A spastic end feel is a type of abnormal end feel characterized by a sudden, hard arrest of movement accompanied by pain, typically invoked by the movement itself. This indicates muscle spasm during range of motion.
Understanding End Feels
Before delving deeper into the spastic end feel, it's crucial to understand the concept of end feels in general. An end feel refers to the sensation a clinician experiences when applying overpressure at the end of a joint's passive range of motion. It provides valuable information about the nature of the restriction.
Characteristics of a Spastic End Feel:
- Sudden Arrest: The movement stops abruptly.
- Hard Resistance: The resistance is firm and unyielding.
- Pain: The movement elicits pain.
- Muscle Spasm: The primary cause is involuntary muscle contraction or spasm.
Causes of Spastic End Feels:
Spastic end feels are often associated with:
- Muscle Spasms: Involuntary contractions of muscles due to injury, inflammation, or neurological conditions.
- Neurological Conditions: Conditions like cerebral palsy or stroke can cause spasticity, leading to this type of end feel.
- Protective Muscle Guarding: The body's attempt to protect an injured or inflamed area by tensing the surrounding muscles.
Distinguishing Spastic End Feels from Other Abnormal End Feels:
| End Feel Type | Description |
|---|---|
| Spastic | Sudden, hard arrest with pain due to muscle spasm. |
| Bony/Hard | Abrupt, hard stop due to bone-on-bone contact (e.g., osteoarthritis). |
| Capsular | A leathery feel with some give, often associated with capsular tightness. |
| Empty | Significant pain prevents reaching the end of the range. |
| Springy Block | Rebound sensation, often indicative of internal joint derangement (e.g., torn meniscus). |
| Muscle Spasm | Sudden and hard dramatic arrest of movement accompanied by pain which is invoked by the movement |
Clinical Significance:
Identifying a spastic end feel is important for:
- Diagnosis: It helps determine the underlying cause of the movement restriction.
- Treatment Planning: It guides the selection of appropriate interventions, such as addressing the muscle spasm or underlying neurological condition.
- Prognosis: It provides insights into the potential for recovery and rehabilitation.
In summary, a spastic end feel is a distinct clinical finding characterized by a sudden, hard arrest of movement with pain, primarily caused by muscle spasm. Its identification is vital for accurate diagnosis and effective treatment.
