Tibial Internal Rotation Mobilization

So now we're going to take a look at her internal rotation passively. We saw what it was when she was doing it actively. She was really limited in internal rotation. So we're going to show you the passive test of this. We're just going to bring her hip up to 90. I like to get in here kind of cup around the heel, try to stabilize The subtalar joint there. And I want to make sure I'm just getting tibial motion. And what I'll do is I'll palpate with my fingers right on that tibial tuberosity. That way I can see where I'm going. I know she has a little bit more external rotation. So I'm going to test that first. But even that is still a little bit limited. She's only probably getting maybe about ten degrees, and we want to see 20 there. And then what we're going to go into internal rotation. Yeah she's really locked up there so she's not getting much. So let's take a look at mobilizing that. And this can be very simple. It does not have to be too complex. So simply if we get her hip, we can we can do it at varying degrees of knee flexion range of motion. So we can do it at 90. If we're trying to work on someone's internal rotation and flexion range of motion we’ll do it more toward their limitation. So we might even go up to 100 if we have a person with a total knee replacement or that type of thing. And all we simply need to do is we can just bias the foot into internal rotation. I like to sit on that foot there to get it nice and stable. And then we can just do our regular mobilizations.  We start in a grade one mobilization there, and then gradually get into more of a grade two. And I'm not necessarily even pushing on one side harder than the other, because I already have that internal rotation bias. I can just get in there, mobilize into my grade three. And then grade four right at that end range, hanging out there to improve knee flexion range of motion and internal rotation range of motion.