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26 Cards in this Set
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Passive Range of Motion with Joint Palpation for Glenohumeral Joint
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PP: seated with GOOD UPRIGHT POSTURE
DP: Standing posterior to the patient CH: Inside hand calcaneal contact applies downward pressure over the clavicle and spine of scapula to limit scapula movement while fingers palpate acromion and head of humerus SH: Outside hand grasps patients elbow or proximal forearm Procedure: SH moves the patient's humerus to induce the following motions at the GHJ Flexion: 120° Extension: 50° ABduction: 120° (palm up in the scapular plane) ADduction: 50° External rotation and Internal rotation: 90° (range varies with arm position; performed with arm at side and with arm at 90° abduction in the scapular plane) |
Common Errors:
- Not adequately stabilizing the scapula with the contact hand - Not palpating over the GHJ with the CH - Not taking GHJ through full range of motion - Moving GHJ beyond 120° of either flexion or ABduction - Patient in a slumped position |
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Supine, Bimanual Thumb Thenar Grasp/Proximal Humerus with Subaxilla Traction for Circumduction Mobilization
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PP: supine, scapula on table, humeral head off table, arm ABducted to 55° in scapular plane
DP: modified fencer (2-line) stance facing the head of the table (inside/superior foot forward) CH and SH: bimanual thumb thenar grasp/proximal humerus and medial subaxilla/distal forearm contacts Procedure: slight long axis traction with CH and SH. Mobilize in circular pattern in the sagittal plane (parallel to patient's torso) |
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Supine, Calcaneal/Proximal Humerus with Subaxilla Traction, for Lateral Distraction (M-L Glide)
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PP: supine, scapula on table, humeral head off the table, arm abducted to 35° in scapular plane (at or near open packed position)
DP: modified fencer (2-line) stance, INSIDE leg forward SH: LATERAL subaxilla/distal forearm contact with hand grasping distal humerus or proximal forearm CH: inside hand calcaneal contact with doctor's fingers under humerus (wrist extended) Procedure: slight long axis traction with SH, the M-L distraction with CH, with vector of correction PERPENDICULAR to the glenoid fossa (perpendicular to sagittal plane, not humeral shaft). Assess, mobilize and/or remove joint slack and impulse |
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Supine, Interlaced Digital/Proximal Humerus, for Lateral Distraction (M-L Glide), in 90° Shoulder Flexino
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PP: supine, scapula on table, humral head off table, arm flexed to 90°, elbow flexed, patient's hand on ipsilateral or contralateral shoulder
DP: modified (2-line) stance or kneeling on cephalad knee facing the table, doctor's head turned caudally or looking ahead (not down at patient's chest) SH and CH: interlaced digital/proximal humerus contact Procedure: blocking patient's distal humerus with doctor's CEPHALAD shoulder, distract M-L with CH and SH. Assess, mobilize and/or remove joint slack and impulse |
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Supine, Thumb Web/Axilla with Subaxilla Traction, for Long Axis Traction
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PP: supine, scapula on the table, humeral head off table, arm abducted to 45° in the scapular plane
DP: modified fencer (2-line) stance with INSIDE leg forward SH: inside hand is internally rotated with thumb web contact placed high in axilla contacting over neck of scapula (MEDIAL to glenoid fossa) with the thumb pointing to the ground. (DO NOT lay the palm of the hand or 4th or 5th digits on the patient's chest) CH: LATERAL subaxilla/distal forearm contact with hand grasping distal humerus or proximal forearm Procedure: Doctor leans back to provide long-axis traction with CH while blocking movement of scapula with SH. Assess, mobilize and/or remove joint slack and impulse |
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Supine, Thumb Web/Axilla with Knee Extension, for Long Axis Traction
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PP: Supine, scapula on table, humeral head off table, arm ABducted for 45° in CORONAL plane
