The Spencer Technique Valerie Robinson, D.O.

Review of Anatomy Bones: clavicle, humerus, scapula Joints: sternoclavicular, acromioclavicular, glenohumeral

Review of Anatomy Muscles Supraspinatus: abductor Infraspinatus: external rotator Teres minor: external rotator Subscapularis: internal rotator Pectoralis major: adductor Deltoid: flexor, abductor, and extensor Teres major: extensor Latissimus dorsi: extensor and adductor

Range of Motion Flexion 180° Extension 50° Abduction 180° Adduction 50° Internal rotation 90° External rotation 90° Spencer technique has been proven to improve range of motion in those with shoulder dysfunction thus improving ability to perform ADLs

Background The Spencer Technique was developed in 1915 by Charles H. Spencer, D.O. as an articulatory technique to increase ROM at the shoulder. It has been modified and personalized by many physicians through the years and even now there are debates on proper technique.

Uses The Spencer Technique is useful in diagnosing and treating some shoulder conditions Improves shoulder mechanics and range of motion Stretches local tissues, improving lymphatic and circulatory flow Treat adhesive capsulitis, post-operative or post-injury myofascial restriction, bursitis/tendonitis May be performed with the patient lying on his/her side or sitting up.

Utilization The Spencer Technique may be utilized as an articulation or a muscle energy technique. To articulate, gently move shoulder into and out of Spencer position 8-10 times, coming to the barrier each time. This is a passive technique To use muscle energy, move shoulder to the barrier, have patient actively resist, then move into new barrier. Perform 3-5 times. This is an active technique

The Technique Stage 1: shoulder extension with elbow flexion Stage 2: shoulder and elbow extension shoulder and elbow flexion Stage 3: abduct to 90°, stabilize shoulder, move in circumduction with compression toward joint Stage 4: abduct to 90°, stabilize shoulder, move in circumduction with traction Stage 5: abduction Stage 6: test internal rotation by placing pts hand behind back and pulling elbow forward Stage 7: arm traction and deltoid pump. This may also be used to start treatment.

Demonstration <iframe width="640" height="360" src="http://www.youtube.com/embed/YGBJm_1bBmg?feature=player_detailpage" frameborder="0" allowfullscreen></iframe> http://www.youtube.com/watch?v=YGBJm_1bBmg&feature=player_detailpage

References JoAnn Ryan, D.O. “Spencer Technique for Shoulder (Articulation).” Lecture notes, October 17, 2007. Lori A. Dolinski, D.O./PhD/MSc. “Chapter Six: Upper Extremities.” Handbook of OMT Review 6th ed. 2010: ProMedica Publishing Company. Pages 73-81 Henry M. Seidel, MD et al. “Chapter 21 Musculoskeletal System.” Mosby’s Guide to Physical Examination 6th Ed. 2006: Mosby Elsevier. Pages 688-715. JANICE A. KNEBL, DO, MBA et al. “Improving functional ability in the elderly via the Spencer technique, an osteopathic manipulative treatment: A randomized, controlled trial.” JAOA Vol 102, No 7, July 2002 pp 387-396. Anthony G. Chila et al. “Approach to the Somatic Component.” Foundations of Osteopathic Medicine. 2010: Lippincott Williams and Wilkins. Pp 779-782