abduction, anterior glide, external rotation, GH joint, glenohumeral, inferior glide, internal rotation, mobility, mobilization, ortho, physical therapy, posterior glide, ROM, shoulder

Distraction

Purpose

A mobilization technique used to increase shoulder (GH) mobility.

Technique

Patient is positioned supine.

Clinician makes sure patient is close to the edge of the table with the GH joint being mobilized is off the table.

Clinician places a towel (or other support system) under the scapula on the side being mobilized.

Clinician stands in staggered stance facing up toward the patient’s head.

Clinician begins by putting the patient’s shoulder in 55 of abduction and 35 of horizontal adduction (the open packed position of the GH joint).

Clinician puts his cranial hand in the patient’s axilla gripping the arm just distal to the joint space and his caudal hand grabs around the elbow to support the arm resting it against his body.

Clinician distracts the arm with his caudal hand and then applies a distraction force through his cranial hand to separate the humerus from the glenoid fossa.

Posterior Glide

Purpose

A mobilization technique used to increase internal rotation of the shoulder.

Technique

Patient is positioned supine.

Clinician makes sure patient is close to the edge of the table with the GH joint being mobilized is off the table.

Clinician places a towel (or other support system) under the scapula on the side being mobilized.

Clinician stands in staggered stance facing up toward the patient’s head.

Clinician begins by putting the patient’s shoulder in 55 of abduction and 35 of horizontal adduction (the open packed position of the GH joint).

Clinician puts his cranial hand in the patient’s axilla gripping the arm just distal to the joint space and his caudal hand grabs around the elbow to support the arm resting it against his body.

Clinician distracts the arm with his caudal hand and then applies a distraction force through his cranial hand to separate the humerus from the glenoid fossa.

Clinician’s cranial hand palpates the edge of the acromion and the Clinical places the lateral side of his hand on the humerus.

Clinician takes up the slack and performs a posterior glide with his cranial hand.

Inferior Glide

Purpose

A mobilization technique used to increase abduction of the shoulder.

Technique

Patient is positioned supine.

Clinician makes sure patient is close to the edge of the table with the GH joint being mobilized is off the table.

Clinician places a towel (or other support system) under the scapula on the side being mobilized.

Clinician stands in staggered stance facing toward the patient’s feet.

Clinician begins by putting the patient’s shoulder in 55 of abduction and 35 of horizontal adduction (the open packed position of the GH joint).

Clinician’s caudal hand is in the patient’s axilla gripping the arm just distal to the joint cradling the patient’s arm against his body.

Clinician’s cranial hand grips up over the superior side of the humerus.

Clinician distracts the joint to take out the slack then performs an inferior glide.

Anterior Glide

Purpose

A mobilization technique used to increase external rotation of the shoulder.

Technique

Patient is positioned in prone.

Clinician makes sure patient is close to the edge of the table with the GH joint and humerus being mobilized is off the table.

Clinician places a towel roll (or other support structure) under the coracoid process on the side being mobilized.

Clinician stands in staggered stance facing up toward the patient’s head.

Clinician begins by putting the patient’s shoulder in 55 of abduction and 35 of horizontal adduction (the open packed position of the GH joint).

Clinician puts his cranial hand in the patient’s axilla gripping the patient’s arm just distal to the joint space and his caudal hand grips superior to the elbow.

Clinician distracts the arm and then places his thigh in the axilla to hold the distraction force.
Clinician’s cranial hand palpates the acromion and he places the lateral side of his cranial hand on the lateral side of the acromion.

Clinician takes up the slack and carefully does an anterior glide making sure to keep both of his elbows extended so both arms go down together during the glide.

References

1. Kaltenborn, F.M. (2007). Manual mobilization of the joints: The extremities volume I (6th ed.). Minneapolis, MN: OPTP.

Related videos:

1. Glenohumeral Distraction
2. Shoulder – Anterior Glide
3. Shoulder – Posterior Glide
4. Radiohumeral Mobilization
5. Proximal Radioulnar Joint Mobilization