Specific Joint Mobilizations to Appendicular System

Glenohumeral Joint
Distraction
Purpose:
- to examine for glenohumeral joint impairment
- To increase accessory motion in GH joint distraction
- To increase range of motion at the GH joint
- To decrease pain
Positing
1. The patient is supine
2. The GH joint is positioned in the resting position if conservative techniques are
indicated or approximating restricted range of motion if more aggressive
techniques are indicated
3. The clinician can use a belt to hold the patient’s scapula against the trunk,
especially in the presence of Scapulothoracic hypermobility or excessive
movement at the Scapulothoracic joint with shoulder elevation
4. The clinician is at the patient’s side, facing the glenohumeral joint
5. The clinician can support the patient’s forearm and hand by positioning them
between the clinician’s upper arm and trunk
6. Both hands grip the proximal humerus as close to the axilla as possible from the
medial and lateral side
Procedure
1. Both hands move the humeral head lateral, anterior, and inferior, perpendicular to the
glenoid joint surface

Inferior Glide
Purpose:
1. To examine for GH joint impairment
2. To increase accessory motion into glenohumeral joint inferior glide
3. To increase range of motion at the GH joint
4. To decrease pain
Positioning:
1. The patient is supine
2. The GH joint is positioned in the resting position if conservative techniques are
indicated or approximating restricted range of motion if more aggressive
techniques are indicated
3. The clinician can use a belt to hold the patient’s scapula against the trunk
4. The clinician is at the patient’s head, facing the glenohumeral joint
5. The clinician can support the patient’s forearm and hand by positioning them
between the clinician’s upper arm and trunk
6. The mobilizing/manipulating hand is positioned with the web space over the
superior surface of the proximal humerus
7. The guiding hand supports the upper limb from the medial side of the distal
humerus

Procedure
1. The clinician applies a grade I traction to the joint
2. The mobilizing/manipulating hand glides the humerus in an inferior direction
3. The guiding hand controls the position of the humerus

Posterior Glide
Purpose:
1. To examine for GH joint impairment
2. To increase accessory motion into glenohumeral joint inferior glide
3. To increase range of motion at the GH joint
4. To decrease pain

Positioning:
1. The patient is supine, with the humerus positioned off the edge of the treatment
table
 2. The GH joint is positioned in the resting position if conservative techniques are
indicated or approximating restricted range of motion if more aggressive
techniques are indicated
3. The clinician is at the patient’s side, facing the patient
4. The clinician can support the patient’s forearm and hand by positioning them
between the clinician’s upper arm and trunk
5. The mobilizing/manipulating hand is positioned over the anterior surface if the
proximal humerus
6. The guiding hand supports the upper limb from the posterior side of the distal
humerus

Procedure
1. The clinician applies a grade I traction to the joint
2. The mobilizing/manipulating hand glides the humerus in a posterior direction
3. The guiding hand controls the position of the humerus
4. When approximating the restricted range of motion for horizontal adduction, if the
shoulder joint can be positioned in at least 90 degrees of horizontal adduction,
the posterior glide can be directed through the shaft of the humerus

Anterior Glide
Purpose:
1. To examine for GH joint impairment
2. To increase accessory motion into glenohumeral joint inferior glide
3. To increase range of motion at the GH joint
4. To decrease pain

Positioning:
1. The patient is supine
2. The GH joint is positioned in the resting position if conservative techinques are
indicated or approximating restricted range of motion if more aggressive
techniques are indicated
 3. The clinician can use a belt to hold the patient’s scapula against the trunk
4. The clinician is at the patient’s side, facing the GH joint
5. The clinician can support the patient’s forearm and hand by positioning them
between the clinician’s upper arm and trunk
6. The mobilizing/manipulating hand is positioned over the posterior surface of the
proximal humerus
7. The guiding hand supports the upper limb from the anterior and posterior sides of
the distal humerus

Procedure:
1. The clinician applies a grade I traction to the joint
2. The mobilizing/manipulating hand glides the humerus in an anterior direction
3. The guiding hand controls the position of the humerus

Scapulothoracic Joint
Distraction
Purpose:
1. To examine for Scapulothoracic joint impairment
2. To increase accessory motion into Scapulothoracic joint distraction
3. To increase range of motion at the shoulder complex
4. To decrease pain
Positioning:
1. The patient is lying on the unaffected side with the posterior surface of the hand
positioned on the sacrum if shoulder range of motion allows
2. The clinician is either in front or behind the patient, facing the patient’s shoulder
3. If the clinician is positioned in front of the patient, a pillow can be used to
separate the patient’s chest from the clinician
4. The mobilizing hand is positioned over the acromion
5. The guiding hand is poisoned adjacent to the inferior angle of the scapula
Procedure:
 1. The mobilizing hand moves the scapula medially and inferiorly over the guiding
hand
2. The guiding hand lefts the scapula away from the ribs

