Overview

The physician must be able to identify and characterize normal and abnormal range of motion in order to identify and characterize normal and abnormal barriers to motion. Most joints are capable of motion in multiple planes (3-dimensional), but for illustration purposes we will limit our discussion of barrier concepts to movement in single plane of motion (2-dimensional).

The total range of motion of a joint is limited by the structural integrity of the physical components. External forces that attempt to move a joint beyond anatomical barriers result in fracture, dislocation, and/or soft tissue damage. The position defined as the anatomical midline (Midline Neutral) is located between the extremes of the anatomical barriers.

The total range of motion can be subdivided into a range of passive motion and a range of active movement. The elastic barrier is a normal barrier to motion that results when all tension has been taken up within the joint and its surrounding tissues. The remaining space between the elastic barrier and the anatomical barrier is termed the paraphysiologic space. It is within this space that the high-velocity, low-amplitude thrust appears to generate its characteristic popping sound.

The range of active motion, defined by the physiological barrier, is less than the range of passive motion. The physiologic barrier is a consequence of increased tension within the muscle and fascial components. Frequently there is a reduction in the available range of active motion due to myofascial shortening.

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No commercial support was received for the development of this content. The developers and presenters have no conflicts to disclose. This product is intended for instructional use only. It is not designed for clinical or diagnostic purposes. The authors, producers, and publishers of these materials shall not be held liable for any loss and/or injury arising from the use of information and procedures contained in these programs.