ESAT week 1-2 Orthopedic Joint Mobilization Techniques

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Questions and Answers

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

Superior misalignment of the scapula

Pain in the proximal humerus

Loss of flexion in the shoulder joint

Loss of A-P accessory movement (correct)

How does the practitioner position themselves for the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

Straddling the affected arm with the patient's epicondyles held between their knees (correct)

Sitting on the edge of the table

Standing on the opposite side of the table

Facing caudad with the patient's elbow on their shoulder

What is the direction of the impulse thrust applied during the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

Posterior-to-anterior

Anterior-to-posterior (correct)

Inferior-to-superior

Superior-to-inferior

What is the primary indication for the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

Loss of accessory movements in inferior glide in flexion Signup and view all the answers

How does the practitioner position themselves for the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

Standing on the involved side in a lunge position Signup and view all the answers

What is the direction of the joint distraction and impulse thrust applied during the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

Superior-to-inferior Signup and view all the answers

What is the primary indication for the Index/Proximal Humerus mobilization technique?

Loss of accessory movements in inferior glide in abduction Signup and view all the answers

In which direction is the impulse-type thrust applied in the Index/Proximal Humerus mobilization technique?

Superior-to-inferior Signup and view all the answers

What is the primary purpose of the cephalic hand in the Index/Proximal Humerus mobilization technique?

To remove articular slack Signup and view all the answers

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension mobilization technique?

Restricted internal rotation accessory joint movement Signup and view all the answers

What is the primary purpose of the caudal hand in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension mobilization technique?

To stabilize the distal humerus and elbow Signup and view all the answers

What is the primary direction of the mobilization force in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension mobilization technique?

Rotational-internal rotation Signup and view all the answers

What is the primary purpose of the knee extension in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension mobilization technique?

To distract the glenohumeral joint Signup and view all the answers

What is the primary indication for the Bimanual Grasp/Hand mobilization technique?

Mobilization of the shoulder and adhesive capsulitis Signup and view all the answers

What is the primary direction of the mobilization force in the Bimanual Grasp/Hand mobilization technique?

Circumduction and distraction Signup and view all the answers

What is the primary purpose of the patient's arm being slightly abducted in the Bimanual Grasp/Hand mobilization technique?

To facilitate the circumduction and distraction movement Signup and view all the answers

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique?

Loss of P-A accessory movements Signup and view all the answers

In the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique, what is the position of the patient's arm?

In slight abduction and with the glenohumeral joint positioned off the edge of the table Signup and view all the answers

What is the direction of the vector of force in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique?

Posterior-to-anterior Signup and view all the answers

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus; Mobilization with Distraction technique?

Intercapsular adhesions and mobilization of the shoulder Signup and view all the answers

In the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique, what is the position of the patient's arm?

In flexion with the elbow flexed so that the hand rests on the patient's shoulder Signup and view all the answers

What is the direction of the vector of force in the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

Superior-to-inferior Signup and view all the answers

What is the primary indication for the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Abduction technique?

Loss of accessory movements in inferior glide in abduction Signup and view all the answers

In the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique, what is the position of the patient's arm?

Behind the back, with the fist in the small of the back Signup and view all the answers

What is the primary indication for the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique?

Loss of rotational movement of the scapulocostal articulation Signup and view all the answers

What is the contact point of the therapist's hand in the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique?

Lateral aspect of the inferior angle of the scapula Signup and view all the answers

What is the primary dysfunction being addressed in the techniques described?

Dysfunctional scapulohumeral rhythm Signup and view all the answers

In which position is the patient placed for the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Medial to Lateral technique?

Side-lying position with the affected side up and the affected arm abducted Signup and view all the answers

What is the direction of the impulse thrust applied during the Crossed Bilateral Mid-Hypothenar (Knife-Edge)/Medial Scapula; Medial-to-Lateral Glide technique?

Medial to lateral Signup and view all the answers

What is the location of the contact point for the caudal hand in the Crossed Bilateral Mid-Hypothenar (Knife-Edge)/Medial Scapula; Medial-to-Lateral Glide technique?

Medial (vertebral) border of the scapula Signup and view all the answers

What is the purpose of the bilateral hand placement in the Bilateral Thumb Thenar/Lateral Scapula; Lateral-to-Medial Glide technique?

