Joint Play

Joint Mobilization Procedure

1. postion patient, start joint in loose pack postion 2. stabilize segments above and below the joint 3. Grasp with whole hand and firmly 4. Patient must stay relaxed for grade 3/4 to be effective

Shoulder Loose Packed Position

Abducted 55 Horizontal Abduction 30 Slight external rotation

Osteokinematics (physiological movements)

Human motion. Voluntary Flexion, extension, abduction, adduction, rotation

Joint Mobilization Precautions

Joint hypermobility Unhealed fracture Excessive Pain Joint replacement Weakened connective tissue Systemic connective tissue diseases.

Joint Mobilization Grade 3

Large amplitude movement up to the limit of available joint play

Joint Mobilization Grade 2

Large amplitude movement within the available joint play but not reaching the limit (1/2 way through ROM).

Arthrokinematics (Accessory Movements)

Movement of joint surface. Can't perform voluntarily. Glide or Slide. Roll Spin

Joint Mobilization Indications

Pain Muscle gurading Spasm Hypomobility

Glides

Parallel to the treatment plane

Joint Mobilization Contraindications

Patient fear or refusal Unstable fracture Ligamentous Tear Malignancy Bone disease Active septic or infectious arthritis

Joint traction

Perpendicular to the treatment plane

Ankle Loose Packed Position

Plantarflexion 15 Slight inversion

Convex-Concave Rule

Roll in the same direction as the osteokinematic motion. Slide in opposited direction convex is moving on cancave. Slide is in the same difection if concave is moving on convex.

Roll

Same point on one surface contacts new points on the oposing surface.

Wrist Loose Packed Position

Slight extension Slight ulnar deviation

Joint Mobilization Grade 1

Small amplitude movement at the begining of available joint play

Joint Mobilization Grade 4

Small amplitude movement up to the limit of the avaliable joint play

Joint Mobilization Grade 5 (Manipulation

Small amplitude, high velocity thrust usually at the point of movement restriction

Joint Play is used to assess...

arthrokinematics/ accessory motion before starting joint mabilizations.

Glide or Slide

congurent surfaces. Some point on one surface contacts new points on the opposing surface. Car sliding on ice.

Joint Play

passive translatory gliding and distraction mobility that is characteristic of all diathrodial joints.

Kinematics

refers to motion of the body without regard to forces or torques that may produce motion

Closed Pack Position

the position that the joint capsule and ligaments are maximally taunt. Little to No joint play.

Loose Pack Position

the position that the joint capsule and surrounding ligaments are most relaxed. Greatest amount of joint paly