In the described rehabilitation protocol, which is the initial treatment step?

• A. Soft tissue manipulation of involved and regional areas
• B. Passive to active
• C. Joint mobilization after normalization of soft tissue
• D. Joint and soft tissue elongation

Answer: (B)

The main idea is to begin rehabilitation with a safe, graded progression of movement that protects healing tissues while rebuilding function. Starting with passive range of motion allows the joint to move without demanding active muscle contraction, which minimizes stress on injured structures. This helps maintain joint mobility, prevents stiffness, and lets clinicians assess how much motion is tolerated. As pain and tissue tolerance improve, active range of motion is gradually introduced to re-educate muscles, improve control, and begin strengthening. Other techniques like soft tissue manipulation or joint mobilization, and stretching, are typically reserved for later phases or once initial motion has been established and tissue tolerance has increased. So the initial step of moving from passive to active motion aligns with a safe, progressive approach to restore movement without overloading healing tissues.