To apply a lateral to medial force to the scapula Signup and view all the answers

What is the direction of the glide movement in the Bilateral Thumb Thenar/Lateral Scapula; Lateral-to-Medial Glide technique?

Lateral to medial Signup and view all the answers

What is the primary purpose of the patient's elbow resting on the practitioner's shoulder in the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

To provide a pivot point for the joint distraction Signup and view all the answers

What is the primary function of the knees in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

To hold the patient's epicondyles in place Signup and view all the answers

What is the primary effect of the slight distraction provided by the knees in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

It increases the joint's accessory movement Signup and view all the answers

What is the primary significance of the glenohumeral joint being positioned off the edge of the table in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

It facilitates the application of the anterior-to-posterior glide Signup and view all the answers

What is the primary purpose of the interlaced fingers in the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

To provide a stable grasp of the humerus Signup and view all the answers

What is the primary effect of the anterior-to-posterior glide in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

It reduces the anterior misalignment of the humerus Signup and view all the answers

What is the primary purpose of the therapist's cephalic hand in the Bimanual Digital Thenar Grasp/Scapula technique?

To establish a thenar contact on the superior aspect of the spine of the scapula Signup and view all the answers

In which direction is the impulse-type thrust applied during the Crossed Bilateral Mid-Hypothenar (Knife-Edge)/Medial Scapula technique?

Medially to laterally Signup and view all the answers

What is the primary dysfunction being addressed in the Bimanual Digital Thenar Grasp/Scapula technique?

All of the above Signup and view all the answers

What is the position of the patient's arm in the Bilateral Thumb Thenar/Lateral Scapula; Lateral-to-Medial Glide technique?

Abducted and resting on the side Signup and view all the answers

What is the contact point of the therapist's caudal hand in the Crossed Bilateral Mid-Hypothenar (Knife-Edge)/Medial Scapula technique?

Medial aspect of the inferior angle of the scapula Signup and view all the answers

What is the direction of the glide movement in the Bilateral Thumb Thenar/Lateral Scapula; Lateral-to-Medial Glide technique?

Lateral to medial Signup and view all the answers

What is the primary purpose of the distraction phase in the Bimanual Thumb Thenar Grasp/Proximal Humerus; Mobilization with Distraction technique?

To remove articular slack Signup and view all the answers

In the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Abduction technique, what is the role of the thumbs?

To wrap around the axilla Signup and view all the answers

What is the relationship between the patient's arm position and the direction of the vector of force in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique?

The arm is abducted and the vector of force is posterior-to-anterior Signup and view all the answers

What is the primary purpose of the cephalic hand in the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

To apply downward pressure Signup and view all the answers

In the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique, what is the orientation of the therapist's fingers?

Across the scapula and pointing towards the spine Signup and view all the answers

What is the primary indication for the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

Loss of accessory movements in inferior glide in flexion Signup and view all the answers

In the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique, what is the role of the knee extension?

To provide leverage for the mobilization force Signup and view all the answers

What is the primary purpose of the patient's arm being placed behind their back in the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique?

To position the scapula for mobilization Signup and view all the answers

In the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Abduction technique, what is the direction of the joint distraction?

Superior-to-inferior Signup and view all the answers

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus; Mobilization with Distraction technique?

Mobilization of the shoulder Signup and view all the answers

What is the primary purpose of the therapist's caudal hand in the Index/Proximal Humerus mobilization technique?

To grasp the distal aspect of the patient's humerus and stabilize the distal humerus and elbow Signup and view all the answers

What is the primary benefit of the long-axis distraction applied during the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension techniques?

To enhance the mobilization of the glenohumeral joint Signup and view all the answers

What is the primary direction of the mobilization force applied during the Bimanual Thumb Thenar Grasp/Proximal Humerus; Mobilization with Distraction technique?

Circumduction and distraction Signup and view all the answers

What is the purpose of the patient's arm being slightly abducted in the Bimanual Grasp/Hand mobilization technique?

To allow for greater freedom of movement in the glenohumeral joint Signup and view all the answers

What is the primary function of the cephalic hand in the Index/Proximal Humerus mobilization technique?

To remove articular slack in the glenohumeral joint Signup and view all the answers

What is the primary indication for the Bimanual Grasp/Hand mobilization technique?

