Accessory Movements

Question 1

How do you know whether the measurement is normal?

Answer 1

Compare to unaffected side or the ‘norm’ amongst the general population

Question 2

What are active movements?

Answer 2

A movement within an unrestricted range of a joint produced by an active contraction of the muscles across that joint. It is produced by the patient themselves.

Question 3

What is the aim of the assessment?

Answer 3

• To reproduce symptoms and work out what structures are being stressed.
• identify if the movement pattern is normal/abnormal
• Obtain a baseline for future reassessment

Question 4

What are you looking for when carrying out the technique?

Answer 4

• Reproduction of symptoms
• ROM
• Résistance through range at end of range (over pressure and end feel)
• Quality of movement

Question 5

What are the normal end feels?

Answer 5

• Soft tissue approximation: soft end feel e.g knee flexion
• capsular feel or firm soft tissue stretch: fairly hard halt to movement e.g. Hip rotation
• Bone to Bone or hard: abrupt halt to movement e.g. elbow extension.

Question 6

What are abnormal end feels?

Answer 6

• Empty feel: no resistance offered
• Springy block: A rebound feel at end range
• Spasm: Sudden hard end feel due to muscle spasm
• Any normal end feel at reduced ROM: As above but reduced range

Question 7

Contraindications

Answer 7

• Immediately post injury
• Early unstable fracture
  -Dislocation
• intolerable pain
• Incomplete muscle/ligament tear
• Compromised circulation