IS it Clinically Appropriate to manipulate the Glenohumeral Joint?
The glenohumeral joint is the most mobile joint in the body. Typically, joints that are very mobile do not require significant mobilization or manipulation; however, there are indications for a glenohumeral joint manipulation.
The lateral manipulation (shown below) is a safe and effective technique to get improve GHJ mobility. Since it is a general lateral distraction manipulation, it can help improve mobility in multiple planes of motion. From a purely biomechanical standpoint, the examiner should expect improvements in horizontal adduction.
Who is appropriate for this technique?
Clinically, I have found the most success with lateral manipulations in patients who have adhesive capsulitis. These patients often have restrictions is multiple planes of motion and joint mobility is a primary impairment. Additionally, individuals with shoulder osteoarthritis, hypomobility, or end-range of motion restrictions are typically good candidates.
Be sure to ask about past shoulder injuries prior to performing the lateral shoulder manipulation. If the client has any history of shoulder dislocations or subluxations, DO NOT perform this technique. Finally, be sure to address all of the causes of shoulder range of motion deficits as well. This includes assessing the thoracic spine, ribcage, scapulohumeral rhythm, and more!
-Jim Heafner PT, DPT, OCS
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