Joint Mobilizations (Week5)

Question 1

What are the loose-pack and close-pack positions for the Tibiofemoral Joint?

Answer 1

• Loose-pack position: 25° flexion.
• Close-pack position: Full extension with external rotation.

Question 2

What are the patient position options for Tibiofemoral Joint distraction?

Answer 2

• Supine: Patient lies on their back.
• Seated: Patient sits with their leg over the edge of the table.

Question 3

How should the therapist position themselves for Tibiofemoral Joint distraction?

Answer 3

• Kneeling/seated at the patient’s foot, facing their knee.
• Both hands grasp the distal leg just proximal to the malleoli.

Question 4

How is a Tibiofemoral Joint distraction performed?

Answer 4

Both hands distract the leg inferiorly.

Question 5

What are the uses of Tibiofemoral Joint distraction?

Answer 5

• To improve general knee mobility.
• For pain control.
• To increase nutrition to articular structures.

Question 6

What is the supine patient position for a Tibiofemoral Joint anterior glide?

Answer 6

Patient is supine, with the hip and knee flexed, and the foot flat on the table.

Question 7

How should the therapist position themselves for a supine anterior glide of the Tibiofemoral Joint?

Answer 7

• Therapist sits on the patient’s foot (use a barrier).
• Both hands grasp the proximal leg.
• Fingers wrap behind the knee, with thumbs gently palpating the anterior joint space on either side of the patellar ligament.

Question 8

What is the prone patient position for a Tibiofemoral Joint anterior glide?

Answer 8

Patient lies prone, with a towel or pillow under the distal femur.

Question 9

How should the therapist position themselves for a prone anterior glide of the Tibiofemoral Joint?

Answer 9

Standing at the side of the table.

• Inferior hand: Grasps the anterior aspect of the distal leg.
• Superior hand: Heel of the palm is on the posterior aspect of the proximal leg.

Question 10

How is a Tibiofemoral Joint anterior glide performed in both supine and prone positions?

Answer 10

The tibia is mobilized anteriorly using body weight.

Question 11

What is the use of a Tibiofemoral Joint anterior glide?

Answer 11

To improve knee extension.

Question 12

What is the patient position for a Tibiofemoral Joint posterior glide?

Answer 12

Hip and knee are flexed with the foot flat on the table.

Question 13

How should the therapist position themselves for a Tibiofemoral Joint posterior glide?

Answer 13

• Sitting on the patient’s foot (use a barrier), similar to the posterior drawer test.
• Both hands grasp the proximal leg.
• Thenar eminences are positioned on the anterior proximal tibia with thumbs gently palpating the anterior joint space on either side of the patellar ligament.

Question 14

How is a Tibiofemoral Joint posterior glide performed?

Answer 14

Mobilize the tibia posteriorly using your body weight.

Question 15

What is the use of a Tibiofemoral Joint posterior glide?

Answer 15

To improve knee flexion.

Question 16

What are the patient position options for Tibiofemoral Rotational Glides?

Answer 16

1. Seated: Leg hanging over the edge of the table.
2. Prone: Knee bent, with the therapist stabilizing the distal thigh.

Question 17

How should the therapist position themselves for Tibiofemoral Rotational Glides in the seated option?

Answer 17

• Kneeling at the patient’s foot, facing their knee.
• Both hands grasp the distal leg just proximal to the malleoli.

Question 18

How should the therapist position themselves for Tibiofemoral Rotational Glides in the prone option?

Answer 18

• Standing beside the table, use your knee to stabilize the patient’s distal thigh against the table (use a barrier).
• Both hands grasp the distal leg just proximal to the malleoli.
• This position is similar to Apley’s Distraction Test.

Question 19

How are Tibiofemoral Rotational Glides performed?

Answer 19

• Distract the leg.
• Rotate the leg medially or laterally.

Question 20

What are the uses of Tibiofemoral Rotational Glides?

Answer 20

• Medial (internal) rotation: Improves knee flexion.
• Lateral (external) rotation: Improves knee extension.

Question 21

What is the patient position for Patellofemoral Glides?

Answer 21

• Supine with the knee a few degrees short of full extension.
• The knee should be supported with a towel roll or pillow.

Question 22

How should the therapist position themselves for Patellofemoral Glides?

Answer 22

• Medial, superior, or inferior glides: Stand on the same side of the table as the knee.
• Lateral glides: Stand on the opposite side of the table.
• Use thumb pads, thenar web spaces, or the base of the palm to position on the patella for the desired glide.

