End Feel -joint end feel - Normal and Abnormal end feel

while taking assessment by physiotherapy this have to been check for to check end range feel that can be pathogical and physiological .

1. PHYSIO_REHAB_AP END FEEL
By - Dr. Anjali Parmar (MPT-MSSS)
Normal
AbnormalP
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B
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_REH
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2. The motion of aa the joint is limited
a particular anatomical structure as
its end range prevents the joint to
move further in that direction.
The type of structure limiting the
joint range of motion has a specific
feeling that can be perceived by
the examiner when the movement
is performed passively, it is
referred as end fell.
END FEEL
A P
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Y
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O
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H
A
B
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3. NORMAL ROM
SOFT END FEEL
FIRM END FEEL
HARD END FEEL
NORMAL
END FEEL
ABNORMAL
END FEEEL
END FEEL
BEFORE REACH NORMAL ROM
ABNORMAL SOFT END FEEL
ABNORMAL FIRM END FEEL
ABNORMAL HARD END FEEL
ABNORMAL EMPTY END FEEL P
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Y
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A
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Physiological
End Feel
Pathological
End Feel
physio_rehab_ap

4. It is also known as mushy end feel. it occurs when soft structures, such as
muscle or subcutaneous fats get compressed between the proximal and
distal part of joint.
ex. end feel of knee flexion ; it is restricted by the muscles of the back of
the thigh and leg.
physio_rehab_ap
NORMAL END FEEL
SOFT END FEEL P
H
Y
S
I
O
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R E
H
A
B
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5. A firm end feel gives the sensation of a firm, elastic response with a slight
give.
ex. Carpal flexion in the normal patient will have a firm end feel.
physio_rehab_ap
NORMAL END FEEL
FIRM END FEEL P
H
Y
S
I
O
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R E
H
A
B
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6. It occurs when there is bone to bone approximation at the end of ROM. A
bone to bone block is felt by the therapist and the joint stops abruptly at
that range.
ex. elbow extension; the olecranon process lodges into the olecranon
fossa restricting further motion.
physio_rehab_ap
NORMAL END FEEL
HARD END FEEL P
H
Y
S
I
O
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R E
H
A
B
_
A
P

7. The sensation is same as that of normal range soft end feel but occure
before the normal range is achieved.
ex. Synovitis of Joint.
physio_rehab_ap
ABNORMAL END FEEL
ABNORNAL SOFT END FEEL P
H
Y
S
I
O
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R E
H
A
B
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A
P

8. The springy end feel felt before the normal range is reached. it is du to
ligament muscle or capsule. The firmness varies in a very wide range from
mild to severe.
ex. end feel in frozen shoulder.
physio_rehab_ap
ABNORMAL END FEEL
ABNORMAL FIRM END FEEL P
H
Y
S
I
O
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R E
H
A
B
_
A
P

9. there is bony mechanical block to ROM which prevents further
movements
ex. myositis ossification , loose body inside the joint.
physio_rehab_ap
ABNORMAL END FEEL
ABNORMAL HARD END FEEL P
H
Y
S
I
O
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R E
H
A
B
_
A
P

10. It is a false end feel as the examiner do not reach the end of motion and
she herself do not feel any resistance to the movement but the patient
do not allow the examiner to mov into further ROM due to severe pain.
ex. acute infection , acute inflammation, recent trauma , and relfx
sympathetic dystrophy (RSD)
physio_rehab_ap
ABNORMAL END FEEL
EMPTY END FEEL P
H
Y
S
I
O
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R E
H
A
B
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P

11. P
H
Y
S
I
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H
A
B
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A
P Assessment of end feel though requires a lot of
experience. it is a very important part of
assessment. it helps to
Find out the presence or absence of any
pathology
identify he structure, limiting the ROM , an
plan the treatment protocol based n that
identify he contraindication , if any
predict the prognosis of the condition

12. CAUSES OF RESTRICTION OF JOINT RANGE
OF MOTION
All the causes of restriction of ROM of a
joint can be explained under the following
headings:
abnormalities within the joint.
abnormalities of the ligament and cause
of joint.
abnormalities in the muscles around the
joint. P
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13. T
h
a
n
k y
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u
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