Define Osteokinematics

bone motion (example: shoulder flexion)

Define Joint plane/Treatment plane

where the joint surfaces come together in space

Explain the Convex-Concave Rule

Which direction do you mobilize for both?

1. When a convex surface moves on a concave surface
   1. the direction of the joint glide (arthrokinematics) is opposite the direction of the osteokinematic motion (glenohumeral flexion)
   2. Mobilize in opposite direction of joint movement
2. When a concave surface moves on a convex surface
   1. the direction of the joint glide (arthrokinematics) is the same as the direction of the osteokinematic movement (knee extension)
   2. Mobilize in same direction of joint movement

3 Grades of Traction (Kaltenborn)

1. ID
2. Function
3. How to perform
4. Used for (for grade 1 and 2)

1. Grade I
1. Unweight
2. Support joint surfaces to cancel out the effects of gravity.
3. Used for pain relief.
2. Grade II
1. Take up slack
2. Pull perpendicular to joint surfaces until capsule tightens.
3. Used for pain relief
3. Grade III
1. Stretch
2. Stretch at end range all tissues crossing the joint.

Grades of Mobilization/manipulation

1. ID
2. Explain how to perform
3. Function

1. I
1. How to perform
   1. Small amplitude oscillation at the beginning of the range
2. Function
   1. Pain relief
2. II
1. How to perform
   1. Large amplitude oscillation at the beginning of the range
2. Function
   1. Pain relief
3. III
1. How to perform
   1. Large amplitude oscillation at the end of the range
2. Function
   1. ↑ motion
4. IV
1. How to perform
   1. Small amplitude oscillations at the end of the range
2. Function
   1. ↑ motion
5. V (Thrust)
1. How to perform
   1. Small amplitude high velocity thrust at the limit of the range
2. Function
   1. ↑ motion

Shoulder Lab Techniques

Week 2

BI

Mobilization rules

1. Joint is in loose / close pack position
2. Ideally, what direction should you mobilize?
3. One hand ___, one hand ___
4. Mobilizing force should be perpendicular / parallel to joint line
   1. Or perpendicular / parallel for traction
5. Therapist’s forearm/body should be perpendicular / parallel with treatment plane

1. Joint is in
   1. loose pack position
2. Mobilizing direction
   1. In direction of gravity (ideally)
3. One hand stabilizes, one hand mobilizes
4. Mobilizing force should be
   1. parallel to joint line
   2. Or perpendicular for traction
5. Therapist’s forearm/body should be
   1. parallel/in line with treatment plane

Glenohumeral joint mobilization

1. What is the loose-packed position?

1. 30 degrees flexion
2. 55 degrees abduction

GH Long Axis Traction

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Ball and Socket
2. Reason
   1. Pain relief
   2. Pressure relief
   3. Stretch
3. Surfaces
   1. Convex Humeral head
   2. Concave Glenoid Fossa
4. Joint/Treatment plane
   
   1. 30° anteriorly twisted to Sagittal Plane
5. Perform
   1. LPP:
      1. 30 degrees flexion
      2. 55 degrees abduction

Alt. GH Long Axis Traction

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Ball and Socket
2. Reason
   1. Pain relief
   2. Pressure relief
   3. Stretch
3. Surfaces
   1. Convex Humeral head
   2. Concave Glenoid Fossa
4. Joint/Treatment plane
   
   1. 30° anteriorly twisted to Sagittal Plane
5. Perform
   
   1. LPP:
      1. 30 degrees flexion
      2. 55 degrees abduction

GH Anterior Glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Ball and Socket
2. Reason
   1. Convex Humeral head on Concave Glenoid Fossa
      1. Mobilize in opposite direction of movement
   2. Improve posterior movements
      1. Shoulder extension
      2. Horizontal abduction
      3. External Rotation
3. Name of surfaces and which is concave/convex
   1. Convex Humeral
   2. Concave Glenoid Fossa
4. Joint/Treatment plane
   