Intracapsular adhesions in the glenohumeral joint Signup and view all the answers

What is the primary purpose of the therapist's knees in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension techniques?

To create a long-axis distraction to the glenohumeral joint Signup and view all the answers

What is the primary direction of the mobilization force applied during the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Internal Rotation technique?

Rotational-internal rotation Signup and view all the answers

What is the primary purpose of the pendular motion applied during the Bimanual Grasp/Hand mobilization technique?

To enhance the mobilization of the glenohumeral joint Signup and view all the answers

What is the primary dysfunction being addressed in the Index/Proximal Humerus mobilization technique?

Loss of accessory movements in inferior glide in abduction Signup and view all the answers

Study Notes

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Anterior-to-Posterior Glide: Indicated for loss of A-P accessory movement, anterior misalignment of the humerus.
Positioning: Patient lies in supine position, with the involved arm in slight abduction and the glenohumeral joint positioned off the edge of the table.
Contact: Proximal humerus with thumbs/thenars together in the midline.
Vector: A-P.
Procedure: Apply an impulse thrust anteriorly to posteriorly with both hands while providing slight distraction with the knees.

Interlaced Digital/Proximal Humerus

Superior-to-Inferior Glide in Flexion: Indicated for loss of accessory movements in inferior glide in flexion, superior misalignment of the humerus.
Positioning: Patient lies in supine position, with the involved arm raised to 90 degrees flexion and the elbow bent so that the hand rests on the shoulder.
Contact: Proximal humerus with interlaced fingers over the superior aspect of the glenohumeral joint.
Vector: S-I.
Procedure: Apply an S-I joint distraction with both hands, finishing with an S-I impulse thrust.

Index/Proximal Humerus

Superior-to-Inferior Glide in Abduction: Indicated for loss of accessory movements in inferior glide in abduction, superior misalignment of the humerus.
Positioning: Patient lies in supine position, with the involved arm abducted to 90 degrees.
Contact: Superior aspect of the proximal humerus with the cephalic hand.
Vector: S-I.
Procedure: Establish a web contact over the superior aspect of the proximal humerus with the cephalic hand, and use the caudal hand to grasp the distal aspect of the patient's humerus, serving as a pivot point, stabilizing the distal humerus and elbow, and finishing with an impulse-type thrust in an S-I direction.

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Internal Rotation: Indicated for restricted internal rotation accessory joint movement, external rotation misalignment of the humerus.
Positioning: Patient lies in supine position, with the affected arm abducted slightly away from the patient's body and the edge of the table in internal rotation.
Contact: Proximal humerus with interlaced fingers of both hands.
Vector: Rotational-internal rotation.
Procedure: Turn the humerus into internal rotation, removing articular slack, and simultaneously straighten both knees, applying a long-axis distraction to the glenohumeral joint.

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

External Rotation: Indicated for restricted external rotation accessory joint movement, internal rotation misalignment of the humerus.
Positioning: Patient lies in supine position, with the affected arm abducted slightly away from the patient's body and the edge of the table, holding the arm in external rotation.
Contact: Proximal humerus with interlaced fingers of both hands.
Vector: Rotational-external rotation.
Procedure: Turn the humerus into external rotation, and simultaneously straighten both knees to create a long-axis distraction to the glenohumeral joint.

Bimanual Thumb Thenar Grasp/Proximal Humerus Grasp

Mobilization with Distraction: Indicated for intracapsular adhesions in the glenohumeral joint and mobilization of the shoulder.
Positioning: Patient lies in supine position, with the affected arm outstretched.
Contact: Humerus with the inside hand, and the outside hand makes a palmar contact on the posterior aspect of the shoulder and scapula to provide support and lift during the mobilization.
Vector: Circumduction and distraction.
Procedure: Use the body weight to assist in producing a mild distraction and circumduction movement of the shoulder in all directions.

Bimanual Grasp/Hand

Pendular Abduction Mobilization: Indicated for intracapsular adhesions in the glenohumeral joint, mobilization of the shoulder, and adhesive capsulitis.
Positioning: Patient lies in supine position, with the affected arm slightly abducted and the forearm flexed to 90 degrees, pointing upward.
Contact: The hand with both hands.
Vector: S-I with passive rocking.
Procedure: Instruct the patient to relax the arm as much as possible, and raise the arm away from the table so that it can swing freely, inducing a pendular motion in the glenohumeral joint by rocking the forearm cephalad and caudal, increasing the arc of abduction motion as tolerated.

