Motion Restrictions - missing adhesions and neural tension Flashcards
restrictions in active ROM
weakness, abnormal tone, pain, unwilling to move, any PROM restrictions
restrictions in passive ROM
soft tissue shortening, adhesions, edema, mechanical block, neural tension, spinal disc herniation
physiological motion
osteokinematic motion of bone segments
- ex. flexion, extension, etc.
accessory motion
arthrokinematic motion at the joint surfaces
- rolling, gliding, sliding
physiological and accessory motion relationship
you can’t have full physiological motion without full accessory motion
convex on concave rule
roll same, glide opposite
- ex. shoulder abduction at glenohumeral joint
concave on convex rule
roll same, glide same
- ex. knee extension at tibiofemoral joint
capsular pattern of restriction
loss of motion in specific pattern because joint capsules shorten around a certain joint
non-capsular pattern of restriction
loss of motions in any pattern or direction not due to joint capsules
- ex. ligament adhesions, extra-articular edema, etc.
contractile tissue
muscle and musculotendinous tissue, needs to be normal for full AROM
non-contractile tissue
skin, fascia, scar tissue, bone, cartilage, ligament, bursa, capsule, nerve, intervertebral disc
- if everything is normal, full PROM
- if dysfunctional, limited PROM and AROM
what is a contracture
shortening of non-contractile and/or contractile soft tissue, limits AROM and PROM
how do contractures occur
lack of motion in tissue that is shortened for a long time causes collagen fibers to cross link
what is an edema
joint capsule is distended (swollen) at end of ROM and lax in a shortened ROM
intra-articular edema
fluid is excessive inside joint capsule which will cause it to distend and limit motion (capsular)
extra-articular edema
fluid accumulates outside joint capsule and can limit motion due to soft tissue approximation (non-capsular)
mechanical block
bone fragments, cartilage tears, bone malunions, or osteophyte (bone spur) formations that block normal accessory motion
“locking” phenomena
mechanical block causes joint movement to have sudden or temporary lack of ROM
spinal disc herniation
herniated material takes up space in the intervertebral canal, which can limit spinal motion
weakness
weak muscles will limit active motion, and can lead to other pathologies
other factors of motion restriction
pain, muscle tone, psychological factors
