Hip Joint Mobilisation and Manipulation Technique

  1. Long axis or indirect traction/manipulation

–Hip joint mibilisation technique to stretch capsule to increase ROM and pain relief.

Long axis or indirect traction/manipulation

Patient position:

–supine, Hip – 300Flexion, 300Abduction and External rotation. Fix patient’s pelvis with belt or ask to hold edge of table.

Therapist position:

–standing at patient’s feet. Wrap belt behind ankle, cross in front of ankle in figure of 8 fashions. Connect behin
d therapist’s waist.

Therapist positionTraction: lean back and provide static force in longitudinal direction.

Manipulation:

–take up slack in hip, at the end of motion, HVLAT in caudal direction.

In Prone: same as in supine except hip in extension, Abduction and external rotation.

2.Direct Traction

Direct TractionPatient position: supine, Hip flexion with lower extremity over therapists shoulder. Therapist places his hand near hip joint.

Traction: inferiorly with hands (belt can be used), cephalically with shoulder to improve inferior distraction. Glide joint to available range further.

3. Lateral distraction:Lateral distraction

–Improves flexion, Adduction, Internal Rotation.Patient position: supine. Hip 90 deg flexion. Knee fully flexed.Therapist position: Standing on side, wrap belt around hip cre
ase,cross in-front of therapist, wrap behind waist.Technique: passively flex, adduct, Internal rotation up to available pain free range. Lean back to slack and provide static distraction in lateral direction.

  1. Hip Caudal Glide

Hip Caudal Glide–posterior capsule stretch, improves flexion

Patient position: supine with hip knee flexion.

Therapist position: Standing on side, wrap belt around hip crease, cross infront of therapist, wrap behind waist.

Technique: passively flex, Adduction/Abduction, Internal rotation/External rotation  up to pain free range. Lean back, static force in caudal direction to proximal femur.

  1. Anterior-posterior mobilisation:

–stretch posterior capsule

Patient position: supine with hip flexion, Adduction and Internal rotation. Foot along lateral aspect of opposite Knee.

Therapist position: standing on opposite side with hands over the knee.

Tech: static force along long axis of femur in posterior direction.

Anterior-posterior mobilisation

# Hip Flexion, Adduction, Internal rotation can be adjusted, foot might not cross other side. Therapist can provide force standing on the same side in this case.

  1. Posterior – anterior Hip Joint Mobilisation;

–stretch anterior capsule.

Patient position: prone with knee flexion

Therapist Position: standing on side, support leg and lift above knee with one hand.

Technique: provide static force in anterior lateral direction. with hypothenar eminence in gluteal fold over proximal femur.

(may use belt or towel as shown in fig below)

  Posterior - anterior Hip Joint Mobilisation

  1. PA Hip joint mobilization with prone figure of 4 position

Same as above except patient hip flexion, Abduction and External rotation

Provide anterior lateral static force with web-space of hand.

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