The Shoulder

Isolated Posterior Capsular Contracture

Treatment:

Isolated posterior capsular shoulder stretch
By Chris d'Hespeel PT, and Laura Tausan SPT - HEALTHSOUTH Rehabilitation Center Sarasota, FL

Any techniques claiming to stretch the posterior capsule would need to include a stable platform.
We have developed an isolated posterior capsule stretch (IPCS) technique that limits and/or eliminates a scapulothoracic substitution.

The maneuver, in contrast with the standard technique, stabilizes the distal segment (humerus) and mobilizes the proximal one (scapula).

This is accomplished by placing the patient in sidelying with the effected shoulder towards the table and in 90 degrees of forward flexion.
The patient is then asked to roll forward as to bring the arm across the chest (figure 1).
The weight of the patient's body is used to stabilize the humerus.

At this point, scapular winging should be visible (figure 2). The therapist then applies pressure, with the palm of the hand, on the medial/inferior border of the scapula towards the thorax, reversing the scapular winging.

The amount of scapular pressure is gauged by therapist position in relation to the patient (figure 3).

Occasionally patients may complain of anterior shoulder pain during the IPCS. We recommend, in such instance, discontinuing the stretch secondary to suspicion of anterior compression pathology. Further testing as it relates to the validity of the IPCS would be recommended.