shoulder Flashcards
anterior glide - purpose & precautions
PURPOSE: increase extension, pain management
PRECAUTIONS: anterior joint capsule is loose & more lax, so don’t over mobilize
anterior glide - hand placement
-stabilizing hand: scapula and clavicle are resting on a firmly rolled towel for support, stabilize distal arm under distal humerus
-mobilizing hand: the head of the humerus in the anterior direction
anterior glide - helpful suggestions
keep patient’s elbow flexed and relaxed to not pull on the biceps tendon
long axis traction - purpose & precautions
PURPOSE: increase overall ROM, pain management
PRECAUTIONS: do not allow the shoulder girdle to move inferiorly as it may compress the brachial plexus between the clavicle & first rib
long axis traction - hand placement
-stabilizing Hand: start with the shoulder girdle in an inferior position, place proximal hand on coracoid process and on the AC joint
-mobilizing Hand: grasp the distal humerus proximal to the epicondyles and distract inferiorly through the long axis of the humerus
long axis traction - helpful suggestions
keep patient’s elbow flexed, therapist rotates body to facilitate pulling humerus
posterior glide - purpose & precautions
PURPOSE: increase internal rotation & flexion, pain management
PRECAUTIONS: do not allow the humerus to externally rotate
posterior glide - hand placement
-stabilizing Hand: spine of scapula on scapula and block arm with hip to prevent external rotation of the humerus
-mobilizing Hand: head of the humerus is moved posteriorly and slightly lateral
posterior glide - helpful suggestions
therapists thumbs are parallel to the joint line and help guide mobilization
inferior glide at 90º ABD - purpose & precautions
PURPOSE: increase ABD & flexion, pain management
PRECAUTIONS: with inferior joint instability use caution, may provoke pain
inferior glide at 90º ABD - hand placement
-stabilizing Hand: proximal to medial epicondyle of humerus, gentle grasp
-mobilizing Hand: gently pull the humerus first then mobilize the head of the humerus inferiorly
inferior glide at 90º ABD - helpful suggestions
depress the shoulder girdle first as this stabilizes the scapulothoracic joint
inferior glide at 90º flexion - purpose & precautions
PURPOSE: increase flexion & ABD, pain management
PRECAUTIONS: do not lever the joint as this may damage the capsule. Take caution for inferior joint instability. Try to minimize pain at the humeral head while mobilizing
inferior glide at 90º flexion - hand placement
-stabilizing Hand: distal humerus on therapists shoulder
-mobilizing Hand: head of the humerus in the inferior direction
inferior glide at 90º flexion - helpful suggestions
make sure mobilizing hand is distal to the acromion
lateral distraction - purpose & precautions
PURPOSE: increase overall ROM, pain management
PRECAUTIONS: do not apply pressure to patient’s chest with forearms, may compress the ribs, your forearm should be just below the breast tissue
lateral distraction - hand placement
-stabilizing Hand: distal humerus at lateral supracondylar crest
-mobilizing Hand: grasp proximal humerus in the axilla and mobilize laterally
superior glide / shoulder elevation - purpose & precautions
PURPOSE: increase shoulder elevation & stability, pain management
PRECAUTIONS: soft touch and light pressure to prevent muscle guarding
superior glide / shoulder elevation - hand placement
-superior hand: on acromion and upper trapezius
-inferior Hand: the inferior angle of the scapula is between your thumb and index finger - mobilize the scapula superiorly between your hands using both hands
superior glide / shoulder elevation
use your body weight to mobilize superiorly rather than arm strength
inferior glide / shoulder depression - purpose & precautions
PURPOSE: increase shoulder depression & mobility, pain management
PRECAUTIONS: If brachial plexus is stretched or compressed, it may cause symptoms during this mobilization, discontinue - perform with care
inferior glide / shoulder depression - hand placement
-superior Hand: on acromion and upper trapezius
-inferior Hand: the inferior angle of the scapula is between your thumb and index finger - mobilize the scapula inferiorly between your hands, using both hands
inferior glide / shoulder depression - helpful suggestions
use your body weight to mobilize superiorly rather than arm strength
lateral rotation (upward) - purpose & precautions
PURPOSE: increase lateral rotation & elevation, pain management
PRECAUTIONS: use a broad and soft contact for numerous bony prominences
lateral rotation (upward) - hand placement
-superior Hand: acromion process and supraspinous fossa
-inferior Hand: inferior angle of the scapula -
mobilize the scapula in a superior lateral (rotational) direction by the inferior angle, while the opposing hand directs the mobilization superiorly and medially
lateral rotation (upward) - helpful suggestions
use a soft touch and light pressure to prevent muscle guarding
medial rotation (downward) - purpose & precautions
PURPOSE: increase medial rotation & depression
PRECAUTIONS: use a broad and soft contact for numerous bony prominences
medial rotation (downward) - hand placement
-superior Hand: acromion process and the deltoids
-inferior Hand: inferior angle between thumb and index finger - mobilize the scapula by pulling the inferior angle of the scapula medially with the inferior hand, the superior hand pulls downward and laterally
medial rotation (downward) - helpful suggestions
use a soft touch and light pressure to prevent muscle guarding
distraction (scapulothoracic) - purpose & precautions
PURPOSE: increase overall mobility, pain management
PRECAUTIONS: Do not perform if patient has winged scapula - too much pressure may cause muscle guarding and pain
distraction (scapulothoracic) - hand placement
retract the scapula with your fingers, lift off the thoracic cage
distraction (scapulothoracic) - helpful suggestions
stand on opposite side of scapula being mobilized
compression to subscapularis - purpose & precautions
PURPOSE: increase scapulothoracic mobility, pain management
PRECAUTIONS: If painful, discontinue
compression to subscapularis - hand placement
-superior Hand: on the scapula
Inferior Hand: grasping just proximal to the elbow
-apply pressure to the scapula while pulling on the humerus. Repeat 5-10 times
compression to subscapularis - helpful suggestions
try to create a gentle rhythm between both hands to prevent muscle guarding