   1. 30° anteriorly twisted to Sagittal Plane
5. Perform
   
   1. LPP:
      1. 30 degrees flexion
      2. 55 degrees abduction
   2. Let arm rest on your leg - let it drop, don't hold it up

GH Posterior Glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Ball and Socket
2. Reason
   1. Convex Humeral head on Concave Glenoid Fossa
      1. Mobilize in opposite direction of movement
   2. Improve anterior movements
      1. Shoulder flexion
      2. Horizontal adduction
      3. IR
3. Name of surfaces and which is concave/convex
   1. Convex Humeral head on Concave Glenoid Fossa
4. Joint/Treatment plane
   1. 30° anteriorly twisted to Sagittal Plane
5. Perform
   1. LPP
      
      1. 30 degrees flexion
      2. 55 degrees abduction
   2. Push in postero-lateral direction

GH Inferior (caudal) glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Ball and Socket
2. Reason
   1. Convex Humeral head on Concave Glenoid Fossa
      1. Mobilize in opposite direction of movement
   2. Improve superior movements
      1. Shoulder elevation
      2. Shoulder flexion
      3. Shoulder Abduction
      4. Scaption
         1. scapular plane elevation
3. Name of surfaces and which is concave/convex
   1. Convex Humeral
   2. Concave Glenoid Fossa
4. Joint/Treatment plane
   1. 30° anteriorly twisted to Sagittal Plane
5. Perform
   1. LPP
      
      1. 30 degrees flexion
      2. 55 degrees abduction

Alt. GH Inferior (caudal) Glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Ball and Socket
2. Reason
   1. Convex Humeral head on Concave Glenoid Fossa
      1. Mobilize in opposite direction of movement
   2. Improve superior movements
      1. Shoulder elevation
      2. Shoulder flexion
      3. Shoulder Abduction
      4. Scaption
3. Name of surfaces and which is concave/convex
   1. Convex Humeral
   2. Concave Glenoid Fossa
4. Joint/Treatment plane
   1. 30° anteriorly twisted to Sagittal Plane
5. Perform
   1. LPP
      
      1. 30 degrees flexion
      2. 55 degrees abduction

For Sternoclavicular joint mobs, what is the loose packed position?

arms resting at side

Elevation/Depression of Clavicle

1. Clavicle and manubrium
   1. ID which is convex and concave
2. Elevation of clavicle requires inferior / superior glide of proximal clavicle
3. Always associated with ____/____ of scapula

1. Clavicle
   1. Convex
2. Manubrium
   
   1. Concave
3. Elevation of clavicle
   1. Inferior glide
      1. Clavicle (convex) moving on manubrium (concave) --> glides opposite to osteokinematic movement
4. Always associated with
   1. Elevation/Depression of Scapula

Protraction/Retraction of Clavicle

1. Clavicle and manubrium
   1. ID which is convex and concave
2. Retraction of clavicle requires inferior / superior glide of proximal clavicle
3. Always associated with ____/____ of scapula

1. Clavicle
   1. Concave
2. Manubrium
   
   1. Convex
3. Retraction of clavicle requires
   1. Posterior glide
      1. Concave moving on convex --> glides in same direction as osteokinematic movement
4. Always associated with
   1. Protraction/Retraction of Scapula

SC Posterior Glide (shld)

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Saddle shaped Synovial joint
2. Reason
   1. Concave Clavicle moving on Convex manubrium
      1. --> mobilize in same direction as osteokinematic movement
   2. Helps increase
      1. Clavicular Retraction
      2. Scapular Retraction
3. Name of surfaces and which is concave/convex
   1. Concave Clavicle
   2. Convex manubrium
4. Joint/Treatment plane
   1. Transverse plane, around Y axis
5. Perform
   1. LPP
      1. Arms resting at side
   2. Use a “dummy finger” on top of clavicle
   3. Push through dummy thumb to create mobilization
   4. Push posterior
   5. Keep thumbs straight!
   6. Watch where your other fingers are going – don’t want to choke them
6. Graded on
1. Patient relaxed and positioned appropriately (10 points)
2. Therapist using good body mechanics (10 points)
3. Stabilizing and mobilizing hands in good position (10 points)
4. Force is in proper direction (10 points)
5. Amount of force is appropriate (10 points)
6. Safety of procedures (5 points)
7. Confidence (5 points)

