Joint Play

Question 1

What is a Grade 1 Joint Mobilization?

Answer 1

Pain Control and Joint Health

Small amplitude (sustained force) movement at the beginning of available joint play.

Force applied only bend the FLY’s legs!

Question 2

What is a Grade 2 Joint Mobilization?

Answer 2

Pain Control and Joint Health

Large amplitude (non-sustained force) movement within available joint play BUT not reaching the limit.

Force bends FLY’s legs and compressing body but still fly alive.

Question 3

What is a Grade 3 Joint Mobilization?

Answer 3

Increase Joint Play using Non-sustained Force.

Large amplitude (non-sustained force) movement up to the limit of available joint play.

Question 4

What is a Grade 4 Joint Mobilization?

Answer 4

Increase Joint Play using Sustained Force

Small amplitude (sustained force) movement up to and slightly beyond the limit of available joint play.

Question 5

What is loose pack position for the Glenohumeral Joint?

Answer 5

55 deg abducted
30 deg horizontal abduction
Slight external rotation

Question 6

Glenohumeral Joint - Distraction

Patient Position:

Hand Placement:

Mobilizing Force:

Answer 6

Patient Position: Supine with arm in loose pack position. Towel under scapula.

Hand Placement: Back to patient between trunk and arm, support arm with trunk.
Web space in patients axilla with thumb just distal to joint and fingers posteriorly.

Mobilizing Force: Using hand in axilla, move patient humerus laterally.

Question 7

Glenohumeral Joint - Caudal (Inferior Glide)

Patient Position:

Hand Placement:

Mobilizing Force:

Answer 7

Patient Position: Supine with arm in loose pack position. Towel under scapula.

Hand Placement: Facing patient with supporting hand at distal humerus.
Webspace superior shoulder, just distal to acromion process.

Mobilizing Force: Using superior hand, glide the humerus inferior.

Question 8

Glenohumeral Joint - Anterior to Posterior Glide

Patient Position:

Hand Placement:

Mobilizing Force:

Answer 8

Patient Position: Supine with arm in loose pack position. Towel under scapula.

Hand Placement: Hand Placement: Back to patient between trunk and arm, support arm with trunk.
Pinky finger just distal to anterior acromion with fingers pointing superiorly.

Mobilizing Force: Glide humeral head in posterior direction.

Question 9

What is Loose-Pack Position for the Radiocarpal Joint?

Answer 9

Slight Extension and Ulnar Deviation

Question 10

Radiocarpal Joint - Distratction

Patient Position:

Hand Placement:

Mobilizing Force:

Answer 10

Patient Position: Seated with forearm on table and towel under wrist over edge.

Hand Placement: From outside patients arm, grasp around styloid processes and fix forearm to table.
Grasp around distal row of carpals.

Mobilizing Force: Pull in distal direction with respect to forearm.

Question 11

Radiocarpal Joint - Volar Glide (Posterior to Anterior Glide)

Patient Position:

Hand Placement:

Mobilizing Force:

Answer 11

Patient Position: Seated with forearm on table and towel under wrist over edge.

Hand Placement: From outside patients arm, grasp around styloid processes and fix forearm to table.
Grasp around distal row of carpals.

Mobilizing Force: Glide in volar direction, towards the floor.

Question 12

Radiocarpal Joint - Distal Glide (Anterior to Posterior Glide)

Patient Position:

Hand Placement:

Mobilizing Force:

Answer 12

Patient Position: Seated with forearm on table and towel under wrist over edge.

Hand Placement: From outside patients arm, grasp around styloid processes and fix forearm to table.
Grasp around distal row of carpals.

Mobilizing Force: Glide in dorsal direction, towards the ceiling.

Question 13

What is Loose-Pack Position for the Talocrural Joint?

Answer 13

15 deg plantar flexed

Slight to Moderate inversion

Question 14

Talocrural Joint - Distraction

Patient Position:

Hand Placement:

Mobilizing Force:

Answer 14

Patient Position: Supine with ankle in loose pack position.

Hand Placement: Stand at foot of table facing patient and wrap fingers of both hands over dorsum of foot, pinky just distal to mortise and thumbs over plantar surface.

Mobilizing Force: Pull foot in distal direction with respect to leg by leaning backwards.

Question 15

Talocrural Joint - Anterior to Posterior Glide

Patient Position:

Hand Placement:

Mobilizing Force:

Answer 15

Patient Position: Supine with ankle in loose pack position.

Hand Placement: Stand at foot of table facing patient, place patient foot against PT thigh.
Place web space of lateral hand over talus just distal to mortise.
Flip inside hand over and fix leg to table.

Mobilizing Force: Glide the talus posteriorly, towards the floor.

Question 16

Talocrural Joint - Posterior to Anterior Glide

Patient Position:

Hand Placement:

Mobilizing Force:

Answer 16

Patient Position: Prone with towel under ankle in loose pack position.

Hand Placement: Stand at foot of table facing patient. Place lateral hand underneath ankle?
Web space of inside hand on posterior aspect of calcaneus.

Mobilizing Force: Push against calcaneus in an anterior direction, towards floor