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Shoulder Mobilizations

Anterior-Posterior GH Mobilization
(High Grade)
Position pt. supine with humerus to be mobilized at the
edge of the table
PT to stabilize the pt.s distal extremity, while placing
other hand over the anterior proximal humerus
PT then provides a force in an A-P direction, starting with
grade 1 and working up to grade 4 as pt. tolerates
Parameters: 8-10 reps (at each grade) hold each mob
for 3 seconds
Note: The pt.s arm should be abducted to the barrier in
motion OR to the pt.s first point of pain, but then backed
off until pain free (if taken to the point of pain, the force
generated by the PT should be less then if no pain
present)
Anterior-Posterior GH
Mobilization
A-P GH Mobilization (Low
Grade)
Position pt. supine with humerus to be
mobilized at the edge of the table, pt.s forearm
and hand resting on their stomach
PT will use both hands (fingertips on anterior
humeral head and thumbs on posterior humeral
head)
PT then provides a force in an A-P direction,
starting with grade 1 and working up to grade 3
as pt. tolerates
Parameters: 8-10 reps (at each grade) hold
each mob for 3 seconds
A-P GH mobilization (Low
Grade)
AC A-P Mobilization
Pt. lies supine with side to be mobilized towards
the edge of the table
PT places one hand under the shoulder, over the
scapula to stabilize it The pisiform of the other
hand is placed directly over the distal end of the
clavicle at the AC jt., perpendicular to the table so
the force is directed straight down
PT then provides a force in an A-P direction,
starting with grade 1 and working up to grade 4
as pt. tolerates
Parameters: 8-10 reps (at each grade) hold each
mob for 3 seconds
AC A-P Mobilization
AC Inferior Mobilization
Pt. positioned supine with arms at the side
PT sits at the head of the pt. with both
thumbs positioned over the superior
surface of the distal clavicle, adjacent to
the AC Jt.
PT then provides a force in an superior to
inferior direction, starting with grade 1 and
working up to grade 4 as pt. tolerates
Parameters: 8-10 reps (at each grade)
hold each mob for 3 seconds
AC Inferior Mobilization
Inferior GH Glide in
Abduction
Pt. lies supine with side to be mobilized towards the edge of the
table, arm abducted off the side of the table
Pt.s neck is laterally flexed toward the side receiving the mob (to
slacken the nerves)
PT stands in lunge position superiorly to the pt.s shoulder: one
hand grasps around pt.s elbow (holding it in slight flexion), the web
space of the other hand is around the proximal humerus
PT then provides a force to the proximal humerus in an inferior
direction, while simultaneously abducting further starting with
grade 1 and working up to grade 4 as pt. tolerates
Parameters: 8-10 reps (at each grade) hold each mob for 3
seconds
Note: The pt.s arm should be abducted to the barrier in motion OR
to the pt.s first point of pain, but then backed off until pain free (if
taken to the point of pain, the force generated by the PT should
cause no more than minor discomfort)
Inferior GH Glide in
Abduction
Inferior GH Glide in Flexion
Pt. lies supine with side to be mobilized towards the edge of the
table
PT stands in lunge position superiorly to the pt.s shoulder: one
hand grasps around pt.s distal humerus (holding the elbow in
90 degrees flexion), the web space of the other hand is around
the proximal humerus
PT then provides a force to the proximal humerus in an inferior
direction, while simultaneously flexing further starting with
grade 1 and working up to grade 4 as pt. tolerates
Parameters: 8-10 reps (at each grade) hold each mob for 3
seconds
Note: The pt.s arm should be flexed to the barrier in motion OR
to the pt.s first point of pain, but then backed off until pain free
(if taken to the point of pain, the force generated by the PT
should cause no more than minor discomfort)
Inferior GH Glide in Flexion
Clavicle Rotation
Pt. positioned supine with arms at the side
Stand near the pt.s shoulder, facing towards the
clavicle
Gently grip the middle of the clavicle using your
thumbs on the inferior surface and fingertips on
the superior surface
Apply a gentile mobilization force using a rocking
or wiggling motion through repetitive wrist
flexion and extension to impart rotation of the
clavicle on its long axis
Parameters: 8-10 reps each grade (up to grade 3)
Clavicle Rotation
FABER P-A mobilization
Pt. starts prone with arm to be mobilized flexed, abducted,
and ER (Forehead resting on the dorsum of the hand)
PT stands by the head of the pt. on the side to be mobilized.
PT places the thumbs and web spaces of both hands on the
posterior proximal humerus, fingers are wrapped around the
anterior surface
PT then provides a P-A force starting with grade 1 and
working up to grade 4 as pt. tolerates
Parameters: 8-10 reps (at each grade) hold each mob for 3
seconds
Note: The pt.s arm should be flexed/Abd to the barrier in
motion OR to the pt.s first point of pain, but then backed off
until pain free (if taken to the point of pain, the force
generated by the PT should cause no more than minor
discomfort)
FABER P-A mobilization
GH External Rotation
Pt. lies supine with side to be mobilized towards the edge of
the table, arm is abducted up to 90 degrees (as pt. can
tolerate) and elbow is flexed to 90 degrees
PT stands facing the pt.s head and stabilizes the pt.s elbow
with one hand, while grasping the wrist with the other (grasp
bony prominences at the elbow and wrist)
PT slowly externally rotates the pt.s shoulder until pt.
discomfort or tissue resistance is met; hold for 3-5 seconds
and then back off.
Repeat up to 30x, and try to move the shoulder a little
further each time as the tissues relax.

