Techniques for Practical Flashcards
PPIVM Assessment of the Cervical Spine (Seated)
Step 1: Have patient seated
Step 2: Stand anterolateral to the patient and cradle their head with one arm.
Step 3: Using your other hand, you will find C2 (A little below the ear and along the spine)
Step 4: Place finger pads slightly below that prominence to be in the intervertebral spaces.
Step 5: At this point you will use the cradled hand/arm to perform the motions of the assessment while feeling for natural gapping in the spaces.
* For Rotation and sidebend, you want the finger pads to be on the contralateral side of the intervertebral spaces *
PPIVM Assessment of the Cervical Spine (Supine)
Step 1: Have patient lay on their back
Step 2: Place hands underneath the occiput and assess their spine to locate C2
Step 3: Place the finger pads in the intervertebral spaces and then assess the motions
PPAVM Assessment of the Cervical Spine (Prone)
Step 1: Ask patient to lay on their stomach and position a pillow on their chest to promote natural flexion of the neck.
Step 2: Identify the vertebra you are working with
Step 3: If promoting flexion/extension, there will be a 2-finger application of force in the anterosuperior direction on the spinous process to allow for a smooth upglide of the vertebra.
If promoting sidebend or rotation, we want to apply the force in the same direction, however, we want to place our force just slightly lateral to the spinous process on the contralateral side of motion we are assessing.
GHJ Humeral Head Inferior Glide
- This technique is used to promote all shoulder elevation related ROMs
Step 1: Have patient in supine with their shoulder in resting position.
Step 2: Place your fixating hand on their distal humerus pressed against your lateral pelvis or trunk
Step 3: Place mobilizing hand on top of the shoulder along the GHJ and press in an inferior direction.
GHJ Inferior Glide variation for shoulder abduction and flexion
- Technique promotes shoulder abduction and flexion because these motions involve a superior roll.
Step 1: Have the patient seated with their arm in 90 degrees of scaption
Step 2: Have the fixated hand on the Acromion
Step 3: Grip onto the proximal end of the GHJ line and push inferiorly - Each time you would increase the shoulder elevation ROM, which can be done by forward trunk leaning
GHJ Posterior Glide
- Technique is to promote Horizontal adduction and Internal rotation.
Step 1: Have patient in supine close to their LPP
Step 2: Place outside hand on the distal humerus and the mobilizing hand on the GHJ line.
Step 3: Apply lateral traction to the Arm by slightly turning the body.
Step 4: Apply a glide to the GHJ in a Posterior direction (into the table)
GHJ Anterior Glide
- This technique is used to promote external rotation and extension ROMs
Step 1: Have the patient in prone or supine
Step 2: Apply a glide in the anterior direction while having a fixed hand on the distal humerus applying slight lateral traction.
GHJ Lateral Gapping/Glide
Step 1: Have the patient in supine
Step 2: Place inside arm into the axilla along the GHJ line and apply a lateral force
Step 3: Take outside arm and apply force in the medial direction to simulate adduction.
BE GENTLE
STA Distraction
- This technique promotes all shoulder ROMs specifically Elevation and Horizontal Adduction
Step 1: Have patient sidelying and bring them as close to you
Step 2: Ask patient to place arm behind their back then hinge the hips to place chest onto their shoulder.
Step 3: Set the scapula in neutral and then Feel for the medial border/side of the scapula and then lift it up
SCJ Mobility/ Joint Play
Step 1: Have patient supine, seated or sidelying. Therapist is on the tested side.
Step 2: Fixate fingers into a key grip like shape and place it onto the SCJ
Step 3: Move the Arm in a caudal, cranial, dorsal and ventral directions.
SCJ Mob
Step 1: Palpate for the SCJ while the patient is in supine
Step 2: Take the shoulder into abduction until you feel the SCJ move into you fingers
Step 3: Apply a slight inferior and medial force onto it
Step 4: Once the SCJ is not caught on your fingers, you can take the arm into further abduction.
ACJ Mobilization (Ventral or Dorsal Glide)
Step 1: Have patient seated with the arm in LPP which is at rest.
Step 2: Distal hand wraps around the acromion and the spine of scapula
Step 3: Proximal hand places fingers onto the clavicle and thenar eminence rests on top of the acromion
Step 4: Clavicle is then moved dorsally or ventrally
Upper thoracic extension
Try to get a live demo of this cause wth
Step 1: Have patient seated with their hands behind their neck with their feet on the ground.
Step 2: Have patient rest their forehead on their forearms
Step 3: Place finger pads onto the thoracic spine and then perform a scooping motion while having their back extend out.
Elbow Extension Mobilization
- This technique promotes elbow extension and remember roll and glide are in the same direction (Dorsal)
Step 1: Patient is seated or in supine with their arm abducted to 45 degrees with slight IR and pronation.
Step 2: Place towel or pillow underneath the distal humerus and wrap fixated hand around it.
Step 3: Mobilize hand on proximal ulna and apply a dorsal + slight inferior force onto it.
Elbow Flexion Mobilization
- This technique promotes elbow flexion. Roll and glide are in the same direction (Volar)
Step 1: Have patient in supine or in prone
Step 2: Apply some traction to the proximal ulna/distal humerus and then begin to lean into the forearm as this will transmit the force in a volar direction.
Elbow Flexion - Radiohumeral volar glide
Step 1: Place patient’s forearm on the table in the LPP with slight pronation to allow palpation of the radial head.
Step 2: Apply the volar-directed force while slowly placing the elbow into flexion.
Radiohumeral traction
Step 1: Have patient in supine
Step 2: Fixating hand stabilizes the distal humerus
Step 3: Grip the distal humerus and lean back to apply traction.
Elbow Extension - Dorsal Glide of the radiohumeral and humeroulnar
Step 1: Have patient seated with their elbow rested on the table in LPP, their wrist should rest on your shoulder
Step 2: palpate the radial head and proximal ulna
Step 3: Press down and mobilize the joint dorsally.
Pronation at the PRUJ (Dorsal Glide of the radial head)
Step 1: Patient is seated with their forearm rested on the table
Step 2: Palpate the anterior radial head and then pronate the forearm
Step 3: Once it feels blocked, mobilize the radial head dorsally.
Forearm supination at the PRUJ (Volar Glide of Radial head)
Step 1: Patient is seated with their forearm rested on the table in extension.
Step 2: Palpate the posterior radial head and then supinate the forearm.
Step 3: Once you feel the block, mobilize the radial head volarly
Forearm Supination at the DRUJ
- Think opposite of the PRUJ with the same opposite rolling/gliding idea
- Dorsal Glide of the radial head or volar glide of the ulna on the radius.
Forearm Pronation at the DRUJ
- Volar glide of the radial head on the ulna and dorsal glide of the ulna on the radius
Wrist Traction
Step 1: Patient has slight pronation with slight palmar flexion
Step 2: Fixating hand is on top of the DRUJ and placing the forearm against the table
Step 3: Mobilizing hand touches knuckles with the fixating hand then the traction is applied along the long axis.
Promote Wrist Extension
- Because the roll and glide are in opposite directions, there will need to be a volar glide of the carpal bones to promote extension.
Step 1: Patient has their hand off the table with their forearm rested on it.
Step 2: Fixating hand is on the distal forearm while the mobilizing hand is on top of the proximal row of carpal bones.
Step 3: Apply a volar glide to the joint
