Accessory movements

Question 1

Potential symptoms

Answer 1

Pain

Resistance

Spasm

At early, middle or late range

Question 2

Describe grading technique

Answer 2

Grade 1:
Small movement without resistance

Grade 2:
Large movement without resistance

Grade 3:
Large movement with resistance

Grade 4:
Small amplitude with resistance

Question 3

Longitudinal Caudad movement

Answer 3

Hip Accessory Movement

Movement of head of femur in a longitudinal direction in relation to the acetabulum

Neel or sit on the plinth
Hook hands over medial and lateral epicondyles

Or perform in hip flexion by grasping around anterior of thigh

Lean back while pulling on the femur

Question 4

AP tibia

Answer 4

Knee accessory movement

Web hands at the level of tibial tubercle

Apply AP movement with knee in flexion

Expected movement is minimal

Mimics knee flexion

Question 5

AP Femur

Answer 5

Supine lying

AP movement on anterior distal femur

apply a graded movement

Mimics knee extension

Question 6

Patellofemoral joint

Answer 6

Medial transverse movement:
Place pads of both thumbs on lateral side with thumbs facing each other

Apply medial glide
Compare to other side

Lateral transverse movement:
Place pads of both thumbs on medial side

Apply graded movement

Question 7

AP Talus

Answer 7

Prone lying and knee flexed

Cup posterior aspect of the lower tibia and fibula with lower hand

Upper hand thumb and index finger placed around anterior aspect of the talus

Hold foot close to chest

Apply AP movement with counter pressure on tibia and fibula

Feel for areas of limitation

Question 8

PA Talus

Answer 8

Prone lying and knee flexed

Cup anterior aspect of tibia and fibula

Upper hand thumb and index finger on posterior aspect of talus

Foot close to chest

Apply PA movement with counter pressure on tibia and fibula

Feel for any areas of limitation

Question 9

Transverse movement medially and laterally

Answer 9

Model: leg flexed and other foot over edge of the plinth but leg in contact

Passively dorsiflex ankle using thigh

Support ankle holding lower tibia and fibula with upper hand

Place heel of other hand on the medial surface of the calcaneus

Apply a lateral glide on calcaneus

Medial
Place heel of hand on lateral surface of calcaneus. Medial glide

Question 10

Metatarsophalangeal AP

Answer 10

Fix distal part of metatarsal with thumb and index finger

Hold proximal phalanx with thumb and index finger of other hand

Apply AP movement on phalanx

Question 11

Metatarsophalangeal PA

Answer 11

Model prone in knee flexion

Distal part of metatarsal with thumb

Other thumb grasps proximal phalanx

Thumbs meet

PA movement

Question 12

Interphalangeal AP

Answer 12

Supine lying

Distal part of more proximal phalanx with thumb

hold proximal part of more distal phalanx with other thumb

Thumb meet

Apply AP

Question 13

Interphalangeal PA

Answer 13

Prone lying

Knee flexed

Same technique as AP