EndFeel

Endfeel is the perceived quality of resistance felt by a clinician at the end of passive joint movement. It is assessed during passive range of motion after the joint has reached its available limit and is influenced by the interaction of soft tissues, joint capsule and ligaments, articular surfaces, and pain. Endfeel helps clinicians differentiate tissue involvement and localize pathology, contributing to the diagnostic process and treatment planning.

Normal end-feel can be described as soft, firm, or hard. Soft end-feel occurs with tissue approximation, such as knee flexion where the calf and thigh come close. Firm end-feel results from capsular or ligamentous stretch and is common with many joints, such as ankle dorsiflexion or shoulder horizontal adduction. Hard end-feel consists of abrupt bony contact, as seen in elbow or knee extension when the joint surfaces meet.

Abnormal or pathologic end-feels include several patterns. Boggy end-feel suggests joint effusion or edema. Empty end-feel occurs when pain prevents reaching the end of ROM, giving no distinct end-feel. Springy end-feel indicates a rebound after a small amount of movement and is often associated with intra-articular pathology such as a meniscal tear or articular cartilage lesion. Spastic end-feel reflects increased tone from CNS involvement and can alter the quality of movement. Capsular and loose-body end-feels may also present atypically.

Endfeel is subjective and can be affected by pain, guarding, technique, and patient factors. While informative, it is one element of a broader musculoskeletal examination.