Shoulder Peripheral Joint Mobilization

No Joint Mobilization Indication Position of Patient Hand Placement Mobilization Force

place hand in axila, place
thumb just distal to the margin
General mobility, with the hand in axilla, move
supine, with arm in resting anteriorly and finger
Joint Traction intial treatment, pain the arm latero ventro
position posteriorly, other hand
control cranially
supports the humerus from
lateral
supine lying one hand in patient axilla, the
Increase abduction,
to reposition humeral web space your other hand is glide the humerus in an
Caudal Glide
G head if superiorly placed distal to the acromiom inferior direction
l positioned
process
e
n stand facing patient feet,
o stabilize patient arm against
h supine,with arm abducted your trunk, place the web with the hand on the
Increase abduction
u Caudal Glide - in available range, less proximal humerus, glide the
when range space of your other hand just
m progression external rotation of the humerus in an inferior
approches 90 degree distal to the acromiom
e humerus mus be added direction
1 process on the proximal
r
a humerus
l Supine , with arm
abducted and elevated to with the hand on yhe
J Increase elevation
Elevation the end of its available same as caudal glide proximal humerus, glide the
o beyond 90 degree of
Progression range, then humerus progression humerus in a progresivelly
i abduction
extrenally rotated to its anterior direction.
n limit
t

Place padding under the

Increase posterior
scapula for stabilization. Place Glide the humerus
gliding when flexion Supine with arm flexedto
Posterior Glide one hand across the proximal posteriorly by pushing down
approches 90 90 degree, internally
Progression surface of the humerus. Place at the elbow through the
degree, increase rotated, with elbow flexed.
your other hand over the long axis of the humerus
horizontal adduction
patient's elbow
No Joint Mobilization Indication Position of Patient Hand Placement Mobilization Force

stand with your back to the

patient, between the patient
G trunk and arm, support his
l arm against your trunk, glide the humeral head
Increase flexion,
e Supine, with arm in resting grasping the distal humerus posteriorly by moving the
Posterior Glide increse internal
n position with your lateral hand. Place entire arm as you bend your
rotation
o the lateral border of your top knees
h hand just distal to the anterior
u margin of the joint, with your
m fingers pointing superiorly.
e
r
a Stand facing the top of the Apply in an anterior and
l table with the leg closeset to slightly medial direction,
the table in a forward stride bend both knees so the
J Prone, with arm in resting
position. Support the patient entire arm moves anterior.
o position over the edge of
Increse extension; arm against your thigh with Precaution; do not lift the
i the tretment plane.
Anterior Glide increase external your outside hand. Place the arm at the elbow and therby
n Supported on your thigh.
rotation ulnar border of your other cause an angulation of the
t Stabilize the acromiom
hand just distal to the humerus; such angulation
with padding
posterior angle of the could lead to an anterior
acromiom process, with your subluxation of the humeral
fingers pointing superiorly. head

Fixate the scapula at the

acromiom process. Stand
behind him and stabilize the
acromiom process with the
Acromioclavic Increase mobility of Your thumb pushes the
2 Anterior Glide Sitting or prone fingers of your lateral hand.
ular Joint the joint clavicle anteriorly
The thumb of your other hand
is placed superiorly on the
clavicle, just medial to the
joint space.
No Joint Mobilization Indication Position of Patient Hand Placement Mobilization Force

S Place your thumb on the

t anterior surface of the
e proximal end of the clavicle.
r Flex your index finger and Push with your thumb in a
Posterior Glide Incresce retraction Supine
n place the middle phalanx posterior direction
o along the caudal surface of
c the clavicle to support the
l thumb
a
v
i Your fingers are placed
3 The fingers and thumb lift
c Anterior Glide Increase Protraction Supine superiorly and thumb inferiorly
u the clavicle anterioly
around the clavicle
l
a
r Your fingers are placed
Your fingers pull the
Inferior Glide Increase elevation Supine superiorly and thumb inferiorly
proximal clavicle caudally
J around the clavicle
o
i
n Your fingers are placed
Your index finger forces in a
t Superior Glide Increase depression Supine superiorly and thumb inferiorly
superior direction
around the clavicle
 Side lying, with the patient
facing you, the pateint arm
is draped over your inferior
This is not a arm and allowed to hang
Increase scapular Your superior hand is placed
true joint, but so that the muscle are
motion of elevation, across the acromiom process The scapula is moved in the
the soft tissue relaxed. Winging is an
depression, to control the direction of desired direction by lifting
Scapulothoraci is stretched in accesory motion that
4 elevation, motion. The fingers of your from the inferior angle or by
c Articulation order to obtain occurs when a person
protarction, inferior hand scoop under the pushing on the acromiom
normal attempts to place the hand
retraction, rotation medial border and inferior process.
shoulder girdle behind the back,
and winging angle of the scapula
mobility accopanying shoulder
internal rotation and
scapular downward
rotation
 Elbow and Forearm Peripheral Joint Mobilization

No Joint Mobilization Indication Position of Patient Hand Placement

Supine, elbow over the

edge of the tretment table
Humeroulnar
Articulation or supported with padding Using your medial hand,
Resting Intial teratment, pain just proximal to the place your fingers over the
1 Joint Traction control, increase olecranon process. The proximal ulna on the volar
position elbow
flexion or extension wrist rests against the surface, reinforce it with your
flexed 70
therapist's shoulder other hand.
degree,
allowing the elbow to be in
forearm
supinated 10 the resting position.
degree.
Tretament
plane; in the
olecranon
fossa, angled
apporximately Same as joint traction,
45 degree except the elbow is
Adjust your position to best
from the long Increase flexion or positioned at the end of its
Traction Progression apply the mobilization force
axis of the extension available range of motion
and stabilize the forearm
ulna. before applying the
Stabilization, mobilizing force
fixate the
humerus
against
tretment table
with a belt or
use an
assistant to
hold it. Distal Glide Increase flexion Same as joint tracton
No Joint Mobilization Indication Position of Patient Hand Placement