DP: straddling patient's involved arm SH: Inside hand is internally rotated with thumb web contact placed high in axilla contacting over neck of scapula (MEDIAL to glenoid fossa) with the thumb pointing to the ground CH: outside hand grasps distal humerus or proximal forearm. Intergenu/distal humerus contact Procedure: Doctor extends knees to provide long-axis traction with intergenu contact while blocking movement of scapula with SH. Assess, mobilize and/or remove joint slack and impulse |
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Supine, Index/Proximal Humerus, for S-I Glide in 90° Shoulder Abduction
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PP: supine, scapula on table, humeral head off table, arm abducted in 90° in coronal plane
DP: kneeling on INSIDE knee at head of table facing caudally SH: distal thigh of outside leg supports patient's arm. Outside hand grasps distal humerus or proximal forearm CH: inside hand index/proximal humerus contact Procedure: Slight long axis traction with SH by abducting doctor's outside leg. Glide S-I with CH. Assess, mobilize and/or remove joint slack and impulse |
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Supine, Interlaced Digital/Proximal Humerus, for S-I Glide, in 90° Shoulder Flexion
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PP: supine, scapula on table, humeral head off table, shoulder flexed to 90°, elbow flexed, patient's hand on ipsilateral or contralateral shoulder
DP: modified fencer (2-line) stance or kneeling on inside knee facing cephalad CH and SH: interlaced digital/proximal humerus contact Procedure: blocking patient's distal humerus with doctro's inside shoulder, glide S-I with CH and SH. Assess, mobilize and/or remove joint slack and impulse |
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Supine, Bimanual Thumb Thenar Grasp/Proximal Humerus with Subaxilla Traction, for A-P glide (and P-A glide)
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PP: supine, scapula on table, humeral head off table, arm abducted to 45° in scapular plane
DP: modified fencer (2-line) stance CH and SH: bimanual thumb thenar grasp/proximal humerus and medial subaxilla/distal forearm contacts Procedure: slight lon axis traction with SH, glide A-P with CH and SH. Assess, mobilize and/or remove joint slack and impulse |
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Supine, Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension, for A-P Glide and (P-A glide)
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PP: supine, scapula on the table, humeral head off table, arm ABducted to 45° in coronal plane
DP: straddling patients involved arm CH and SH: bilateral thumb thenar grasp/proximal humerus and intergenu/distal humerus contacts Procedure: slight long axis traction with intergenu contact, glide A-P with both hands. Assess, mobilize and/or remove joint slack and impulse |
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Supine, Calcaneal/Proximal Humerus with Subaxilla Traction for A-P Glide
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PP: supine, scapula on table, humeral head off table, arm abducted to 45° in scapular plane
DP: modified fencer (2-line) stance CH: calcaneal/proximal humerus contact using inside or outside hand contact SH: other hand makes a subaxilla/distal forearm contact with hand grasping distal humerus or proximal forearm Procedure: Slight long axis traction with SH, glide A-P with CH. Assess, mobilize and/or remove joint slack and impulse |
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Supine, Palmar/Olecranon, For A-P in 90° Shoulder Flexion
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PP: Supine, scapula on table, humeral head off table, ARM FLEXED to 90°, elbow flexed, patient's hand resting on ipsi or contralateral shoulder
DP: modified fencer (2-line) stance with OUTSIDE leg forward, facing cephalad CH: Palm of inside hand on patients olecranon SH: Outside hand palpates posterior aspect of patient's GHJ Procedure: Doctor leans on CH with inside shoulder. Glide A-P. Assess, mobilize and/or remove joint slack and impulse |
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Seated, Reinforced Palmar/Olecranon, for A-P glide in 90° shoulder flexion
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PP: Seated, arm FLEXED to 90°, elbow flexed, patient's hand on ipsilateral or contralateral shoulder
