Mobs and Manips For Shoulder and Scap Flashcards
What is the purpose of GH distraction (short axis)? 4 + another name
examine GH joint impairment increase ROM decrease pain improve periarticular ms performance GH Traction
How do you do GH distraction/traction (short axis)? Pt position: Arm position: First hand: Second hand: Action:
Pt position: supine
Arm position: ABD 20 deg or so (for more aggressive mob, approximate the restricted ROM)
First hand: underside of pt arm, right by jt space (basically in their underarm)
Second hand: distal humerus, posterior side
Action: press 1st hand OUT, looking for joint distraction in the short axis of the GH jt
Additional GH distraction/traction tips (short axis):
use a belt to stabilize the pt’s scapula if they have scapulothoracic hypermobility
What does the GH inferior glide restore? + another name
shoulder ABD (and flexion) Caudal Humeral Glide
Describe the GH joint (only):
and roll/glide combo?
convex humerus on a concave glenoid fossa located on the scapula
Roll and Glide=opposites
How do you do a GH inferior/caudal humeral glide? Pt position: PT position: Arm position: First hand: Second hand: Action:
Pt position: supine
PT position: above their head
Arm position: 90 deg ABD
First hand: head of humerus (on top/superior portion of the shoulder) just distal to jt space
Second hand: supporting pt’s arm AND distracting pt’s arm at about elbow level
Action: 1st hand presses down (inferiorly) on humeral head to do the inferior glide. 2nd hand brings the pt’s arm into further and further ABD after each glide
What does the GH posterior glide restore? + another name
shoulder flexion, and internal rotation
AND
horizontal ADDuction
Dorsal Humeral Glide
How do you do the GH posterior/dorsal humeral glide? this one has 2 action steps Pt position: Arm position: First hand: Second hand: Action:
Pt position: supine
You: with body/hip btw pt’s body and pt’s arm
Arm position: ABD 45 deg
First hand: head of humerus on anterior portion of shoulder, just distal to jt space
Second hand: supporting pt arm at elbow
Action 1: (SH Flx and Ext) you gently turn your body away from the pt, distracting joint, while you use 1st hand to press down (posterior direction) on humeral head
Action 2: (H ADD) pt arm in horizontal ADDuction, elbow at 90, use a belt or hand to distract humerus out, press down (along long axis) on OP of elbow for posterior glide (1 hand on olecranon process, one stabilizing arm at GH jt)
Additional GH posterior/dorsal humeral glide tips:
can use a belt
What does an anterior glide restore? + another name
External Rotation, shoulder extension, and Horizontal ABD
Ventral Humeral Glide
How do you do the GH anterior/ventral humeral glide? 2 possible positions Pt position: Arm position: First hand: Second hand: Action:
Pt position: prone
Arm position: 90/90/neutral (or into external rotation for the aggressive technique)
First hand: head of humerus on posterior portion of shoulder, just distal to jt space
Second hand:
Action: PT in btw pt’s arm and pt’s body, press down (towards anterior of body)
What is the purpose of scapulothoracic distraction?
to increase ROM within shoulder complex
decrease pain
periarticular ms performance
increase ST accessory motion
How do you do the ST/scapulothoracic distraction? Pt position: Arm position: First hand: Second hand: Action:
Pt position: side lying
Arm position: bent behind the back
First hand:on the ball of the shoulder jt, pushing medially and inferiorly
Second hand:fingers hooked into/under the vertebral border of the scap
Action: pull the scap away from the rib cage with the second hand
How do you do a graded physiological internal rotation glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: supine
Arm position: 90/90/ neutral
First hand: supporting elbow from underneath
Second hand: holding wrist
Action: continue to pulse/rotate the arm into IR
What does graded physiological internal rotation restore?
internal rotation
How do you do a graded physiological external rotation glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: supine
Arm position: 90/90/ neutral
First hand: supporting elbow from underneath
Second hand: holding wrist
Action: continue to pulse/rotate the arm into ER
What does graded physiological external rotation restore?
external rotation
Superior glide of Sternoclavicular jt restores what? + another name
clavicular depression (?) i think but I need confirmation \+Craniodorsal SC Glide
Inferior glide of the sternoclavicular jt restores what? + another name
clavicular elevation (?) i think but I need confirmation Caudoventral SC glide
Posterior Glide of the sternoclavicular jt restores what?
clavicular retraction (?) i think but I need confirmation
Shoulder ABD restored by?
GH inferior glide
Shoulder flexion restored by?
GH inferior glide
Shoulder extension restored by?
GH anterior glide
Shoulder IR restored by?
GH posterior glide
Shoulder ER restored by?
GH anterior glide
Shoulder Horizontal ADD restored by?
