Accessory Movements

Question 1

State the definition of a accessory movement?

Answer 1

An accessory movement is a joint movement which cannot be performed by an individual.

Question 2

Outline what accessory movements do specifically stating what each grade on the Maitland’s grading scale does.

Answer 2

Accessory movements are used to reduce pain and stiffness at the joint with grade 1 and 2 being used to reduce pain and grade 3 and 4 being used to reduce stiffness.

Question 3

Identify 7 different types of accessory movements.

Answer 3

AP
PA
Longitudinal Caudad
Longitudinal Cephalad
Distraction
Medial Glide
Lateral Glide

Question 4

Explain how accessory movements reduce pain.

Answer 4

Pain gate mechanism- the accessory movements will stimulate a Delta fibres which will reach the inhibitory interneurons faster then the pain signals. This will inhibit the interneuron from working as the gate will be closed preventing pain reaching the brain.

Descending inhibition

Question 5

State the contraindications of accessory movements.

Answer 5

Bone disease
Cancer
Pregnancy
Spinal instability 
Arthritis
Recent whiplash

Question 6

How would you carry out a longitudinal caudad and cephalad of the elbow joint?

Answer 6

Fixate the distal humerus
Support the distal ulnar and radius
Pull the arm upwards to the ceiling for caudad and for celphalad push the arm down.

Question 7

PA and AP of the glenohumeral joint

Answer 7

Palpate the posterior section of the coracoid process and then move down onto the posterior section of the deltoid.
Place both thumbs under the posterior deltoid and use it to push it up.
For and AP fixate the scapula and go for the anterior side of the deltoid.

Question 8

Knee AP and PA

Answer 8

Bend knee to 90 degrees and ask patient to relax their foot and sit on it to stabilise everything.
Then place your thumbs either side of the patella and wrap your fingers round onto the gastroc.
Then just lean in pushing in through your thumbs.

For a PA do the same thing but pull with your fingers that are wrapped around the gastroc and pull the knee towards you.

Question 9

Hip AP and PA

Answer 9

Hold onto the the ilieum with the hand closest to the models head.
Place the other hand on the greater trochanter at a 90 degree angle inbetween the if the hand was pointing to the head or leg and push the trochanter away from you using your palm.

For a PA do the same thing but stand behind the models bum.