The Shoulder

Technique:

• The patient adopts the half-sitting position, the arm at the side and the elbow in flexion and supination.
• In this postion the greater tuberosity points laterally, the lesser tuberosity anteriorly.
• The sulcus lies in between the tubercles and can easily be palpated - see palpation of the subscapularis tendon.
• The therapist stands at the side, facing the patient.
• The thumb of the contralateral hand is put flat on the sulcus, the other fingers curve around the arm to give counter-pressure at the back of the shoulder. Pressure towards the humerus is applied with the thumb.
• With the other hand the therapist grasps the patient's lower arm.
• He now forces the arm into medial rotation. During this movement the tendon glides under the thumb and friction is achieved.
• The arm is then brought back into lateral rotation meanwhile releasing the pressure on the tendon - this is the passive phase of the procedure
• These alternating movements are performed during 15-20 minutes three times a weak. Result may be expected after 3 to 6 sessions.