Superior Glide
Purpose:
1. To examine for Scapulothoracic joint impairment
2. To increase accessory motion into Scapulothoracic superior glide
3. To increase range of motion at the shoulder complex
4. To decrease pain

Positioning:
1. The patient is lying on the unaffected side with the arm in a neutral position
2. The clinician is in front of the patient, facing the patient’s shoulder
3. A pillow can be used to separate the patient’s chest from the clinician
4. The mobilizing hand is positioned adjacent to the inferior angle of the scapula
5. The guiding hand is positioned over the acromion

Procedure:
1. The clinician applies a grade I traction to the joint
2. The mobilizing hand glides the scapula in a superior direction
3. The guiding hand controls the position of the scapula

Inferior Glide
Purpose:
1. To examine for Scapulothoracic joint impairment
2. To increase accessory motion into Scapulothoracic inferior glide
3. To increase range of motion at the shoulder complex
4. To decrease pain

Positioning:
 1. The patient is lying on the unaffected side with the arm in a neutral position
2. The clinician is in front of the patient, facing the patient’s shoulder
3. A pillow can be used to separate the patient’s chest from the clinician
4. The mobilizing hand is positioned over the acromion
5. The guiding hand is positioned over the inferior angle of the scapula

Procedure:
1. The clinician applies a grade I traction to the joint
2. The mobilizing hand glides the acromion in an inferior direction
3. The guiding hand controls the position of the scapula

Posterior Glide
Purpose:
1. To examine for Scapulothoracic joint impairment
2. To increase accessory motion into Scapulothoracic joint distraction
3. To increase range of motion at the shoulder complex
4. To decrease pain

Anterior Glide of Clavicle on Sternum

Acromioclavicular Joint
Posterior Glide
Purpose:
1. To examine for acromioclavicular joint impairment
2. To increase accessory motion into acromioclavicular posterior glide
3. To increase range of motion at the shoulder complex
4. To decrease pain

Positioning:
1. The patient is sitting with the arm resting at the side
 2. The clinician is in front of the patient, facing the anterior surface of the
acromioclavicular joint
3. The stabilizing hand is positioned over the posterior surface of the scapula
4. The mobilizing/manipulating hand is positioned with the thumb over the thumb of
the guiding hand
5. The guiding hand, which is the same hand as the stabilizing hand, is positioned
with the thumb over the anterolateral surface of the clavicle

Procedure:
1. The stabilizing hand holds the scapula in position
2. The mobilizing/manipulating hand glides the clavicle in a posterior direction
3. The guiding hand controls the position of the mobilizing/manipulation hand

Anterior Glide
Purpose:
1. To examine for acromioclavicular joint impairment
2. To increase accessory motion into acromioclavicular posterior glide
3. To increase range of motion at the shoulder complex
4. To decrease pain

Positioning:
1. The patient is sitting with the arm resting at the side
2. The clinician is behind the patient, facing the posterior surface of the
acromioclavicular joint
3. The stabilizing hand is positioned hand is positioned over the anterior acromion
and over the anterior surface of the proximal humerus
4. The mobilizing/manipulating hand is positioned wit the thumb over the thumb of
the guiding hand
5. The guiding hand, which is the same hand as the stabilizing hand, is positioned
with the thumb over the posterolateral surface of the clavicle
Procedure:
1. The stabilizing hand holds the acromion in position
2. The mobilizing/manipulating hand glides the clavicle in an anterior direction
3. The guiding hand controls the position of the mobilizing/manipulating hand

Humeroulnar Glide
Distraction
Purpose:
1. To examine for humeroulnar joint impairment
2. To increase accessory motion into humeroulnar joint dislocation
3. To increase range of motion at the elbow complex
4. To decrease pain

Positioning:
1. The patient is supine
2. The humeroulnar joint is positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician id at the patient’s hip, facing the humeroulnar joint, with the patient’s
upper arm resting on the treatment table, the elbow joint positioned off the edge
of the table, and the distal forearm resting on the clinician’s shoulder
4. The stabilizing hand grips the distal humerus from the anterior side
5. Instead of or in addition to the stabilizing hand, the clinician can use a belt to hold
the patient’s humerus to the treatment table
6. The mobilizing/manipulating hand grips the proximal ulna from the anterior side,
avoiding contact with the radius

