Closed Packed Positions and capsular Patterns for Joints - Physiotherapy

Closed Packed Positions and capsular Patterns for Joints - Physiotherapy

Upper Body

Joint	Closed Packed Position	Capsular Pattern
Temporomandibular Joint	Clenched teeth	Opening mouth
Cervical spine	Extension also for Thoracic and Lumbar Spine	Side flexion and rotation equally limited; flexion is full but painful, extension is limited
Glenohumeral joint	Abduction and lateral rotation	Lateral rotation then abduction then medial rotation
Humeroulnar	Extension	Flexion then extension
Trapeziometacarpal joint	None	Abduction and extension, full flexion
Metacarpophalangeal joint	Flexion Opposition	Flexion then extension
Interphalangeal joint	Extension	Flexion then extension

Lower Body

Joint	Closed Packed Position	Capsular Pattern
Hip	Extension and medial rotation	Flexion, abduction and medial rotation. Extension maybe limited
Knee	Extension and lateral rotation of the tibia	Flexion the extension
Talocrural	Dorsiflexion	Plantarflexion the dorsiflexion
Subtalar	Inversion	Inversion
Mid-tarsal	Inversion	Dorsiflexion, plantarflexion, adduction and medial rotation
First metatarsalphalangeal joint	Extension	Extension then flexion