DP: posterior to patient, doctor's ipsilateral pectoralis area or sternum stabilizing patient's scapula. DO NOT block the head of the humerus CH: palm of outside hand on olecranon SH: inside arm around contralateral side of the patient's neck and hand reinforces CH Procedure: Glide A-P. Assess, mobilize and/or remove joint slack and impulse Note: Either CH or SH can be used to contact the olecranon with other hand used to reinforce |
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Supine, Bimanual Grasp/Proximal Humerus with Subaxilla Traction for External Rotation (and Internal Rotation)
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PP: supine, scapula on table, humeral head off table arm abducted to 45° in scapular plane
DP: 1) Modified fencer (2-line) stance with outside leg forward, doctor facing cephalad CH and SH: bimanual grasp/proximal humerus and MEDIAL subaxilla/distal forearm contacts Procedure: place the patient's arm in external (or internal) rotation and remove tissue slack. Provide slight long axis traction with subaxilla contact and rotate humerus into external (or internal) rotation. Assess, mobilize and/or remove joint slack and impulse |
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SCJ, Supine, Bimanual Thumb Index Pinch/Proximal Clavicle, for A-P, P-A glides and S-I, I-S Glides
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PP: supine, patient's arm at side
DP: fencer (1-line) stance, facing cephalad SH and CH: bimanual thumb index pinch/PROXIMAL clavicle contact Procedure: Glide A-P, P-A and Glide S-I, I-S. Assess mobilize and/or remove joint slack and impulse Alternate Contact: Doctor stands at superior end of table and uses bimanual thumb/proximal clavicle contact for S-I glide |
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ACJ, Supine, Bimanual Thumb Index Pinch/Distal Clavicle, for S-I, I-S glides and A-P, P-A glides
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PP: supine, patient's arm at side
DP: fencer (1-line) stance, facing cephalad SH and CH: bimanual thumb index pinch/ DISTAL clavicle contact Procedure: Glide A-P, P-A and Glide S-I, I-S. Assess, mobilize and/or remove joint slack and impulse |
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SCJ, Supine, Hypothenar/Distal Clavicle, Hypothenar/Manubrium, for Long Axis Traction - with 90° Shoulder ABduction
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PP: Supine, THORACIC BLOCK is placed as fulcrum under upper thoracic area. The ipsilateral arm abducted to 90°
DP: fencer (1-line) stance, facing cephalad, ARMS CROSSED CH: INSIDE arm makes a hypothenar/distal clavicle contact SH: OUTSIDE arm makes a hypothenar/manubrium contact just medial to the sternoclavicular joint Procedure: Inside contact stabilizes patient's manubrium. Outside contact traction A-P and M-L on clavicle. Assess, mobilize and/or remove joint slack and impulse with OUTSIDE contact ONLY |
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SCJ, Seated, Thenar/Clavicle, Thenar/Manubrium, for Long Axis Traction
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PP: seated
DP: standing behind patient at 45° facing involved side with doctor's hip at level of patient's upper thoracic area. Doctor uses HIP as a fulcrum CH: Doctor's ipsilateral hand reaches over the patient's ipsilateral shoulder and makes a thenar contact on the mid-clavicle with the doctor's forearm across the patient's ipsilateral shoulder SH: contralateral hand reaches around and over the patient's contralateral shoulder and makes a thenar contact on the manubrium with the doctor's forearm across the patients clavicle and shoulder Procedure: SH tractions patient's manubrium and shoulder M-L and A-P. CH tractions patient's clavicle and shoulder M-L and A-P. Assess, mobilize and/or remove joint slack and impulse with CH ONLY separating the proximal clavicle from the manubrium |
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ACJ, Seated, Bimanual Thumb/Distal Clavicle for P-A Glide
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PP: seated, patient's arm at side
DP: standing behind the patient SH and CH: bimanual thumb (or thumb on thumb)/posterior DISTAL clavicle contact (close to ACJ) with fingers of doctors outside hand blocking anterior acromion with A-P pressure Procedure: Glide P-A. Assess, mobilize and/or remove joint slack and impulse |
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SCJ, Seated, Hypothenar/Proximal Clavicle, Hypothenar/Spine of Scapula, for A-P Glide
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PP: seated, patient's arm at side (SCOOT PATIENT TO END OF TABLE!)
