PERIPHERAL Joint Mobilization
Chapter 5
Part 4
PERIPHERAL JOINT MOBILIZATION
TECHNIQUES
Wrist Complex
Wrist Complex
• When mobilizing the wrist,
begin with general
distractions and glides that
include the proximal row
and distal row of carpals as
a group. For full ROM,
individual carpal
mobilizations/manipulatios
may be necessary.
Radiocarpal Joint
• The concave distal
radius articulates with
the convex proximal
row of carpals, which is
composed of the
scaphoid, lunate, and
triquetrum
Bones and joints of the wrist and hand
Radiocarpal Joint
Resting Position
• The resting position is a
straight line through the
radius and third metacarpal
with slight ulnar deviation.
Treatment Plane
• The treatment plane is in the
articulating surface of the
radius perpendicular to the
long axis of the radius.
Stabilization
• Distal radius and ulna
Radiocarpal Distraction
Indications
• Testing
• initial treatment
• pain control
• general mobility of the
wrist
Wrist joint: general distraction.
Radiocarpal Joint, General Glides, and
Progression
• Indications
• Dorsal glide to increase
flexion
Wrist joint: general mobilization. (A) Dorsal
glide
Radiocarpal Joint, General Glides, and
Progression
• Indications
• volar glide to increase
extension
Radiocarpal Joint, General Glides, and
Progression
• Indications
• radial glide to increase
ulnar deviation
Radiocarpal Joint, General Glides, and
Progression
• Indication
• ulnar glide to increase
radial deviation
Wrist joint: general mobilization—ulnar glide.
Specific Carpal Gliding
N O T E Specific techniques to mobilize
individual carpal bones may be
necessary to gain full ROM of the wrist
Indications
• To increase flexion.
• Glide the concave radius volarly
on the stabilized scaphoid.
• Glide the concave radius volarly
on the stabilized lunate
• Glide the concave trapeziumtrapezoid unit volarly on the
stabilized scaphoid.
• Glide the concave lunate volarly
on the stabilized capitate.
• Glide the concave triquetrum
volarly on the stabilized hamate
Specific carpal mobilizations: stabilization of the distal bone
and volar glide of the proximal bone. Shown is stabilization of the
scaphoid and lunate with the index fingers and a volar glide to the
radius with the thumbs to increase wrist flexion
Specific Carpal Gliding
Specific carpal mobilizations
Indications
To increase extension.
•Glide convex scaphoid volarly on the
stabilized radius.
•Glide convex lunate volarly on the
stabilized radius.
•Glide convex scaphoid volarly on the
stabilized trapezium-trapezoid unit.
•Glide convex capitate volarly on the
stabilized lunate
•Glide convex hamate volarly on the
stabilized triquetrum
stabilization of the proximal bone and volar
guide of the distal bone. Shown is stabilization
of the lunate with the index fingers and volar
glide to the capitate with the thumbs to
increase extension
Ulnar-Meniscal Triquetral Articulation
Indications
• To unlock the articular
disk, which may block
motions of the wrist or
forearm; apply a glide
of the ulna volarly on a
fixed triquetrum
Self-mobilization of the ulnomeniscaltriquetral (UMI) joint
Hand and Finger Joints
Carpometacarpal and Intermetacarpal Joints
of Digits II–V: Distraction
Indication
• To increase mobility of
the hand
Carpometacarpal joint: distraction
Carpometacarpal and
Intermetacarpal: Volar Glide
Indication
• To increase mobility of
the arch of the hand.
Carpometacarpal Joint of the Thumb
Carpometacarpal Distraction (Thumb)
Carpometacarpal Glides (Thumb)
Indication
• Ulnar glide to increase
flexion
Carpometacarpal Glides (Thumb)
• Indication
radial glide to increase
extension
Radial glide to increase extension
Carpometacarpal Glides (Thumb
• Indication
• dorsal glide to increase
abduction
Dorsal glide to increase abduction.
Carpometacarpal Glides (Thumb)
• Indication
• volar glide to increase
adduction.
Volar glide to increase adduction
Metacarpophalangeal and
Interphalangeal Joints of the Fingers
• In all cases, the distal end of the
proximal articulating surface is
convex, and the proximal end of
the distal articulating surface is
concave
Resting Position
• The resting position is in light
flexion for all joints.
Treatment Plane
• The treatment plane is in the
distal articulating surface.
Stabilization
• Rest the forearm and hand on the
treatment table; fixate the
proximal articulating surface with
the fingers of one hand
Metacarpophalangeal and
Interphalangeal Distraction
•
•
•
•
•
Indications
Testing;
Initial treatment
Pain control
General mobility
Metacarpophalangeal joint: distraction.
Metacarpophalangeal and
Interphalangeal Glides and Progression
Indications
Volar glide
• To increase flexion
dorsal glide
• To increase extension
radial or ulnar glide
(depending on finger)
• To increase abduction
or adduction
Metacarpophalangeal joint: volar glide