Mobilization-Therapy vs. Motion-Therapy

Having been an advocate of ATM-2 therapy for nearly 13 years I have been encouraged to recognize how instability (hyper-mobility or excessive motion in-the-neutral zone of a motion segment) differs from hypo-mobility in several key ways. Most Chiropractic procedures have as their implicit “finding” a segment in need of mobilization. However the difficulty with our ubiquitous concept (at the core of virtually all techniques) is that hypo-mobility has no objectifier i.e. no valid or reliable tests to prove its existence. Recent videofluoroscopy studies suggest hyper, hypo & paradoxical motion are “random” occurrences within the spine…if you observe the spine consistently under precise conditions the motion-segments fluctuate (this is not the case with severe degenerative or anatomically fused segments of course) so the “when and how” of “mobilization” remains elusive.
Hyper-mobility however can be clinically validated via force-closure/muscle-contraction tests. Muscles brace and stiffen the spine and as such will buttress motion and stop the pain-invoking shear. The “when & how” of “motion-therapy” is more secure.

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