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Posterior-to-Anterior Glide: Indicated for loss of P-A accessory movements, posterior misalignment of the humerus.
Positioning: Patient lies in prone position, with the involved arm in slight abduction and the glenohumeral joint positioned off the edge of the table.
Contact: Proximal humerus with both hands, with thumbs together in the midline.
Vector: P-A.
Procedure: Provide slight distraction with the knees, and apply an impulse thrust posteriorly to anteriorly with both hands.

Bimanual Thumb Thenar Grasp/Proximal Humerus

Mobilization with Distraction: Indicated for intracapsular adhesions and mobilization of the shoulder.
Positioning: Patient lies prone, with the affected arm hanging down and off the side of the table.
Contact: Proximal humerus with both hands, with thumbs together on the posterior aspect of the humerus while the fingers wrap around and into the axilla on the underside of the humerus.
Vector: Circumduction.
Procedure: Use both hands to first distract the glenohumeral joint in the long axis of the humerus, and then move the humerus toward and away from you, cephalad and caudal, in a figure-8 motion.

Interlaced Digital/Proximal Humerus

Superior-to-Inferior Glide in Flexion: Indicated for loss of accessory movements in inferior glide in flexion, superior misalignment of the humerus.
Positioning: Patient stands, with feet spread at least shoulder-distance apart, and the involved arm is flexed to 90 degrees, and the elbow is flexed so that the hand rests on the patient's shoulder.
Contact: Proximal humerus with fingers interlaced on the superior aspect of the joint capsule while the thumbs wrap into the axilla.
Vector: S-I.
Procedure: First, draw away from the patient, creating a joint separation, and then apply a downward pressure to remove articular slack, and give a thrust in the S-I direction.

Interlaced Digital/Proximal Humerus

Superior-to-Inferior Glide in Abduction: Indicated for loss of accessory movements in inferior glide in abduction, superior misalignment of the humerus.
Positioning: Patient stands with legs at least shoulder-distance apart, with the involved arm abducted to 90 degrees, and the elbow flexed so that the hand rests on the patient's shoulder.
Contact: Proximal humerus with fingers interlaced on the superior aspect of the joint capsule while the thumbs wrap into the axilla.
Vector: S-I.
Procedure: Back away from the patient to distract the joint while applying a downward pressure with the hands to remove articular slack, and give an impulse thrust in the S-I direction.

Bimanual Digital Thenar Grasp/Scapula

Rotation—Inferior Angle Lateral to Medial: Indicated for loss of rotational movement of the scapulocostal articulation, dysfunctional scapulohumeral rhythm, subscapular adhesions.
Positioning: Patient is in a side-lying position, with the affected side up and the affected arm placed behind the back, with the fist in the small of the back.
Contact: Lateral aspect of the inferior angle of the scapula.
Vector: Rotational.
Procedure: Use both hands to induce a rotational, twisting action, using an impulse-type thrust to drive the inferior angle of the scapula laterally to medially.

Bimanual Digital Thenar Grasp/Scapula

Rotation—Inferior Angle Medial to Lateral: Indicated for loss of rotational movement of the scapulocostal articulation, dysfunctional scapulohumeral rhythm, subscapular adhesions.
Positioning: Patient is in a side-lying position, with the affected side up and the affected arm abducted, with the hand behind the head.
Contact: Medial aspect of the inferior angle of the scapula.
Vector: Rotational.
Procedure: Use both hands to create a rotational, twisting action, using an impulse-type thrust to drive the inferior angle of the scapula medially to laterally.

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Anterior-to-Posterior Glide: Indicated for loss of A-P accessory movement, anterior misalignment of the humerus.
Positioning: Patient lies in supine position, with the involved arm in slight abduction and the glenohumeral joint positioned off the edge of the table.
Contact: Proximal humerus with thumbs/thenars together in the midline.
Vector: A-P.
Procedure: Apply an impulse thrust anteriorly to posteriorly with both hands while providing slight distraction with the knees.

