Techniques Flashcards
Knee joint distraction
Patient position:
Seated,Leg hanging over table
Knee joint in loose pack position (at least 25 degrees flextion)
Therapist:
Kneeling at patients foot, facing knee
Both hands grasp distal leg, proximal to malleoli
Mobilization:
Both hands traction leg caudally
Distraction of talus from the Mortise
Patient position:
Seated or supine
Talocrural In loose pack position (10 degrees plantar flexion)
Therapist position:
End of table
One hand grasps neck of talus (ant hand)
Post hand grasps post talus and calcaneus
Mobilization
Both hands traction distally (use body weight to assist)
Hip joint distraction
Patient position
Supine
Leg positioned over therapist shoulder, so back of knee rests on top of shoulder, hip joint positioned as close to loose packed as possible (30 fl, 30 ab, slight er)
Therapist:
At side of table facing head end of table
Hands are positioned on the proximal thigh centrally and medially fingers interlaced
Mobilization
Bob hands move the proximal femur/femoral head away from acetabulum
Movement is directed at a 90 degree angle to the acetabulum resulting in a caudal and lateral distraction
Knee joint ventral Glide
Patient position
Supine
Hip and knee flexed, flat foot on table
Therapist
Sitting on foot, as per acl test
Both hands grasp proximal leg
Fingers dorsally wrap around the back of the leg
Thumbs ventrally palpating the joint line/space without pressure on either side of ligament
Mobilization
Both hands glide the proximal leg in a ventral direction
Knee joint dorsal Glide
Patient position
Supine
Hip and knee flexed, flat foot on table
Therapist
Sitting on foot, as per acl test
Both hands grasp proximal leg
Pressure is directed post via thenar eminences
Thumbs ventrally palpating the joint line/space without pressure on either side of ligament
Mobilization
Both hands glide the proximal leg in a dorsal direction
Knee joint rotation
Patient position
Seated or prone
Knee joint in Resting position
Therapist
Both hands grasp the distal leg proximal to malleoli
Distract leg from thigh grade 1 only
Rotate leg medially and laterally
Ankle talocrural joint posterior Glide
Patient position
Supine
Pillow beneath distal leg or foot of the end of the table
Ankle joint in resting position
Therapist
At side of table facing patients ankle
Stabilizing cranial hand supports dorsal surface of distal leg
Mobilizing caudal hand web space grips the neck of the talus: thumb and index fingers should rest just distal to the malleoli
Mobilization
Stabilizing hand holds distal leg in position
Mobilizing hand glides trochlea dorsally within mortise
Ankle (talocrural joint) anterior Glide
Patient position
Supine
Pillow beneath distal leg or foot of the end of the table
Ankle joint in resting position
Therapist
At side of table facing patients ankle
Stabilizing cranial hand supports ventral surface of distal leg
Mobilizing caudal hand cups the calcaneus/talus, posteriorly
forearm cAn direct foot into resting position
Mobilization
Stabilizing hand holds distal leg in position
Mobilizing hand lifts calcaneus/talus anterior
Hip joint dorsal Glide
Patient
Supine
Hip joint in slight flexion
Therapist
At side facing hip
Caudal stabilizing f supports thigh from medial knee and maintains resting position at hip joint
Cranial mobilizing hand rest over anterior proximal thigh
Mobilization
Therapist applies body weight as mobilization hand direct proximal femur dorsally
Stabilizing hand controls thigh position
Hip joint ventral Glide
Patient
Prone
Pillow under abdomen
Therapist
At side facing hip
mobilizing hand is over dorsal surface anterior proximal thigh
StabiliZing hand is positioned on the ventral surface of the distal thigh (from medial side of knee) and maintains thigh in position of slight extension and leg in position of flexion
Mobilization
Mobilizing hand Glides the proximal femur ventrally as therapist applies body weight
Stabilizing hand controls position of the thigh
Mobilization
Therapist applies body weight as mobilization hand direct proximal femur dorsally
Stabilizing hand controls thigh position
Superior tibiofibular joint treatment
Patient position
Supine
Hip and knee of side to be treated flexed
Foot flat on table
Therapist
Sitting on patients foot
Medial hand: stabilizes the anterior surface of proximal tibia, over tibial tuberosity
Lateral hand: thumb of front of head of fibula
Finger posteriorly grasping gastrocnemius
Mobilization.
