The Spencer Technique

Valerie Robinson, D.O.

Review of Anatomy

0Bones: clavicle, humerus, scapula0 Joints: sternoclavicular, acromioclavicular, glenohumeral

Review of Anatomy

0Muscles0 Supraspinatus: abductor0 Infraspinatus: external rotator0 Teres minor: external rotator0 Subscapularis: internal rotator

0 Pectoralis major: adductor0 Deltoid: flexor, abductor, and extensor0 Teres major: extensor0 Latissimus dorsi: extensor and adductor

Range of Motion

0Flexion 180°0Extension 50°0Abduction 180°0Adduction 50°0 Internal rotation 90°0External rotation 90°

0Spencer technique has been proven to improve range of motion in those with shoulder dysfunction thus improving ability to perform ADLs

Background

0The Spencer Technique was developed in 1915 by Charles H. Spencer, D.O. as an articulatory technique to increase ROM at the shoulder. It has been modified and personalized by many physicians through the years and even now there are debates on proper technique.

Uses

0The Spencer Technique is useful in diagnosing and treating some shoulder conditions

0 Improves shoulder mechanics and range of motion0Stretches local tissues, improving lymphatic and

circulatory flow0Treat adhesive capsulitis, post-operative or post-

injury myofascial restriction, bursitis/tendonitis0May be performed with the patient lying on his/her

side or sitting up.

Utilization

0The Spencer Technique may be utilized as an articulation or a muscle energy technique.

0To articulate, gently move shoulder into and out of Spencer position 8-10 times, coming to the barrier each time. This is a passive technique

0To use muscle energy, move shoulder to the barrier, have patient actively resist, then move into new barrier. Perform 3-5 times. This is an active technique

The Technique

0 Stage 1: shoulder extension with elbow flexion0 Stage 2: shoulder and elbow extension shoulder and elbow flexion 0 Stage 3: abduct to 90°, stabilize shoulder, move in

circumduction with compression toward joint0 Stage 4: abduct to 90°, stabilize shoulder, move in

circumduction with traction0 Stage 5: abduction0 Stage 6: test internal rotation by placing pts hand behind

back and pulling elbow forward0 Stage 7: arm traction and deltoid pump. This may also be

used to start treatment.

Demonstration

References

0 JoAnn Ryan, D.O. “Spencer Technique for Shoulder (Articulation).” Lecture notes, October 17, 2007.

0 Lori A. Dolinski, D.O./PhD/MSc. “Chapter Six: Upper Extremities.” Handbook of OMT Review 6th ed. 2010: ProMedica Publishing Company. Pages 73-81

0 Henry M. Seidel, MD et al. “Chapter 21 Musculoskeletal System.” Mosby’s Guide to Physical Examination 6th Ed. 2006: Mosby Elsevier. Pages 688-715.

0 JANICE A. KNEBL, DO, MBA et al. “Improving functional ability in the elderly via the Spencer technique, an osteopathic manipulative treatment: A randomized, controlled trial.” JAOA Vol 102, No 7, July 2002 pp 387-396.

0 Anthony G. Chila et al. “Approach to the Somatic Component.” Foundations of Osteopathic Medicine. 2010: Lippincott Williams and Wilkins. Pp 779-782