Interlaced Digital/Proximal Humerus

Superior-to-Inferior Glide in Flexion: Indicated for loss of accessory movements in inferior glide in flexion, superior misalignment of the humerus.
Positioning: Patient lies in supine position, with the involved arm raised to 90 degrees flexion and the elbow bent so that the hand rests on the shoulder.
Contact: Proximal humerus with interlaced fingers over the superior aspect of the glenohumeral joint.
Vector: S-I.
Procedure: Apply an S-I joint distraction with both hands, finishing with an S-I impulse thrust.

Index/Proximal Humerus

Superior-to-Inferior Glide in Abduction: Indicated for loss of accessory movements in inferior glide in abduction, superior misalignment of the humerus.
Positioning: Patient lies in supine position, with the involved arm abducted to 90 degrees.
Contact: Superior aspect of the proximal humerus with the cephalic hand.
Vector: S-I.
Procedure: Establish a web contact over the superior aspect of the proximal humerus with the cephalic hand, and use the caudal hand to grasp the distal aspect of the patient's humerus, serving as a pivot point, stabilizing the distal humerus and elbow, and finishing with an impulse-type thrust in an S-I direction.

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Internal Rotation: Indicated for restricted internal rotation accessory joint movement, external rotation misalignment of the humerus.
Positioning: Patient lies in supine position, with the affected arm abducted slightly away from the patient's body and the edge of the table in internal rotation.
Contact: Proximal humerus with interlaced fingers of both hands.
Vector: Rotational-internal rotation.
Procedure: Turn the humerus into internal rotation, removing articular slack, and simultaneously straighten both knees, applying a long-axis distraction to the glenohumeral joint.

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

External Rotation: Indicated for restricted external rotation accessory joint movement, internal rotation misalignment of the humerus.
Positioning: Patient lies in supine position, with the affected arm abducted slightly away from the patient's body and the edge of the table, holding the arm in external rotation.
Contact: Proximal humerus with interlaced fingers of both hands.
Vector: Rotational-external rotation.
Procedure: Turn the humerus into external rotation, and simultaneously straighten both knees to create a long-axis distraction to the glenohumeral joint.

Bimanual Thumb Thenar Grasp/Proximal Humerus Grasp

Mobilization with Distraction: Indicated for intracapsular adhesions in the glenohumeral joint and mobilization of the shoulder.
Positioning: Patient lies in supine position, with the affected arm outstretched.
Contact: Humerus with the inside hand, and the outside hand makes a palmar contact on the posterior aspect of the shoulder and scapula to provide support and lift during the mobilization.
Vector: Circumduction and distraction.
Procedure: Use the body weight to assist in producing a mild distraction and circumduction movement of the shoulder in all directions.

Bimanual Grasp/Hand

Pendular Abduction Mobilization: Indicated for intracapsular adhesions in the glenohumeral joint, mobilization of the shoulder, and adhesive capsulitis.
Positioning: Patient lies in supine position, with the affected arm slightly abducted and the forearm flexed to 90 degrees, pointing upward.
Contact: The hand with both hands.
Vector: S-I with passive rocking.
Procedure: Instruct the patient to relax the arm as much as possible, and raise the arm away from the table so that it can swing freely, inducing a pendular motion in the glenohumeral joint by rocking the forearm cephalad and caudal, increasing the arc of abduction motion as tolerated.

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Posterior-to-Anterior Glide: Indicated for loss of P-A accessory movements, posterior misalignment of the humerus.
Positioning: Patient lies in prone position, with the involved arm in slight abduction and the glenohumeral joint positioned off the edge of the table.
Contact: Proximal humerus with both hands, with thumbs together in the midline.
Vector: P-A.
Procedure: Provide slight distraction with the knees, and apply an impulse thrust posteriorly to anteriorly with both hands.

Bimanual Thumb Thenar Grasp/Proximal Humerus

Mobilization with Distraction: Indicated for intracapsular adhesions and mobilization of the shoulder.
Positioning: Patient lies prone, with the affected arm hanging down and off the side of the table.
Contact: Proximal humerus with both hands, with thumbs together on the posterior aspect of the humerus while the fingers wrap around and into the axilla on the underside of the humerus.
Vector: Circumduction.
Procedure: Use both hands to first distract the glenohumeral joint in the long axis of the humerus, and then move the humerus toward and away from you, cephalad and caudal, in a figure-8 motion.

