MS II 6 - shoulder mobs
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MS II 6 - shoulder mobs
scapular mobility testing should be done in what 6 directions?
pt should be in what pos for scap mobility testing
facing the pt,
w pillow under head,
neck in neutral alignment
PT hand placement for scapular mobility testing
one hand on upper lateral border of scap (w pt's arm hanging over yours to make sure it's out of the way "neutral")
other hand on inf border, cradling the inf angle in yr thenar webspace
scapular distraction - useful when?
when you hear clicking during passive movement testing
how to do scap distraction -- pt position
sidelying, w shoulder retracted so med border of scap is prominant, visible, available for grip
don't allow GH flexion or abd past 90 degrees
how to do scap distraction -- PT position
body/sternum is on acromion for stabilization to prevent glide of scapula on thorax
hands on med border of scap
lift scap away from wall
when is inferior glide also longitudinal distraction?
when arm is in resting position
inferior glide/longitudinal of GH tests for what? what does it treat?
tests for inferior capsule mobility
can be used to treat pain w rhythmic ossilations
pt pos for inf glide/longitudinal
supine w shoulder in resting pos (50 abd, 30 horiz add)
PT pos for inf glide/longitudinal of GH
standing by pt's torso, so you'll be pulling, not pushing (you push in the inf glide/caudal maneuver)
: right in the armpit, border of hand on the scap, thumb on the coracoid
: distal aspect of humerus prox to elbow
pull (getting soft tissue out of the way)
inf glide/caudal of GH - what's it for?
helps facilitate abd when abd is limited under 90 degrees
pt pos for inf glide/caudal GH
supine w shoulder abd to limits of pathological range
PT pos for inf glide/caudal GH jt
standing by pt's head, so you'll be pressing, not pulling
: support distal elbow
: just lat to acromion, apply inf glide w heel of hand or thenar webspace
GH post/dorsal glide - tests for what? can facilitate what?
: post capsule mobility
: (flexion), IR
pt pos for post/dorsal GH glide
supine w stabilizing towel under acromion
arm in resting pos
PT pos for post/dorsal GH glide
: supporting distal humerus, helping it move w prox hum (DON'T allow GH flexion)
: just lat/distal to acromion jt line, using heel or thenar websapce to push down
ant/ventral GH glide tests for what? treats what?
: ant capsule mobility
: (extension), ER
pt pos for ant/ventral GH glide
prone w stabilizing towel under clavicle
arm in resting pos
(can do in supine if pt can't tolerate prone)
PT pos for ant/ventral GH glide
: distal ant hum to help guide hum and prevent extension
: right up in axilla, just distal to the joint, pressing down w heel of hand or thenar webspace
lat glide at GH jt tests what? treats what?
: lateral glide of capsule
: it creates lateral traction force and a separation of hum from glenoid fossa (to promote overall mobility?)
pt pos for GH lat glide
stabilizing towel behind scap
arm in resting pos
can also be done w GH flexion to 90 or to pathological limit
PT pos for lat glide of GH jt
standing btwn pt and pt's arm
: distal hum, lateral - can apply some counter pressure so arm doesn't abduct
: right up in axilla, palm pressing laterally
inf, post, and ant glides at sternoclavicular jt (SC jt)-- pt & PT pos
: supine for inf, post, ant
PT for inf and post
: stand to pt's side
PT for ant
: stand sup to pt, by pt's head
PT for SC glides inf
standing beside pt
thumb on sup surface of clavicle by the sternum, avoiding stress on the airway
monitor joint w one finger
have elbow in line w force
SC glide sup - for whom? facilitates what?
only done for the pt w jacked up shoulders
PT for SC glides sup
stand beside pt
thumb on inf surface of clavicle
pres sup and slightly med
PT for SC glides post
pt beside pt
thumb on ant clavicle, gently pressing post
PT for SC glides ant
use medial surface of index to hook onto sup surface of clavicle and lift ant
inf glide at SC joint increases....?
sup glide at SC joint increases....?
A-P glide at SC joint increases....?
P-A glide at SC joint increases....?
SC joint - for elev/depress the action is __ on __
for pro/retraction it's __ on__
convex on concave
concave on convex
keep this in mind when comparing osteo and arthro kinematics -- for elev/dep they're opposite, for pro/retraction they go in same dir
inf glide w IR or ER
arm abd to 90, elbow bent, forearm positioned for IR or ER
: on elbow
: on shoulder just past joint
GH thumb techniques inferior glide
for grade I
: pt supine, arm in resting pos supported on a pillow
thumbs on greater tuberosity, gently ossilation
GH thumb techniques ant glide, grade I
supine, resting pos, on a pillow
thumbs on posterior or greater tuberosity
lift humerus toward ceiling and release to create a grade I ossilation
Gh jt post glide w 90 degrees shoulder flexion-- pt pos?
supine, shoulder at 90, hand on opposite shoulder
Gh jt post glide w 90 degrees shoulder flexion-- PT pos?
: posterior scapula
: pressing post on the pt's elbow
GH jt lat glide at 90 degrees flex, pt and PT positions
: supine, flexed elbow, hand by opp shoulder
: mobilizing hand by joint line on prox hum, body/sternum or hand resisting/supporting on distal hum
GH jt inf glide at end of range of abd and flexion -- pt and PT pos
: supine w arm raised
: supports pt's arm between her body & arm (held by elbow) at the end of PROM... hands on prox sup humerus, pressing caudally
which movements may and mayn't you do at AC joint?
ant/post - fine
sup/inf - NO!
pt pos for AC joint mobs
supine, seated, or sidelying
PT pos for AC mobs in supine
: holding post and ant acromion btwn thumb and index (looks like hand over shoulder) - this hand must keep the shoulder unmoving so you know the motion is just clavicle
: thumb right next to stablizing thumb, pressing post, or for ant motion, on post clavical pressing ant - can push w index knuckle if it's too tight for the thumb
to find the AC joint, follow the bones looking for a sulcus
PT pos for AC mobs in sidelying
: hold the ant & post acromion
: index and thumb holding the clavicle, now you can guide it forwards and back
AC joint is __ on __
convex on convex