Feel – Normal and Abnormal
When assessing passive movements, the
examiner should apply overpressure at the end of the ROM to
determine the quality of the "end-feel". The sensation
that is felt in the joint as it reaches the end of the ROM.
A proper evaluation of the end feel can
help determine a prognosis for the condition and learn the
severity or stage of the problem.
This is a "Hard" unyielding sensation that is
tissue approximation Knee
This is a yielding compression that stops further movement.
dorsiflexion, Shoulder, external rotation, finger extension.
is a hard or firm (springy) type of movement with a slight give.
Towards the end of the ROM, there is a feeling of elastic
muscle spasm Acute
protective spasm associated with inflammation
end feel is invoked by movement, with a sudden arrest of movement
often accompanied by pain. The end feel is sudden and hard. Early
muscle spasm occurs early in the ROM, almost as movement starts.
Spasm caused by instability
above, but occurs at or near then of the ROM. It is caused by
instability and the resulting irritability caused by movement. As
is the Apprehension Test for Shoulders.
types of muscle spasm are the result of the subconscious efforts
of the body to protect the injured join or structure.
Frozen shoulder, chronic conditions.
end feel is similar to Tissue stretch, but it does not occur where
one would expect.
capsule end feel has a 'thick" quality to it. Limitation
comes abruptly after a smooth, friction free movement.
Synovitis, soft tissue oedema.
is similar to "normal" but with a restricted ROM. Is
often found in acute conditions, with stiffness occurring early in
the range and increasing until the end of range. It has a soft,
boggy end feel.
abnormal bone-to-bone end feel comes well before the normal end
Acute subacromial bursitis
end feel is detected when considerable pain is produced by
movement. The movement is stopped by pain with no real mechanical
is similar to a tissue stretch, but occurs unexpectedly. Usually
occurs in joints with a meniscus. There is a "rebound"
effect, and usually indicates an internal derangement.