Interlaced Digital/Proximal Humerus

Superior-to-Inferior Glide in Flexion: Indicated for loss of accessory movements in inferior glide in flexion, superior misalignment of the humerus.
Positioning: Patient stands, with feet spread at least shoulder-distance apart, and the involved arm is flexed to 90 degrees, and the elbow is flexed so that the hand rests on the patient's shoulder.
Contact: Proximal humerus with fingers interlaced on the superior aspect of the joint capsule while the thumbs wrap into the axilla.
Vector: S-I.
Procedure: First, draw away from the patient, creating a joint separation, and then apply a downward pressure to remove articular slack, and give a thrust in the S-I direction.

Interlaced Digital/Proximal Humerus

Superior-to-Inferior Glide in Abduction: Indicated for loss of accessory movements in inferior glide in abduction, superior misalignment of the humerus.
Positioning: Patient stands with legs at least shoulder-distance apart, with the involved arm abducted to 90 degrees, and the elbow flexed so that the hand rests on the patient's shoulder.
Contact: Proximal humerus with fingers interlaced on the superior aspect of the joint capsule while the thumbs wrap into the axilla.
Vector: S-I.
Procedure: Back away from the patient to distract the joint while applying a downward pressure with the hands to remove articular slack, and give an impulse thrust in the S-I direction.

Bimanual Digital Thenar Grasp/Scapula

Rotation—Inferior Angle Lateral to Medial: Indicated for loss of rotational movement of the scapulocostal articulation, dysfunctional scapulohumeral rhythm, subscapular adhesions.
Positioning: Patient is in a side-lying position, with the affected side up and the affected arm placed behind the back, with the fist in the small of the back.
Contact: Lateral aspect of the inferior angle of the scapula.
Vector: Rotational.
Procedure: Use both hands to induce a rotational, twisting action, using an impulse-type thrust to drive the inferior angle of the scapula laterally to medially.

Bimanual Digital Thenar Grasp/Scapula

Rotation—Inferior Angle Medial to Lateral: Indicated for loss of rotational movement of the scapulocostal articulation, dysfunctional scapulohumeral rhythm, subscapular adhesions.
Positioning: Patient is in a side-lying position, with the affected side up and the affected arm abducted, with the hand behind the head.
Contact: Medial aspect of the inferior angle of the scapula.
Vector: Rotational.
Procedure: Use both hands to create a rotational, twisting action, using an impulse-type thrust to drive the inferior angle of the scapula medially to laterally.

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This quiz assesses the student's understanding of joint mobilization techniques, specifically the bimanual thumb thenar grasp/proximal humerus with knee extension and anterior-to-posterior glide. It covers the indications, patient positioning, and therapist's position for this technique.

ESAT week 1-2 Orthopedic Joint Mobilization Techniques

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Questions and Answers

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

How does the practitioner position themselves for the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

What is the direction of the impulse thrust applied during the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

What is the primary indication for the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

How does the practitioner position themselves for the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

What is the direction of the joint distraction and impulse thrust applied during the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

What is the primary indication for the Index/Proximal Humerus mobilization technique?

In which direction is the impulse-type thrust applied in the Index/Proximal Humerus mobilization technique?

What is the primary purpose of the cephalic hand in the Index/Proximal Humerus mobilization technique?

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension mobilization technique?

What is the primary purpose of the caudal hand in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension mobilization technique?

What is the primary direction of the mobilization force in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension mobilization technique?

What is the primary purpose of the knee extension in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension mobilization technique?

What is the primary indication for the Bimanual Grasp/Hand mobilization technique?

What is the primary direction of the mobilization force in the Bimanual Grasp/Hand mobilization technique?

What is the primary purpose of the patient's arm being slightly abducted in the Bimanual Grasp/Hand mobilization technique?

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique?

In the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique, what is the position of the patient's arm?

What is the direction of the vector of force in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique?

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus; Mobilization with Distraction technique?

In the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique, what is the position of the patient's arm?

What is the direction of the vector of force in the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

What is the primary indication for the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Abduction technique?

In the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique, what is the position of the patient's arm?

What is the primary indication for the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique?

What is the contact point of the therapist's hand in the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique?

