Scapular Assistance TestScapular Assistance Test• Intra-rater Intra-rater

reliabilityreliability

.76 - scapular elev.76 - scapular elev

.84 – flexion.84 – flexion

• Limitation –Limitation –

Non-specific w/ Non-specific w/ dx./shoulder pathologydx./shoulder pathology

EXTERNAL ROTATIONEXTERNAL ROTATIONPUSH

TECHNIQUE POSITION - SIDE -

Scapula retracted HAND POSITION- R

PALM ON CORACOID/ (L) PALM ON MEDIAL SCAPULAR BORDER

FORCE - ( R ) HAND APPLIES POSTERO-MEDIAL FORCE

ALTERNATE : ( R ) HAND ON AXILLARY BORDER

PULL TECHNIQUEPULL TECHNIQUE POSITION - SIDE/

PRONE Scapula retracted

HAND POSITION- (R ) fingers ON CORACOID/ (L) PALM ON MEDIAL SCAPULAR BORDER

FORCE - ( R ) HAND APPLIES POSTERO-MEDIAL FORCE

ALTERNATE : ( R ) HAND ON AXILLARY BORDER

POSTERIOR TILTPOSTERIOR TILTPUSH

TECHNIQUE POSITION - SIDE OR

UPRIGHT - Scapula retracted

HAND POSITION- ®PALM ON CORACOID/ (L) PALM ON INFERIOR ½ OF SCAPULA

FORCE - ( R ) HAND APPLIES SUPERO-POSTERIOR FORCE

Stand @ head of patient

PULL TECHNIQUEPULL TECHNIQUE POSITION - SIDE/

PRONE/UPRIGHT -Scapula retracted

HAND POSITION- ®HAND GRIPS SUPERIOR BORDER /(L) PALM ON INFERIOR ½ OF SCAPULA

FORCE - ( R ) HAND PULLS INTO POSTERO-INFERIOR DIRECTION

UPWARD ROTATION UPWARD ROTATION TECHNIQUE POSITION - SIDE OR

PRONE - Scapula retracted

HAND POSITION- ( L ) WEB SPACE CUPS SUPERIOR ANGLE/ (R) WEB SPACE CUPPING INFERIOR ANGLE

FORCE - COUNTEROTATION

COMBINED- UR/ POST TILTCOMBINED- UR/ POST TILT

SCAPULAR ASSISTANCE TESTHAND POSITION- (L) HAND GRIPS

SUPERIOR BORDER / R WEB SPACE CUPS INFERIOR ANGLE

FORCE - ( L ) HAND PULLS INTO POSTERO-INFERIOR DIRECTION

( R ) HAND - PROMOTES UPWARD ROTATION

G-H MOBILIZATIONSG-H MOBILIZATIONS

POSTERIORPOSTERIOR

Scapular PlaneScapular Plane

Horizontal AdductionHorizontal Adduction

INFERIORINFERIOR

Scaption (90-120˚) Scaption (90-120˚)

G-H MOBILIZATIONSG-H MOBILIZATIONS

ANTERIORANTERIOR

ExtensionExtension

Horizontal AbductionHorizontal Abduction

LATERALLATERAL

“ “Fulcrum” TechniqueFulcrum” Technique

MANUAL TECHNIQUES FOR MANUAL TECHNIQUES FOR THE HYPOMOBILE SHOULDERTHE HYPOMOBILE SHOULDER

INCORPORATION OFINCORPORATION OF : :

SOFT TISSUE RELEASESOFT TISSUE RELEASE (MUSCLE-CAPSULE)(MUSCLE-CAPSULE) VIA CONTRACTION OFVIA CONTRACTION OF

ANTAGONISTANTAGONIST AGONISTAGONIST

ACTIVE MOVEMENTACTIVE MOVEMENT

STRETCHSTRETCH

PRINCIPLES OF RXPRINCIPLES OF RX

IDENTIFY RESTRICTED TISSUEIDENTIFY RESTRICTED TISSUE

APPLY MANUAL PRESSUREAPPLY MANUAL PRESSURE

MAINTAIN PRESSURE - ADDMAINTAIN PRESSURE - ADD

REPEATED CONTRACTIONSREPEATED CONTRACTIONS

STRETCH INTO RESTRICTED STRETCH INTO RESTRICTED RANGERANGE

ANTERIOR-SUPERIOR ANTERIOR-SUPERIOR CAPSULECAPSULE

MOTION AFFECTEDMOTION AFFECTED

ER ( IN 0-45˚ OF ABD)ER ( IN 0-45˚ OF ABD)

MANUAL PRESSURE TO:MANUAL PRESSURE TO:

SUPRASPINATUSSUPRASPINATUS

TECHNIQUETECHNIQUE

SUPINESUPINE

RESISTED ER/IRRESISTED ER/IR

ANTERIOR CAPSULEANTERIOR CAPSULE MOTION AFFECTEDMOTION AFFECTED ER ( IN 45˚-90˚ OF ER ( IN 45˚-90˚ OF

ABD)ABD)

MANUAL PRESSURE:MANUAL PRESSURE: SUBSCAPULARISSUBSCAPULARIS TECHNIQUETECHNIQUE SUPINESUPINE RESISTED ER/IRRESISTED ER/IR

POSTERIOR CAPSULEPOSTERIOR CAPSULE

MOTION AFFECTEDMOTION AFFECTED IR ( IN 90˚ OF ABD)IR ( IN 90˚ OF ABD)

MANUAL PRESSURE:MANUAL PRESSURE: TERES MINORTERES MINOR INFRASPINATUSINFRASPINATUS

TECHNIQUETECHNIQUE SEATED /SUPINESEATED /SUPINE RESISTED ER/IRRESISTED ER/IR

POSTERIOR-INFERIOR POSTERIOR-INFERIOR CAPSULECAPSULE

MOTION AFFECTEDMOTION AFFECTED

Horizontal AbductionHorizontal Abduction

MUSCLES AFFECTEDMUSCLES AFFECTED

TERES MINORTERES MINOR

INFRASPINATUSINFRASPINATUS

TECHNIQUETECHNIQUE

SidelyingSidelying

RESISTED HORIZ. ADDRESISTED HORIZ. ADD

((ROWING MOTIONROWING MOTION))

POSTERIOR-INFERIOR POSTERIOR-INFERIOR CAPSULECAPSULE

MOTION AFFECTEDMOTION AFFECTED ELEVATION (FLEX)ELEVATION (FLEX) Horiz add.Horiz add.

MANUAL PRESSURE:MANUAL PRESSURE: TERES MAJORTERES MAJOR LATISSIMUS DORSILATISSIMUS DORSI

TECHNIQUETECHNIQUE SUPINESUPINE RESISTED FLEX/EXT RESISTED FLEX/EXT