In Metacarpophalangeal Flexion of the Thumb, what is the expected end feel and ROM?

• A. HARD end feel; 0-60 degrees
• B. FIRM or HARD end feel; 0-50 degrees
• C. SOFT end feel; 0-30 degrees
• D. FIRM end feel; 0-50 degrees

Answer: (B)

When the thumb’s metacarpophalangeal joint is flexed, the limiting structures are the joint capsule, ligaments, and the palmar plate, with the soft tissues guiding the motion rather than the bones coming into hard contact. This produces a firm end feel as you approach the end of range. The typical range is from 0 degrees (full extension) to about 50 degrees of flexion; some references note up to 60 degrees, but 0–50 degrees is commonly assessed in clinical practice. Because the end feel is mainly from soft-tissue tension, it’s usually firm, though in some individuals there can be a harder end feel if there is early bony approximation. Thus the description of a firm or hard end feel with 0–50 degrees of motion best fits the test.