What is the primary dysfunction being addressed in the techniques described?

In which position is the patient placed for the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Medial to Lateral technique?

What is the direction of the impulse thrust applied during the Crossed Bilateral Mid-Hypothenar (Knife-Edge)/Medial Scapula; Medial-to-Lateral Glide technique?

What is the location of the contact point for the caudal hand in the Crossed Bilateral Mid-Hypothenar (Knife-Edge)/Medial Scapula; Medial-to-Lateral Glide technique?

What is the purpose of the bilateral hand placement in the Bilateral Thumb Thenar/Lateral Scapula; Lateral-to-Medial Glide technique?

What is the direction of the glide movement in the Bilateral Thumb Thenar/Lateral Scapula; Lateral-to-Medial Glide technique?

What is the primary purpose of the patient's elbow resting on the practitioner's shoulder in the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

What is the primary function of the knees in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

What is the primary effect of the slight distraction provided by the knees in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

What is the primary significance of the glenohumeral joint being positioned off the edge of the table in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

What is the primary purpose of the interlaced fingers in the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

What is the primary effect of the anterior-to-posterior glide in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension technique?

What is the primary purpose of the therapist's cephalic hand in the Bimanual Digital Thenar Grasp/Scapula technique?

In which direction is the impulse-type thrust applied during the Crossed Bilateral Mid-Hypothenar (Knife-Edge)/Medial Scapula technique?

What is the primary dysfunction being addressed in the Bimanual Digital Thenar Grasp/Scapula technique?

What is the position of the patient's arm in the Bilateral Thumb Thenar/Lateral Scapula; Lateral-to-Medial Glide technique?

What is the contact point of the therapist's caudal hand in the Crossed Bilateral Mid-Hypothenar (Knife-Edge)/Medial Scapula technique?

What is the direction of the glide movement in the Bilateral Thumb Thenar/Lateral Scapula; Lateral-to-Medial Glide technique?

What is the primary purpose of the distraction phase in the Bimanual Thumb Thenar Grasp/Proximal Humerus; Mobilization with Distraction technique?

In the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Abduction technique, what is the role of the thumbs?

What is the relationship between the patient's arm position and the direction of the vector of force in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique?

What is the primary purpose of the cephalic hand in the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

In the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique, what is the orientation of the therapist's fingers?

What is the primary indication for the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Flexion technique?

In the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Posterior-to-Anterior Glide technique, what is the role of the knee extension?

What is the primary purpose of the patient's arm being placed behind their back in the Bimanual Digital Thenar Grasp/Scapula; Rotation—Inferior Angle Lateral to Medial technique?

In the Interlaced Digital/Proximal Humerus; Superior-to-Inferior Glide in Abduction technique, what is the direction of the joint distraction?

What is the primary indication for the Bimanual Thumb Thenar Grasp/Proximal Humerus; Mobilization with Distraction technique?

What is the primary purpose of the therapist's caudal hand in the Index/Proximal Humerus mobilization technique?

What is the primary benefit of the long-axis distraction applied during the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension techniques?

What is the primary direction of the mobilization force applied during the Bimanual Thumb Thenar Grasp/Proximal Humerus; Mobilization with Distraction technique?

What is the purpose of the patient's arm being slightly abducted in the Bimanual Grasp/Hand mobilization technique?

What is the primary function of the cephalic hand in the Index/Proximal Humerus mobilization technique?

What is the primary indication for the Bimanual Grasp/Hand mobilization technique?

What is the primary purpose of the therapist's knees in the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension techniques?

What is the primary direction of the mobilization force applied during the Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension; Internal Rotation technique?

What is the primary purpose of the pendular motion applied during the Bimanual Grasp/Hand mobilization technique?

What is the primary dysfunction being addressed in the Index/Proximal Humerus mobilization technique?

Study Notes

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Interlaced Digital/Proximal Humerus

Index/Proximal Humerus

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Bimanual Thumb Thenar Grasp/Proximal Humerus Grasp

Bimanual Grasp/Hand

Bimanual Thumb Thenar Grasp/Proximal Humerus with Knee Extension

Bimanual Thumb Thenar Grasp/Proximal Humerus

Interlaced Digital/Proximal Humerus

Interlaced Digital/Proximal Humerus