The Shoulder

Technique

• The patient sits, with the arm abducted to the horzontal and the elbow resting on a couch.
• The supraspinous fossa can easily be found just posterior to the AC joint. The musculotendinous junction of the supraspinatus lies in the lateral corner of the de fossa and under the AC joint. The fibres run in a lateral direction.
• The therapist stands at the painfree side and faces the joint.
• Friction is performed by the middle finger of the ipsilateral hand, reinforced by the index finger. The thumb is extended, ring- and little fingers are flexed.
• The middle finger is brought as deeply as possible in the fossa and under the claviculo-scapulo-acromial angle.
• The active movement is supination of the forearm.
  During the passive phase, the finger is brought back to the initial starting position.
• These to-and-fro movements are repeated with a rhythm of about 60 to 80 movements per minute.
• Movement is performed mainly within shoulder and elbow joints; wrist and hand joints are kept rigid.
  General principles technique