SC Inferior Glide (shld)

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Saddle shaped Synovial joint
2. Reason
   1. Convex Clavicle moving on Concvave manubrium --> mobilize in opp direction of ostekinematic movement
   2. Helps ↑
      1. Clavicular elevation
      2. Scapular elevation
3. Name of surfaces and which is concave/convex
   1. Convex Clavicle
   2. Concvave manubrium
4. Joint/Treatment plane
   1. Frontal plane, around Z axis
5. Perform
   1. LPP
      1. Arms by the sides
   2. Use dummy thumb
   3. Mobilizing thumb directly over dummy thumb
   4. Push down towards their toes
   5. Make sure you’re not choking them
   6. Make sure your thumbs are straight, don’t hyperextend them
6. Graded on
   1. Patient relaxed and positioned appropriately (10 points)
   2. Therapist using good body mechanics (10 points)
   3. Stabilizing and mobilizing hands in good position (10 points)
   4. Force is in proper direction (10 points)
   5. Amount of force is appropriate (10 points)
   6. Safety of procedures (5 points)
   7. Confidence (5 points)

Scapulothoracic joint mobs (Anterior position)

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Not a true joint
   2. "Functional / False" Joint
2. Reason
   1. Improve mobility
      1. Ex: Pt's with Frozen Shoulder
   2. Any direction scapula is pulled towards, opposite muscles are stretched
   3. Protraction
      1. You're mobilizing anteriorly -->
         1. ↑ anterior movements
   4. Retraction
      1. You're mobilizing posteriorly -->
         1. ↑ posterior movements
   5. Elevation
      1. You're mobilizing superiorly -->
         1. ↑ superior movements
   6. Depression
      1. You're mobilizing inferiorly-->
         1. ↑ inferior movements
   7. Upward Rotation
      1. You're mobilizing superiorly and protraction -->
         1. ↑ superior movements and protraction
   8. Downward Rotation
      1. You're mobilizing inferiorly and retraction-->
         1. ↑ inferior movements and retraction
3. Name of surfaces and which is concave/convex
   1. Concave surface of the anterior scapula
   2. Convex surface of the posterior thoracic cage
4. Joint/Treatment plane
   1. 30 degrees anterior from frontal plane
5. Perform
   1. Pillow placed between PT and pt

Scapulothoracic joint mobs (Posterior position)

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Not a true joint
   2. "Functional / False" Joint
2. Reason
   1. Improve mobility
      1. Ex: Pt's with Frozen Shoulder
   2. Any direction scapula is pulled towards, opposite muscles are stretched
   3. Protraction
      1. You're mobilizing anteriorly -->
         1. ↑ anterior movements
   4. Retraction
      1. You're mobilizing posteriorly -->
         1. ↑ posterior movements
   5. Elevation
      1. You're mobilizing superiorly -->
         1. ↑ superior movements
   6. Depression
      1. You're mobilizing inferiorly-->
         1. ↑ inferior movements
   7. Upward Rotation
      1. You're mobilizing superiorly and protraction -->
         1. ↑ superior movements and protraction
   8. Downward Rotation
      1. You're mobilizing inferiorly and retraction-->
         1. ↑ inferior movements and retraction
3. Name of surfaces and which is concave/convex
   1. Concave surface of the anterior scapula
   2. Convex surface of the posterior thoracic cage
4. Joint/Treatment plane
   1. 30 degrees anterior from frontal plane
5. Perform
   1. Pillow placed between PT and pt

Elbow Lab Techniques

Week 3

BI

Humeroulnar joint

1. LPP
2. ID which structures are Concave and Convex
3. Operates in which plane?
4. You mobilize perpendicular / parallel to it
5. Which direction do you mobilize? (Same or Opposite)
6. Which direction do you mobilize to help increase:
   1. Flexion
   2. Extension

