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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