How Does It Work?
A joint does not simply hinge. Alongside the obvious swing, the surfaces glide and roll across each other, and it is this accessory movement that is usually lost first after injury, immobilisation or long-standing stiffness. You cannot restore it yourself, because it is not a movement you can voluntarily produce.
Mobilisation applies that glide from outside. The therapist stabilises one bone and moves the other through small, repeated oscillations at a chosen depth in the available range. Working early in range calms pain; working at the end of range addresses stiffness. The grade is selected from the assessment and adjusted as the joint responds.
The effect appears to be a combination of mechanical and neurological change: a genuine increase in available range, alongside a reduction in pain sensitivity and in the protective muscle guarding that was limiting movement in the first place.
This is deliberately distinct from high-velocity manipulation. Mobilisation stays within your control, can be stopped instantly, and does not depend on producing an audible pop.
Types/Variations We Offer
Maitland graded oscillations: rhythmic movements from grade I to IV, chosen according to whether pain or stiffness dominates.
Mulligan mobilisation with movement: the therapist sustains a glide while you actively move the joint, often producing immediate pain-free range.
Sustained accessory glides: a steady hold rather than an oscillation, used for capsular tightness such as frozen shoulder.
Traction or distraction: the joint surfaces are gently separated to offload an irritable joint.
Conditions Treated
Advantages & Expected Benefits
Restores glide that no amount of self-stretching can reach
Reduces pain through the joint itself rather than by masking it
Settles the protective muscle guarding that limits movement
Graded and reversible, with intensity matched to how irritable the joint is
Creates the window of movement in which strengthening can actually be done
Particularly effective for stiffness after immobilisation in a cast or sling
Potential Risks & Short-term Side Effects
Short-lived soreness or stiffness for up to twenty-four hours after treatment
A temporary increase in symptoms if the joint was more irritable than it appeared
Rarely, bruising in people with fragile tissue or on anticoagulants
Contra-Indications / Precautions
This treatment may not be suitable for individuals with:
- •Recent unhealed fracture, dislocation or surgical fixation at the joint being treated
- •Active joint infection, inflammatory flare, or suspected septic arthritis
- •Known or suspected malignancy, or unexplained night pain and weight loss
- •Significant ligamentous instability, or connective-tissue disorders causing hypermobility
- •Cervical mobilisation is avoided where there are signs of vertebral artery insufficiency, and is approached with particular caution in rheumatoid arthritis and Down syndrome given upper cervical instability risk
- •Advanced osteoporosis, where force must be substantially reduced or the technique avoided
What to Expect in a Session
Assessment: active range, passive range and accessory glide are tested and compared side to side, so the specific direction of restriction is identified.
Irritability grading: how easily the joint flares determines whether treatment starts gently for pain or firmly for stiffness.
Treatment: the chosen glide is applied in sets of oscillations, with the joint reassessed between sets rather than at the end.
Active follow-through: you immediately move into the range that was just gained, so the nervous system registers and keeps it.
Home programme: a specific range-of-motion and strengthening plan, because a joint that gains range and is not loaded tends to give it back.
Evidence & Clinical Guidelines
Manual therapy combined with exercise is more consistently supported by trial evidence than manual therapy alone, which is why mobilisation here is always paired with a loading programme.
For neck and low back pain, guidelines from several countries include manual therapy as one option within a package that has exercise and education at its centre, rather than as a first-line treatment on its own.
The immediate range gains after mobilisation with movement are well documented in short-term studies; how long they persist depends on the exercise that follows.
Frequently Asked Questions
Is this the same as chiropractic cracking?
No. Mobilisation uses slow, graded, controlled movements that you can stop at any moment, and does not involve a sudden thrust or aim to produce a pop. Dr. Surabhi Bansal is a physiotherapist, and mobilisation is a core physiotherapy technique.
Will I hear a click?
Sometimes a joint releases audibly during movement, and it is harmless, but it is not the goal and it is not a sign that anything has been put back into place. Nothing is out of place to begin with.
Why does my shoulder need this rather than just stretching?
Stretching lengthens muscle. Frozen shoulder and post-cast stiffness are largely capsular, meaning the joint lining itself has tightened, and the glide that has been lost is not a movement you can produce voluntarily. That is what mobilisation restores.
Is it safe for my neck?
It is, once screening is done. Your neck is examined for the specific signs that would make mobilisation unsuitable before any technique is applied, and treatment is stopped if you report dizziness, visual change or any unusual symptom.
Need More Information?
Our expert physiotherapists are here to answer any questions you may have about Joint Mobilisations.
Medically Reviewed
This content was reviewed for medical accuracy by Dr. Surabhi Bansal, BPT, MPT (Ortho) with 14+ years of clinical experience.
At Modern Physio, all medical content undergoes a thorough review process to ensure accuracy and alignment with current physiotherapy standards. Our content is created to educate and should not replace professional medical advice. Learn more about our review process.