Position yourself on the ulnar

side of the patients forearm.
Increse mobility of Stabilize the patient's
the radius, to correct humerus with your superior
Supine or lying, with the
Humeroradial pushed elbow hand, grasp around the distal
2 Joint Traction arm resting on the
Articulation (proximal radius with the fingers and
tretment table
displacement of the thenar eminence of your
radius inferior hand, be sure you
are not grasping around the
distal ulna

Stabilize the humerus from

the medial side of the
Dorsal glide, to Supine or sitting with the
patient's arm. Place the
Dorsal or Volar glide increase extension; elbow extended and
palmar surface of your lateral
of the radius Volar glide, to supinated as far as
hand on the volar aspect and
increase flexion possible
your fingers on the dorsal
aspect of the radial head

Using the same hand as that

of the patient, place your
thenar eminence against the
To reduce a pulled
Joint Compression Sitting or supine patient's thenar eminence
elbow subluxation
(lockin thumbs).fixate the
humerus and proximal ulna
against a firm object
No Joint Mobilization Indication Position of Patient Hand Placement

Proximal radioulnar
joint (Resting
position; elbow Fixate the ulna with your
flexed 70 degree, medial hand around the
forearm supinated 35 Dorsal glide, to medial aspect of the forearm;
Sitting or supine, with the
Radioulnar degree, treatment increase pronation; place your other hand
3 elbow and forearm in
Articulations plane; in the radial volar glide to around the head of the
resting position
notch of the ulna, increase supination radius with the fingerson the
paralel to the long volar surface and the palm
axis of the ulna, on the dorsal surface
stabilization;
proximal ulna)

Distal Radioulnar
Joint (Resting Stabilize the distal ulna by
position; supinated placing the fingers of one
10 degree, treatment Dorsal glide; to hand on the dorsal surface,
Sitting, with arm on the
plane; articulating increase supination, and thenar eminence and
treatment table; forearm in
surface of the radius, volar glide; to thumb on the volar surface.
resting position
paralel to the long increase pronation Place your other hand in the
axis of the radius, same manner around the
stabilization; distal distal radius.
ulna)
 Mobilization Force

Force against the proximal

ulna at a 45 degree angle to
the shaft

Always force against the ulna

at a 45 degree angle, no
matter at what angle the
elbow is.

Use a scooping motion in

which distraction is applied to
the joint first as in joint
traction. Then pull along the
long axis of the ulna
 Mobilization Force

Pull the radius distally (long

axis traction will cause joint
traction

Force the radial head dorsally

with the palm of your hand
and volary with your fingers. If
a stronger force is needed for
the volar glide, turn the
forearm over, relign your
body, and push with the base
of your hand against the
dorsal surface in a volar
direction

Push aong the long axis of the

radius by putting preasure
against the thenar eminence,
simultaneously supinate the
forearm.
 Mobilization Force

Force the radial head volary

by pushing with your palm or
dorsally by pulling with your
fingers. If a stronger force is
needed for the dorsal glide,
move around to the other side
of the patient, switch hands
and push from the volar
surfacewith the base of your
hand against the radial head.

Glide the distal radius dorsally

or volary paralel to the ulna.
 Wrist Peripheral Joint Mobilization

No Joint Mobilization Indication Position of Patient Hand Placement

Joint Traction
Radiocarpal Resting Position;
Joint (concave straight line through
distal radius the radius and third With the hand closest to the
articulates with metacarpal with patient, grasp around the
Sitting, with the forearm
the convex slight ulnar deviation, Intial treatment, pain styloid processes and fixate
supported on the
1 proximal row of treatment plane; in control, general the radius and ulna against
treatment table, wrist over
carpals which is the articulating mobility of the wrist the table. Your other hand
the edge of the table
composed of surface of the radius grasps around the distal row
the schapoid, perpendicular to the of carpals
lunate and long axis of the
triquetrum) radius, stabilization;
distal radius and ulna

Dorsal glide to
increase flexion;
volar glide to Same as joint traction,
increase extension; except roate the forearm
General Glides radial glide to when doing radial or ulnar
increase ulnar glide for ease in doing the
deviation; ulnar glide technique
to increase radial
deviation
 Stabilization; to
increase flexion, the Sitting, with the hand
index fingers being held by the therapist
Specific gildes Place your index fingers on
stabilize the distal so that the elbow hangs
of the carpals in the volar surface of the bone
bone (schapoid or unsupported. The weight
2 the proximal to be stabilized, the thumbs
lunate). To increase of the arm provides slight
row with the on the dorsal surface of the
extension, the index joint traction so the
radius and ulna bone to be mobilized.
fingers stabilize therapist then needs only
proximal bone to apply the glides
(radius)

To increase flexion,
glide radius volary on
Scaphoid-radius fixed scaphoid, or
(scaphoid convex, glide radius volary on
radius con cave), fixed lunate. To
Lunate Radius increase extension,
(lunate convex, glide scaphoid volary
radius concave) on fixed radius or
glide lunate volary on
fixed radius.

To unlock the
articular disk, which
Ulnar meniscal may block motions of
triquetral articulation the wrist or forearm,
glide ulna volary on
fixed triquetrum

3
 Mobilization Force

Put in a distal direction with

respect to the arm

Comes from the hand

around the distals carpals