End-Feels

Question 1

Soft

Answer 1

Normal end feel.
- Due to soft tissue approximation
Ex. Knee flexion

Question 2

Firm

Answer 2

Normal end feel

3 types: muscular stretch, capsular stretch, and ligamentous stretch

Question 3

Firm: muscular stretch

Answer 3

Normal end feel
Due to stretching of muscles
Ex. Hip flexion with knee extended. Hamstrings are stretching

Question 4

Firm: capsular stretch

Answer 4

Normal end feel
Due to tension in the joint capsule
Ex. Extension of MCP joints of fingers. Tension in ant. capsule

Question 5

Firm: ligamentous stretch

Answer 5

Normal end feel
Due to stretching of the ligaments
Ex. Forearm supination. Tension in the palmar radioulnar lig of inferior radioulnar joint, interosseous membrane, and oblique cord.

Question 6

Hard

Answer 6

Normal end feel
Due to bone contacting bone
Ex. Elbow extension

Question 7

Bone to bone (bony)

Answer 7

Pathological
Hard, unyielding end feel when it shouldn’t be a bone-to-bone end feel. Restriction occurs before the end of normal ROM.
Ex. Osteophytes, degenerative joint disease, or malunion of joint after a fracture

Question 8

Muscle spasm end feel

Answer 8

Pathological
Sudden and hard dramatic arrest of movement accompanied by pain which is invoked by the movement. It will have a springy rebound end feel. It is reflexive (protective) muscle guarding to prevent further injury.

Question 9

Empty end feel

Answer 9

Pathological
No physical restriction to the movement, but there is pain. May get to full ROM but with pain.
Ex. Acute bursitis or joint inflammation

Question 10

Springy block end feel (internal derangement)

Answer 10

Pathological
Springy or rebound sensation in a non-capsular pattern. Usually occurs before the end of normal ROM.
Ex. Loose cartilage gets stuck between the articulating surfaces like in a torn meniscus.

Question 11

Leathery end feel (capsular stretch)

Answer 11

Pathological
Similar to tissue stretch but occurs when ROM is reduced
- Two types: hard capsular and soft capsular

Question 12

Hard capsular

Answer 12

Pathological

There is a thick quality, and the limitation comes on abruptly.

Question 13

Soft capsular

Answer 13

Pathological
More often seen with acute conditions. Stiffness occurs early in the range and increases until the end of the range is reached.

Question 14

Boggy or soft end feel

Answer 14

Pathological
Occurs if you have a joint effusion (swollen joint) or edema. It may be mushy or have a soft quality to it. It can indicate acute inflammation.
Ex. Acute moderate to severe pain, ligamentous injury