Okay we're at the ankle and we have the malleoluses here, talocrural joint. So what I'd like
to do is I'm going to do a traction. So I'm going
to stabilize on the calcaneus
and the anterior aspect of the foot over the mid-foot, the metatarsophalangeals.
And I'm going to apply
pressure in an
inferior direction or towards me. I'm going to stretch the
talocrural or, I should say, take up the slack, sustained grade two
traction.
Now from here what I can do
is I can do the anterior-posterior glides by simply stabilizing. Could you just move up a
little, just a little? There, right there.
I want to stabilize my left
hand over top of the medial and lalteral malleolus.
I want to grasp
and when I do grasp I want to feel
the navicular tubercle in my thumb and
I want to have
a small space where the talocrural joint comes together.
Stabilizing the malleolus
over the navicular
and I'm going to do a posterior glide, sustained grade two.
So my right hand here is pushing down and my left hand is stabilizing,
posterior. So I'm doing a little bit of
a grade one and then into a grade two.
And the grade one is just making sure I don't compress the joint. So the grade one is moving
in an inferior direction.
A little grade one and then
posterior, sustained grade two.
Now in this position
do the same thing but I'm going to come anterior. So my left hand is going to stabilize,
my right hand is moving towards me, lifting up towards the ceiling
in a straight line. You don't want to do this or do this.
You want to move up
straight towards the ceiling.
So a little grade one and then an
anterior direction.
So that's traction, anterior and posterior glides with the talocrural joint.
We're here at the patella. So we're going to do several different directions.
Place my thumbs on the lateral side of the patella and move medially,
sustained grade two.
Place my index finger on the medial aspect and move
lateral, sustained grade two.
Place my right hand on the inferior portion of the patella
and move superiorly.
Now if somebody has patellofemoral, has knee problems, they may react to these,
particularly when you're moving anteriorly.
Stabilizing,
taking my left hand and placing it over the superior part of the patella,
moving inferiorly.
So you can move this
in multiple directions.
So we're going to do
a traction and distraction of the tibiofibular joint.
So I'm going to stabilize above the knee. Grasp just above the,
around the malleolus, the medial-lateral malleolus.
And then I'm going to
do long axis traction
directly away from the joint.
Now I'm going to do distraction, So what I can do is come up here, bend the knee at 90 degrees.
Grab around the posterior aspect of the knee and move in an inferior direction.
Now you can stabilize here if you choose to,
but the femur's fairly stable so
you can do simply
distraction in this direction.
Okay? Towards my body.
So now we're going to do a
posterior glide. We find the greater trochanter
right in through here.
We're going to do a posterior glide of the
head of the femur
in a posterior direction, sustained grade two.
Applying pressure, taking up the slack.
Now we're going to do it
at a long axis traction
and I'm going to position my right hand just above the knee or
just posterior to the knee
and my other hand above the ankle and I'm just going to lean
and do long axis traction
of the femoral head out of the acetabulum.
The next one
I want to do is a posterior glide
in a flex position.
So basically the posterior glide I'm going to drive, push the femoral head in a
posterior direction
going down in this direction,
sustained grade two. Comfortable there? >>Yep. >>Right.
And finally
I'm going to do a distraction in flexion, so
bring Meghan's leg up
beside my shoulder, on my shoulder.
Grasp here
and I'm going to move out
in about a 45 degree angle towards my body,
distracting the femoral head.
So we're doing the hip. The hip is a difficult area to do.
If the person has adhesive capsulitis of the hip you'd have to use
belts to stabilize the hip to do it.
But today we're just showing the hand position.
So I'm going to find the greater trochanter here. And I have my right hand underneath her knee.
And I'm just going to lift up a little bit,
find the greater trochanter, apply my
palm, my hand,
on top of that and apply
an anterior pressure,
creating an
anterior glide of the
femur in an anterior direction.
So we're going to be working on the SI joint and the innominate bone.
I'm going to be stabilizing the innominate bone or the iliac crest
and I'm going to move the sacrum in an anterior-superior direction,
stabilizing here. This hand is going to be doing the movement.
So I'm putting my hand over the sacrum,
stabilizing the innominate bone at the iliac crest
and moving anteriorly, sustained grade two.
The other movement I can put my hand, left hand over top of the sacrum
other hand on the ischial tuberosity, moving in an inferior direction, stabilizing
the ischial tuberosity, which stabilizes the innominate bone
and move inferiorly, sustained grade two.
Now I can find the sacrum here,
left hand over the sacrum,
right hand over the ASIS
and I'm going to stabilize on the ASIS. I'm going to push with my left hand in a
direction towards the table,
moving the sacrum in an anterior direction.
So again we're going to be working on the innominate bone.
And we're going to move the innominate bone in a
counternutated direction or anterior.
So I'm going to use the femur as a lever.
I'm going to place my hand here. My other hand, my left hand is over top of the ASIS
and I'm going to lift and apply pressure in an anterior direction
to encourage the innominate bone to go into a
counternutated direction.
Okay?
Okay again we're working on the innominate bone.
I'm going to go a nutation or a
posterior direction.
So how we do this, I'm going to place my hand on the ischial tuberosity.
My other, my left and on top of the ASIS or anterior on the ASIS.
I'm going to move in a sustained grade two, moving
in a posterior direction or moving
nutated, in a nutation. Holding, good.
We're going to do the metacarpophalangeal of the index finger. Stabilize
the metacarpal.
Grasp the phalangeal
and I'm going to do a sustained grade two
traction
and then I'm going to do a posterior glide moving towards me. You should be able to see
the finger move a little bit,
the knuckle move.
And then an anterior glide
moving
my left hand towards Meghan's side,
all sustained grade two. Good.