Upper Extremity HVLA Flashcards
Flexion/Extension ROM for Glenohumeral Joint
Flexion: 180
Extension: 60
Abduction/Adduction ROM for Glenohumeral joint
Abduction 180
Horizontal abduction: 130-145 or 40-55
Horizontal ADduction: 40-50 or 130-140
What are the indications for glenohumeral BLT?
Subdeltoid bursitis or frozen shoulder
Scapular elevation leads ____ motion of SC joint.
Inferior motion
in 90 degrees flexion, what actions lead to posterior glide of the clavicle at the SC joint?
Protraction
_____ leads to anterior glide of the clavicle at the SC joint.
Retraction
SC Elevated/ADducted SD Still technique
- Pt seated. Physician behind pt monitoring SC joint w/ 1 hand and grasping elbow with the other
- Start with the elbow adducted and slightly extended
- Add compression toward the SC joint
- Move the shoulder into superior glide and abduction, engaging a posterior circumbduction motion.
- Remove compression and return to neutral
- Reassess
SC SD HVLA
- Pt supine. Physician at head of table
- Place thenar eminence of monitoring hand over restricted SC joint
- Apply cephalad traction on arm on side of dysfunction
- Apply thrust on SC joint while simultaneously inducing a rapid traction force through pt’s arm
- ADduction (elevated SC): inferior thrust
- Extension SD (Anterior SC): posterior thrust
- Reassess
AC Joint Separated SD Still Technique
- Pt seated, physician in front of pt
- Affected side is abducted, with slight extension to open the AC joint
- Traction is applied
- The arm is moved into adduction/flexion
- Traction is removed and arm returned to neutral
- Reassess
Ulnar abduction SD (Valgus) HVLA
- Pt seated
- Supinate and fully extend elbow. Grasp elbow w/ fingers of monitoring hand on either side of olecranon. Other hand grasps distal radius/ulnar
- Move elbow into ulnar adduction. Apply a medial to lateral thrust over the medial olecranon
- Reassess
Ulnar ADduction SD HVLA
- Pt seated
- Supinate and fully extend elbow, grasp either side
- Move elbow into ulnar abudction. Apply a lateral to medial thrust over the lateral olecranon
- Reassess
Anterior Radial Head SD HVLA
- Pt seated, physician faces pt
- Place thumb of one hand intot the crease of the pt’s elbow contacting directly over anterior radial head. The other hand flexes elbow and pronates forearm
- Exert a rapid hyperflexion force while simultaneously thrusting the radial head posteriorly
- Reassess
Posterior Radial Head SD HVLA
- Pt seated. Physician stands facing pt
- Extend and supinate elbow. Place thumb over posterior radial head
- Exert rapid hyperextension force while simultaneously thrusting the radial head anteriorly
- Reassess
Radiocarpal Joint SD ART with Traction
- Physician cups hands by approximating thenar and hypothenar eminences to form a groove in each hand
- Physicians hands are placed over the dysfxn with the grooves parallel to joint line
- Physician squeezes b/w his/her hands, producing traction as the eminences separate
- Physician maintains the squeeze and traction while articulating the pt’s wrist in clockwise, then counterclockwise motion (figure 8), carrying the dysfxn through the restrictive barrier
- Reassess
Wrist Extension/Ventral Carpal SD HVLA
- Pt seated. Physician standing facing the pt
- Pronate elbow. Grasp pt’s hand, thumbs contacting dorsally at the proximal carpal bones (radiocarpal joint)
- Deliver a whip-like thrust moving from extension to flexion through the carpal dysfunction
- Reassess