This is a great functional mobilization that works as a progression to your standard distraction, inferior, posterior glides to improve shoulder IR and elevation. You can't tell from the video, but it can be quite forceful as a mobilization with movement. I progress to this technique as a end of week 2/beginning of week 3 of rehab when the very restricted pt is more tolerant of manual therapy. I usually do this for 3-5 minutes of oscillations and some PNF then re-test function and/or ROM.
Pt:
- supine
- Involved UE at rest beside their body
PT
- standing above involved UE
- mob UE webspace just distal to the acromion
- may place your elbow against your iliac crest to stabilize
- forearm in line with force
- stabilize scapula and set to neutral position if anteriorly tipped or protracted
- assisting hand firmly grasping distal forearm of involved UE
Technique
- the pt slides their hand superiorly while abducting their shoulder
- PT assisting hand holds the forearm flat on the table to promote IR
- mob hand pushes and holds the humeral head inferiorly while it is actively rolling superiorly
- repeat on and off, oscillate at end range, and progress to PNF at end ranges
Indications
- limited IR and/or elevation
- shoulder impingements
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