Shoulder MOBS
GH Caudal Glide
Indication: Increase ABD, subacromial space
Pt in supine w/ GH in resting position
Resting: 55 ABD, 30 Horiz ADD, Neutral Rotation
Closed: Max ABD, ER
Capsular pattern of restrict: ER>ABD>IR
Vex (humeral head) on cave (glenoid fossa)
What special tests of the shoulder are done in the scapular plane?
Crank test, neer impingement test, empty/full can test, hornblowers sign test, external rotation lag sign
Humeroulnar Joint info
Resting: 70 flexion, 10 supination
Closed: Elbow extended and forearm supinated
Capsular pattern of restict: flexion > extension
Trochlea (convex), trochlear notch/groove (concave)
Cave on vex
What two tests are used for cubital tunnel syndrome
Elbow flexion test, pressure provocation/tinels
Distal Radioulnar joint info
Resting: 10 supination
Closed: Max pronation or supination
Cap pattern of restriction: Pronation and supination are restricted equally
Cave (radius) on vex (ulna)
AC joint (A/P glide)
Resting position: arms at side
Closed pack position: 90 ABD
Capsular pattern of restric: Extreme ROM, especially
Acromion (concave), clavicle (convex)
Actions: Up/Down Rotation, IR/ER, Anterior/posterior tilt
In this test, infraspinatus and supraspinatus are being tested. Pt elbow flexed passively to 90, shoulder held in a position of ~70-90 of elevation in scapular plane and full ER. Therapist holds elbow and lets go on wrist, directing pt to hold the position.
External Rotation Lag Sign and Dropping Sign
-Infraspinatus: can't maintain arm in full ER, with arm ABD BELOW 90 deg
-Teres Minor: can't maintain arm in full ER, with arm ABD ABOVE 90 deg
-Supraspinatus: can't maintain ABD, arm drops into ADD
Humeroradial Joint info
Resting: Elbow extended, forearm supinated
Closed: elbow flexed to 90, forearm supinated to 5
Cap pattern of restriction: Flexion>extension
Radial head (concave), capitulum (convex)
Cave on vex
Tests to assess UCL integrity
Milking maneuver, moving valgus stress test, valgus test
Radiocarpal joint info
Closed: Max ext
Cap pattern of restriction: Equal in all directions
Vex (scaphoid,lunate,triquetral) on cave (radius,ulnar articular disc)
SCJ posterior glide
Pushing thumb into medial clavicle posteriorly
Resting position: arm by side
Closed Pack position: full elevation
Saddle joint
Elevation/depression: vex on cave
Retraction/protraction: cave on vex
In this test, it assesses for Unstable SLAP lesion. Good for bucket handle tears (3, 4) Pt supine, arm elevated 160 in scapular plane, compress through humerus while rotating into ER/IR. (+) pain with ER.
Crank test
Proximal Radioulnar Joint info
Resting: 70 elbow flexion, 35 forearm supination
Closed: Max pronation or supination
Cap pattern of restriction: Pronation/supination restricted equally
Radial head (convex), ulna (concave)
Vex on cave
What band of the UCL is tested in the milking maneuver and moving valgus test
Posterior band
A radial glide at the radiocarpal joint will be used to increase _______
Ulnar deviation
STJ Lateral glide
Indication: Increase scapular protraction, elevation, lateral rotation
Resting position: arm by side
Closed: None, not a synovial joint
Cave (scapula) on Vex (thorax)
This test can be used for labral tear identification/ AC Joint abnormalities
Obriens Test
Patient is limited on mobility in pronation at the proximal radioulnar joint, what is your treatment
Dorsal glide, G. 3/4
What are the two positions of medial epicondylitis testing
-Seated with elbow in slight flexion, forearm supinated. Resists wrist flexion
-Seated with forearm fully supinated. Pt in max supination,wrist extension
A dorsal glide at the intercarpals would be used to increase __________
Extension
Patient is in alot of pain and is limited in ER and Extension of their arm, what would be the best mobilization to do?
Grade 1-2 of Anterior GH Glides
What are the grades in the load and shift test
-Normal laxity: translation of 25% or less of the humeral head diameter anteriorly
-Grade 1: translation of 25-50% with head riding up to the glenoid rim and spontaneous reduction
-Grade 2: translation greater than 50% and the head feels as though its riding over glenoid rim but spontaneously reduces
-Grade 3: Implies that the humeral head rides over the glenoid rim and does not spontaneously reduce
45, allows a glide perpendicular to joint surface
What are the three tests for lateral epicondylitis
Cozens, Mills, Maudsley
A dorsal glide in the CMC joint would be used to increase ______________
Thumb ABD, pain control