MANUAL THERAPY
[SHS.405]
CONTENTS
The kaltenbom treatment plane.
Translatoric joint play movements.
Determining the direction of restricted
gliding.
Glide test..
Kaltenborn convex-concave rule.
Grades of translatoric movement.
Normal grades of translatoric movement
(grades i - iii).
Pathological grades of translatoric
movement.
Using translatoric grades of movement.
TRANSLATORIC JOINT PLAY
In the OMT Kaltenbom-Evjenth system:
We use translatoric (linear) joint play
movements in relation to the treatment
plane in both evaluation and treatment.
We apply translatoric traction , compression and
gliding joint play movements to evaluate joint
function.
We apply translatoric gliding and traction
mobilizations to restore joint play.
THE KALTENBORN TREATMENT
PLANE
The Kaltenborn Treatment Plane passes
through the joint and lies at a right angle to a
line running from the axis of rotation.
The Kaltenbom Treatment Plane remains
with the concave joint surface whether the
moving joint partner is concave or convex.
THE KALTENBORN TREATMENT
PLANE
TRANSLATORIC JOINT PLAY
MOVEMENTS
Traction:
“a linear translatoric joint play movement at
a right angle to and away from the treatment
plane”.
TRACTION
TRANSLATORIC JOINT PLAY
MOVEMENTS
Compression:
“a linear translatoric movement at a right
angle to and toward the treatment plane”.
COMPRESSION
TRANSLATORIC JOINT PLAY
MOVEMENTS
Gliding:
“A joint play movement parallel to the
treatment
Plane”.
GLIDING
DETERMINING THE DIRECTION OF
RESTRICTED GLIDING
There are two methods of determining the
direction of restricted joint gliding:
Glide Test
Kaltenborn Convex Concave Rule
GLIDE TEST (THE DIRECT
METHOD)
Apply passive translatoric gliding movements
in all possible directions.
Determine in which directions joint gliding is
restricted.
Gives the most accurate information about
the degree and nature of a gliding restriction.
KALTENBORN CONVEX-CONCAVE
RULE
(THE INDIRECT METHOD)
Determine which bone rotations are
decreased.
Determine the moving joint partner is convex
or concave.
Deduce the direction of decreased joint
gliding by applying the Convex Concave
Rule.
KALTENBORN CONVEX-CONCAVE
RULE
(THE INDIRECT METHOD)
KALTENBORN CONVEX-CONCAVE
RULE
(THE INDIRECT METHOD)
GRADES OF TRANSLATORIC
MOVEMENT
The translatoric movements of traction and
gliding are divided into three grades:
These grades are determined by the amount
of joint slack (looseness and resistance) in
the joint that you feel when performing
passive joint play movements .
GRADES OF TRANSLATORIC
MOVEMENT
Slack:
All
joints have a characteristic amount of joint play
movement before tissues crossing the joint tighten.
This slack in the capsule and ligaments is
necessary for normal joint function.
When gliding is performed, the slack is taken up
in the direction of joint gliding.
When traction is performed, the slack is taken
up in the direction of traction.
Joint play movements are greatest, and easiest
to produce and palpate, in joint's resting
position.
NORMAL GRADES OF
TRANSLATORIC MOVEMENT
A Grade I " loosening" movement is an
extremely small traction force which
produces no appreciable increase in joint
separation.
Grade I traction nullifies the normal compressive
forces acting on the joint.
A Grade II ''tightening'' movement first
takes up the slack in the tissues surrounding
the joint and then tightens the tissues.
Inthe Slack Zone (SZ) at the beginning of the
Grade II range, there is very little resistance to
passive movement.
NORMAL GRADES OF
TRANSLATORIC MOVEMENT
In the Transition Zone (TZ), the tissues
tightens and the practitioner senses more
resistance to passive movement.
At the end of the Grade II range, the practitioner
feels a marked resistance, called the First Stop.
A Grade III "stretching" movement is
applied beyond the Transition Zone.
Can safely stretch tissues crossing the joint.
NORMAL GRADES OF
TRANSLATORIC MOVEMENT
NORMAL GRADES OF
TRANSLATORIC MOVEMENT
NORMAL GRADES OF
TRANSLATORIC MOVEMENT
Mobilization for pain relief takes place in
the Slack Zone and stops at the beginning of
the Transition Zone. Why?
PATHOLOGICAL GRADES OF
TRANSLATORIC MOVEMENT
In the presence of joint pathology, the quality
of end-feel and grades of movement may be
altered.
In the presence of a marked hypo mobility,
the slack is taken up sooner.
In hyper mobility, the slack is taken up later
than normal.
PATHOLOGICAL GRADES OF
TRANSLATORIC MOVEMENT
PATHOLOGICAL GRADES OF
TRANSLATORIC MOVEMENT
USING TRANSLATORIC GRADES
OF MOVEMENT
Grade I:
Relieve pain with vibratory and oscillatory
movements.
To reduce or eliminate compression force.
USING TRANSLATORIC GRADES
OF MOVEMENT
Grade II:
Test joint play traction and glide movements.
Relieve pain.
Maintain movement.
Relaxation mobilization.
USING TRANSLATORIC GRADES
OF MOVEMENT
Grade III
Test joint play end-feel.
Increase mobility and joint play by stretching
shortened tissues.
Thank You
