Transcript The Spencer Technique

Review of Anatomy
0 Bones: clavicle, humerus, scapula
0 Joints: sternoclavicular, acromioclavicular, glenohumeral
Review of Anatomy
0 Muscles
0 Supraspinatus: abductor
0 Infraspinatus: external rotator
0 Teres minor: external rotator
0 Subscapularis: internal rotator
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Pectoralis major: adductor
Deltoid: flexor, abductor, and extensor
Teres major: extensor
Latissimus dorsi: extensor and adductor
Range of Motion
0 Flexion 180°
0 Extension 50°
0 Abduction 180°
0 Adduction 50°
0 Internal rotation 90°
0 External rotation 90°
0 Spencer technique has been proven to improve range
of motion in those with shoulder dysfunction thus
improving ability to perform ADLs
Background
0 The 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
0 The Spencer Technique is useful in diagnosing and
treating some shoulder conditions
0 Improves shoulder mechanics and range of motion
0 Stretches local tissues, improving lymphatic and
circulatory flow
0 Treat adhesive capsulitis, post-operative or postinjury myofascial restriction, bursitis/tendonitis
0 May be performed with the patient lying on his/her
side or sitting up.
Utilization
0 The Spencer Technique may be utilized as an
articulation or a muscle energy technique.
0 To articulate, gently move shoulder into and out of
Spencer position 8-10 times, coming to the barrier
each time. This is a passive technique
0 To 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 flexion
0 Stage 2: shoulder and elbow extension
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shoulder and elbow flexion
Stage 3: abduct to 90°, stabilize shoulder, move in
circumduction with compression toward joint
Stage 4: abduct to 90°, stabilize shoulder, move in
circumduction with traction
Stage 5: abduction
Stage 6: test internal rotation by placing pts hand behind
back and pulling elbow forward
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).”
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Lecture notes, October 17, 2007.
Lori A. Dolinski, D.O./PhD/MSc. “Chapter Six: Upper Extremities.”
Handbook of OMT Review 6th ed. 2010: ProMedica Publishing
Company. Pages 73-81
Henry M. Seidel, MD et al. “Chapter 21 Musculoskeletal System.”
Mosby’s Guide to Physical Examination 6th Ed. 2006: Mosby Elsevier.
Pages 688-715.
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.
Anthony G. Chila et al. “Approach to the Somatic Component.”
Foundations of Osteopathic Medicine. 2010: Lippincott Williams and
Wilkins. Pp 779-782