What are the different type of joint-end feels?

There are multiple types of joint end-feels all of which are different for each individual!

Bone on Bone

When the end of range is encountered, the SMT will feel the bone on bone contact as the articular surfaces meet. This end-feel will be hard and abrupt.

If the SMT feels any grating, grinding or juddering towards the end of this range or if the ROM is limited, it is likely that this is abnormal. If the ROM is appropriate and the hard sensation is clean (e.g. when reaching the end of range during elbow extension), it is likely this end-feel is normal.

Capsular

When a joint capsule or ligaments are stretched at the end of range, the end-feel can be described as ‘capsular’. This will feel ‘leathery’ – the joint will allow no further movement but there may be some minor give, similar to that felt when stretching leather.

Firm

This end-feel is similar to a capsular end-feel although the ROM is limited by the stretch of a muscle or tendon. The ROM will end firmly, although there can be a little give as the stretch of soft tissue occurs. The difference between a capsular and a firm end-feel is that the firm end-feel will not have a leathery effect.

Tissue approximation

This joint end-feel is soft as it occurs when two soft tissue masses meet one another, limiting further movement e.g. when the hamstrings and calf complex meet during knee flexion, it feels soft and cushioned.

Spongy block

This type of end-feel is usually abnormal in nature as it is most likely that the motion has been stopped before the end of range and the client may report pain. This type of end-fel is usually caused by a piece of loose soft tissue (e.g. torn cartilage in the knee) blocking normal motion. In addition to the limited ROM and client pain, this type of end-feel is spongy and there may be some ‘spring back’ as the soft blockage is encountered.

Empty

‘Empty’ is the description used when the client will not allow full ROM because they experience considerable pain. This type of end-feel is usually encountered when there is joint inflammation, a fracture or another acute injury that causes sharp, significant pain upon joint movement.

Muscle Spasm

When a muscle is in spasm, there is likely to be some limitation of ROM as well as considerable pain, particularly when end of range is approached. The client may recoil and report pain as ROM is progressed, giving a similar feel to a spongy block. The SMT may be able to sense the spasm itself, although it would be unwise to stress the joint further once client pain is perceived.