1. LPP
   1. 70 degrees flexion
2. ID which structures are Concave and Convex
   1. Concave
      1. Ulna (Olecranon)
   2. Convex
      1. Humerus (Trochlea)
3. Operates in which plane?
   1. Transverse plane
4. You mobilize
   1. perpendicular to it
5. Which direction do you mobilize?
   1. Concave moving on convex --> mob in same direction
6. Which direction do you mobilize to help increase:
   1. Flexion
      1. Anterior
   2. Extension
      1. Posterior

HU Distal Glide – HU Scoop

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Hinge joint
2. Reason
   1. Concave Trochlear Notch of Ulna gliding on Convex Trochlea of Humerus
      1. Mobilize in same direction as osteokinematic movement
   2. Anterior glide --> helps with elbow flexion
      1. Pt usually was in a cast
      2. Surgery, elbow fracture, etc.
3. Name of surfaces and which is concave/convex
   1. Concave Trochlear Notch of Ulna
   2. Convex Trochlea of Humerus
4. Joint/Treatment plane
   1. Transverse plane
5. Perform
   1. LPP: 70 flexion
   2. Arm relaxed, elbow resting on table
   3. Press into the joint to get down to level of joint
      1. PT hands are pretty much just distal to crease
   4. Thumbs are wrapped on back of arm
   5. “Scoop” along line of joint towards yourself
   6. Be sure to maintain the LPP
   7. To Pt, feels like PT is just pulling on elbow

HR Anterior glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Hinge joint
2. Reason
   1. Concave radial head gliding on Convex Capitulum of Humerus
      1. Mobilize in same direction as osteokinematic movement
   2. Helps with
      1. Improves elbow flexion
3. Name of surfaces and which is concave/convex
   1. Concave radial head
   2. Convex Capitulum of Humerus
4. Joint/Treatment plane
   1. Transverse Plane
5. Perform
1. LPP
   1. Full extension
2. Get pt’s arm as straight as possible
3. Sit on opposite side of table
4. Stabilizing hand can be on top or underneath
5. Mobilizing hand thumb – find radial head
   1. Supinate and pronate --> can feel that spool spinning
6. Push forward on the radius
   1. You can feel the beginning and end range
   2. Can grade 1-4
7. Try to get mob arm directly behind direction you’re pushing so you can push in a stratight line
6. Graded on
   1. Patient relaxed and positioned appropriately (10 points)
   2. Therapist using good body mechanics (10 points)
   3. Stabilizing and mobilizing hands in good position (10 points)
   4. Force is in proper direction (10 points)
   5. Amount of force is appropriate (10 points)
   6. Safety of procedures (5 points)
   7. Confidence (5 points)

HR Posterior glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Hinge joint
2. Reason
   1. Concave radial head gliding on Convex Capitulum of Humerus
      1. Mobilize in same direction as osteokinematic movement
   2. Helps
      1. Improves elbow extension
3. Name of surfaces and which is concave/convex
   1. Concave radial head
   2. Convex Capitulum of Humerus
4. Joint/Treatment plane
   1. Transverse plane
5. Perform
   1. LPP
      1. Full extension
   2. PT stands up
   3. Get up on top of the joint you’re working on
      1. Turn the pt legs to make room
   4. Pt’s forearm flat on table
   5. Stabilize humerus with non-mobilizing hand
   6. With mob hand
      1. Push through radius with heel of hand through all the soft tissue
      2. Use other fingers to palpate radial head so that when you push, you can tell when it starts to move
         1. You apply force directly over the radial head
      3. Chad palpates radial head with index finger then leans hand over the anterior surface

Radioulnar (RU) joint

1. LPP
2. Joint function
3. Joint is in what plane?
4. ID which structures are Concave and Convex
   1. Proximally
   2. Distally

1. LPP
   1. Forearm supinated, resting on table
2. Joint function
   1. Pronation
   2. Supination
3. Plane
   1. Sagittal
4. Proximally
   1. Concave Ulna
   2. Convex Radius
5. Distally
   1. Convex Ulna
   2. Concave Radius

