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7 Stages of Spencer Technique: Articulatory Technique of the Shoulder

Spencer Techniques:

  • Useful in diagnosis and treating musculoskeletal dysfunction including restriction and pain in the shoulder
  • Diagnoses:
  • Bursitis
  • Tendinitis
  • Tenosynovitis
  • Fibrous adhesive capsulitis
  • Used to evaluate ROMs of shoulder:
  • Degree of motion before pain
  • Total permitted ROM

Primarily treatment for restricted motion!!

Deltoid (Axillary N. C5-C6)

  • Distal attachment is into the deltoid tuberosity of the humerus:
  • Clavicular (Anterior) part
  • Proximal attachment to the lateral 1/3 of the clavicle
  • Action: Flexion and Medial Rotation of the arm
  • Acromial (Middle) part
  • Proximal attachment to the acromion process of the scapula
  • Action: Abduction of the arm
  • Spinal (Posterior) part
  • Proximal attachment to the spine of the scapula
  • Action: Extension and Lateral Rotation of the arm

Big Picture: Shoulder Chief Complaint

Stage 4: Traction Circumduction (Tracking)

Glenohumeral Joint

Latissimus Dorsi (Thoracodorsal N. C6-C8)

I. Appropriate History:

Inflammation

Infection

Trauma

Tumor

II. Apporpriate Physical Examination:

Eliminate any life threatening conditions

ROM

Special tests

Neurological testing

Pulses

  • Stabilize shoulder
  • Extend arm and Abduct to 90 degrees
  • Place slight traction through the arm
  • Begin to induce small circles in CW
  • Slowly make circles larger
  • Start over with small circles in CCW
  • Slowly make the circle larger

O: Spinous processes T7-T12, thoracolumbar fascia, sacrum

I: Intertuberular (bicipital) groove

Adducts, extends, medially rotates arm

  • Labrum
  • fibrocartilagenous structure
  • deepens glenoid fossa
  • provides increased stability
  • Typical ball-socket joint
  • Highly mobile

IV. Apporpriate Osteopathic Structural Examination dependent on:

History

Capabilities

Tolerance of positioning

Response to technique

V. Diagnose SD

VI. Apply OMT

VII. Follow Up

Stage 5a: Abduction (Abigail)

  • Stabilize shoulder
  • Bend arm at elbow and Abduct arm till barrier *

Stage 5b: Flexion, Adduction, External Rotation (FAE)

  • Stabilize shoulder
  • Have patient place their hand on forearm
  • Take elbow toward table to induce adduction w/ ext. rotation until barrier*

Stage 6: Internal Rotation (Inside)

  • Stabilize shoulder
  • Have patient flex elbow and place dorsum on low back
  • Take elbow forward to induce int. rotation*

Stage 1: Extension (Ellie)

  • Stabilize shoulder
  • Pull arm into shoulder extension till barrier
  • *Do this 6-8 times repetitively as ART
  • Continuously assess patient's ROM

Stage 2: Flexion (Flew)

  • Stabilize shoulder
  • Pull or push arm into shoulder flexion till barrier*

Stage 3: Compression Circumduction (Camly)

Stage 7: Glenohumeral Gapping (Glades)

  • Place patient's hand physician's shoulder until elbows straighten
  • Use finger to contact deltoid muscle and humoral head
  • Using scopping motion, lift humoral head away from fossa*
  • Can be done before Stage 1
  • Stabilize shoulder
  • Bend arm at elbow and Abduct shoulder 90 degrees
  • Place slight compression on elbow
  • Begin to induce small circles in CW
  • Slowly make circles larger
  • Start over with small circles in CCW
  • Slowly make the circle larger
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