Physical therapists are good at assessing general lumbar AROM. Our skills often suffer when breaking down the gross active movements into specific segmental mobility testing. When performing lumbar segmental mobility, we should be looking to see if a facet joint is hypomobile. As a general rule, physical therapists are better at assessing hypomobilities than hypermobilities. It is important to assess segmental mobility because this assessment helps the clinician determine which segment is not moving properly.
When performing lumbar segmental mobility testing, the examiner should be assessing:
1) Expected normal mobility of the segment
2) Comparing mobility to joints above and below
3) Comparing left to ride asymmetries
4) Consider patient's age, gender, and body type
During my lumbar examination, I perform segmental mobility testing after I have watched the patient's functional movements, cardinal plane AROM, PA joint mobility and performed special testing. I am using the findings from each portion of the exam to paint a clinical picture. For example, if the patient is a middle-aged male, acute onset of low back pain, moderate obesity, generally feels "stiff," and lacks adequate cardinal plane AROM, I can confidently assume the patient has some segmental mobility deficits. See below to assess how I perform lumbar segmental mobility.
Let me know if you have any questions or comments.