Therapist Positioning

Question 1

What is therapist positioning for knee joint distraction?

2

Answer 1

Kneeling at patients foot, facing knee
+
Both hands grasp distal leg, proximal to malleoli

Question 2

What is therapist positioning for distraction of the talus from the mortise?
(3)

Answer 2

End of table 
\+
One hand grasps neck of talus (ant hand)
\+ 
Post hand grasps post talus and calcaneus

Question 3

What is therapist positioning for distraction of the femur?
(hip joint)
(3)

Answer 3

At side of table facing head end of table
+
Hands are positioned on the proximal thigh centrally and medially
+
fingers interlaced

Question 4

What is therapist positioning for knee joint ventral glide?

4

Answer 4

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

Question 5

What is therapist positioning for knee joint rotation?

3

Answer 5

Both hands grasp the distal leg proximal to malleoli 
\+
Distract leg from thigh - grade 1 only 
\+
Rotate leg medially and laterally

Question 6

What is therapist positioning for ankle (talocrural) posterior glide?
(4)

Answer 6

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

Question 7

What is therapist positioning for ankle (talocrural) anterior glide?
(4)

Answer 7

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

Question 8

What is therapist positioning for hip joint dorsal glide?

3

Answer 8

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

Question 9

What is therapist positioning for hip joint ventral glide?

3

Answer 9

At side facing hip
+
mobilizing hand is over dorsal surface of 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

Question 10

What is therapist positioning for long axis traction?

Answer 10

SAMMICH

Question 11

What is therapist positioning for superior tibiofibular joint?
(4)

Answer 11

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

Question 12

What is therapist positioning for inferior tibiofibular joint ventral glide?
(3)

Answer 12

At foot of table facing patients leg 
\+
Stabilizing hand holds distal tibia 
\+
Mobilizing hand is positioned to comfortably grasp the lateral malleolus

Question 13

What is therapist positioning for inferior tibiofibular joint dorsal glide?
(3)

Answer 13

At foot of table facing patients leg 
\+
Stabilizing hand holds distal tibia 
\+
Mobilizing hand is positioned to comfortably grasp the lateral malleolus

Question 14

What is therapist positioning for subtalar joint distraction?
(3)

Answer 14

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

Question 15

What is therapist positioning for subtalar joint inversion/eversion?
(3)

Answer 15

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

Question 16

What is therapist positioning for patellofemoral joint glides?
(4)

Answer 16

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

Question 17

What is therapist positioning for talonavicular joint dorsal/plantar glides?
(4)

Answer 17

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

Question 18

What is therapist positioning for cuneonavicular joint dorsal/plantar glides?
(5)

Answer 18

Standing lateral to foot facing lateral foot
+
Cephaled stabilizing hand’s thenar webspace is tight to dorsal aspect of navicular
+
Caudal mobilizing hand’s thenar webspace is tight to dorsal aspect of 3 cuneiform bones
+
index finger covers cuneiforms and remaining fingers wrap into arch of foot
+
Hands should be tight together

Question 19

What is therapist positioning for calcaneocuboid joint dorsal/plantar glides?
(4)

Answer 19

Standing at foot of table facing plantar surface of foot
+
Stabilizing hand (medial) grasps calcaneus
+
Mobilizing hand (lateral) thumb on plantar surface of cuboid
+
Mobilizing hand index index finger on dorsal surface of cuboid

Question 20

What is therapist positioning for tarsometatarsal joints rotation?
(4)

Answer 20

Standing lateral to foot facing lateral foot
+
Cephaled hand thenar webspace on dorsal aspect of 3 cuneiforms bones (fingers wrap under arch of foot)
+
Caudal hand’s (mobilizing hand) thenar webspace on dorsal aspect of bases of metatarsal bones (fingers wrap under arch of foot)
+
Hands should be tight together

Question 21

What is therapist positioning for tarsometatarsal joints dorsal/plantar glides?
(4)

Answer 21

Standing lateral to foot facing lateral foot
+
Cephaled hand’s thenar webspace on dorsal aspect of 3 cuneiforms 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

Question 22

What is therapist positioning for distal intermetatarsal joint dorsal / plantar glides?
(4)

Answer 22

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)
+
Mobilize the first on the second
Mobilize the third on the second
MobiliZe the fourth on the third
Mobilize the fifth on the fourth

Question 23

What is therapist positioning for metatarsophalangeal joints distraction?
(3)

Answer 23

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)

Question 24

What is therapist positioning for metatarsophalangeal joints dorsal / plantar glides?
(3)

Answer 24

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)

Question 25

What is therapist positioning for knee joint dorsal glide?
(4)
How does it differ from ventral glide?

Answer 25

Sitting on foot, as per acl test
+
Both hands grasp proximal leg
+
Pressure is directed posterior via thenar eminences
+
Thumbs ventrally palpating the joint line/space without pressure on either side of ligament

DIFFERENCE - ANTERIOR PRESSURE FOR VENTRAL GLIDE