Range Of Motion
Motions of the Gleno-Humeral Joint
- Flexion
- Extension
- Abduction
- Adduction
- External Rotation
- Internal Rotation
- Horizontal Abduction
- Horizontal Adduction
- Circumduction
Techniques to Increase ROM -
(1) Joint Mobilizations
- Inferior Joint mobilization to increase flexion and abduction ROM
- Posterior joint mobilization to increase flexion and internal rotation ROM
- Anterior joint mobilization to increase extension and external rotation ROM
(2) Proprioceptive Neuromuscular Facilitation (PNF)
- Utilize reciprocal inhibition and autogenic inhibition to increase stretch
- Contract-relax (CR)
- Hold relax (HR)
- Slow reversal-hold-relax (SRHR) (also refered to as contract-relax-agonist contraction (CRAC))
Shoulder Stretching Techniques as Utilized by the
Ithaca College Baseball Team
- Athlete should warm up using a UBE (Upper Body Ergometer) or bike to increase core temperature
- Perform inferior, posterior, and anterior joint mobilizations (20 Grade III mobilizations in each direction)
- Perform median, ulnar, and radial neural glides to stretch nervous tissue (30 neural glides in each direction)
- Stretch anterior capsule by positioning athlete in supine, with arm hanging off table in extension - apply static stretch, hold for 30 seconds
- Stretch biceps tendon by positioning athlete in supine, with shoulder extended, elbow flexed and wrist extended - apply static stretch, hold for 30 seconds
- Stretch inferior capsule by positioning athlete in supine, with shoulder completely flexed, should stretch triceps as well - apply static stretch, hold for 30 seconds
- Stretch posterior capsule by positioning athlete in supine, shoulder flexed to 90 degrees, elbow flexed, and scapula off the side of the table* - apply posterior stretch directly through the axis of the arm, hold for 30 seconds
- Stretch internal rotators by positioning athlete in supine, stabilizing lateral border of the scapula, 90 degrees of shoulder flexion, athlete stretched muscles by pulling into horizontal adduction, hold for 30 seconds
- Stretch external rotators without compromising integrity of the joint - position athlete in supine, shoulder flexed to 90 degrees, provide anterior traction of joint, then provide static stretch into external rotation, hold for 30 seconds, OR
- Stretch external rotators without compromising integrity of the joint - position athlete in supine, 0 degrees of shoulder flexion or abduction, 90 degrees of elbow flexion, then provide static stretch into external rotation, hold for 30 seconds (utilize more comfortable stretch for the athlete)
*Scapular positioning is extremely important, because if scapula is still on the table during the stretch the humeral head will be forced into the glenoid fossa, potentially causing the patient pain or further injury