UE Glides/Manips Flashcards
wrist - distal RU joint (palmar and dorsa glide)
**looking for: neutral zone, R1, R2, any pain
Pt: Seated or supine & F/A in resting position
Pht:
- Standing, facing pt’s hand
- One hand: stabilizes ulna
- One hand: grasp pt’s distal radius
wrist - RC joint (palmar and dorsal glide)
**looking for: neutral zone, R1, R2, any pain
Pt: Seated, F/A resting on bed; wrist over edge & in RP
Pht:
- Standing, close to pt’ hand
- One hand: stabilize distal radius/ulna close to jt line
- One hand: grasp proximal row of carpals
wrist (RC joint) - radial and ulnar glide
**looking for: neutral zone, R1, R2, any pain
wrist (RU joint) traction and compression
**looking for: neutral zone, R1, R2, any pain
fingers - MCP joint (palmar, dorsal, medial, lateral glides)
Pt seated, FA on bed & joint in RP (slight flexion)
Pht: using a pinch grip with both hands
- For palmar & dorsal glides: on palmar/dorsal aspect of bones
- For radial & ulnar glides on radial/ulnar aspect of bones
- One hand: stabilize distal MC (♂), close to jt line
- One hand: grasp proximal phalanx (♀)
fingers - MCP joint (traction/compression)
Pt seated, FA on bed & joint in RP (slight flexion)
Pht: using a pinch grip with both hands
- For palmar & dorsal glides: on palmar/dorsal aspect of bones
- For radial & ulnar glides on radial/ulnar aspect of bones
- One hand: stabilize distal MC (♂), close to jt line
- One hand: grasp proximal phalanx (♀)
fingers - IP joint (palmar and dorsal glide)
Pt seated, with FA on bed & joint in resting position (slight flexion)
Pht: using a pinch grip with both hands
- One hand: stabilize proximal phalanx (♂), close to jt line
- One hand: grasp base of adjacent (distal) phalanx (♀)
fingers - IP joint (traction/compression)
Pt seated, with FA on bed & joint in resting position (slight flexion)
Pht: using a pinch grip with both hands
- One hand: stabilize proximal phalanx (♂), close to jt line
- One hand: grasp base of adjacent (distal) phalanx (♀)
Wrist mobs of lateral column
The carpal bones should be mobilized in flexion.
Wrist mobs of medial column
mobs should be done in wrist flexion
Wrist mobs of mid column
mobs should be down with wrist in flexion
Thumb (CMC) traction/compression
Thumb (CMC) dorsal glide
Thumb (CMC) palmar glide
Thumb (CMC) radial glide
Thumb (CMC) ulnar glide
wrist manipulation - thrust in traction (lunate on radius)
Indications:
S/A: Mechanism of injury: full extension or flexion
O/A:
- Observation/palpation: any protuberance or dimple
- ROM: flexion or extension ↓ & hard EF & pain
- Glide: carpal bone palmar or dorsal glide ↓ NZ & hard EF
Special Considerations:
- Scaphoid fracture (< 2wks) – can have been missed on x-ray
- Carpal bones hypermobility
- Nerves & blood vessel compression
wrist manipulation - palmar glide (lunate on radius)
Indications:
S/A: Mechanism of injury: full extension or flexion
O/A:
- Observation/palpation: any protuberance or dimple
- ROM: flexion or extension ↓ & hard EF & pain
- Glide: carpal bone palmar or dorsal glide ↓ NZ & hard EF
Special Considerations:
- Scaphoid fracture (< 2wks) – can have been missed on x-ray
- Carpal bones hypermobility
- Nerves & blood vessel compression
wrist manipulation - dorsal glide (lunate on radius)
Indications:
S/A: Mechanism of injury: full extension or flexion
O/A:
- Observation/palpation: any protuberance or dimple
- ROM: flexion or extension ↓ & hard EF & pain
- Glide: carpal bone palmar or dorsal glide ↓ NZ & hard EF
Special Considerations:
- Scaphoid fracture (< 2wks) – can have been missed on x-ray
- Carpal bones hypermobility
- Nerves & blood vessel compression
GH joint - posterior glide
*Pt always in supine!
GH resting position
- Anterior glide (ER/Ext)
- Posterior glide (IR/Flex)
- Inferior glide (Abd)
- Traction/compression
GH joint - anterior glide
*Pt always in supine!
