MS II 6 - shoulder mobs

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Author:
shmvii
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203923
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MS II 6 - shoulder mobs
Updated:
2013-02-27 22:06:29
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MS II
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MS II
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  1. scapular mobility testing should be done in what 6 directions?
    • elevation/depression
    • protraction/retraction
    • up/down rotation
  2. pt should be in what pos for scap mobility testing
    • sidelying,
    • facing the pt,
    • w pillow under head,
    • neck in neutral alignment
  3. 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
  4. scapular distraction - useful when?
    when you hear clicking during passive movement testing
  5. 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
  6. 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
  7. when is inferior glide also longitudinal distraction?
    when arm is in resting position
  8. 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
  9. pt pos for inf glide/longitudinal
    supine w shoulder in resting pos (50 abd, 30 horiz add)
  10. 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)
    • stabilizing hand: right in the armpit, border of hand on the scap, thumb on the coracoid
    • mobilizing hand: distal aspect of humerus prox to elbow

    pull (getting soft tissue out of the way)
  11. inf glide/caudal of GH - what's it for?
    helps facilitate abd when abd is limited under 90 degrees
  12. pt pos for inf glide/caudal GH
    supine w shoulder abd to limits of pathological range
  13. PT pos for inf glide/caudal GH jt
    • standing by pt's head, so you'll be pressing, not pulling
    • stabilizing hand: support distal elbow
    • mobilizing hand: just lat to acromion, apply inf glide w heel of hand or thenar webspace
  14. GH post/dorsal glide - tests for what? can facilitate what?
    • tests for: post capsule mobility
    • can facilitate: (flexion), IR
  15. pt pos for post/dorsal GH glide
    • supine w stabilizing towel under acromion
    • arm in resting pos
  16. PT pos for post/dorsal GH glide
    • stabilizing hand: supporting distal humerus, helping it move w prox hum  (DON'T allow GH flexion)
    • moving hand: just lat/distal to acromion jt line, using heel or thenar websapce to push down
  17. ant/ventral GH glide tests for what? treats what?
    • tests for: ant capsule mobility
    • facilitates: (extension), ER
  18. 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)
  19. PT pos for ant/ventral GH glide
    • stabilizing hand: distal ant hum to help guide hum and prevent extension
    • moving hand: right up in axilla, just distal to the joint, pressing down w heel of hand or thenar webspace
  20. lat glide at GH jt tests what? treats what?
    • tests for: lateral glide of capsule
    • treats: it creates lateral traction force and a separation of hum from glenoid fossa (to promote overall mobility?)
  21. pt pos for GH lat glide
    • supine
    • stabilizing towel behind scap
    • arm in resting pos

    can also be done w GH flexion to 90 or to pathological limit
  22. PT pos for lat glide of GH jt
    • standing btwn pt and pt's arm
    • stabilizing hand: distal hum, lateral - can apply some counter pressure so arm doesn't abduct
    • moving hand: right up in axilla, palm pressing laterally
  23. inf, post, and ant glides at sternoclavicular jt (SC jt)-- pt & PT pos
    • pt: 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
  24. 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
    • press inferolaterally 
    • have elbow in line w force
  25. SC glide sup - for whom? facilitates what?
    • only done for the pt w jacked up shoulders
    • facilitates depression
  26. PT for SC glides sup
    • stand beside pt
    • thumb on inf surface of clavicle
    • pres sup and slightly med
  27. PT for SC glides post
    • pt beside pt
    • thumb on ant clavicle, gently pressing post
  28. PT for SC glides ant
    use medial surface of index to hook onto sup surface of clavicle and lift ant
  29. inf glide at SC joint increases....?
    elevation
  30. sup glide at SC joint increases....?
    depression
  31. A-P glide at SC joint increases....?
    retraction
  32. P-A glide at SC joint increases....?
    protraction
  33. 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
  34. inf glide w IR or ER
    • arm abd to 90, elbow bent, forearm positioned for IR or ER
    • stabilizing hand: on elbow
    • mobilizing hand: on shoulder just past joint
  35. GH thumb techniques inferior glide
    • for grade I: pt supine, arm in resting pos supported on a pillow
    • thumbs on greater tuberosity, gently ossilation
  36. 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
  37. Gh jt post glide w 90 degrees shoulder flexion-- pt pos?
    supine, shoulder at 90, hand on opposite shoulder
  38. Gh jt post glide w 90 degrees shoulder flexion-- PT pos?
    • stabilizing hand: posterior scapula
    • mobilizin hand: pressing post on the pt's elbow
  39. GH jt lat glide at 90 degrees flex, pt and PT positions
    • pt: supine, flexed elbow, hand by opp shoulder
    • PT: mobilizing hand by joint line on prox hum, body/sternum or hand resisting/supporting on distal hum
  40. GH jt inf glide at end of range of abd and flexion -- pt and PT pos
    • pt: supine w arm raised
    • PT: supports pt's arm between her body & arm (held by elbow) at the end of PROM... hands on prox sup humerus, pressing caudally
  41. which movements may and mayn't you do at AC joint?
    • ant/post - fine
    • sup/inf - NO!
  42. pt pos for AC joint mobs
    supine, seated, or sidelying
  43. PT pos for AC mobs in supine
    • stabilizing hand: 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
    • mobilizing hand: 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
  44. PT pos for AC mobs in sidelying
    • stabilizing hand: hold the ant & post acromion
    • mobilizing hand: index and thumb holding the clavicle, now you can guide it forwards and back
  45. AC joint is __ on __
    convex on convex

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