With lateral hand direct fingers anterior for ventral Glide
With lateral hand direct the fingers posteriorly for dorsal Glide
Move your body as you mobilize not just your arm
Inferior tibiofibular joint ventral Glide
Patient position
Prone or supine
Ankle to treated on pillow
Therapist
At foot of table facing patients leg
Stabilizing hand holds distal tibia
Mobilizing hand is positioned to comfortably grasp the lateral malleolus
Mobilization
Stabilizing Hand stabilizes tibia in position
Mobilizing hand glides lateral malleolus ventrally
Inferior tibiofibular joint dorsal Glide
Patient position
supine
Ankle to treated on pillow
Therapist
At foot of table facing patients leg
Stabilizing hand holds distal tibia
Mobilizing hand is positioned to comfortably grasp the lateral malleolus
Mobilization
Stabilizing Hand stabilizes tibia in position
Mobilizing hand glides lateral malleolus dorsally
Subtalar joint distraction
Subtalar joint distraction
Patient position
Seated or supine
Subtalar joint in resting position
Therapist
Lateral to leg if patient is seated
Stabilizing hand grasps the ventral aspect of the talus at the distal leg with the thenar web space
Mobilizing hand grasps the calcaneus
Mobilization
Stabilizing hand holds the talus in position and controls the foot
Mobilizing hand tractions the calcaneus distally
Subtalar joint inversion/eversion
Patient position
Seated or supine
Subtalar in resting position
Therapist
Lateral to leg if patient is seated
Stabilizing hand grasps the ventral aspect of the talus at the distal leg with the thenar webspace
Mobilizing hand grasps dorsal aspect of calcaneus
Mobilization
Stabilizing hand holds the talus in position
Mobilizing hand distracts the calcaneus distally
Mobilizing hand tilts calcaneus medially for inversion
Mobilizing hand Tilts calcaneus laterally for eversion
Patellofemoral Glide
Patient position
Supine
Patellofemoral joint in resting position
Pillow beneath knee quadriceps muscle quiet
Therapist Standing at side of table facing knee Use thumb pads of thenar webspace Do not compress patella against femur Mobilizing hand positioned on patella according to desired Glide
Caudal surface for cranial Glide
Cranial surface for caudal Glide
Lateral surface for medial Glide
Medial surface for lateral Glide
Mobilization Mobilizing hand Glides patella cranially to increase knee ext Caudally to increase knee joint flexion Medially to increase medial tracking Laterally to increase lateral tracking
Talonavicular joint dorsal/plantar Glide
Patient
Supine
Talonavicular In resting position
Hip and knee joints may be flexed
Therapist
Standing lateral to foot facing lateral side of foot
Stabilize neck of talus with webspace of cephaled, thumb and index finger extend down and back towards calcaneus
Place webspace of mobilizing hand over navicular fingers wrap into arch of foot and index finger covers tuberosity of navicular
Hands should be tight together
Mobilization
Stabilizing hand holds talus in position
Mobilizing hand moves navicular in plantar direction to increase midtarsal pronation
Mobilizing hand moves navicular in dorsal direction to increase midtarsal supination
Cuneonavicular joint dorsal plantar Glide
Patient
Supine
Therapist
Standing lateral to foot facing lateral foot
Cephaled hand stabilizing hand thenar webspace is tight dorsal aspect of navicular
Caudal hand mobilizing hand thenar webspace is tight to dorsal aspect of 3 cuneforms bones index finger covers cuneforms and remaining fingers wrap into arch of foot
Hands should be tight together
Mobilization
Cranial hand stabilizes navicular
Caudal hand mobilizes 3 cuneforms In dorsal direction to increase mid foot inversion/supination
Caudal hand mobilizes 3 cuneforms In plantar direction to increase midfoot eversion pronation
