Traction must be applied in the direction and magnitude to obtain its desired effect. As soft tissue and muscle relax, the amount of weight required may change to maintain the desired pulling force. When traction is applied countertraction needs to be considered. Countertraction is a force acting in the opposite direction, for Bob this was achieved by elevating the foot of the bed.
When applying traction there are many factors to be considered for example, any factor which might reduce the pull or alter the line of pull must be eliminated. Skin should be assessed for abrasions and circulatory problems before the application of skin traction, as it must be in a healthy condition to tolerate the traction. The patient should be in good body alignment in the middle of the bed. Ropes and weights must be unobstructed. Knots in the rope or footplate must not touch the pulley or the foot of the bed.