DP: standing lateral to the patient CH: Hypothenar/PROXIMAL clavicle contact with forearm parallel to floor SH: Hypothenar/spine of the scapula in-line with CH, forearm parallel to the floor Procedure: interlace fingers of CH and SH and approximate hypothenars. Glide A-P. Assess, mobilize and/or remove joint slack and impulse |
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ACJ, Seated, Hypothenar/Distal Clavicle, Hypothenar/Spine of Scapula for A-P Glide
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PP: seated, patient's arm at side (SCOOT PATIENT TO END OF TABLE)
DP: standing lateral to the patient CH: Hypothenar/DISTAL clavicle contact with forearm parallel to floor SH: Hypothenar/spine of the scapula in-line with CH, forearm parallel to floor Procedure: Interlace fingers of CH and SH, and approximate hypothenars. Glide A-P. Assess, mobilize and/or remove joint slack and impulse |
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SCJ, Supine, Hypothenar/Proximal Clavicle: with Shoulder Protraction for A-P Glide
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PP: supine
DP: fencer (1-line) stance, facing cephalad (INSIDE leg steps BACK) CH: inside hand hypothenar/PROXIMAL clavicle contact on the anterior aspect of clavicle SH: LATERAL subaxilla/distal forearm contact with hand grasping distal humerus or proximal forearm Procedure: Sh tractions patient's arm P-A while CH applies pressure A-P. |
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SCJ, Supine, Hypothenar/Proximal clavicle with Shoulder Depression for I-S Glide
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PP: supine
DP: fencer (1-line) stance, facing cephalad CH: Inside hand hypothenar/PROXIMAL clavicle contact on INFERIOR aspect of clavicle SH: LATERAL subaxilla/distal forearm contact with hand grasping distal humerus or proximal forearm Procedure: SH tractions patient's arm S-I while CH applies pressure I-S |
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SCJ, Supine, Hypothenar/Proximal Clavicle, for S-I Glide with 90° Shoulder Abduction
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PP: supine, arm abducted to 90° in CORONAL plane
DP: kneeling on INSIDE knee at the head of the table facing caudally CH: inside hand hypothenar/PROXIMAL clavicle contact on superior aspect of the clavicle. Forearm of CH is parallel to the floor SH: Distal thigh on OUTSIDE leg supports patient's arm with outside hand grasping distal humerus or proximal forearm Procedure: Slight long axis traction is applied to patient's arm with SH by ABducting doctor's outside leg. CH glides S-I |
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ACJ, Supine, Hypothenar/Distal Clavicle, for S-I Glide with 90° Shoulder ABduction
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PP: supine, arm abducted to 90° in CORONAL plane
DP: kneeling on INSIDE knee at the head of the table, facing caudally CH: INSIDE hand hypothenar/DISTAL clavicle contact on superior aspect of clavicle. Forearm of CH is parallel to the floor SH: distal thigh of outside leg supports patient's arm with outside hand grasping distal humerus or proximal forearm Procedure: slight long axis traction is applied to patient's arm with SH by ABducting doctor's outside leg. CH glides S-I. |
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ACJ, Seated, 2nd MCP/Distal Clavicle, for S-I Glide with 90° Shoulder ABduction
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PP: seated, arm abducted to 90° in CORONAL plane
DP: standing behind patient, OUTSIDE foot on table, with patient's arm on doctor's DISTAL thigh CH: inside hand 2nd MCP/DISTAL clavicle (superior aspect) SH: Outside hand stabilizes patient's arm on doctor's knee Procedure: The patient leans away from the side of contact. Doctor applies slight lateral traction by ABducting the outside leg. CH glides joint S-I. |
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