A mobilization technique used to increase internal rotation of the shoulder.

Technique

Patient is positioned supine.

Clinician makes sure patient is close to the edge of the table with the GH joint being mobilized is off the table.

Clinician places a towel (or other support system) under the scapula on the side being mobilized.

Clinician stands in staggered stance facing up toward the patient’s head.

Clinician begins by putting the patient’s shoulder in 55 of abduction and 35 of horizontal adduction (the open packed position of the GH joint).

Clinician puts his cranial hand in the patient’s axilla gripping the patient’s arm just distal to the joint space and his caudal hand grabs around the elbow to support the arm resting it against his body.

Clinician distracts the arm with his caudal hand and then applies a distraction force through his cranial hand to separate the humerus from the glenoid fossa and moves the hip closest to the patient the axilla to maintain the distraction force.

Clinician’s cranial hand palpates the edge of the acromion and the Clinical places the lateral side of his hand on the humerus.

Clinician takes up the slack and performs a posterior glide with his cranial hand.

References

1. Kaltenborn, F.M. (2007). Manual mobilization of the joints: The extremities volume I (6th ed.). Minneapolis, MN: OPTP.

Related videos:

1. Shoulder – Anterior Glide
2. Glenohumeral Distraction
3. Glenohumeral Mobilization

A mobilization technique used to increase external rotation of the shoulder.

Technique

Patient is positioned in prone.

Clinician makes sure patient is close to the edge of the table with the GH joint and humerus being mobilized is off the table.

Clinician places a towel roll (or other support structure) under the coracoid process on the side being mobilized.

Clinician stands in staggered stance facing up toward the patient’s head.

Clinician begins by putting the patient’s shoulder in 55 of abduction and 35 of horizontal adduction (the open packed position of the GH joint).

Clinician puts his cranial hand in the patient’s axilla gripping the patient’s arm just distal to the joint space and his caudal hand grips superior to the elbow.

Clinician distracts the arm and then places his thigh in the axilla to hold the distraction force.

Clinician’s cranial hand palpates the acromion and he places the lateral side of his cranial hand on the lateral side of the acromion.

Clinician takes up the slack and carefully does an anterior glide making sure to keep both of his elbows extended so both arms go down together during the glide.

References

1. Kaltenborn, F.M. (2007). Manual mobilization of the joints: The extremities volume I (6th ed.). Minneapolis, MN: OPTP.

Related videos:

1. Shoulder – Posterior Glide
2. Glenohumeral Mobilization
3. Glenohumeral Distraction

These tests are used to assess the integrity of the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) of the knee.

Technique

Varus Test

Patient positioned in supine.

Clinician sits on the plinth and cradles the medial part of the leg being tested against his body.

Clinician’s palpation finger palpates the LCL which is located just proximal to the fibular head.

Clinician’s other hand is the mobilization hand and he places it in the medial joint line.

Clinician takes patient’s knee into full knee extension and then brings the patients knee about 5° out of full extension.

Clinician then applies a varus force to knee with mobilization hand.

Clinician tests both knees.

Valgus Test

Patient positioned in supine.

Clinician stands and cradles the lateral part of the leg being tested against his body.

Clinician’s palpation finger palpates the MCL which is located in the medially in the medial joint space.

Clinician’s other hand is the mobilization hand and he places it in the lateral joint line.

Clinician takes patient’s knee into full knee extension and then brings the patients knee about 5° out of full extension.

Clinician then applies a valgus force to knee with mobilization hand.

Clinician tests both knees.

Positive

Varus Test

Lateral knee pain and/or increased varus moment compared to other knee.

Valgus Test

Medial knee pain and/or increased valgus moment compared to other knee.

Interpretation

A positive test indicates laxity or a tear to the ligament being tested.

References

1. Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.

Related videos:

1. Elbow Varus & Valgus Stress Test
2. Meniscal Quadrant Test
3. McMurray’s Test

This test is used to assess the integrity of the PCL.

Technique

Patient is positioned supine.

Clinician flexes the patient’s hips and knees to 90°.

Clinician observes the tibial plateaus looking for sag or posterior translation of the tibia.

Clinician compares both sides.

Positive

Posterior sag of the tibia or a sulcus at the tibial plateau.

Interpretation

A positive test indicates a torn PCL.

References

1. Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York, NY: The McGraw-Hill Companies, Inc.

Related videos:

1. Posterior Drawer Test
2. Anterior Drawer Test
3. Lachman’s Test