NMT IV: the Clavicle and Scapula

[liveonearth]

CLAVICULAR ASSESSMENT AND MOBILIZATION
AC joint more mobile, ligamentous sprains are common
compare AC to AC
SC joint fibrous, not much mvt, rarely damaged
indic: anxious, upper chest breather, shoulder pain or decr ROM

POSTERIOR GLIDE
pt supine
create tension by lifting arm to anterior with ipsilateral arm
place heel of contralateral hand in center of clavicle
slight upward pull on arm and push clavicle A-->P
then repeat with heel of hand closer to SC joint, then AC joint

INFERIOR GLIDE
segue to inferior glide maintaining same arm grip
trap pts arm btw your arm and body
rotate my body for optimal inferior push
stabilize pts arm by pulling it up slightly
check in middle and on each end

SUPERIOR GLIDE
pull upward on clavicle using hypothenar eminence
(karate chop below clavicle and lift)
stabilize pt neck on opposite side
at nape, thumb on scalenes, fingers behind C-spine

SCAPULAR GLIDE
this feels great

PRONE
capture scap around periphery
move to end of ROM in all directions
six movements
superior
inferior
retraction
protraction
lateral rotation
medial rotation

SIDE LYING
hook arm under pt arm and rest hand on shoulder
insert fingers of other hand under medial scapular border
pull gently back on shoulder to open space behind scap, lift and move
stretches serratus and subscap
move scapula in circles to assess glide in all directions