NPTE- MSK- Open and Closed Pack Joint Positions

Vertebral--Open pack

Midway between flexion and extension

Vertebral--Closed pack

maximal extension

Temporomandibular--Open Pack

jaw slighly open

TMJ--Closed Pack

maximal retrusion (mouth closed with teeth clenched) or maximal anterior position mouth maximally opened

Sternoclavicular--Open Pack

arm resting by side

Stenoclavicular--closed pack

arm maximally extended

Acromioclavicular--open pack

arm resting by side

AC--Closed pack

arm abducted to 90 deg

Glenohumeral--open pack

55-70 deg of abuction, 30 horiz adduction, neutral rot

GH--closed pack

maximal abduction and ext rot

humeroulnar--open pack

70 deg flexion, 10 deg supination

humeroulnar--closed pack

full extension and supination

humeroradial--open pack

full extension and supination

humeroradial--closed pack

90 flexion and 5 deg supination

proximal radioulnar--open pack

70 deg flexion and 35 deg supination

prox radioulnar--closed pack

5 deg supination and full extension

distal radioulnar--open pack

10 deg supination

distal radioulnar--closed pack

5 deg supination

radio/ulnarcarpal--open pack

neurtral with slight ulnar deviation

radio/ulnarcarpal--closed pack

full extension with radial deviation

midcarpal--open pack

neutral with slight flexion and ulnar deviation

midcarpal--closed pack

full extension

Carpometacarpal (2-5) -open pack

midway between flexion/ext

carpometacarpal (2-5)-closed pack

full opposition

trapeziometacarpal--open pack

midway betwee flexion/ext and between ab/adduction

trapeziometacarpal--closed pack

full opposition

metacarpophalangeal (MCP)-open pack

1st MCP: slight flexion

2-5: slight flexion with ulnar deviation

MCP-closed pack

1st MCP: full extension

2-5: full flexion

interphalangeal (IP): open pack

proximal IP joints: 10 deg flexion

DIPs: 30 deg flexion

IP closed pack

full extension

Hip-open pack

30 deg flexion, 30 deg abduction, slight ER

Hip-closed pack

ligamentous: full ext, abduction, IR

bony: 90 deg flexion, slight abduction, slight ER

Knee-open pack

25 deg flexion

Knee-closed pack

full ext and ER

talocrural-open pack

mid iversion/eversion and 10 deg plantarflexion

talocrural-closed pack

full dorsiflexion

subtalar-open pack

midway between extremes of ROM and 10 deg plantarflexion

subtalar-closed pack

full inversion

midtarsal-open pack

midway between extremes of ROM and 10 deg plantarflexion

midtarsal-closed pack

full supination

tarsometatarsal--open pack

midway between supination and pronation

tarsometatarsal-closed pack

full supination

metatarsophalangeal (MTP)-open pack

neutral

MTP-closed pack

full extension

interphalangeal-open pack

slight flexion

IP-closed pack

full extension