3a - Tissue End Feels

Question 1

Thinking about contractile structures: would pain increase or decrease with active and resisted movements in the same direction?

Answer 1

Increase

Question 2

Thinking about contractile structures: would pain increase or decrease with passive movements in the opposite direction?

Answer 2

Increase

Question 3

Thinking about inert structures: what provokes pain?

Answer 3

Stretching the tissue

Question 4

Thinking about inert structure: are resisted movements painful?

Answer 4

No, tissue isn’t on stretch

Question 5

Thinking about inert structures: would pain increase or decrease with active and passive movements in the same direction?

Answer 5

Increase

Question 6

What does PPM stand for?

Answer 6

Passive Physiological Movements

Question 7

What is the definition of an end feel?

Answer 7

A sensation that the therapist feels in the joint and surrounding tissues at the end of available ROM during passive movement

Question 8

What are the three types of NORMAL end feels?

Answer 8

Bone to Bone
Capsular or Soft Tissue Stretch
Soft Tissue Approximation

Question 9

What does a bone on bone end feel, feel like?

Answer 9

Abrupt stop in motion, two bone surfaces coming together

Ex. elbow extension

Question 10

What does a capsular/soft tissue stretch end feel, feel like?

Answer 10

Hard-ish stop in motion. Spring like or slight give

Ex. shoulder lateral/external rotation

Question 11

What does a soft tissue approximation end feel, feel like?

Answer 11

Squishy and gives a lot
Movement is stopped by limb hitting against soft tissue of another body part
Ex. knee flexion or elbow flexion

Question 12

What are some examples of ABNORMAL end feels?

Answer 12

Empty, Spasm, Springy block, Abnormal bone to bone, Abnormal capsular

Question 13

What is an empty end feel?

Answer 13

When the movement is stopped by pain before resistance is felt

Question 14

What is a spasm end feel?

Answer 14

it is involuntary and vibrant twang (usually happens with a recent fracture)

Question 15

What is a springy block end feel?

Answer 15

It is an unexpected rebound, non-capsular patter restriction (ex. tear)

Question 16

What is an abnormal bone to bone end feel?

Answer 16

It is an early abrupt stop may have crepitus or grating (ex. post-immobilization)

Question 17

What is an abnormal capsular end feel?

Answer 17

It is an early hard-ish stop before end range (ex. frozen shoulder)

Question 18

What is a capsular pattern of restriction?

Answer 18

It is a characteristic pattern of expected proportional limitation of movement
It is specific to a particular joint

Question 19

What types of joints does capsular pattern of restriction occur in?

Answer 19

Only occurs in joints controlled by muscles which has a joint capsule and is lined by a synovial membrane

Question 20

How do you determine a capsular pattern of restriction?

Answer 20

Through passive movements

Question 21

What is the definition of a closed packed position?

Answer 21

It is the most stable position of a joint, also provides the greatest protection.
It is where there is the greatest congruency or surfaces and places the capsule and ligaments under max tension

Question 22

True or false: if a joint is swollen you can still reach a closed packed position

Answer 22

False

Question 23

What is the definition of a loose packed position?

Answer 23

Technically any other position besides the closed packed.
It is when the joint surfaces are not congruent
The capsule and ligaments are relaxed so there is the least amount of stress on structures.
It is a naturally adopted position for when there is pain

Question 24

What is the difference between a loose packed position and the resting position of a joint?

Answer 24

Resting position is a specific loose packed position where there is the least amount of congruency between surfaces.
Capsule and ligaments have greatest laxity

Question 25

What is the constant length phenomenon?

Answer 25

Limitation of movement at one joint is dependant on the position at which another joint is held.