Proximal Tibiofibular Joint Manipulation

FEATURED COURSE: Joint Manipulation: Ankle, Midfoot and Tibiofibular Joint
Course counts for 2 credits towards the BI IMT or CECs
brookbushinstitute.com/course...
Patient and Practitioner set-up
- The patient should be lying supine, closer to the edge of the affected side, with the affected leg flexed at hip and knee.
The table should be at approximately the height of the practitioner's hip.
- The practitioner should be standing on the patient's affected side.
Passive Motion Assessment
- Arthrokinematic motion of the proximal tibiofibular joint can be assessed using posterior-to-anterior (PA) or anterior-to-posterior (AP) mobilization. Generally, this is done with a pincer grip, with the patient positioned ready for the manipulation.
- If there is no joint play (there is no "wiggle") this technique may be recommended. If the joint moves easily, even just 2 - 3mm, then this technique is not recommended. The proximal tibiofibular joint may become hypomobile or hypermobile. It is never recommended to perform manipulations on hypermobile joints.
Note: If mobilization is the intent, then the position used for proximal tibiofibular mobilization may be used for arthrokinematic assessment.
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What about the direction of force from your second mcp? Should it be a medial to lataral combimed with A-P from your indifferent hand?