I. Shoulder joints Composition: glenohumeral joint, acromioclavicular joint, sternoclavicular joint, scapulothoracic wall joint. Physiological movements: forward flexion, back extension, adduction, abduction, rotation of the shoulder joint. Wang Hui, Department of Pediatrics, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine Accessory movements: separation, long-axis traction, extrusion, anterior-posterior sliding, etc. 1. glenohumeral joint: ① Separation traction generally loosens and relieves pain. ②Long-axis traction ③Sliding to the cephalad side ④Sliding to the pedalad side in forward flexion-increase the range of motion of shoulder forward flexion. ⑤ Abduction sliding to the pedicle side – increases the range of motion of shoulder abduction. (6) Anterior-posterior sliding-increases the range of motion of shoulder pronation and internal rotation. (7) Posterior-anterior sliding-increases the range of motion of shoulder posterior extension and external rotation. (8) Abduction swing – further increases the range of motion of abduction when the abduction is >90°. (⑨) Lateral sliding-increases the range of motion of horizontal shoulder adduction. (⑩Horizontal internal rotation. (11) Posterior anterior rotation to increase the range of motion of shoulder internal rotation. (12) Internal rotation oscillation (13) External rotation oscillation-increase the range of motion of shoulder external rotation 2. Sternoclavicular joint ① Anterior-posterior sliding-increase the clavicular retraction (2) Up and down sliding – increases the range of motion of the clavicle up and down. 3. Shoulder lock joint Backward and forward sliding – increase the range of motion of the scapula. Elbow joint Composition: humeral joint, humeral-radial joint, proximal radial-ulnar joint. Physiological activities: flexion, extension, anterior rotation, posterior rotation. Accessory movements: detachment traction, long axis traction, anterior-posterior sliding, posterior-anterior sliding, lateral sliding. 1. Humeral ulnar joint ① Separate traction to increase the range of motion of the flexed elbow. ②Long axis traction ③Lateral sliding – increase lateral movement of the humeral ulnar joint. ④Flexion swing-increases the range of motion of the flexed elbow. (5) Elbow extension swing – increase the range of motion of elbow extension. 2. Brachioradialis joint ① Separate traction increases the range of motion of the brachioradialis joint and increases flexion and extension of the elbow. ②Long axis traction ③Lateral oscillation-increases the range of motion of elbow extension. 3. Proximal radial ulnar joint ①Long axis traction – general loosening. (ii) Anterior-posterior sliding-increases the anterior range of motion of the forearm. ③Posterior-anterior sliding-increase the range of motion of forearm rotation posteriorly. ④Forearm rotation-increases the range of motion of forearm rotation. (3) Wrist joint: Composition: distal radial ulnar joint, radial carpal joint, intercarpal joint. Physiological movements – wrist flexion, wrist extension, abduction, adduction, rotation Auxiliary movements – separation and traction, anterior-posterior sliding, posterior-anterior sliding, lateral sliding. 1. distal radial ulnar joint ① anteroposterior sliding – increases the range of motion of forearm rotation. (2) Posterior-anterior sliding – increases the range of motion of the forearm posteriorly. 2. Radial carpal joint ① Separate traction – general loosening and pain relief. (2) Anterior-posterior sliding-increases the range of motion of wrist flexion. ③Posterior-anterior sliding-increase the range of wrist extension. ④Ulnar side sliding-increase the range of abduction. ⑤ Radial sliding – increase the range of internal rotation. (6) Rotational oscillation – increases the range of wrist rotation. 3. Intercarpal activities ① Anterior-posterior sliding – increases the range of wrist flexion. ② Posterior-anterior sliding-increases the range of motion of the extensor muscles. Hand joints Composition: carpometacarpal joint, interphalangeal joint, metacarpophalangeal joint, thumb carpometacarpal joint, proximal and distal pointing joints. Physiological movements: flexion, extension, adduction, abduction, thumb to palm. Accessory movements: detached traction, long-axis traction and sliding in all directions. 1. Carpometacarpal joint: long-axis traction, general loosening, pain relief. 2. Intermetacarpophalangeal joint: anterior-posterior or posterior-anterior sliding – increase metacarpophalangeal extension. 3. Metacarpophalangeal joint: ① Separate traction, ② Long-axis traction/general release, increase the range of motion of the metacarpophalangeal joint in flexion and extension. (3) Anterior-posterior sliding – increase metacarpophalangeal flexion; posterior-anterior sliding – increase metacarpophalangeal extension. ④Measuring square movement-increases the range of motion of the metacarpophalangeal joint from retraction and abduction. ⑤ Rotational swing – generally loosens the range of motion of the metacarpophalangeal joint. 4. Carpometacarpal joint of the thumb ①Long axis traction: general relaxation and pain relief. (2) Anterior gliding – increases the range of motion of the thumb metacarpophalangeal joint in flexion. (3) Posterior anterior sliding – increases the range of motion of the thumb metacarpophalangeal joint in extension. (iv) Ulnar sliding-increases the range of thumb abduction. ⑤ Radial sliding – increases the range of motion of the thumb to the palm. 5. Interphalangeal joints Including proximal and distal interphalangeal joints, the release technique is the same as that for metacarpophalangeal joints.
