Maximally Loose Packed Position (MLPP) & Close Packed Position (CPP) Explained

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The maximally / maximum loose packed position abbreviated as MLPP and the close packed position (CPP) are essential if we want to compress or lock / apply traction to a joint.
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This is not medical advice! The content is intended to be educational only for health professionals and students. If you are a patient, seek care of a health care professional.

[@rachelalbright5187]

Love hearing from these instructors...always clear and thorough explanations!!

[@trishkitrevv6277]

This is golden! SPTA during Covid....Thanks Subscribed!

[@ruairiwaterford18]

Very helpful, thank you very much.

[@studypedia6698]

Hey thats an awesome explanation

[@priyankamidha5071]

Thank you, great video! May I ask how does the reduced contact area b/w the joints affect lubrication? (1:35)- my guess would be that more room for synovial fluid? :P

[@camparker1990]

I’m a new grad PTA these videos help refresh my brain. Thanks

[@Physiotutors]

That's one of the reasons we make these videos for!

[@sunkillsmoon]

How are you doing? I'm in PTA school right now

[@the_scrunchies_studio6952]

Can give me link of this table I can't find it

[@quinngrace1758]

Good video

[@Physiotutors]

Happy you like it!

[@dudukeza9767]

I am PTA student, this video helps me. Do you have more videos? THANK YOU

[@Physiotutors]

Of course, there are about 500. Ur welcome

[@leenalsayeh206]

isnt cpp for hip joint abd+ ?

[@omercan5996]

I 'm PT also and very thank you but i recently read something like this in a website for Clinicans, please check: For example, when performing a prone SIJ distraction manipulation, the hip needs to be placed in extension, abduction, and internal rotation. These three movements are the close-packed position of the hip joint. You must lock out the hip so you do not manipulate it when you are targeting the SIJ.

[@sirmanni4534]

Great comparative video. Is the Close pak position also used to fixate a joint so that you may mobilize/ manipulate an adjacent joint?

[@Physiotutors]

Yes indeed

[@satyajitapte7036]

Hi! Some sources say that the MLPP position for the knee joint is 25 degrees as opposed to the 70 degrees mentioned in the image you refered to. Which is the correct MLPP position for the knee?

[@Physiotutors]

The MLPP is actually 30°. Don't remember where we got this table from. Unlike in other joints, you won't get the maximal joint play in the knee with 30° due to tension in the cruciate ligaments. Maximal joint play can be felt at 70°, which is why this number probably ended up in this table

[@satyajitapte7036]

@@Physiotutors I don't think it's ever possible to get a perfect maximal joint play position because the cruciate ligaments are always taut in some degree or the other. The more you flex the knee, the more the AMB starts getting taut and the more you extend, the more the PLB starts getting taut

[@AliAli-qi8ux]

What is the difference b/w capsular pattern and close packed position?

[@Physiotutors]

Capsular pattern is a theory that describes which movements will be restricted first in an affected joint (however research doesn’t support it) The close packed Position is the position at which the convex and concave joint surfaces have the most congruency.

[@AliAli-qi8ux]

@@Physiotutors ahhhhh okkky ... Thank you

[@hadiqanadeem]

What's the difference between MLPP and LPP?

[@Physiotutors]

Bringing a joint towards its position near its restriction is called loose-packed position (without the 'maximal') and it's defined as the following: "A position away from M.L.P.P. , sub maximally in the direction of the limited or painful direction gives us a situation where the affected capsule parts are pre-stretched. An ideal position for mobilization of the affected capsule part. The L.P.P. is therefore a pathology related position"

[@np7961]

Is there any easier to remember all positions?

[@Physiotutors]

Sorry but we don’t get your question

[@np4266]

Physiotutors is there any easier way to remember all Close pack and loose pack positions for joints??

[@Physiotutors]

Not that we know of unfortunately. Let us know if you find one!

[@waverave24124]

Most of these followers are mainly PTA students....including myself lol

[@Physiotutors]

PTAs, PTs, chiros, osteopaths, some med students and people trying to self diagnose themselves 😜

[@bipulprasadray5495]

Do u know that indian physio fraternity loves u 🙌🙌🙌💓💓💓

[@izakaru009]

Is this really significant though? Why would we want to mobilize a joint in a position that's not near the restriction point? I can understand for traction mobilizations, but for joint mobilizations, I don't agree that it should be performed in MLPP. Biomechanical vs neurophysiologic effects is another thing to consider

[@Physiotutors]

We mentioned that you cannot mobilize a joint in its CPP - there is nothing to move there anymore if the joint capsule+ligaments are under maximal tension. Bringing a joint towards its position near its restriction is called loose-packed position (without the 'maximal') and it's defined as the following: "A position away from M.L.P.P. , sub maximally in the direction of the limited or painful direction gives us a situation where the affected capsule parts are pre-stretched. An ideal position for mobilization of the affected capsule part. The L.P.P. is therefore a pathology related position" We only focused on the different joint positions and their implications, not on biomechanical vs. neurophysiological effects. That's maybe for another video.

[@haroldpan561]

Jorge Arana

[@morsz6829]

the MLPP of knee joint should be 25-30 flection.