SOME GUIDELINES FOR JOINT PLAY EXAMINATION AND MANIPULATION

1. The patient is relaxed.
2. The doctor’s grasp must be firm and supportive but not uncomfortable.
3. One joint is examined at a time.
4. One movement is examined at a time, even in combined movements.
5. One hand is active, the other stabilizes.
6. Joint play is no more than ~1/8 inch in the plane of any synovial joint capsule.
7. Compare endfeel to normal based on experience or the patient’s other joints with normal endfeel.
8. In the presence of inflammation, fracture, or disease process, no examining movements need to be undertaken.
9. Forceful or abnormal movements must never be used.
10. The examining movement must be stopped at any point at which pain is elicited – determine if the pain is due to irritation or inflammation.
11. The manipulative thrust is controlled, short, and sharp.
12. Before the manipulative thrust is given, take out all the slack and FEEL THE RESISTANCE to determine the line and degree of correction.
13. Reevaluate afterwards.
14. Joint play evaluation and manipulation is a PART of an overall evaluation and care plan.