Lower extremity joint mobilization】 I. Hip joint: Composition: acetabulum and femoral head. Physiological movements: flexion, extension, internal retraction, abduction, internal rotation, external rotation. Accessory movements: detached traction, long-axis traction, anterior-posterior, posterior-anterior sliding, and rotation. 1. long axis traction 2. detachment traction/general loosening, pain relief 3. Anterior-posterior sliding – increase the range of motion of hip flexion and external rotation. 4. Posterior-anterior sliding – increase the range of motion of posterior extension and internal rotation. 5. Flexion swing – increase flexion range of motion. 6.Rotational swing – increase the range of motion of internal and external rotation. 7. Internal retraction and internal rotation swing – increase the range of motion of internal retraction and internal rotation. 8. Abduction and external rotation swing – increases the range of motion of abduction and external rotation. Knee joints: femoro-tibial joint, hip-femoral joint and upper tibio-fibular joint. Physiological movements: flexion, extension, internal rotation, external rotation (when knee is flexed) Accessory movements: long-axis traction, anterior-posterior, posterior-anterior, measurement-side sliding 1. femoro-tibial joint ①Long-axis traction generally loosens and relieves pain. (2) Anterior-posterior sliding – increases the range of motion of knee extension. ③Posterior-anterior sliding-increases knee flexion range of motion. ④Lateral sliding-increases the range of motion of the knee joint. ⑤ knee extension swing-increase knee extension range of motion. (6) Rotational swing-Internal rotation: increases the range of motion of knee internal rotation; External rotation swing: increases the range of motion of knee external rotation. 2. Patellofemoral joint ① Separate traction ② Lateral sliding/general loosening to increase patellar range of motion ③Up and down sliding-up: increase range of motion of knee extension; down; increase range of motion of knee flexion. 3. Upper tibiofibular joint ① anterior-posterior sliding ② posterior-anterior sliding/general loosening; relieves pain. C. Ankle joints: Composition: lower tibiofibular joint, tibial talofibular (superior talofibular) joint, subtalar joint, intertarsal joint. Physiological movements: plantarflexion, dorsiflexion, inversion, valgus. Auxiliary movements: long axis traction Anterior-posterior, posterior-anterior, up-and-down sliding 1. lower tibiofibular joint Anterior-posterior or posterior-anterior sliding – increases the range of motion of the ankle joint 2. Tibiofibular joint ① Separate traction – general loosening and pain relief. (2) Anterior-posterior sliding – increase the range of motion of ankle dorsiflexion (3) Posterior-anterior sliding – increase the range of motion of ankle plantarflexion ④Sliding medially-increases the range of motion of ankle valgus. (⑤) Sliding to the lateral side – increase the range of motion of ankle valgus. (6) Flexion and extension swing – increase the range of motion of ankle flexion and extension. (7) Flip and swing – inversion swing: increase the range of motion of inversion; valgus swing: increase the range of motion of valgus. 3. Subluxation joint ① Separate traction – general loosening and pain relief. (2) Anterior-posterior sliding – increase the range of motion of dorsal extension. ③posterior-anterior sliding-increase plantarflexion range of motion. ④Lateral sliding, flexion-extension swing and flexion-flip swing. Same techniques as for tibial talar joint. 4. Intertarsal joint – same as carpals. Slide up and down – increase the range of motion of ankle dorsiflexion and plantar flexion. 5. Tarsometatarsal joint ①Sliding up and down – increase intertarsal movement. (2) Pre-rotation swing: increase the range of external rotation; post-rotation swing: increase the range of internal rotation. The intermetatarsal joint slides up and down to increase the intermetatarsal activity. 2. Up and down sliding of the metatarsophalangeal joint – increase the activity of the metatarsophalangeal joint. 3. Intermetatarsal joint – same as interphalangeal joint.