GH posterior glide
Shoulder Horizontal ABD restored by?
GH anterior glide
There is no __________ glenohumeral glide.
superior
How do you do a craniodorsal/superior clavicular glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: supine
Arm position: at side
First hand: thumb on inferior aspect of clavicle, 3 cm lateral to SC jt
Second hand: thumb on top of other thumb, also inferior aspect of clavicle, 3 cm lateral to SC jt
Action: one side at a time! glide clavicle in superior direction
Scapolothoracic mobs are more of a ________.
soft tissue stretch, not a synovial jt
How do you do a caudoventral/inferior clavicular glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: supine
Arm position: at side
First hand: thumb on inferior aspect of clavicle, 3 cm lateral to SC jt
Second hand: thumb on top of other thumb, also inferior aspect of clavicle, 3 cm lateral to SC jt
Action: one side at a time! glide clavicle in inferior direction
How do you do a posterior/dorsal clavicular glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: supine
Arm position: at side
First hand: thumb on inferior aspect of clavicle, 3 cm lateral to SC jt
Second hand: thumb on top of other thumb, also inferior aspect of clavicle, 3 cm lateral to SC jt
Action: one side at a time! glide clavicle in posterior direction
How do you do a anterior/ventral clavicular glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: supine
Arm position: at side
First hand: on sternum
Second hand: gripping the most medial part of the clavicle, just lateral to jt line
Action: glide sternum inferiorly while stabilizing the clavicle, this imparts an anterior glide to the clavicle
Anterior/ventral Glide of the sternoclavicular jt restores what?
clavicular protraction (?) i think but I need confirmation
What does a posterior/dorsal A-C glide restore?
find out
How do you do a posterior/dorsal A-C glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: sitting
Arm position: at side
First hand: fingers stabilizing scapula but thumb up and around on top of the anteriolateral surface of the clavicle
Second hand: fingers resting on anterior/superior surface of shoulder with thumb on top of other thumb
Action: first hand stabilizes scap while second hand glides clavicle in posterior direction
What does a posterior/dorsal A-C glide restore?
find out
How do you do a anterior/ventral A-C glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: sitting
Arm position: at side
Your Position: standing at pt’s back
First hand: around humeral head, fingers ant but thumb on posterior surface of shoulder/AC jt
Second hand: fingers around ant surface of clavicle, thumb on top of other thumb at post surface of shoulder/AC jt
Action: first hand stabilizes humeral head/Acromion, second (more medial) hand glides clavicle anteriorly
Another way to do the anterior/ventral A-C glide?
with pt laying prone on table
How do you do a superior scapular glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: side lying
Arm position: wrapped around a pillow in front of body
First hand:on the ball of the shoulder jt, stabilizing
Second hand: thumb and fingers in a Y around inferior scap angle
Action: second hand glides scap superiorly
How do you do a inferior scapular glide? Pt position: Arm position: First hand: Second hand: Action:
Pt position: side lying
Arm position: wrapped around a pillow in front of body
First hand: on the ball of the shoulder jt,
Second hand: thumb and fingers in a Y around inferior scap angle
Action: first hand glides the GH/AC inferiorly
How do you do a medial scapular glide?
Pt position: side lying
Arm position: wrapped around a pillow in front of body
First hand:on the ball of the shoulder jt, stabilizing
Second hand: medial/vertebral border of scap
Action: Both hands glide scap medially
How do you do a lateral scapular glide?
Pt position: Arm position: First hand: Second hand: Action:
Pt position: side lying
Arm position: wrapped around a pillow in front of body
BOTH hands: on the vertebral border of scap
Action: Both hands glide scap laterally
How do you do a up/down rotation of the scapula?
Pt position: Arm position: First hand: Second hand: Action:
this is the one that you remember from class pt side lying, one hand with fingers wrapped around vertebral border, one hand supporting pt arm, wing both up together (chicken dance)
How do you do a dorsal scapular tilt glide? Pt position: PT position: Arm position: First hand: Second hand: Action:
Pt position: prone
PT position: at pt’s side
Arm position: at side
First hand: cupping ant part of shoulder (ball of front shoulder)
Second hand: fingers dug underneath the inf angle/medial scapular border
Action: bring shoulder complex/scap up and out together (so at a superior and lateral angle…diagonally upward)
s
Pt position: PT position: Arm position: First hand: Second hand: Action:
How do you do dorsal-ventral oscillations? Pt position: PT position: Arm position: First hand: Second hand: Action:
Pt position: supine
PT position: at side
Arm position: ABD 20 or so degrees
First hand: 2 pinching fingers on clavicle and scap
Second hand: 2 pinching fingers on humeral head
Action: humeral head fingers oscillate back and forth (ventrally/dorsally)
