Joint Mobilization (Week 4)

Question 1

What is the loose-pack and close-pack position for the Distal Tibiofibular Joint?

Answer 1

• Loose-pack: Maximum dorsiflexion
• Close-pack: 10° plantarflexion

Question 2

What is the typical movement of the distal fibula during dorsiflexion and plantarflexion?

Answer 2

• Dorsiflexion: The distal fibula moves superiorly and externally rotates.
• Plantarflexion: The distal fibula moves inferiorly and internally rotates.

Question 3

What is the patient position for the Distal Tibiofibular Joint Anterior Glide?

Answer 3

The ankle is supported by a pillow or towel roll.

Question 4

Describe the therapist’s position for the Distal Tibiofibular Joint Anterior Glide.

Answer 4

The therapist is at the end of the table:

• Stabilizing/medial hand: Holds the distal tibia/medial malleolus.
• Mobilizing/lateral hand: Grasps the distal fibula/lateral malleolus.

Question 5

How is the mobilization performed for the Distal Tibiofibular Joint Anterior Glide?

Answer 5

• Mobilize (pull or push) the fibula/lateral malleolus anteriorly.
• Use body weight.

Question 6

What is the primary use of the Distal Tibiofibular Joint Anterior Glide?

Answer 6

To improve dorsiflexion.

Question 7

What is the patient position for the Distal Tibiofibular Joint Posterior Glide?

Answer 7

Supine or prone with the ankle supported by a pillow or towel roll.

Question 8

Describe the therapist’s position for the Distal Tibiofibular Joint Posterior Glide.

Answer 8

The therapist is at the end of the table:

• Stabilizing/medial hand: Holds the distal tibia/medial malleolus.
• Mobilizing/lateral hand: Grasps the distal fibula/lateral malleolus.

Question 9

How is the mobilization performed for the Distal Tibiofibular Joint Posterior Glide?

Answer 9

• Mobilize (pull or push) the fibula/lateral malleolus posteriorly.
• Use body weight.

Question 10

What is the primary use of the Distal Tibiofibular Joint Posterior Glide?

Answer 10

To improve plantarflexion.

Question 11

What is the patient position for the Distal Tibiofibular Joint Superior Glide?

Answer 11

Supine or prone with the ankle supported by a pillow or towel roll.

Question 12

Describe the therapist’s position for the Distal Tibiofibular Joint Superior Glide.

Answer 12

The therapist is at the end of the table:

• Stabilizing/medial hand: Holds the distal tibia/medial malleolus.
• Mobilizing/lateral hand: Grasps the distal fibula/lateral malleolus.

Question 13

How is the mobilization performed for the Distal Tibiofibular Joint Superior Glide?

Answer 13

• Mobilize (push) the fibula/lateral malleolus superiorly.
• Use body weight.

Question 14

What is the primary use of the Distal Tibiofibular Joint Superior Glide?

Answer 14

To improve dorsiflexion.

Question 15

What is the patient position for the Distal Tibiofibular Joint Inferior Glide?

Answer 15

Supine or prone with the ankle supported by a pillow or towel roll.

Question 16

Describe the therapist’s position for the Distal Tibiofibular Joint Inferior Glide.

Answer 16

The therapist is at the end of the table:

• Stabilizing/medial hand: Holds the distal tibia/medial malleolus.
• Mobilizing/lateral hand: Grasps the distal fibula/lateral malleolus.
• Option: Facing the dorsum of the foot, place the heel of your hand on the superior lateral malleolus.

Question 17

How is the mobilization performed for the Distal Tibiofibular Joint Inferior Glide?

Answer 17

• Mobilize (pull or push) the fibula/lateral malleolus inferiorly.
• Use body weight.

Question 18

What is the primary use of the Distal Tibiofibular Joint Inferior Glide?

Answer 18

To improve plantarflexion.

Question 19

How does the fibular head move during dorsiflexion and plantarflexion?

Answer 19

• During dorsiflexion: The fibular head moves superiorly and externally rotates.
• During plantarflexion: The fibular head moves inferiorly and internally rotates.

Question 20

What is the loose-pack and close-pack position for the Proximal Tibiofibular Joint?

Answer 20

Loose-pack position: 0° plantarflexion.
Close-pack position: Full dorsiflexion.

Question 21

What is the patient position for Proximal Tibiofibular Joint glides?

Answer 21

Supine, with the hip and knee flexed, and the foot flat on the table.

Question 22

How should the therapist position themselves for Proximal Tibiofibular Joint glides?

Answer 22

• Sitting on the patient’s foot (use a barrier).
• Stabilizing/medial hand: Positioned over the proximal anterior tibia/tibial tuberosity.

Mobilizing/lateral hand:
• Thumb or thenar eminence is positioned on the anterior surface of the fibular head.
• Fingers wrap posteriorly around the lateral head of the gastrocnemius.

Question 23

How is an anterior glide performed for the Proximal Tibiofibular Joint?

Answer 23

• Use the fingers of the mobilizing hand to mobilize the fibular head anteriorly.
• Use body weight during mobilization.

Question 24

How is a posterior glide performed for the Proximal Tibiofibular Joint?

Answer 24

• Use the thumb or thenar eminence of the mobilizing hand to mobilize the fibular head posteriorly.
• Use body weight during mobilization.

Question 25

What precautions should the therapist take during Proximal Tibiofibular Joint mobilizations?

Answer 25

Avoid compressing the common peroneal nerve during mobilization.

Question 26

What are the uses of Proximal Tibiofibular Joint anterior and posterior glides?

Answer 26

• To improve general ankle mobility. • To reduce positional faults at the superior tib-fib joint.

Question 27

Why are rotational movements at the superior tib-fib joint inconsistent?

Answer 27

Due to structural variations in the joint.