Front Matter

132 Canine Sports Medicine and Rehabilitation

Traction

Traction is a sustained force that separates joint
surfaces. It is performed at a right angle to the
treatment plane. It is considered a more general
technique than glides since it has a global effect
on the capsule rather than affecting a particular
aspect of the capsule. Grade I and II tractions
are used for treating pain; grade III is used to
stretch the surrounding tissues. Kaltenborn rec­
ommends intermittent traction with 10‐second
holds and a rest between each repetition. Other
authors propose maintaining the traction for
20–30 seconds (Kaltenborn et al., 1999). Grading
of traction is shown in Table 6.5.
The technique for performing glides or traction
involves starting with the joint in a position of
maximal comfort in order to minimize muscle
tension. This is the resting position. The therapist
places the stabilizing hand on the nonmoving
part (usually the proximal segment) as close
to the joint space as possible. The mobilizing
hand is on the joint partner to be moved, gen­
erally as close to the joint space as possible,
though in some traction techniques a longer
lever arm will be used, necessitating moving
the mobilizing hand more distal on the limb.
Treatment direction depends upon the technique
to be performed. Traction techniques are per­
formed perpendicular to the treatment plane
(grades I–III), while gliding techniques are per­
formed parallel to the treatment plane (grades I–
IV). The specific direction of the glide (dorsal,
ventral, cranial, caudal, medial, lateral) will
depend on the particular restriction determined
by the assessment glide (arthrokinematic motion)
and corresponding PROM/AROM (osteokine­
matic motion) limitations. Under standing the con­
vex‐concave rule allows the therapist to determine
the best direction of the treatment glide. Treatment
grade is based on the goal of the treatment (to
decrease pain or to increase mobility) (Table 6.6).

Treatment example

Kaltenborn’s techniques are based on an under­

standing of normal joint arthrokinematics. For

example, glenohumeral extension is associated

with a caudal glide of the humeral head,

whereas glenohumeral abduction is associated

with a medial glide of the humeral head.

The  arthrokinematic motion is opposite to the

osteokinematic motion because the convex sur­

face of the humeral head is moving on the con­

cave surface of the scapula. Therefore, limited

shoulder osteokinematic ROM into extension is

associated with a restricted caudal assessment

glide of the humerus due to a tight caudal

capsule. Therefore, the appropriate treatment

for restricted shoulder extension that is limited

by capsular tightness is a grade III or IV caudal

glide of the humerus (Table 6.7; Figure 6.13) and

that for caudal mobilization of the tibiofemoral

joint is provided in Table 6.8 (Figure 6.14).

Applying the convex‐concave rule at the

tibiofemoral joint:

● A caudal glide will promote stifle flexion.

● A cranial glide will promote stifle extension.

● Distraction promotes general joint mobility.

When using joint mobilization to increase

ROM, consider how to maximize the treatment.

This may include preparing the tissues. If the

goal is to increase the extensibility of the capsule,

warming the joint tissues may be an effective

Table 6.5 Grading of traction

Grade Characteristics

I No appreciable joint separation; eliminates

compression forces

II Slack is taken up, ligaments and capsule are

taut

III Slack has been taken up and more traction force

is applied; surrounding tissues are stretched

Table 6.6 Determination of treatment grades

Problem Treatment Grade

Pain Traction Grades I, II

Glide Grades I, II

Hypermobility Traction Grade III

Glide Grades III, IV

Table 6.7 Technique for caudal mobilization of shoulder

Goal To increase shoulder extension,

decrease pain

Patient Lateral recumbency; shoulder in resting

position

Therapist Stabilizing hand: thumb on caudal

aspect of the acromion

Mobilizing hand: index finger on the

cranial aspect of the proximal humerus