Joint Integrity (9/11a) Flashcards
Joint integrity
describing if the joint is anatomically and biomechanically normal
Considers more than just mobility
Joint mobility
the ability of the joint to be moved passively
Accessory motion/joint play
small, isolated motions normally present at a joint that must be performed passively by an examiner or external force
can’t be done actively
Force production issues (AROM is less than PROM)
nerve recruitment (PNS/CNS)
low muscle mass
muscle is tethered or inferior
lack of motivation
Reduced PROM can be due to
Shortened internal joint structures (ligaments and joint capsules)
Fat tissue adhered to structures around joint
Muscles are too tight
Patient is afraid or in pain
Assessment of joint play considers what
anatomical issues causing reduced ROM and also overstretching injuries
Sprain
overstretched ligaments and capsules
Strain
overstretched muscles and tendons
Grades of sprains
Grade 1: overstretching, majority of fibers intact
Generally pain, normal motion, normal end feel
Grade 2: partial tear
Generally pain, slightly abnormal, softer end feel
Grade 3: complete tear
Generally no pain, abnormal amount of motion, soft end feel
Swelling
general term for extra fluid in an area
Edema
fluid between tissue layers; joint was violated and fluid got out or something else going on
Effusion
fluid encapsulated within the joint, usually needs a needle to remove the fluid
Hypermobile
more than normal mobility
Hypomobile
less than normal mobility
Generally expect more mobility from
women and younger age groups
Laxity vs Instability
Laxity - more motion than normal, loose motion, CT longer than normal
Instability - symptomatic manifestation
End feel
the sensation the PT can feel at the end of ROM
Types of End Feel (PT terms)
Tissue approximation Capsular end feel Bony end feel Spasm end feel Empty end feel
End Feel - Tissue approximation
subcutaneous tissues pushing against each other and limiting ROM
EX: elbow flexion
End Feel - Capsular
joint capsule is limiting the ROM
Feels like stretching a leather belt
EX: shoulder lateral rotation
End Feel - Bony
bone touching bone is limiting the ROM
hard, clear stop
EX: elbow extension
End Feel - Spasm
muscles abruptly halt motion due to intense pain and guarding
End Feel - Empty
patient may be in pain but nothing physically stops you from going farther into ROM
