The end-feel of a joint is determined by the structure of the joint, and can range from a hard to a soft end-feel. It depends on whether or not the joint involves many tendons, two bones that hit or only muscle attachments that keep the joint in place. The type of structure that limits the range of motion will usually determine the type of end-feel the joint will have. It is very important for physical therapists and doctors to understand what normal end-feels of joints are, because a change in the end-feel could indicate some type of abnormality or injury to the joint.
- Skill level:
- Moderately Challenging
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Have your patient allow you to passively extend their elbow. You will notice when you reach the end of the range of motion, that the end-feel for the elbow is hard. This is because there are two bones coming together to lock the elbow in place at the end of that motion.
Ask your patient to lay down on the exam table and passively flex their hip. Notice that the end-feel of the hip is soft. You will notice there is a lot more "give" in the hip flexion than with the elbow extension because there is much more muscle bulk surrounding the hip joint.
Have the patient turn over so they are laying on their front on the table. Passively extend their hip until you get the full range of motion. The end-feel for the hip extension is "firm" because of the tension in the anterior capsule of the hip and the tension put on the hip flexor muscles.
Memorise the end feels of the joints of the body. This can be done by looking at a chart or a book that lists all joint end-feels. You must memorise these so you know which end-feel pertains to which joint, so you will be able to easily notice if there is an abnormality with an end-feel.
Use differential diagnosis to come up with a reason that a joint would have a different end-feel than what you memorised if you come across it in the clinic. It could be caused by injury, illness or neurological damage, to name a few.
Tips and warnings
- Test a joint you know is healthy to understand what a hard, firm or soft end-feel feels like. This will help you to determine an abnormal end-feel if you come across one in your practice.
- Make sure you only take the joint to the end of the full range of motion. Pushing a joint to go far beyond its limits could cause injury to the joint and cause you to misread the diagnosed end-feel.
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