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Scapular Assistance Test

Scapular Assistance Test

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Scapular Assistance Test

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  1. Scapular Assistance Test • Intra-rater reliability .76 - scapular elev .84 – flexion • Limitation – Non-specific w/ dx./shoulder pathology

  2. EXTERNAL ROTATION PUSH 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 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

  3. POSTERIOR TILT PUSH 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 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

  4. 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

  5. COMBINED- UR/ POST TILT • SCAPULAR ASSISTANCE TEST • HAND 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

  6. G-H MOBILIZATIONS POSTERIOR Scapular Plane Horizontal Adduction INFERIOR  Scaption (90-120˚)

  7. G-H MOBILIZATIONS ANTERIOR  Extension  Horizontal Abduction LATERAL  “Fulcrum” Technique

  8. MANUAL TECHNIQUES FOR THE HYPOMOBILE SHOULDER INCORPORATION OF :  SOFT TISSUE RELEASE(MUSCLE-CAPSULE)VIA CONTRACTION OF • ANTAGONIST • AGONIST  ACTIVE MOVEMENT  STRETCH

  9. PRINCIPLES OF RX  IDENTIFY RESTRICTED TISSUE  APPLY MANUAL PRESSURE  MAINTAIN PRESSURE - ADD REPEATED CONTRACTIONS  STRETCH INTO RESTRICTED RANGE

  10. ANTERIOR-SUPERIOR CAPSULE  MOTION AFFECTED  ER ( IN 0-45˚ OF ABD)  MANUAL PRESSURE TO:  SUPRASPINATUS TECHNIQUE  SUPINE  RESISTED ER/IR

  11. ANTERIOR CAPSULE  MOTION AFFECTED  ER ( IN 45˚-90˚ OF ABD)  MANUAL PRESSURE:  SUBSCAPULARIS TECHNIQUE  SUPINE  RESISTED ER/IR

  12. POSTERIOR CAPSULE  MOTION AFFECTED  IR ( IN 90˚ OF ABD)  MANUAL PRESSURE: TERES MINOR  INFRASPINATUS TECHNIQUE  SEATED /SUPINE  RESISTED ER/IR

  13. POSTERIOR-INFERIOR CAPSULE  MOTION AFFECTED  Horizontal Abduction  MUSCLES AFFECTED  TERES MINOR  INFRASPINATUS TECHNIQUE  Sidelying RESISTED HORIZ. ADD (ROWING MOTION)

  14. POSTERIOR-INFERIOR CAPSULE  MOTION AFFECTED  ELEVATION (FLEX)  Horiz add.  MANUAL PRESSURE:  TERES MAJOR  LATISSIMUS DORSI TECHNIQUE  SUPINE  RESISTED FLEX/EXT