Joints Capsular Patterns, Loose Packed Position, Closed Pack Position

CAP CAPSULA ULAR PATTER TERN

Temporomandibular

Facet (Cervical, thoracic and lumbar spine)  "tlanto#occpital  "tlanto#occpital $lenohumeral

 "cromnioclavicular  "cromnioclavicular

Sternoclavicular

1lnohumeral (elbo!) .adiohumeral roximal (Superio ( Superior) r) .adioulnar  5ista 5istall (6nf (6nferi erior) or) .adio .adiouln ulnar ar .adiocarpal (!rist) 6ntercarpal Midcarpal

Limitation of of mo mouth opening Side flexion, rotation eually limited, extension Side flexion, flexion, extension extension eually limited Lateral rotation, abduction, medial rotation - at extreme extreme ./M especially hori*ontal abduction + full elevation - at extreme ./M especially hori*ontal adduction + full elevation Flexion, extension

LOOSE OSE/ OPEN OPEN PACK

CLOSED PACK

POSITION

POSITION

Mouth slightly open, lips together, teeth not in contact Mid!ay bet!een flexion and extension

Clenched teeth

%&'#' abduction, &' hori*ontal adduction

Full abduction + lateral rotation

 "rm resting by side in normal physiologic position  "rm resting by side in normal physiologic position 2&' flexion, 3&' supination Flexion, extension, Full extension, full supination, pronation supination Supination, pronation 2&' flexion, 3&' eually limited supination Full Full ./M, ./M, - at extre extremes mes 3&' supination of rotation Flexion + extension 7eutral !ith slight ulnar eually limited deviation 7one 7eutral or slight flexion

 "rm abduction abduction to 0&' 0&'

Flexion + extension eually limited "bduction, extension

4xtension !8 ulnar deviation Full opposition

Maximum shoulder elevation + protraction 4xtension !ith supination 4lbo! flexed 0&', forearm supinated at ' ' supination ' supination 4xtension !8 radial deviation 4xtension

4ua 4uall limitat limitation ion in all all directions Flexion, extension

7eutral or slight flexion !8 ulnar deviation Mid!ay bet!e t!een abduction#adduction + flexion#extension Mid!ay bet!een flexion and extension Slight flexion

Full flexion

Flexion, extension

Slight flexion

Full opposition

Slight flexion Resting: 7eutral Loose: Counternutation Loose: Counternutation &' flexion, &' abduction, slight lateral rotation

Full extension 7utation

Tibiofemoral (;nee)

Flexion, extension - !hen 9oints are stressed Flexion, abduction, medial rotation (in some cases medial rotation is most limited) Flexion, extension

<' flexion

5istal tibiofibular

- !hen 9oints are

lantar flexion

Full extension, lateral rotation of tibia Maximum dorsiflexion

Carpometacarpal (Thumb)

Carpo Carpomet metaca acarpa rpall (Fing (Fingers ers)) Metacarpophalangeal (Fingers) Metacarpophalangeal (Thumb) 6nterphalangeal Sacroiliac, symphysis pubis + saccrococcygeal :ip

Full flexion

Full extension, medial rotation, abduction

stressed Talocrural ("n=le)

lantar flexion, dorsiflexion

Talocalcaneal (Subtalar )

Limitation of ./M (varus, valgus)

Midtarsal

5orsiflexion, plantarflexion, adduction, medial rotation 7one

Tarsometatarsal

Metatarsophalangeal

6nterphalangeal

Big toe: 4xtension, flexion 2 nd  to 5 th: >ariable Flexion, extension

3&' plantar flexion, mid!ay inversion + eversion Mid!ay bet!een extremes of range of movement Mid!ay bet!een extremes of range of movement Mid!ay bet!een extremes of range of movement Full extension

Maximum dorsiflexion

Full extension

Full extension

Full extension

Supination

Supination

Supination