Any condition in which mobility of the scapula relative to the thoracic wall is reduced and/or painful.
Perform lateral glide for protraction and elevation, medial glide for retraction, upward rotation glide for elevation, downward rotation glide for return to neutral, superior glide for elevation, and inferior glide for depression.
Accessory Motion Technique
Patient/Clinician Position: The patient is side lying with the arm at the side and the scapula being mobilized in neutral. The shoulder may be pre-positioned at the point of restriction. Stabilization is provided through the patient’s body weight. Stand facing the patient.
Hand Placement: Place your caudal hand beneath the patient’s arm capturing the inferior angle of the scapula and your cephalad hand at the superior angle of the scapula. Place your chest or abdomen in contact with the patient’s anterior shoulder to provide another point of contact for the mobilization.
Force Application: Through your hand contacts at the superior and inferior angles of the scapula, produce a distraction force as if lifting the scapula away from the thoracic wall. Both mobilization hands work in unison to mobilize the scapula in a superior, inferior, lateral, medial, or up/downward rotation direction while maintaining distraction.
FIGURE 1. Scapulothoracic medial and lateral glide.
FIGURE 2. Scapulothoracic superior and inferior glide.
FIGURE 3. Scapulothoracic upward and downward rotation.
