Glides of the Head of the Humerus

Anterior-Posterior Glide of the Head of the Humerus

Patient Position

The patient is prone, with the involved extremity over the edge of the table abducted to the desired range. A strap may be used to stabilize the scapula.

Therapist Position

The therapist is seated facing to one side, with the patient's forearm of the affected limb between the therapist's knees. Both hands grasp the patient's head of the humerus and apply anterior-posterior motion to swing the humeral head. Grades I and II are mainly used with this technique, to stimulate the activity of mechanoreceptors.

Anterior-Posterior Glide of the Head of the Humerus

Patient Position

The patient is supine, with the involved extremity supported by the table. A towel roll, pillow, or wedge is placed under the patient’s elbow to hold the arm in the POS.

Therapist Position

The therapist is facing laterally in a sitting position. The fingertips hold the head of the humerus while a gentle up-and-down movement is applied. This technique is used with grade I and II oscillations.

External Rotation of the Humerus

Patient Position

The patient is supine, with the involved extremity supported by the table. The arm is held in the POS.

Therapist Position

The therapist looks sideways, with the caudal mobilizing hand grasping the patient's distal humerus and the heel of the cephalic mobilizing hand on the lateral aspect of the humerus head. Force is applied with both hands. The caudal hand externally rotates the patient's humerus and provides a distraction along the axis, while the cephalic hand pushes the head of the humerus in a posterior direction.

External Rotation, Abduction, and Inferior Glide of the Humerus

Position

The patient is supine, with the involved extremity supported by the table. The arm is abducted in the POS.

Therapist Position

The therapist is facing laterally, with the caudal hand holding the patient’s distal humerus and the heel of the cephalad hand over the head of the humerus. The caudal hand abducts the patient’s arm and externally rotates the humerus while maintaining the POS. The cephalad hand simultaneously

pushes the head of the patient’s humerus into external rotation and slight inferior glide. The force can be oscillated or thrusted, or it can be a prolonged stretch. 

STERNOCLAVICULAR AND ACROMIOCLAVICULAR TECHNIQUES

Superior Glide of the Sternoclavicular Joint

Patient Position

The patient is supine, with the involved extremity close to the edge of the table.

Therapist Position

The therapist looks cranially. The left fingertip of the volar surface is positioned on the inferior surface of the most medial aspect of the clavicle. The right thumb strengthens the dorsal aspect of the left thumb. Both thumbs move the collarbone upward. Gradual swings are most successful with this technique.

Inferior-Posterior Glide of the Sternoclavicular Joint

Patient Position

The patient is supine, with the head supported on a pillow. The patient’s cervical spine side is bent toward and rotated away from the involved side 20 to 30.

Therapist Position

The therapist is at the head of the patient and uses thumb pad or pisiform contact on the most medial portion of the patient’s clavicle. Mobilization is performed in an inferior-posterior-lateral direction parallel to the joint line. Elevating the involved shoulder to a position of restriction and then performing mobilization of the sternoclavicular joint may assist the rotational component of clavicle motion joint.

Anterior Glide of the Acromioclavicular Joint

Patient Position

The patient is supine, at a diagonal to allow the involved acromioclavicular joint to be over the edge of the table.

Therapist Position

Mobilizing force is performed with both thumbs (dorsal surfaces together). The therapist places the distal tips of the thumbs posteriorly to the most lateral edge of the patient’s clavicle. Both thumbs push the clavicle anteriorly. Graded oscillations are mainly used with this technique.

Gapping of the Acromioclavicular Joint

Patient Position

The patient is sitting close to the edge of the table.

Therapist Position

The therapist is facing laterally, with the heel of the left hand over the spine of the patient’s scapula and the thenar eminence to the right hand over the distal clavicle. The force is applied simultaneously. Both hands push the bones in opposite directions, to obtain a general stretch to the capsular structures of the acromioclavicular joint. Oscillations or a prolonged stretch are used with this technique.

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