Positive Health Online

Looking at joints

Anyone doing bodywork is aware that joints in the human body are vulnerable spots, and thus are often the places for pain or stress.

Where two or more bones join we have a joint, and a joint is a place which generally allows movement. There is, however, a trade-off between joint movement and invulnerability. That is, the price we pay for being able to move a joint is that the joint is susceptible to damage. Of course, when a joint is not operating properly, it can, and usually does, affect the structure and functioning of the whole body.

For example, if someone injures their left ankle joint, then they will do all they can, both consciously and unconsciously, to keep their weight off their left leg. This will lead to the whole right side being compressed, and could even lead to the spinal discs on the right being compressed, causing back pain.

At a more subtle level, whenever a joint is not free to move, the muscles that move that joint can't work properly. And when one area of the body is under strain, the strain at some level carries right through the whole body.

Thus, whatever type of bodywork you are involved in, it is important to pay attention to joints.

Joint play

Movement in joints can be described in two different ways. Usually, when anatomy or movement books describe the movement of joints, they refer implicitly to voluntary movement, that is, movement produced by the action of the voluntary muscles. But from a practical point of view, working with people, I have found a different way of looking at joints to be extremely useful and powerful in doing bodywork. that is, the concept of "joint play", as coined by Mennell. He says that, "Joint play refers to the movement in a joint which cannot be produced by the action of voluntary muscles". Joint play refers to the basic range of movement that is possible for each joint. And for the voluntary movement of a joint to be normal and without strain, this more basic joint play must be normal. Normal joint play can be checked by the practitioner, for each individual part of a joint has its own particular range of possible movements.

The knee joint

To illustrate this basic but relatively unknown concept, let us consider the knee joint.

If you look at an anatomy book, it will state that the knee joint is a freely movable (synovial) hinge joint. The joint is stabilized by a combination of ligaments and muscles. And the movements of the knee joint are flexion, extension and slight rotation. But this refers only to the voluntary movements of the knee joint.

Let us consider the more basic involuntary movements of joint play in the knee joint.

Joint play in the knee joint

In order to understand this, we must separate the knee into three joints:

1) the femorotibial joint
2) the patellofemoral joint
3) the superior tibiofibular joint.

In the femorotibial joint, the movements of joint play are:

1) side tilt medially
2) side tilt laterally
3) anteroposterior glide.

Side tilt medially refers to the practitioner being able to move the femur while stabilizing the tibia to create more space between the medial aspect of the joint.

Side tilt laterally refers to moving the femur in the opposite direction to create more space at the lateral aspect of the joint.

Anteroposterior glide occurs when the femur is stabilized and the tibia is moved forward; then the tibia is stabilized and the femur is moved forward.

In the patellofemoral joint, the joint play is moving the patella downward and left and right while the femur and tibia are still.

The only joint play movement in the tibiofibular joint is anteroposterior moving the fibula forward and backward while holding the tibia still.

The point is, that if these joint play movements are lacking, too limited, painful or larger than normal, then there is a joint problem which will show up either as pain or strain which will affect the body functionally, structurally and energetically this concept applies to all moving joints in the body, including the spine.

Applying the concept in your work

My feeling is that if any bodyworker or massage therapist has a client with joint pain, stress and strain at a certain joint, or limited voluntary joint motion, then the practitioner should check joint play. They could then make it one of the goals of the session to improve the joint play and recheck it at the end of the session.

The goal of this article was to acquaint you with the concept of joint play, and hopefully whet your appetite so that you pursue it further.

There is not enough information here to allow you actually to do it. I suggest you start by referring to the excellent works of Mennell.

Mennell's books, however, are not that easy to find.

Consider the search a treasure hunt.

Good hunting!

References:

Mennell GM. Back Pain. Boston, Mass: Little, Brown and Company; 1960

Mennell GM. Joint Pain. Boston, Mass: Little, Brown and Company; 1964.

Copyright C 1996 by Allan Rudolf