Proximal RU Anterior Glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Synovial joint
      1. Diarthrodial uniaxial joints of the pivot (trochoid) type
2. Reason
   1. Convex Head of Radius gliding on Concave Radial Notch of Ulna
      1. --> mobilize in opposite direction of osteokinematic motion
   2. Helps
      1. Increase Supination
3. Name of surfaces and which is concave/convex
   1. Convex Head of Radius
   2. Concave Radial Notch of Ulna
4. Joint/Treatment plane
   1. Sagittal plane
5. Perform
   1. LPP
      1. Forearm supinated, resting on table
   2. Come from behind pt’s arm
   3. Find radial head
   4. Stabilizing hand "locks" the ulna
   5. Push out in line against radial head
   6. Can grade these 1-4

Proximal RU Posterior Glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Synovial joint
      1. Diarthrodial uniaxial joints of the pivot (trochoid) type
2. Reason
   1. Convex Head of Radius gliding on Concave Radial Notch of Ulna
      1. --> mobilize in opposite direction of osteokinematic motion
   2. Helps
      1. Increase pronation
3. Name of surfaces and which is concave/convex
   1. Convex Head of Radius
   2. Concave Radial Notch of Ulna
4. Joint/Treatment plane
   1. Sagittal plane
5. Perform
   
   1. LPP
      1. Forearm supinated, resting on table
   2. PT stands up
   3. Pt is angled so you can get in close
   4. Palpate radial head with index finger
   5. Stand and push down in line with radial head (directly over)
   6. If small forearm, can just use thumbs and fingers, but don’t get used to during it that way
      • “skinny people don’t really go to therapy”

Distal RU Posterior Glide

1. Joint type
2. AKA
3. Reason
4. Name of surfaces and which is concave/convex
5. Joint/Treatment plane
6. Perform

1. Joint type
   1. Pivot type synovial joint
2. AKA
   1. Anterior Glide of Ulnar Head
3. Reason
   1. Concave Ulnar Notch on Radius on Convex Ulnar Head
      1. --> mobilize in same direction as osteokinematic movement
   2. Helps
      1. Increase Supination
4. Name of surfaces and which is concave/convex
   1. Concave Ulnar Notch of Radius on
   2. Convex Ulnar Head
5. Joint/Treatment plane
   1. Sagittal
6. Perform
   
   1. LPP
      
      1. Forearm supinated, resting on table
   2. Arm relaxed on table
   3. Turn their legs away
   4. Stabilizing hand
      1. Wrap hand around ulna – stabilize
   5. Other hand on radius straight on top of the joint, lean down to create posterior glide
   6. "Block" ulna - don't let it move
   7. Press down on radius
7. Graded on
   1. Patient relaxed and positioned appropriately (10 points)
   2. Therapist using good body mechanics (10 points)
   3. Stabilizing and mobilizing hands in good position (10 points)
   4. Force is in proper direction (10 points)
   5. Amount of force is appropriate (10 points)
   6. Safety of procedures (5 points)
   7. Confidence (5 points)

Distal RU Anterior Glide

1. Joint type
2. AKA
3. Reason
4. Name of surfaces and which is concave/convex
5. Joint/Treatment plane
6. Perform

1. Joint type
   1. Pivot type synovial joint
      
2. AKA
   1. Posterior glide of ulnar head
3. Reason
   1. Convex Ulnar head on Concave Ulnar Notch of the Radius
      1. --> mobilize in opposite direction of osteokinematic movement
   2. Helps
      1. Increase pronation (posterior movement)
4. Name of surfaces and which is concave/convex
   1. Convex Ulnar head
   2. Concave Ulnar Notch of the Radius
5. Joint/Treatment plane
   1. Sagittal
6. Perform
   1. LPP
      1. Forearm supinated, resting on table
   2. Arm relaxed on table
   3. Turn their legs away
   4. Make sure you're right on top of pt's hand
   5. Stabilizing hand
      1. Wrap hand around radius – stabilize / blocks it
   6. Other hand on ulna - straight on top of the joint, lean down to create "anterior" glide
   7. Press down on radius