Calcaneocuboid dorsal plantar Glide
Patient prone or supine
Knee can be flexed to 90 if necessary
Therapist
Standing at foot of table facing plantar surface of foot
Stabilizing hand medial grasps calcaneus
Mobilizing hand lateral hand thumb on plantar surface of cuboid
Mobilizing hand index index finger on dorsal surface of cuboid
Mobilization
Stabilizing hand holds the calcaneus and steadies hindfoot
Mobilizing hand Glides cuboid In dorsal direction to increase midfoot eversion
Mobilizing hand Glides cuboid In plantar direction to increase midfoot inversion
Tarsometarsal joint rotation
Patient position
Therapist
Standing lateral to foot facing lateral foot
Cephaled hand thenar webspace on dorsal aspect of 3 cuneforms bones (fingers wrap under arch of foot)
Caudal hand (mobilizing hand) thenar webspace on dorsal aspect of bases of metatarsal bones fingers wrap under arch of foot
Hands should be tight together
Mobilization
Cephaled hand stabilizes midfoot
Caudal hand rotates metatarsal bases toward inversion to increase range of tarsometarsal joint inversion/forefoot adductilon
Caudal hand mobilizes bases of metatarsals toward eversion to increase range of forefoot abduction
Tarsometarsal joint dorsal plantar Glide
Patient position
Therapist
Standing lateral to foot facing lateral foot
Cephaled hand thenar webspace on dorsal aspect of 3 cuneforms bones (fingers wrap under arch of foot)
Caudal hand (mobilizing hand) thenar webspace on dorsal aspect of bases of metatarsal bones fingers wrap under arch of foot
Hands should be tight together
Mobilization
Cephaled hand stabilizes midfoot
Caudal hand dorsal metatarsal bases dorsal direction to increase range of tarsometarsal joint dorsal Glide
Caudal hand mobilizes bases of metatarsals in plantar direction to increase range of plantar Glide
Intermetatatssl joints dorsal plantar Glide
Patient position
Supine
Foot in neutral position
Therapist
Standing at the end of the table facing foot
Stabilizing hand grasps the shaft of the metatarsal proximal to head
Thumb on dorsum of foot, index finger on plantar surface
Mobilizing hand grasps shaft of adjacent metatarsal proximal to head, thumb on dorsum of foot, index finger on plantar surface
Mobilization
Stabilizing hand holds the second metatarsal in position
Mobilizing hand Glides the first metatarsal in a dorsal direction on the second metatarsal to decrease the transverse arch of the foot
Mobilizing hand Glides the first metatarsal in a plantar direction direction on the second metatarsal to increase the transverse arch of the foot
Mobilize the first on the second
Mobilize the third on the second
MobiliZe the fourth on the third
Mobilize the fifth on the fourth
Metatarsalphalangeal distraction
Patient
Supine
Therapist
Standing lateral to foot facing lateral aspect of foot
Stabilizing hand grasps head of metatarsal thumb on dorsum of foot fingers wrap around to plantar surface of foot
Mobilizing hand grasps proximal end of proximal phalanx thumb on dorsum of phalanx fingers on plantar surface of phalanx
Mobilization
Stabilizing hand holds metatarsal in position
Mobilizing hand applies distraction
Metatarsalphalangeal joint dorsal plantar Glide
Patient
Supine
Mtp joint positioned in resting
Therapist
Standing lateral to foot
Stabilizing hand (cephaled) grasps head of metatarsal, thumb of dorsum of foot, fingers wrap around to plantar surface of foot
Mobilizing hand (caudal) grasps proximal end of proximal phalanx thumb on dorsum of phalanx, fingers on plantar surface of phalanx
Mobilization
Stabilizing hand holds metatarsal in position
Mobilizing hand Glides base of proximal phalanx dorsally to increase mtp joint extension
Mobilizing hand glides base of proximal phalanx In plantar direction to increase mtp joint flexion
