Specific Joints: Closed/Open Pack Position and Capsular Pattern

Question 1

Glenohumeral

Answer 1

Loose pack position: 55 deg abduction, 30 deg horizontal adduction
Close packed position: abduction and lateral rotation
Capsular pattern: lateral rotation, abduction, medial rotation

Question 2

Sternoclavicular

Answer 2

Loose pack position: arm resting by side
Close packed position: max shoulder elevation
Capsular pattern: pain at extremes range of motion

Question 3

Acromioclavicular

Answer 3

Loose pack position: arm resting by side
Close packed position: arm abducted to 90 deg
Capsular pattern: pain at extremes range of motion

Question 4

Radiohumeral

Answer 4

Loose pack position: full extension, supination
Close packed position: 90 deg flexion, 5 deg supination
Capsular pattern: flexion, extension, supination, pronation

Question 5

Ulnohumeral

Answer 5

Loose pack position: 70 deg elbow flexion, 10 deg supination
Close packed position: extension
Capsular pattern: flexion, extension

Question 6

Proximal Radioulnar

Answer 6

Loose pack position: 70 deg elbow flexion, 35 deg supination
Close packed position: 5 deg supination
Capsular pattern: supination, pronation

Question 7

Radiocarpal

Answer 7

Loose pack position: neutral with slight ulnar deviation
Close packed position: extension with radial deviation
Capsular pattern: flexion and extension equally limited

Question 8

Hip - Illiofemoral

Answer 8

Loose pack position: 30 deg flexion, 30 deg abduction, slight lateral rotation
Close packed position: full extension, medial rotation
Capsular pattern: flexion, abduction, medial rotation (sometimes medial rotation most limited)

Question 9

Knee - Tibiofemoral

Answer 9

Loose pack position: 25 deg flexion
Close packed position: full extension, lateral rotation of tibia
Capsular pattern: flexion, extension

Question 10

Talocrural joint

Answer 10

Loose pack position: 10 deg PF
Close packed position: max DF
Capsular pattern: PF, DF

Question 11

Subtalar joint

Answer 11

Loose pack position: midway between extremes of ROM
Close packed position: supination
Capsular pattern: varus ROM

Question 12

Midtarsal joint

Answer 12

Loose pack position: midway between extremes of ROM
Close packed position: supination
Capsular pattern: DF, PF, adduction, medial rotation

Question 13

Cervical Spine

Answer 13

Loose pack position: midway between flexion and extension
Close packed position: extension
Capsular pattern: lateral flexion and rotation equally limited, extension

Question 14

Thoracolumbar Spine

Answer 14

Loose pack position: midway between flexion and extension
Close packed position: extension
Capsular pattern: lateral flexion and rotation equally limited, extension