Wrist and Hand

Week 4

BI

RC Traction / Distraction

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Synovial joint
2. Reason
   1. Improves general ROM
      1. Ex: If they were in a cast
3. Name of surfaces and which is concave/convex
   1. Convex Proximal carpal row on Concave Radius
4. Joint/Treatment plane
   1. Transverse plane
5. Perform
   1. LPP
      1. Neutral wrist
   2. Pt's hand pronated
   3. Stabilizing hand around radial styloid
      1. Should feel radial styloid by thumb and index finger
   4. Mobilizing hand right next to stabilizing hand, should be touching
   5. Lean back and provide traction

RC Ulnar Glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Synovial joint
2. Reason
   1. Convex Proximal carpal row on Concave Radius
      1. Mobilize in the opposite direction of osteokinematic motion
   2. Improves radial devation
3. Name of surfaces and which is concave/convex
   1. Convex Proximal carpal
   2. Concave Radius
4. Joint/Treatment plane
   1. Transverse plane
5. Perform
   1. LPP
      1. Neutral wrist
   2. Pt's hand in neutral
   3. Stabilizing hand around radial styloid
      1. Should feel radial styloid by thumb and index finger
   4. Mobilizing hand right next to stabilizing hand, should be touching
   5. Push down with straight arms in ulnar direction toward floor

RC Radial Glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Synovial joint
2. Reason
   1. Convex Proximal carpal row on Concave Radius
      1. Mobilize in the opposite direction of osteokinematic motion
   2. Improves Ulnar deviation
3. Name of surfaces and which is concave/convex
   1. Convex Proximal carpal
   2. Concave Radius
4. Joint/Treatment plane
   1. Transverse plane
5. Perform
   1. LPP
      1. Neutral wrist
   2. Pt's hand in neutral
   3. Stabilizing hand around radial styloid
      1. Should feel radial styloid by thumb and index finger
   4. Mobilizing hand right next to stabilizing hand, should be touching
   5. Pull up towards ceiling in radial direction

RC Dorsal Glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Synovial joint
2. Reason
   1. Convex Proximal carpal row on Concave Radius
      1. Mobilize in the opposite direction of osteokinematic motion
   2. Improves Wrist Flexion
3. Name of surfaces and which is concave/convex
   1. Convex Proximal carpal
   2. Concave Radius
4. Joint/Treatment plane
   1. Transverse plane
5. Perform
   1. LPP
      1. Neutral wrist
   2. Pt's hand is supinated
   3. Stabilizing hand around radial styloid
      1. Should feel radial styloid by thumb and index finger
   4. Mobilizing hand right next to stabilizing hand, should be touching
   5. Push down with straight arms towards floor in dorsal direction

RC Volar Glide

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Synovial joint
2. Reason
   1. Convex Proximal carpal row on Concave Radius
      1. Mobilize in the opposite direction of osteokinematic motion
   2. Improves Wrist Extension
3. Name of surfaces and which is concave/convex
   1. Convex Proximal carpal
   2. Concave Radius
4. Joint/Treatment plane
   1. Transverse plane
5. Perform
   1. LPP
      1. Neutral wrist
   2. Pt's hand is pronated
   3. Stabilizing hand around radial styloid
      1. Should feel radial styloid by thumb and index finger
   4. Mobilizing hand right next to stabilizing hand, should be touching
   5. Push down with straight arms towards floor

Intercarpal Mobilization

1. Joint type
2. Reason
3. Joint/Treatment plane
4. Perform

1. Joint type
   1. Synovial plane joints
      
2. Reason
   1. Improve general ROM
      1. usually after immobilization such as a cast
3. Joint/Treatment plane
   1. Sagittal
4. Perform
   1. Get a hold of one and the one next to it and wiggle”
   2. Not really specific or exact
   3. You can’t feel dividing line between most carpal bones
   4. Basically, just squeeze one and wiggle the next door bone