Medial Gap
Purpose:
1. To examine for humeroulnar joint impairment
2. To increase accessory motion into humeroulnar medial glide
 3. To increase range of motion at the elbow joint
4. To decrease pain

Positioning:
1. The patient is supine
2. The humeroulnar joint is positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is facing the patient, between the patient’s arm and trunk, with the
patient’s forearm between the clinician’s upper arm and trunk
4. The stabilizing hand grips the distal humerus from the medial side
5. The mobilizing/manipulating hand grips the proximal radius from the lateral side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the humerus in position
3. The mobilizing/manipulating hand glides the proximal ulna in a medial direction
indirectly through the radius while the clinician’s trunk guides the motion

Lateral Gap
Purpose:
1. To examine for humeroulnar joint impairment
2. To increase accessory motion into humeroulnar lateral glide
3. To increase range of motion at the elbow joint
4. To decrease pain

Positioning:
1. The patient is supine
2. The humeroulnar joint is positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
 3. The clinician is at the patient’s side, facing the humeroulnar joint with the patient’s
forearm, between the clinician’s upper arm and trunk
4. The stabilizing hand grips the distal humerus from the lateral side
5. The mobilizing/manipulating hand grips the proximal ulna from the medial side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the humerus in position
3. The mobilizing/manipulating hand glides the proximal ulna in a lateral direction
while the clinician’s trunk guides the motion

Humeroradial Joint
Distraction
Purpose:
1. To examine for humeroradial joint impairment
2. To increase accessory motion into humeroradial joint dislocation
3. To increase range of motion at the elbow joint
4. To decrease pain

Positioning:
1. The patient is supine
2. The humeroradial joint is positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is at the patient’s side, facing the humeroradial joint
4. The stabilizing hand grips the distal humerus from the anterior side
5. The mobilizing/manipulating hand grips the distal radius, avoiding contact with
the ulna

Procedure:
1. The stabilizing hand holds the humerus in position
 2. The mobilizing/manipulating hand moves the radial head distally perpendicular to
the radial joint surface

Posterior glide
Purpose:
1. To examine for humeroradial joint impairment
2. To increase accessory motion into humeroradial joint posterior glide
3. To increase range of motion at the elbow joint
4. To decrease pain

Positioning:
1. The patient is supine with the shoulder medially rotated
2. The humeroradial joint is positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is at the patient’s side, facing the humeroradial joint
4. The stabilizing hand grips the distal humerus from the posterior side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the humerus in position
3. The mobilizing/manipulating hand glides the proximal radius in a posterior
direction

Anterior Glide
Purpose:
1. To examine for humeroradial joint impairment
2. To increase accessory motion into humeroradial joint posterior glide
3. To increase range of motion at the elbow joint
4. To decrease pain
Positioning:
1. The patient is supine with the shoulder medially rotated
2. The humeroradial joint is positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is at the patient’s side, facing the humeroradial joint
4. The stabilizing hand grips the distal humerus from the anterior side
5. The mobilizing/manipulating hand grips the proximal radius from the posterior
side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the humerus in position
3. The mobilizing/manipulating hand glides the proximal radius in an anterior
direction

Proximal Radioulnar Joint

Posterior Glide of Proximal Radius
Purpose:
1. To examine for radialulnar joint impairment
2. To increase accessory motion into proximal Radioulnar posterior glide
3. To increase range of motion at the forearm
4. To decrease pain

Positioning:
1. The patient is sitting with the forearm resting on the treatment table
2. The proximal Radioulnar joint is positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is at the patient’s side, facing the proximal radioulnar joint
4. The stabilizing hand grips the proximal ulna from the posterior surface
 5. The mobilizing/manipulating hand grips the radial head anteriorly

Procedure:
1. The stabilizing hand holds the ulna in position
2. The mobilizing/manipulating hand glides the radial head in a posterior direction

Anterior Glide of Distal Radius

Purpose:
1. To examine for radioulnar joint impairment
2. To increase accessory motion into proximal radioulnar anterior glide
3. To increase range of motion at the forearm
4. To decrease pain

Positioning:
1. The patient is sitting with the forearm resting on the treatment table
2. The proximal radioulnar joint is positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is at the patient’s side, facing the proximal radioulnar joint
4. The stabilizing hand grips the proximal ulna from the anterior surface
5. The mobilizing/manipulating hand grips the radial head posteriorly