Question 23

How are Patellofemoral Glides performed?

Answer 23

• Mobilize the patella according to the desired direction of glide.
• Avoid positioning hands or applying pressure that compresses the patella against the femur.

Question 24

What are the uses of Patellofemoral Glides?

Answer 24

• Inferior glide: Improves knee flexion.
• Superior glide: Improves knee extension.
• Medial glide: Improves medial tracking.
• Lateral glide: Improves lateral tracking.

Question 25

What are contraindications and progressions for Patellofemoral Glides?

Answer 25

• Contraindication: If the patient has a history of patellar dislocation, avoid mobilizing in the direction of dislocation (usually lateral).
• Progression: Position the knee in greater degrees of flexion for more advanced mobilization.

Question 26

What is the loose-pack position of the hip joint?

Answer 26

• 30° flexion
• 30° abduction
• Slight external rotation

Question 27

What is the close-pack position of the hip joint?

Answer 27

• Full extension
• Medial rotation
•Abduction

Question 28

What is the patient position for hip distraction?

Answer 28

• Supine
• Leg to be mobilized is draped over the therapist’s shoulder with the back of the knee resting on the therapist’s shoulder (use a barrier).
• Hip should be positioned as close to loose-pack position as possible.

Question 29

How should the therapist position themselves for hip distraction?

Answer 29

• At the side of the table, facing the head of the table.
• Hands placed on the anterior and medial aspect of the proximal thigh.

Question 30

How is hip distraction performed?

Answer 30

• Mobilize the proximal femur/femoral head away from the acetabulum (laterally and inferiorly) using body weight.
• Apply slight counterpressure with the shoulder.

Question 31

What are the uses of hip distraction?

Answer 31

• Improve general hip mobility.
• Provide pain control.
• Increase nutrition to articular structures.

Question 32

What is the patient position for hip traction?

Answer 32

• Supine with the hip in loose-pack position.
• A belt may stabilize the pelvis by wrapping around the patient and the table.

Question 33

How should the therapist position themselves for hip traction?

Answer 33

• At the side of the table, close to the patient’s knee.
• Grasp the distal thigh with both hands or use a forearm “sandwich.”

Question 34

How is hip traction performed?

Answer 34

Apply traction inferiorly using body weight.

Question 35

What are the uses of hip traction?

Answer 35

• Improve general hip mobility.
• Provide pain control.
• Increase nutrition to articular structures.

Question 36

What is the patient position for a hip posterior glide?

Answer 36

Supine with the hip in slight flexion.

Question 37

How should the therapist position themselves for a hip posterior glide?

Answer 37

• Stand at the side of the table, facing the patient’s hip.
• Stabilizing hand: Support the medial side of the distal thigh to maintain slight hip flexion.
• Mobilizing hand: Positioned over the anterior proximal femur.

Question 38

How is a hip posterior glide performed?

Answer 38

Mobilize the femur posteriorly using body weight.

Question 39

What are the uses of a hip posterior glide?

Answer 39

• Improve hip flexion.
• Improve hip internal rotation.

Question 40

What is the patient position for a hip anterior glide?

Answer 40

Prone with a pillow under the abdomen.

Question 41

How should the therapist position themselves for a hip anterior glide?

Answer 41

• Stand at the side of the table, facing the patient’s hip.
• Stabilizing hand: Supports the anterior distal femur medially, maintaining slight hip extension and knee flexion.
• Mobilizing hand: Positioned over the anterior proximal femur.

Question 42

How is a hip anterior glide performed?

Answer 42

Mobilize the femur anteriorly using body weight.

Question 43

What are the uses of a hip anterior glide?

Answer 43

• Improve hip extension.
• Improve hip external rotation.

Question 44

What are the patient position options for a hip inferior glide?

Answer 44

• Supine with the hip abducted.
• Supine with the hip flexed.
• Sidelying with the hip abducted.
• A belt may stabilize the pelvis by wrapping around the patient and the table.

Question 45

How should the therapist position themselves for a hip inferior glide?

Answer 45

• Stand close to the patient’s hip.
• Inferior hand: Grasp the medial aspect of the distal thigh.
• Mobilizing hand: Positioned as close to the articulation as possible.

Question 46

How is a hip inferior glide performed?

Answer 46

Mobilize the femur inferiorly while staying close to the hip and using the torso to apply mobilization.

Question 47

What is the use of a hip inferior glide?

Answer 47

Improve hip abduction.