Intermetacarpal Joints 2-5 Dorsal / Volar Glide

1. Joint type
2. Reason
3. Joint/Treatment plane
4. Perform

1. Joint type
   1. Synovial plane joints
2. Reason
   1. Improve general ROM
      1. usually after immobilization such as a cast
3. Joint/Treatment plane
   1. Sagittal
4. Perform
   1. Get a hold of one and the one next to it and "wiggle”
      1. Dorsal - Pull up towards ceiling
      2. Volar - Push down towards palm
   2. Not really specific or exact
   3. Basically, just squeeze one and wiggle the next door bone

Intermetacarpal Joints Cupping

1. Joint type
2. Reason
3. Joint/Treatment plane
4. Perform

1. Joint type
   1. Synovial plane joints
2. Reason
   1. Increase general ROM
      1. Usually after immobilization such as a cast
   2. Just trying to spread metacarpals apart to increase concavity
3. Joint/Treatment plane
   1. Sagittal
4. Perform
   
   1. Can also do hand position opposite to pic
      1. Thumbs on Dorsal surface of hand

Intermetacarpal Joints Flattening

1. Joint type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Synovial plane joints
2. Reason
   1. Increase general ROM
      1. Usually after immobilization such as a cast
3. Joint/Treatment plane
   1. Sagittal
4. Perform
   
   1. Can also do hand position opposite to pic
      1. Thumbs on Dorsal surface of hand

CMC Joint of Thumb Radial Glide

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Saddle joint
2. Reason
   1. Helps
      1. Increases extension
3. Name of surfaces and which is concave/convex
   1. Concave 1st metacarpal
   2. Convex Trapezium
4. Joint/Treatment plane
   1. Sagittal plane
5. Perform
   1. Stabilizing hand
      1. Wiggle 1st metacarpal to see where it ends
      2. Come just proximal to the 1st MC (where there's no movement) - this is the Trapezium
      3. Stabilize trapezium
   2. Mobilizing hand
      1. Hold thumb and pull up on the thumb in radial direction parallel to palm

CMC Joint of Thumb Ulnar Glide

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Saddle joint
2. Reason
   1. Increases flexion
3. Name of surfaces and which is concave/convex
   1. Concave first MC
   2. Convex Trapezium
4. Joint/Treatment plane
   1. Sagittal plane
5. Perform
   1. Stabilizing hand
      1. Wiggle 1st metacarpal to see where it ends
      2. Come just proximal to the 1st MC (where there's no movement) - this is the Trapezium
      3. Stabilize trapezium
   2. Mobilizing hand
      1. Hold thumb and drive thumb down in ulnar direction parallel to palm

CMC Joint of Thumb Dorsal Glide

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint type
   1. Saddle joint
2. Reason
   1. Improve abduction
3. Name of surfaces and which is concave/convex
   1. Convex first MC
   2. Concave Trapezium
4. Joint/Treatment plane
   1. Sagittal
5. Perform
   1. Stabilizing hand
      1. Wiggle 1st metacarpal to see where it ends
      2. Come just proximal to the 1st MC (where there's no movement) - this is the Trapezium
      3. Stabilize trapezium
   2. Mobilizing hand
      1. Hold thumb and pull up on the thumb in dorsal direction

MCP Joints 2-5 Medial Glide

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint Type
   1. Condyloid joint
2. Reason
   1. Concave phalanx moves on Convex metacarpal
      1. Mobilize in same direction as osteokinematic motion
   2. Help improve adduction
3. Name of surfaces and which is concave/convex
   1. Concave phalanx
   2. Convex metacarpal
4. Joint/Treatment plane
   1. Transverse
5. Perform
   1. LPP
      1. MCP in Full Extension
   2. Pinch knuckle (head of MC)
   3. Mob hand
      • Get on top or bottom of phalanx

MCP Joints 2-5 Lateral Glide

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint Type
   1. Condyloid joint
2. Reason
   1. Concave phalanx moves on Convex metacarpal
      1. Mobilize in same direction as osteokinematic motion
   2. Help improve abduction
3. Name of surfaces and which is concave/convex
   1. Concave phalanx
   2. Convex metacarpal
4. Joint/Treatment plane
   1. Transverse
5. Perform
   1. LPP
      1. MCP in Full Extension
   2. Pinch knuckle (head of MC)
   3. Mob hand
      • Get on top or bottom of phalanx

