the preferred HV- LA. ANATOMICAL BARRIER • We can breech this barrier in degrees (plastic zone). These are usually graded. There are plastic changes of tissues about the joint that occur initially before total separation &/or permanent damage. Changes to this barrier effect future joint stability. • Limits of Motion (Barriers)