GH resting position
- Anterior glide (ER/Ext)
- Posterior glide (IR/Flex)
- Inferior glide (Abd)
- Traction/compression
GH joint - inferior glide
*Pt always in supine!
GH resting position
- Anterior glide (ER/Ext)
- Posterior glide (IR/Flex)
- Inferior glide (Abd)
- Traction/compression
GH joint - traction and compression
*Pt always in supine!
GH resting position
- Anterior glide (ER/Ext)
- Posterior glide (IR/Flex)
- Inferior glide (Abd)
- Traction/compression
AC joint AROM
AC joint PROM ant rot
AC joint PROM post rot
AC joint - ant glide
AC joint post glide
AC joint inf glide
AC joint sup glide
AC joint compression
SC joint - post glide
SC joint - inf glide
SC joint sup glide
SC joint ant glide
Dynamic Scapula Test (bilat abd)
Bilateral abduction with thumbs up
Elbow (UH joint) - anterior/posterior glides
Anterior glide: Apply an anterior force through the long axis of ulna
Posterior glide: Apply a posterior force through the long axis of ulna
Elbow (UH joint) - lateral medial glides
Lateral glide: Apply a lateral force to proximal ulna
Medial glide: Apply a medial force to proximal ulna (Lat border of olecranon)
Elbow (UH joint) - traction/compression
Elbow (RH joint) - ant/post glide
Pt supine in elbow resting position (Full extension & supination versus 30 flex)
Pht:
Btw pt’s trunk & arm; cradle pt’s F/A
Cranial hand: stabilize distal humerus (against the table)
Caudal hand grasp radial head (thumb ant & fingers post)
Elbow (RH joint) - traction/compression
Elbow (RU joint) - glides
Elbow combined flexion/abduction
FLEXION/ADDUCTION Ulna ANT GLIDE + LAT GLIDE
EXTENSION/ABDUCTION Ulna POST GLIDE + MED GLIDE
whitmore 204
elbow combined flexion/adduction
FLEXION/ADDUCTION Ulna ANT GLIDE + LAT GLIDE
EXTENSION/ABDUCTION Ulna POST GLIDE + MED GLIDE
whitmore 204
elbow combined extension/adduction
FLEXION/ADDUCTION Ulna ANT GLIDE + LAT GLIDE
EXTENSION/ABDUCTION Ulna POST GLIDE + MED GLIDE
whitmore 203
elbow combined extension/abduction
FLEXION/ADDUCTION Ulna ANT GLIDE + LAT GLIDE
EXTENSION/ABDUCTION Ulna POST GLIDE + MED GLIDE
whitmore 203
elbow manipulation - ulnohumoral distraction
Special considerations:
- Ax ULNTs before
- Joint hypermobility
elbow manipulation - lateral thrust of ulno-humoral joint
Special considerations:
- Ax ULNTs before
- Joint hypermobility
Dysfunction: Ulna fixed in abduction
Subjective: Fall on outstretch arm
Pt’s c/o: Tennis elbow, De Quervain’s, May c/o wrist pain
Observation: ↑ carrying angle, Hand slight ulnar deviation & flexion
AROM
- ↓ Elbow flexion & supination
- ↓ Wrist extension & radial deviation
PROM
- Adduction: ↓ & hard EF
- ↓combined movt in flexion/supination (& adduction) & hard EF
Glide: lateral glide: ↓ NZ & hard EF
- Flex combined with adduction & lateral glide
elbow manipulation - medial thrust of ulno-humoral joint
Special considerations:
- Ax ULNTs before
- Joint hypermobility
Dysfunction: Ulna fixed in adduction
Subjective: secondary to trauma
Observation
- ↓ carrying angle
- Wrist in slight radial deviation & extension
AROM
- ↓Elbow extension & pronation (Hard EF)
- ↓combined movt of extension & pronation (& abduction) - ↓Wrist flexion & ulnar deviation
PROM: Abduction: ↓ & hard EF
Glide: Med glide: ↓ & hard EF
- Ext combined with abduction & medial glide
elbow manipulation - posterior thrust of proximal RU joint
Dysfunction Radius fixed in supination
- AROM/PROM: ↓ FA pronation & hard EF
- Glide: ↓ posterolateral glide & hard EF
elbow manipulation - anterior thrust of proximal RU joint
Dysfunction Radius fixed in pronation
- AROM/PROM: ↓ FA supination (Hard EF)
- Glide: ↓ anteromedial glide (hard EF)
