Upper limb muscle energy treatment

Notes

Upper limbs

Upper limb muscle energy treatment

UPPER LIMB MUSCLE ENERGY TECHNIQUES
REGIONSOMATIC DYSFUNCTIONTREATMENT POSITIONPATIENT 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
  • 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.