* Note: Encourage the pt. to completely relax as much as


possible!
GH External Rotation
GH Internal Rotation
Pt. lies supine with side to be mobilized towards the edge of the
table, arm is abducted up to 90 degrees (as pt. can tolerate)
and elbow is flexed to 90 degrees
PT stands facing the pt.s feet and stabilizes the pt.s elbow with
one hand, while grasping the wrist with the other (grasp bony
prominences at the elbow and wrist)
Note: May have to stabilize the pt.s shoulder girdle instead of holding
at elbow if compensation occurs
PT slowly internally rotates the pt.s shoulder until pt. discomfort
or tissue resistance is met; hold for 3-5 seconds and then back
off.
Repeat up to 30x, and try to move the shoulder a little further
each time as the tissues relax.

* Note: Encourage the pt. to completely relax as much as


possible!
GH Internal Rotation
GH Horizontal Adduction
Pt. lies supine on the table with the uninvolved side toward the edge
of the table; Pt.s involved arm is place in 80-90 degrees of shoulder
flexion and 90 degrees of elbow flexion
PT stands on pt.s uninvolved side, facing the pt. PT grasps the pt.s
involved side at the posterior/medial elbow, and uses the heel of the
other hand to stabilize the pt.s scapula
The technique involves first stabilizing the scapula and then
horizontally adduct the shoulder until the barrier is felt. Once the
barrier is felt, PT then provides a posterior force starting with grade 1
and working up to grade 4 as pt. tolerates. As motion is gained,
horizontally adduct the shoulder further until a new barrier is felt
Parameters: 8-10 reps (at each grade) hold each mob for 3 seconds

* Note: Be careful not to flex the pt.s shoulder past 90 degrees to


avoid creating an impingement at the shoulder
GH Horizontal Adduction
GH Longitudinal Distraction
Pt. lies supine with the shoulder to receive
treatment at the edge of the treatment table
PT stands on the side to receive treatment, facing
towards the pt.s head. Stabilize the pt.s forearm
against the PTs side. PTs medial arm cups the
middle to proximal humerus and lateral arm cups
laterally around the humeral head.
The PT gently distracts the humerus by pulling
toward their body, imparting an oscillatory force
(30-50x) once distracted.
*Note: Make sure the PT moves his whole body to
provide the distraction force, do not just pull with
arms
GH Longitudinal Distraction
P-A GH Mobilization
Pt. lies prone with arm to be mobilized toward the edge
of the table in 90 degrees of abduction (off the table),
elbow flexed with some glenohumeral internal rotation.
PT grasps the pt.s distal humerus, allowing forearm to
hang down toward the ground. Heel of proximal hand is
placed against the posterior humeral head with elbow
locked.
PT then provides a P-A force by moving their body/trunk
down through their locked out elbow, starting with
grade 1 and working up to grade 4 as pt. tolerates
Parameters: 8-10 reps (at each grade) hold each mob
for 3 seconds
P-A GH Mobilization
Scapular Elevation-
Depression
Pt. is sidelying (facing the PT) with shoulder and elbow
flexed and forearm resting on clinicians forearm
PT: Lower hand is placed around the inferior angle of
the scapula with the thumb and forefinger along lateral
and medial scapula borders. Upper hand grasps the
spine of the scapula, cupping the heel of the hand
anteriorly over the clavicle
PT mobilizes scapula superior and inferior by using
trunk to provide the key force through the arms. PT
starts with grade 1 and works up to grade 4 as pt.
tolerates
Parameters: 8-10 reps (at each grade) hold each mob
for 3 seconds
*Note: Pt. must completely relax scapula musculature.
Scapular Elevation-
Depression
Scapular Protraction -
Retraction
Pt. is sidelying (facing the PT) with shoulder and elbow
flexed and forearm resting on clinicians forearm
PT: Lower hand is placed around the inferior angle of the
scapula with the thumb and forefinger along lateral and
medial scapula borders. Upper hand grasps the spine of
the scapula, cupping the heel of the hand anteriorly
over the clavicle
PT mobilizes scapula medially and laterally by using
trunk to provide the key force through the arms. PT
starts with grade 1 and works up to grade 4 as pt.
tolerates
Parameters: 8-10 reps (at each grade) hold each mob
for 3 seconds
*Note: Pt. must completely relax scapula musculature.
Scapular Protraction -
Retraction
Translational Glenohumeral
Mobilization
Pt. lies supine with the arm to be mobilized toward the
edge of the table with the arm abducted to 90 degrees
PT stands to the side that will be mobilized and
supports the pt.s forearm against their side. Both
hands grasp the glenohumeral joint at the site of
articulation with the thumbs on the superior-anterior
surface, and the fingers wrapped around the posterior-
inferior aspect of the joint.
A short lever-arm translational glide is imparted to the
glenohumeral joint in anterior, posterior, superior, and
inferior directions.
*Note: You may add a distraction force to produce more
tension through the glenohumeral joint capsule
Translational Glenohumeral
Mobilization