Upper limb muscle energy treatment
Notes
Upper limbs
Upper limb muscle energy treatment
UPPER LIMB MUSCLE ENERGY TECHNIQUES | |||
REGION | SOMATIC DYSFUNCTION | TREATMENT POSITION | PATIENT INSTRUCTION |
Sternoclavicular (SC) joint | Superior medial clavicle | Abduct shoulder to 45º, extend and internally rotate into barrier | Lift upper extremity toward ceiling (flexion) while you (physician) resist |
Inferior medial clavicle | Flex shoulder to 90º with elbow extended | Retract upper extremity while you resist | |
Acromioclavicular (AC) joint | External rotation | Gently grasp AC joint to stabilize, internally rotate the shoulder | Externally rotate shoulder while you resist |
Internal rotation | Gently grasp AC joint to stabilize, externally rotate the shoulder | Internally rotate shoulder while you resist | |
Radial head* | Posterior radial head (pronation) | Supinate forearm, grasp posterior to radial head and apply anterior pressure when engaging each new barrier | Pronate forearm while you resist |
Anterior radial head (supination) | Pronate forearm, grasp anterior to radial head and apply posterior pressure when engaging each new barrier | Supinate forearm while you resist | |
Radiocarpal (wrist) joint | Flexion | Extend wrist | Flex wrist |
Extension | Flex wrist | Extend wrist while you resist | |
Abduction | Adduct wrist | Abduct wrist while you resist | |
Adduction | Abduct wrist | Adduct wrist while you resist |
* radial head moves posteriorly with pronation and anteriorly with supination
SPENCER TECHNIQUE
Spencer technique of the shoulder involves engaging restrictive barriers and is usually passive. If a significant barrier is encountered, muscle energy can be used to help reduce this restriction by having the patient move directly opposite the direction of the Spencer technique step. Spencer technique can be used to treat general shoulder somatic dysfunction, bursitis, tenosynovitis, and adhesive capsulitis.
The patient lies in the lateral recumbent position with the shoulder to be treated facing up. A pillow is placed under the patient's head to remove drag on the shoulder from the cervical and shoulder girdle musculature.
Stages
The patient lies in the lateral recumbent position with the shoulder to be treated facing up. A pillow is placed under the patient's head to remove drag on the shoulder from the cervical and shoulder girdle musculature.
Stages
- 1: Extension
- 2: Flexion
- 3: Circumduction with compression
- 4. Circumduction with traction
- 5a: Abduction
- 5b: Adduction / internal rotation
- 6: Internal rotation
- 7: Distraction in abduction ("Pump")
Figure 1. The seven stages of Spencer technique of the shoulder.
Summary
Upper limb muscle energy treatment is a manual therapy technique that uses the patient's own muscle contractions to help correct joint dysfunction and improve joint mobility in the upper extremities, including the shoulder, elbow, wrist, and hand. The technique involves the use of active patient participation in which the patient performs a specific muscle contraction while the therapist applies a counterforce to the affected joint.