Upper Limb Accessory Mobilization

Question 1

Glenohumeral Joint Distraction - Position, Movement and Indications

Answer 1

Supine, shoulder as close to bed as possible. Shoulder 90° flexion, elbow stabilized on sternum. Hands as close to joint as possible on humerus, apply lateral force to humerus.
To increase all motions of the GH joint.

Question 2

Glenohumeral Joint Inferior Glide (<90°) - Position, Movement and Indications

Answer 2

Supine, shoulder as close to bed as possible. Support forearm between trunk and elbow. Arm in <90° abduction. Semisquat, facing the side of the patient. Mobilizing hand: web space is placed just distal to acromion process, and apply inferior glide.
To improve GH abduction.

Question 3

Glenohumeral Joint Inferior Glide (>90°) - Position, Movement and Indications

Answer 3

Supine, shoulder as close to bed as possible. Support forearm between trunk and elbow. Arm in >90° abduction. Lunge position, facing the feet of the patient. Mobilizing hand: web space is placed just distal to acromion process, and apply inferior glide.
To improve inferior capsular mobility and GH abduction.

Question 4

Glenohumeral Joint Antero-Posterior Glide - Position, Movement and Indications

Answer 4

Supine, shoulder as close to edge of bed. Stabilising humerus on thigh. Stabilising hand: on forearm.
Mobilising hand: wrapping hand around humerus and push downward.
To improve posterior capsular mobility.
PA: patient in prone, same hand positioning.

Question 5

Humeroulnar Joint Distraction - Position, Movement and Indications

Answer 5

Supine, elbow at edge of table. Elbow 70° flexion, 10° supination. Rest patient wrist on your shoulder.
Stabilising hand: over anterior distal humerus.
Mobilising hand: just distal to elbow joint on the forearm.
Lunge position and moving backwards.
To relieve pain, generally increase elbow motion.

Question 6

Humeroulnar Joint Medial Glide - Position, Movement and Indications

Answer 6

Supine. Stabilising forearm and wrist between your arm and trunk. Stabilising hand on distal humerus, near medial epicondyle.
Mobilising hand on proximal lateral forearm, near elbow joint. Apply medial glide on radius.
To relieve pain, improve elbow flexion or extension.

Question 7

Humeroulnar Joint Lateral Glide - Position, Movement and Indications

Answer 7

Supine. Stabilising forearm and wrist between your arm and trunk. Stabilising hand on distal humerus, near lateral epicondyle.
Mobilising hand on proximal medial forearm, near elbow joint. Apply lateral glide to ulna.
To relieve pain, improve elbow flexion or extension.

Question 8

Humeroradial Joint Traction - Position, Movement

Answer 8

Supine, arm in slight flexion, supination.
Stabilising hand on distal humerus.
Mobilising hand around distal radius, apply traction force inferiorly.

Question 9

Humeroradial Joint Posterior Anterior Glide - Position, Movement and A-P Glide

Answer 9

Supine, small pillow under humerus.
Stabilising hand on distal humerus.
Mobilising hand on proximal radium, fingers on posterior radius, thumb stabilising anterior radius. Fingers move radial head in a P-A direction.
A-P the same except thumb and thenar eminence push radial head down in a A-P direction.

Question 10

Proximal Radioulnar Joint Dorsal Glide - Position, Movement and Indications and Ventral Glide

Answer 10

Supine with arm supported on table.
Stabilising hand: medial hand on proximal ulna.
Mobilising hand: around radial head, thumb and thenar eminence anterior and fingers posterior. Pushing down the radial head, posteriorly with thumb and thenar.
To increase pronation.
Ventral glide: push up, anteriorly with fingers. To improve supination.

Question 11

Distal Radioulnar Joint AP and PA Glides - Position, Movement and Indications

Answer 11

Sitting or supine, arm resting on bed.
Stabilising hand on distal ulna. Mobilising hand on distal radius, thenar eminence and thumb anterior, fingers posterior.
Glide radius dorsally (down) to increase supination.
Glide radius ventrally (up) to increase pronation.

Question 12

Wrist Traction - Position, Movement and Indications

Answer 12

Supine or sitting with arm resting on table. Towel under distal forearm. Palm facing up.
Stabilising hand: holding around the styloid processes, just proximal to the wrist or fixating radius and ulna against the bed.
Mobilising hand: over distal carpal row, pulling it away, longitudinal traction force.
Pain control, general mobility of the wrist.

Question 13

Wrist Dorsal and Volar Glides - Position, Movement and Indications

Answer 13

Supine or sitting, arm resting on bed, towel under distal forearm, wrist hanging off bed, palm facing up.
Stabilising hand around forearm, just proximal to wrist.
Mobilising hand: around carpal bones, glide down (dorsal) or glide up (volar).
Dorsal glide to increase flexion.
Ventral glide to increase extension.

Question 14

Wrist Radial and Ulnar Glide - Position, Movement and Indications

Answer 14

Supine or sitting with arm resting on table, pronation, towel under, wrist hanging off the bed.
Stabilising hand on distal forearm. Mobilising hand over carpal rows. Radial glide, hand on ulnar side. increases ulnar deviation.
Ulnar glide, hand on radial side. increases radial deviation.