elbow

Question 1

humeroulnar / trochlear joint - 3 joint mobilizations

Answer 1

1. Distraction (#1 and #2)
2. Medial and Lateral Gap
3. Medial and Lateral Glide

Question 2

humeroulnar / trochlear - DISTRACTION #1: purpose & precautions

Answer 2

PURPOSE: increase overall ROM, pain management
PRECAUTIONS: soft hand approach so pressure applied does not cause pain. Caution, as the median nerve and brachial artery are medial to the biceps tendon and not to be compressed

Question 3

humeroulnar / trochlear - DISTRACTION: hand placement

Answer 3

-stabilizing Hand: firm pressure to humerus towards the table to stabilize the humerus
-mobilizing Hand: 2nd MCP joint on the anterior surface of the proximal end of the ulna. Then direct the mobilization perpendicular (at right angles) to the ulna in order to distract the ulna from the humerus

Question 4

humeroulnar / trochlear - DISTRACTION: helpful suggestions

Answer 4

must apply pressure to distal humerus towards the table, before mobilizing with your MCP joint, the humerus may move inferiorly. Use a pillow/towel under the patients elbow

Question 5

humeroulnar / trochlear - DISTRACTION #2: purpose & precautions

Answer 5

PURPOSE: increase overall ROM, pain management
PRECAUTIONS: Soft hand approach, to not cause pain. Caution, median nerve and brachial artery are close by medial to the biceps tendon

Question 6

humeroulnar / trochlear - DISTRACTION #2: hand placement

Answer 6

-stabilizing Hand: distal forearm on your shoulder, stabilize humerus by applying pressure towards the table
-mobilizing Hand: place index, middle and ring fingers of both hands on the anterior surface of the proximal end of the ulna, direct the mobilization perpendicular to the ulna in order to separate or distract the ulna from the humerus

Question 7

humeroulnar / trochlear - DISTRACTION #2: helpful suggestions

Answer 7

applying pressure towards the table before mobilizing with your fingers is vital to be effective with this technique. Use a pillow under the patient’s elbow

Question 8

humeroulnar / trochlear - medial gap: purpose & precautions

Answer 8

PURPOSE: increase elbow flexion & extension, pain management
PRECAUTIONS: do not lever the joint by pulling the forearm laterally

Question 9

humeroulnar / trochlear - medial gap: hand placement

Answer 9

-stabilizing Hand: distal forearm on ulnar side
-mobilizing Hand: crosses the lateral joint line, apply gentle force from lateral to medial stressing the medial collateral ligament

Question 10

humeroulnar / trochlear - medial gap: helpful suggestions

Answer 10

make sure the humerus doesn’t rotate laterally or medially, as this will make the mobilization ineffective

Question 11

humeroulnar / trochlear - lateral gap: purpose & precautions

Answer 11

PURPOSE: increase elbow flexion & extension, pain management
PRECAUTIONS: do not mobilize in full extension, do not lever the joint

Question 12

humeroulnar / trochlear - lateral gap: hand placement

Answer 12

-stabilizing Hand: radial side of distal forearm
-mobilizing Hand: crosses the medial joint line, apply gentle force from medial to lateral stressing the lateral collateral ligament

Question 13

humeroulnar / trochlear - medial glide: purpose & precautions

Answer 13

PURPOSE: increase overall ROM, pain management
PRECAUTIONS: do not compress the ulnar nerve in the cubutal tunnel and do not squeeze with your fingers as this may cause pain and muscle guarding

Question 14

humeroulnar / trochlear - medial glide: hand palcement

Answer 14

-stabilizing Hand: proximal to the joint line on the medial surface of the humerus
-mobilizing Hand: distal to the joint line on the proximal ulna applying a medial force. Index fingers guide the mobilization on the olecranon. This facilitates an easier and more effective mobilization to the ulna and less pressure on the radius

Question 15

humeroulnar / trochlear - medial glide: helpful suggestions

Answer 15

keep the patient’s elbow on the table for stability and support, stay close tot he joint line

Question 16

humeroulnar / trochlear - lateral glide: purpose & precautions

Answer 16

PURPOSE: increase overall ROM, pain management
PRECAUTIONS: do not squeeze with your fingers as this may cause pain and muscle guarding

Question 17

humeroulnar / trochlear - lateral glide: hand placement

Answer 17

-stabilizing Hand: proximal to the joint line of the elbow on the lateral surface
-mobilizing Hand: distal to the joint line, apply a lateral force on the proximal ulna. Use your index finger to guide the mobilization on the olecranon. Direct the mobilization force onto the medial side of the olecranon.

Question 18

humeroulnar / trochlear - lateral glide: helpful suggestions

Answer 18

keep the elbow on the table for stability and use a rolled up towel under distal forearm for support. Stay close to the joint line

Question 19

humeroradial joint - 3 joint mobilizations

Answer 19

1. Axial distraction
2. Posterior glide radius on humerus
3. Anterior glide radius on humerus

Question 20

humeroradial joint - axial distraction: purpose & precautions

Answer 20

PURPOSE: increase overall ROM, pain management
PRECAUTIONS: grasp the wrist proximally, do not pull on the carpal bones