Procedure:
1. The stabilizing hand holds the ulna in position
2. The mobilizing/manipulating hand glides the radial head in an anterior direction

Distal Radioulnar Joint

Posterior Glide of Distal Radius
Purpose:
1. To examine for distal radialulnar joint impairment
2. To increase accessory motion into distal radioulnar posterior glide
 3. To increase range of motion at the forearm
4. To decrease pain

Positioning:
1. The patient is sitting with the forearm resting on the treatment table
2. The distal radioulnar joint is positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is at the patient’s side, facing the distal radioulnar joint
4. The stabilizing hand grips the distal ulna from the posterior surface
5. The mobilizing/manipulating hand grips the distal radius anteriorly

Procedure:
1. The stabilize hand holds the ulna in position
2. The mobilizing/manipulating hand glides the distal radius in a posterior direction

Anterior Glide of Distal Radius

Purpose:
1. To examine for distal radialulnar joint impairment
2. To increase accessory motion into distal radioulnar anterior glide
3. To increase range of motion at the forearm
4. To decrease pain

Positioning:
1. The patient is sitting with the forearm resting on the treatment table
2. The distal radioulnar joint is positioned in the resting position if conservative
techniques are indicated approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is at the patient’s side, facing the distal radioulnar joint
4. The stabilizing hand grips the distal ulna from the anterior surface
5. The mobilizing/manipulating hand grips the radial radius posteriorly
Procedure:
1. The stabilizing hand holds the ulna in position
2. The mobilizing/manipulating hand glides the distal radius in an anterior direction

Radiocarpal & Ulnocarpal Joint

Distraction
Purpose:
1. To examine for radiocarpral and ulnocarpral joint impairment
2. To increase accessory motion into radiocarpral and ulnocarpral joint distraction
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
1. The patient is sitting with the anterior surface of the forearm on the treatment
table and the hand off the table
2. The radiocarpral and ulnocarpral joints are positioned in the resting position if
conservative techniques are indicated or approximating restricted range of motion
if more aggressive techniques are indicated
3. The clinician is facing the radiocarpral and ulnocarpral joints
4. The stabilizing hand grips the distal radius and ulna from the posterior side
5. The mobilizing/manipulating hand grips the proximal row of carpals from the
posterior side

Procedure:
1. The stabilizing hand holds the radius and ulna to the treatment table
2. The mobilizing/manipulating hand moves proximal row of carpals distally
perpendicular to the radioulnar joint surface

Posterior Glide
Purpose:
 1. To examine for radiocarpral and ulnocarpral joint impairment
2. To increase accessory motion into radiocarpral and ulnocarpral joint posterior
glide
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
1. The patient is sitting with the medial (ulnar) surface of the forearm on the
treatment table and the hand off the table
2. The radiocarpral and ulnocarpral joints are positioned in the resting position if
conservative techniques are indicated or approximating restricted range of motion
if more aggressive techniques are indicated
3. The clinician is facing the radiocarpral and ulnocarpral joints
4. The stabilizing hand grips the distal radius and ulna from the posterior side
5. The mobilizing/manipulating hand grips the proximal row of carpals from the
posterior side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the radius and the ulna to the treatment table
3. The mobilizing/manipulating hand glides the proximal row of carpals in a posterior
direction

Anterior Glide
Purpose:
1. To examine for radiocarpral and ulnocarpral joint impairment
2. To increase accessory motion into radiocarpral and ulnocarpral joint anterior glide
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
 1. The patient is sitting with the anterior surface of the forearm on the treatment
table and the hand off the table
2. The radiocarpral and ulnocarpral joints are positioned in the resting position if
conservative techniques are indicated or approximating restricted range of motion
if more aggressive techniques are indicated
3. The clinician is facing the radiocarpral and ulnocarpral joints
4. The stabilizing hand grips the distal radius and ulna from the posterior side
5. The mobilizing/manipulating hand grips the proximal row of carpals from the
posterior side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the radius and the ulna to the treatment table
3. The mobilizing/manipulating hand glides the proximal row of carpals in a anterior
direction