MCP Joints 2-5 Dorsal Glide

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint Type
   1. Condyloid joint
2. Reason
   1. Concave phalanx moves on Convex metacarpal
      1. Mobilize in same direction as osteokinematic motion
   2. Increases extension
3. Name of surfaces and which is concave/convex
   1. Concave phalanx
   2. Convex metacarpal
4. Joint/Treatment plane
   1. Transverse
5. Perform
   1. LPP
      1. MCP in Full Extension
   2. Pinch knuckle (head of MC)
   3. Mob hand
      • Get on top or bottom of phalanx

MCP Joints 2-5 Volar Glide

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint Type
   1. Condyloid joint
2. Reason
   1. Concave phalanx moves on Convex metacarpal
      1. Mobilize in same direction as osteokinematic motion
   2. Increases flexion
3. Name of surfaces and which is concave/convex
   1. Concave phalanx
   2. Convex metacarpal
4. Joint/Treatment plane
   1. Transverse
5. Perform
   1. LPP
      1. MCP in Full Extension
   2. Pinch knuckle (head of MC)
   3. Mob hand
      • Get on top or bottom of phalanx

MCP Joints 2-5 Traction/Distraction

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint Type
   1. Condyloid joint
2. Reason
   1. Concave phalanx moves on Convex metacarpal
      1. Mobilize in same direction as osteokinematic motion
   2. Increases general ROM
3. Name of surfaces and which is concave/convex
   1. Concave phalanx
   2. Convex metacarpal
4. Joint/Treatment plane
   1. Transverse
5. Perform
   1. LPP
      1. MCP in Full Extension
   2. Pinch knuckle (head of MC)
   3. Mob hand
      • Get on top or bottom of phalanx

IP Joints Dorsal Glide

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint Type
   1. Hinge joint
2. Reason
   1. Concave Distal Phalanx on Convex Proximal Phalanx
      1. Mobilize in same direction as osteokinematic motion
   2. Helps increase extension
3. Name of surfaces and which is concave/convex
   1. Concave Distal Phalanx
   2. Convex Proximal Phalanx
4. Joint/Treatment plane
   1. Transverse
5. Perform
   1. LPP: Slight Flexion
   2. Stabilize around distal end of proximal phalanx
   3. Grasp proximal phalanx
   4. Stabilizing and mobilizing fingers should be on either side of the joint, very close to one another

IP Joints Volar Glide

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint Type
   1. Hinge joint
2. Reason
   1. Concave Distal Phalanx on Convex Proximal Phalanx
      1. Mobilize in same direction as osteokinematic motion
   2. Helps increase Flexion
3. Name of surfaces and which is concave/convex
   1. Concave Distal Phalanx
   2. Convex Proximal Phalanx
4. Joint/Treatment plane
   1. Transverse
5. Perform
   1. LPP: Slight Flexion
   2. Stabilize around distal end of proximal phalanx
   3. Grasp proximal phalanx
   4. Stabilizing and mobilizing fingers should be on either side of the joint, very close to one another

IP Joints Traction/Distraction

1. Joint Type
2. Reason
3. Name of surfaces and which is concave/convex
4. Joint/Treatment plane
5. Perform

1. Joint Type
   1. Hinge joint
2. Reason
   1. Helps increase general ROM
      1. Concave Distal Phalanx on Convex Proximal Phalanx
         1. Mobilize in same direction as osteokinematic motion
3. Name of surfaces and which is concave/convex
   1. Concave Distal Phalanx
   2. Convex Proximal Phalanx
4. Joint/Treatment plane
   1. Transverse
5. Perform
   1. LPP: Slight Flexion
   2. Stabilize around distal end of proximal phalanx
   3. Grasp proximal phalanx
   4. Stabilizing and mobilizing fingers should be on either side of the joint, very close to one another
   5. Lean/Pull back, providing traction