342 Canine Sports Medicine and Rehabilitation
Palpation
Palpation provides the therapist with a subjec-
tive evaluation of specific tissues including
bone, muscle, fascia, and ligaments. By manu-
ally challenging the tissues, palpation assess-
ment provides the therapist with information
regarding the specific tissue type and location
of edema, heat, pain, tone, and tightness.
Palpation findings help specify the anatomic
structure and chronicity of a primary or sec-
ondary orthopedic injury. For example, during
the evaluation of the thoracic limb, palpation
assessment of the latissimus dorsi requires
pressing the fingertips into the muscle tissue
along the ventral boarder of the muscle from
origin to insertion and through the muscle belly
from the proximal caudal border of the humerus
into the thoracodorsal fascia (Figure 13.7). A
positive response to palpation, including the
subjective feeling of edema, heat, and tone as
well as visible pain or muscle spasm, leads the
therapist to further assess the scapulothoracic
and glenohumeral joints and thoracolumbar
areas. Thorough objective palpation includes
all joints, muscles (Table 13.1), and bony land-
marks of the thoracic limb.
Clear the spine
Clearing the spine is required before initiating
joint play examination as it is unknown at this
time if, in the canine model, mobilizing the
facet joints of the spine has a negative impact
on the disk or the nerve roots. The purpose of
clearing the spine is to capture significant pain
or neurological signs that would contraindicate
joint play tests. Clearing the spine is initiated
with the dog in standing; the conscious propri-
oception test is completed (see Chapter 17). If
the patient displays delayed or absent con-
scious proprioception reactions, this is noted in
the objective portion of the evaluation, and
joint play tests are not completed. Next, active
range of motion of the spine is completed. If
during the course of active range of motion the
patient demonstrates significant pain, this is
noted in the evaluation, and joint play tests are
not completed.Joint play
The purpose of joint play assessments of the
thoracic limb is to determine arthrokinematic
quality and quantity and joint capsule integrity.
By stabilizing one side of the joint and mobiliz-
ing the other, a therapist feels for abnormal
joint surface qualities such as crepitus, a
decreased quantity of bone‐on‐bone move-
ment, and joint capsule hyper‐ or hypomobility
that may be affecting osteokinematic range of
motion. For example, decreased cranial glide of
the humeral head in the glenoid fossa may be
limiting shoulder joint flexion (Figure 13.8).
The therapist must determine if this limitation(A) (B)Figure 13.7 (A) Manual palpation of the latissimus dorsi muscle challenges the muscle tissues along the ventral border
of the muscle from origin to insertion, feeling for tissue changes including edema, heat, tone, pain, and muscle spasm.
(B) Manual palpation of the latissimus dorsi also challenges tissues in the central portion of the muscle belly, paying
particular attention to areas of pain and tightness that may indicate trigger points.