Radial Glide
Purpose:
1. To examine for radiocarpral and ulnocarpral joint impairment
2. To increase accessory motion into radiocarpral and ulnocarpral joint lateral
(radial) glide
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
1. The patient is sitting with the anterior surface of the forearm on the treatment
table and the hand off the table
2. The radiocarpral and ulnocarpral joints are positioned in the resting position if
conservative techniques are indicated or approximating restricted range of motion
if more aggressive techniques are indicated
3. The clinician is facing the radiocarpral and ulnocarpral joints
 4. The stabilizing hand grips the distal radius and ulna from the posterior side
5. The mobilizing/manipulating hand grips the proximal row of carpals from the
medial (ulnar) side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the radius and the ulna to the treatment table
3. The mobilizing/manipulating hand glides the proximal row of carpals in a lateral
(radial) direction

Ulnar Glide
Purpose:
1. To examine for radiocarpral and ulnocarpral joint impairment
2. To increase accessory motion into radiocarpral and ulnocarpral joint medial
(ulnar) glide
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
1. The patient is sitting with the medial (ulnar) surface of the forearm on the
treatment table and the hand off the table
2. The radiocarpral and ulnocarpral joints are positioned in the resting position if
conservative techniques are indicated or approximating restricted range of motion
if more aggressive techniques are indicated
3. The clinician is facing the radiocarpral and ulnocarpral joints
4. The stabilizing hand grips the distal radius and ulna from the anterior side
5. The mobilizing/manipulating hand grips the proximal row of carpals from the
lateral (radial) side

Procedure:
1. The clinician applies a grade I traction to the joint
 2. The stabilizing hand holds the radius and the ulna to the treatment table
3. The mobilizing/manipulating hand glides the proximal row of carpals in a medial
(ulnar) direction

Midcarpal Joint
Distraction
Purpose:
1. To examine for Midcarpal joint impairment
2. To increase accessory motion into Midcarpal joint distraction
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
1. The patient is sitting with the anterior surface of the forearm on the treatment
table and the hand off the table
2. The midcarpal joints are positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is facing the midcarpal joints
4. The stabilizing hand grips the proximal row of carpals from the posterior side
5. The mobilizing/manipulating hand grips the proximal row of carpals from the
posterior side

Procedure:
1. The stabilizing hand holds the proximal row of carpals to the treatment table
2. The mobilizing/manipulating hand glides the distal row of carpals distally
perpendicular to the proximal carpal row joint surface

Posterior Glide
Purpose:
 1. To examine for Midcarpal joint impairment
2. To increase accessory motion into midcarpal joint posterior glide
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
1. The patient is sitting with the medial (ulnar) surface of the forearm on the
treatment table and the hand off the table
2. The midcarpal joints are positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is facing the midcarpal joints
4. The stabilizing hand grips the proximal row of carpals from the posterior side
5. The mobilizing/manipulating hand grips the distal row of carpals from the
posterior side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the proximal row of carpals to the treatment table
3. The mobilizing/manipulating hand glides the distal row of carpals in a posterior
direction

Anterior Glide
Purpose:
1. To examine for Midcarpal joint impairment
2. To increase accessory motion into midcarpal joint anterior glide
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
 1. The patient is sitting with the anterior surface of the forearm on the treatment
table and the hand off the table
2. The midcarpal joints are positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is facing the midcarpal joints
4. The stabilizing hand grips the proximal row of carpals from the posterior side
5. The mobilizing/manipulating hand grips the distal row of carpals from the
posterior side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the proximal row of carpals to the treatment table
3. The mobilizing/manipulating hand glides the distal row of carpals in an anterior
direction

Radial Glide
Purpose:
1. To examine for Midcarpal joint impairment
2. To increase accessory motion into midcarpal joint medial (ulnar) glide
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
1. The patient is sitting with the medial (ulnar) surface of the forearm on the
treatment table and the hand off the table
2. The midcarpal joints are positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is facing the midcarpal joints
4. The stabilizing hand grips the proximal row of carpals from the posterior side
 5. The mobilizing/manipulating hand grips the distal row of carpals from the lateral
(radial) side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the proximal row of carpals to the treatment table
3. The mobilizing/manipulating hand glides the distal row of carpals in a medial
(ulnar) direction

Ulnar Glide
Purpose:
5. To examine for Midcarpal joint impairment
6. To increase accessory motion into midcarpal joint anterior glide
7. To increase range of motion at the wrist joint
8. To decrease pain

Positioning:
6. The patient is sitting with the anterior surface of the forearm on the treatment
table and the hand off the table
7. The midcarpal joints are positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
8. The clinician is facing the midcarpal joints
9. The stabilizing hand grips the proximal row of carpals from the posterior side
10. The mobilizing/manipulating hand grips the distal row of carpals from the
posterior side

