Shoulder Mobilization: Difference between revisions

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== Scapulothoracic Mobilization &amp; Thrust Manipulation<br> ==
== Scapulothoracic Mobilization &amp; Thrust Manipulation<br> ==
 
'''Scapulothoracic mobilization-'''
Overall, there is limited but promising evidence supporting the use of cervico-thoracic&nbsp;(CT) mobilization and thrust manipulation for patients with shoulder pain.&nbsp;<ref>Walser RF, Meseve BB, Boucher TR. The Effectiveness of Thoracic Spine Manipulation for the Management of Musculoskeletal Conditions: A Systematice Review and Meta-Analysis of Randomized Controlled Trials. J Man Manip Ther. 2009; 17(4): 237-246.</ref>&nbsp;Possible mechanisms for the&nbsp;effectiveness of CT mobilization/ manipulation include:
 
'''Mobility-'''
 
*'''Thoracic spine and scapular mobility'''-&nbsp;Thoracic spine forms a key link in the kinematic sequence of arm elevation.&nbsp;Thoracic side bending and rotation are caused by unilateral humeral motions.&nbsp;Thoracic rotation and ER indicate significant coupling of these segmental movements. <ref>Crosbie J, Kilbreathe SL, Hooman L, York S. Scapulohumeral rhythm and associated spinal motion. Clin Biomechan. 2008; 23: 184-192.</ref>
*'''Postural dysfunctions'''-&nbsp;Upper crossed postural syndrome. Weak deep neck flexors coupled with weak rhomboids and lower trapezius (LT) and&nbsp;Tight pecs coupled with tight upper traps.
*'''Regional Interdependance'''-&nbsp;Unrelated impairments in a remote anatomical region may contribute to, or be associated with, the patient’s primary complaint. <ref>Wainner RS, Whitman JM, Cleland JA, Flynn TW. Regional Interdependence: A Musculoskeletal Examination Model Whose Time Has Come. J Ortho Sports Phys Ther. 2007; 37(11): 658-660.</ref><br>
 
'''Neurophysiologic-'''
 
*'''Increased scapular strength with manipulation'''- Improved LT strength following thoracic spine mobilization <ref>Liebler EJ, et al. The Effect of Thoracic Spine Mobilization on Lower Trapezius Strength Testing. J Man Manip Ther. 2001; 9(4): 207-212.</ref>and thrust manipulation. <ref>Cleland J, et al. Short-Term Effects of Thoracic Manipulation on Lower Trapezius Muscle Strength. J Man Manip Ther. 2004; 12(2): 82-90.</ref>
*'''Spinal level pain control- '''Immediate short-term reduction in numeric pain rating score (NPRS) and shoulder pain and disability index (SPADI) following cervico-thoracic spine manipulation. <ref>Boyles RE, et al. The short-term effects of thoracic spine thrust manipulation on patients with shoulder impingement syndrome. Man Ther. 2009;14(4): 375-80.</ref>
*'''Placebo effect-'''
 
<br>


'''Scapulothoracic mobilization-'''


Scapulothoracic mobilization is performed when there is&nbsp;dysfunction of the scapulothoracic articulation (e.g. restriction of upward rotation or lateral glide). Mobilizations that are commonly used include: medial/lateral glides, superior/inferior glides, upward and downward rotation, and diagonal patterns.  
Scapulothoracic mobilization is performed when there is&nbsp;dysfunction of the scapulothoracic articulation (e.g. restriction of upward rotation or lateral glide). Mobilizations that are commonly used include: medial/lateral glides, superior/inferior glides, upward and downward rotation, and diagonal patterns.  


*Patient Postition-Typically, the patient is lying side-lying with the involved side up and the arm resting on the therapist's arm. The therapist stands in front of the patient, facing them. Hand contacts for these glides are the inferior angle of the scapula and the acromion. Direction and magnitude of force are dependent upon the technique being utilized and the amount of motion that is desired.<ref>Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. 4th ed. LW&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;W, Philadephia, 2006.</ref>
*Patient Postition-Typically, the patient is lying side-lying with the involved side up and the arm resting on the therapist's arm. The therapist stands in front of the patient, facing them. Hand contacts for these glides are the inferior angle of the scapula and the acromion. Direction and magnitude of force are dependent upon the technique being utilized and the amount of motion that is desired.<ref>Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. 4th ed. LW&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;W, Philadephia, 2006.</ref>


== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==

Revision as of 05:59, 5 April 2011

Original Editor - David Drinkard.

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Posterior Glenohumeral Mobilization[edit | edit source]

[1]

Patient Position: Supine

Therapist Position: Force Hand on Proximal Humerus

Mobilization: A posteriorally directed force is directed perpendicular to the humerus

Inferior Glenohumeral Mobilization[edit | edit source]

[2]

Lateral Glenohumeral Mobilization[edit | edit source]

[3]

Inferior Glenohumeral Manipulation[edit | edit source]

 

 Lateral Glenohumeral Manipulation[edit | edit source]

 

Cervico-Thoracic Spine Joint Manipulation[edit | edit source]

Upper Thoracic Spine Spine Joint Manipulation[edit | edit source]

Thoracic Spine Joint Manipulation[edit | edit source]

Scapulothoracic Mobilization & Thrust Manipulation
[edit | edit source]

Scapulothoracic mobilization-


Scapulothoracic mobilization is performed when there is dysfunction of the scapulothoracic articulation (e.g. restriction of upward rotation or lateral glide). Mobilizations that are commonly used include: medial/lateral glides, superior/inferior glides, upward and downward rotation, and diagonal patterns.

  • Patient Postition-Typically, the patient is lying side-lying with the involved side up and the arm resting on the therapist's arm. The therapist stands in front of the patient, facing them. Hand contacts for these glides are the inferior angle of the scapula and the acromion. Direction and magnitude of force are dependent upon the technique being utilized and the amount of motion that is desired.[4]

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. ↑ Online video, available at http://www.youtube.com/watch?v=At5YYf-LtjU&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;feature=player_embedded# (last accessed 3/23/10)
  2. ↑ Online video, accessible at http://www.youtube.com/watch?v=XnynTee7kak&amp;amp;amp;amp;amp;amp;amp;amp;feature=player_embedded . Last accessed 3/23/10
  3. ↑ Online video, accessible at http://www.youtube.com/watch?v=fQh2XnYuiHs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;feature=player_embedded , last accessed 3/23/10
  4. ↑ Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. 4th ed. LW&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;W, Philadephia, 2006.
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