Procedure:
4. The clinician applies a grade I traction to the joint
5. The stabilizing hand holds the proximal row of carpals to the treatment table
 6. The mobilizing/manipulating hand glides the distal row of carpals in an anterior
direction

Radial Glide
Purpose:
1. To examine for Midcarpal joint impairment
2. To increase accessory motion into midcarpal joint lateral (radial) glide
3. To increase range of motion at the wrist joint
4. To decrease pain

Positioning:
1. The patient is sitting with the lateral (radial) surface of the forearm on the
treatment table and the hand off the table
2. The midcarpal joints are positioned in the resting position if conservative
techniques are indicated or approximating restricted range of motion if more
aggressive techniques are indicated
3. The clinician is facing the midcarpal joints
4. The stabilizing hand grips the proximal row of carpals from the posterior side
5. The mobilizing/manipulating hand grips the distal row of carpals from the medial
(ulnar) side

Procedure:
1. The clinician applies a grade I traction to the joint
2. The stabilizing hand holds the proximal row of carpals to the treatment table
3. The mobilizing/manipulating hand glides the distal row of carpals in a lateral
(radial) direction

1st Carpometacarpal Joint

Distraction
Posterior Glide
Anterior Glide
Radial Glide
Ulnar Glide

Intermetacarpal Joint
Distraction
Radial Glide
Ulnar Glide

Metacarpophalangeal Joints 2-5

Distraction
Posterior Glide
Anterior Glide
Radial Glide
Ulnar Glide

Interphalangeal Joints
Distraction

Posterior Glide
Anterior Glide

Hip Joint
Distraction
Inferior Glide/Long axis traction
Posterior Glide
Anterior Glide
Lateral Glide

Tibiofemoral Joint
Distraction
Posterior glide
Anterior Glide
Medial Glide
Lateral Glide
Medial Gap
Lateral Gap

Patellofemoral Joint
Superior Glide
Inferior Glide
Medial Glide
Lateral Glide
Medial Tilt
Lateral Tilt

Proximal Tibiofibular Joint

Posterior Glide of proximal Fibula
Purpose:
1. To examine for proximal tibiofibular joint impairment
2. To increase accessory motion into proximal tibiofibular joint posterior glide
3. To decrease pain

Positioning:
1. The patient is supine with the knee supported by a small pillow
2. The proximal tibiofibular joint is positioned in the resting position
3. The clinician is at the side of the patient’s leg, facing the patient’s knee
4. The stabilizing hand grips the proximal tibia from the medial and posterior side
5. The mobilizing/manipulating hand is positioned with the heel of the hand on the
anterior surface of the fibular head, taking care to avoid contact with the common
fibular nerve

Procedure:
 1. The stabilizing hand holds the tibia in position
2. The mobilizing/manipulating hand glides the proximal fibula in a posterior
direction

Anterior Glide of proximal Fibula

Purpose:
1. To examine for proximal tibiofibular joint impairment
2. To increase accessory motion into proximal tibiofibular joint anterior glide
3. To decrease pain

Positioning:
1. The patient is prone with the knee supported by a small pillow
2. The proximal tibiofibular joint is positioned in the resting position
3. The clinician is at the side of the patient’s leg, facing the patient’s knee
4. The stabilizing hand grips the proximal tibia from the medial and medial side
5. The mobilizing/manipulating hand is positioned with the heel of the hand on the
posterior surface of the fibular head, taking care to avoid contact with the
common fibular nerve

Procedure:
1. The stabilizing hand holds the tibia in position
2. The mobilizing/manipulating hand glides the proximal fibula in an anterior
direction

Distal Tibiofibular Joint

Posterior Glide of Distal Fibula
Anterior Glide of Distal Fibula
Superior Glide of Fibula
Inferior Glide of Fibula

Talocrural Joint
Distraction
Posterior Glide
Anterior Glide

Subtalar Joint
Distraction
Medial Glide
Lateral Glide
Medial Gap
Lateral Gap

Midtarsal Joint
Dorsal Glide of Navicular
Plantar Glide of Navicular
Dorsal Glide of Cuboid
Plantar Glide of Cuboid

Intermetatarsal Joint
Dorsal Glide
Plantar Glide

Metatarsophalangeal Joint
Distraction
Dorsal Glide
Plantar Glide
Medial Glide
Lateral Glide

Interphalangeal Joint
Distraction
Dorsal Glide
Plantar Glide